Approaches to health assessment related to housing

NARCIS (Netherlands)

Guerra Santin, O.

2006-01-01

This research had the purpose of providing more information about possible approaches and indicators to measure indoor health in relation to housing. In researches related with health and some Life Cycle Assessment (LCA) databases, the model used for health assessment is the Impact Pathway Analysis

Understanding and Measuring LGBTQ Pathways to Health: A Scoping Review of Strengths-Based Health Promotion Approaches in LGBTQ Health Research.

Science.gov (United States)

Gahagan, Jacqueline; Colpitts, Emily

2017-01-01

Health research traditionally has focused on the health risks and deficits of lesbian, gay, bisexual, transgender, and queer (LGBTQ) populations, obscuring the determinants that can promote health across the life course. Recognizing, appropriately measuring, and rendering visible these determinants of health is paramount to informing appropriate and engaging health policies, services, and systems for LGBTQ populations. The overarching purpose of this article is to provide an overview of the findings of a scoping review aimed at exploring strengths-based health promotion approaches to understanding and measuring LGBTQ health. Specifically, this scoping review examined peer-reviewed, published academic literature to determine (a) existing methodological frameworks for studying LGBTQ health from a strengths-based health promotion approach, and (b) suggestions for future methodological approaches for studying LGBTQ health from a strengths-based health promotion approach. The findings of this scoping review will be used to inform the development of a study aimed at assessing the health of and improving pathways to health services among LGBTQ populations in Nova Scotia, Canada.

Fibromyalgia and Complementary Health Approaches

Science.gov (United States)

... Musculoskeletal and Skin Diseases Web site . What the Science Says About Complementary Health Approaches for Fibromyalgia Mind ... Complementary and alternative medical therapies in fibromyalgia . Current Pharmaceutical Design . 2006;12(1):47–57. Sherman KJ, ...

Health Services Approach to the Communication Audit

OpenAIRE

Tereza Balcarová

2014-01-01

This paper deals with the use of a communication audit as a tool for evaluating the effectiveness of public relations within health services. The research was conducted within healthcare institutions operating in the Czech Republic. Areas of research questions were focused on these aspects of health services: The approach to the implementation of a communication audit: Is the communication audit tied to the level of public relations effectiveness evaluation? Is the approach influenced by publ...

Supporting self-management of chronic health conditions: common approaches.

Science.gov (United States)

Lawn, Sharon; Schoo, Adrian

2010-08-01

The aims of this paper are to provide a description of the principles of chronic condition self-management, common approaches to support currently used in Australian health services, and benefits and challenges associated with using these approaches. We examined literature in this field in Australia and drew also from our own practice experience of implementing these approaches and providing education and training to primary health care professionals and organizations in the field. Using common examples of programs, advantages and disadvantages of peer-led groups (Stanford Courses), care planning (The Flinders Program), a brief primary care approach (the 5As), motivational interviewing and health coaching are explored. There are a number of common approaches used to enhance self-management. No one approach is superior to other approaches; in fact, they are often complimentary. The nature and context for patients' contact with services, and patients' specific needs and preferences are what must be considered when deciding on the most appropriate support mode to effectively engage patients and promote self-management. Choice of approach will also be determined by organizational factors and service structures. Whatever self-management support approaches used, of importance is how health services work together to provide support. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

Sociology, environment and health: a materialist approach.

Science.gov (United States)

Fox, N J; Alldred, P

2016-12-01

This paper reviews the sociology of environment and health and makes the case for a postanthropocentric approach based on new materialist theory. This perspective fully incorporates humans and their health into 'the environment', and in place of human-centred concerns considers the forces that constrain or enhance environmental capacities. This is not an empirical study. The paper uses a hypothetical vignette concerning child health and air pollution to explore the new materialist model advocated in the paper. This paper used sociological analysis. A new materialist and postanthropocentric sociology of environment and health are possible. This radically reconfigures both sociological theory and its application to research and associated policies on health and the environment. Theoretically, human health is rethought as one among a number of capacities emerging from humans interactions with the social and natural world. Practically, the focus of intervention and policy shifts towards fostering social and natural interactions that enhance environmental (and in the process, human) potentiality. This approach to research and policy development has relevance for public health practice and policy. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

The relationship between sales of SSRI, TCA and suicide rates in the Nordic countries

Directory of Open Access Journals (Sweden)

Zahl Per-Henrik

2010-08-01

Full Text Available Abstract Background In the period 1990-2006, strong and almost equivalent increases in sales figures of selective serotonin re-uptake inhibitors (SSRIs were observed in all Nordic countries. The sales figures of tricyclic antidepressants (TCAs dropped in Norway and Sweden in the nineties. After 2000, sales figures of TCAs have been almost constant in all Nordic countries. The potentially toxic effect of TCAs in overdose was an important reason for replacing TCAs with SSRIs when treating depression. We studied whether the rapid increase in sales of SSRIs and the corresponding decline in TCAs in the period 1990-98 were associated with a decline in suicide rates. Methods Aggregated suicide rates for the period 1975-2006 in four Nordic countries (Denmark, Finland, Norway and Sweden were obtained from the national causes-of-death registries. The sales figures of antidepressants were provided from the wholesale registers in each of the Nordic countries. Data were analysed using Fisher's exact test and Pearson's correlation coefficient. Results There was no statistical association (P = 1.0 between the increase of sales figures of SSRIs and the decline in suicide rates. There was no statistical association (P = 1.0 between the decrease in the sale figures of TCAs and change in suicide rates either. Conclusions We found no evidence for the rapid increase in use of SSRIs and the corresponding decline in sales of TCAs being associated with a decline in the suicide rates in the Nordic countries in the period 1990-98. We did not find any inverse relationship between the increase in sales of SSRIs and declining suicide rates in four Nordic countries.

Prospective Health: Duke's Approach to Improving Employee Health and Managing Health Care Costs

Science.gov (United States)

Davidson, H. Clint, Jr.

2004-01-01

If developing a healthy workforce is critical to reining in the skyrocketing cost of health care, then why have so many attempts at preventive health or disease management fallen short? How can employers connect with employees to engage them in changing unhealthy habits or lifestyles? Duke University has launched an innovative new approach called…

Workplace mental health: developing an integrated intervention approach

Science.gov (United States)

2014-01-01

Background Mental health problems are prevalent and costly in working populations. Workplace interventions to address common mental health problems have evolved relatively independently along three main threads or disciplinary traditions: medicine, public health, and psychology. In this Debate piece, we argue that these three threads need to be integrated to optimise the prevention of mental health problems in working populations. Discussion To realise the greatest population mental health benefits, workplace mental health intervention needs to comprehensively 1) protect mental health by reducing work–related risk factors for mental health problems; 2) promote mental health by developing the positive aspects of work as well as worker strengths and positive capacities; and 3) address mental health problems among working people regardless of cause. We outline the evidence supporting such an integrated intervention approach and consider the research agenda and policy developments needed to move towards this goal, and propose the notion of integrated workplace mental health literacy. Summary An integrated approach to workplace mental health combines the strengths of medicine, public health, and psychology, and has the potential to optimise both the prevention and management of mental health problems in the workplace. PMID:24884425

A comprehensive approach to women’s health: lessons from the Mexican health reform

Directory of Open Access Journals (Sweden)

Frenk Julio

2012-12-01

Full Text Available Abstract Background This paper discusses the way in which women’s health concerns were addressed in Mexico as part of a health system reform. Discussion The first part sets the context by examining the growing complexity that characterizes the global health field, where women’s needs occupy center stage. Part two briefly describes a critical conceptual evolution, i.e. from maternal to reproductive to women’s health. In the third and last section, the novel “women and health” (W&H approach and its translation into policies and programs in the context of a structural health reform in Mexico is discussed. W&H simultaneously focuses on women’s health needs and women’s critical roles as both formal and informal providers of health care, and the links between these two dimensions. Summary The most important message of this paper is that broad changes in health systems offer the opportunity to address women’s health needs through innovative approaches focused on promoting gender equality and empowering women as drivers of change.

The biopsychosocial approach and global mental health: Synergies and opportunities

Directory of Open Access Journals (Sweden)

Emmanuel Babalola

2017-01-01

Full Text Available The biopsychosocial (BPS approach proposed by Engel four decades ago was regarded as one of the most important developments in medicine and psychiatry in the late 20th century. Unlike the biomedical model, the BPS approach posits that biological, psychological, and social factors play a significant role in disease causation and treatment. This approach brought about a new way of conceptualizing mental health difficulties and engendered changes within research, medical teaching and practice. Global mental health (GMH is a relatively new area of study and practice that seek to bridge inequities and inequality in mental healthcare services provision for people worldwide. The significance of the BPS approach for understanding mental health difficulties is being debated in the context of GMH initiatives. This paper critically evaluates strengths and weaknesses of the BPS approach to mental health difficulties and explores its relevance to GMH initiatives.

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

OpenAIRE

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

2014-01-01

Background: 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 particip...

A Social Work Approach to Policy: Implications for Population Health.

Science.gov (United States)

Miller, Daniel P; Bazzi, Angela R; Allen, Heidi L; Martinson, Melissa L; Salas-Wright, Christopher P; Jantz, Kathryn; Crevi, Katherine; Rosenbloom, David L

2017-12-01

The substantial disparities in health and poorer outcomes in the United States relative to peer nations suggest the need to refocus health policy. Through direct contact with the most vulnerable segments of the population, social workers have developed an approach to policy that recognizes the importance of the social environment, the value of social relationships, and the significance of value-driven policymaking. This approach could be used to reorient health, health care, and social policies. Accordingly, social workers can be allies to public health professionals in efforts to eliminate disparities and improve population health.

Integrated Nationwide Electronic Health Records system: Semi-distributed architecture approach.

Science.gov (United States)

Fragidis, Leonidas L; Chatzoglou, Prodromos D; Aggelidis, Vassilios P

2016-11-14

The integration of heterogeneous electronic health records systems by building an interoperable nationwide electronic health record system provides undisputable benefits in health care, like superior health information quality, medical errors prevention and cost saving. This paper proposes a semi-distributed system architecture approach for an integrated national electronic health record system incorporating the advantages of the two dominant approaches, the centralized architecture and the distributed architecture. The high level design of the main elements for the proposed architecture is provided along with diagrams of execution and operation and data synchronization architecture for the proposed solution. The proposed approach effectively handles issues related to redundancy, consistency, security, privacy, availability, load balancing, maintainability, complexity and interoperability of citizen's health data. The proposed semi-distributed architecture offers a robust interoperability framework without healthcare providers to change their local EHR systems. It is a pragmatic approach taking into account the characteristics of the Greek national healthcare system along with the national public administration data communication network infrastructure, for achieving EHR integration with acceptable implementation cost.

A new approach to criteria for health risk assessment

International Nuclear Information System (INIS)

Spickett, Jeffery; Katscherian, Dianne; Goh, Yang Miang

2012-01-01

Health Impact Assessment (HIA) is a developing component of the overall impact assessment process and as such needs access to procedures that can enable more consistent approaches to the stepwise process that is now generally accepted in both EIA and HIA. The guidelines developed during this project provide a structured process, based on risk assessment procedures which use consequences and likelihood, as a way of ranking risks to adverse health outcomes from activities subjected to HIA or HIA as part of EIA. The aim is to assess the potential for both acute and chronic health outcomes. The consequences component also identifies a series of consequences for the health care system, depicted as expressions of financial expenditure and the capacity of the health system. These more specific health risk assessment characteristics should provide for a broader consideration of health consequences and a more consistent estimation of the adverse health risks of a proposed development at both the scoping and risk assessment stages of the HIA process. - Highlights: ► A more objective approach to health risk assessment is provided. ► An objective set of criteria for the consequences for chronic and acute impacts. ► An objective set of criteria for the consequences on the health care system. ► An objective set of criteria for event frequency that could impact on health. ► The approach presented is currently being trialled in Australia.

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

Innovative approaches for improving maternal and newborn health--A landscape analysis.

Science.gov (United States)

Lunze, Karsten; Higgins-Steele, Ariel; Simen-Kapeu, Aline; Vesel, Linda; Kim, Julia; Dickson, Kim

2015-12-17

Essential interventions can improve maternal and newborn health (MNH) outcomes in low- and middle-income countries, but their implementation has been challenging. Innovative MNH approaches have the potential to accelerate progress and to lead to better health outcomes for women and newborns, but their added value to health systems remains incompletely understood. This study's aim was to analyze the landscape of innovative MNH approaches and related published evidence. Systematic literature review and descriptive analysis based on the MNH continuum of care framework and the World Health Organization health system building blocks, analyzing the range and nature of currently published MNH approaches that are considered innovative. We used 11 databases (MedLine, Web of Science, CINAHL, Cochrane, Popline, BLDS, ELDIS, 3ie, CAB direct, WHO Global Health Library and WHOLIS) as data source and extracted data according to our study protocol. Most innovative approaches in MNH are iterations of existing interventions, modified for contexts in which they had not been applied previously. Many aim at the direct organization and delivery of maternal and newborn health services or are primarily health workforce interventions. Innovative approaches also include health technologies, interventions based on community ownership and participation, and novel models of financing and policy making. Rigorous randomized trials to assess innovative MNH approaches are rare; most evaluations are smaller pilot studies. Few studies assessed intervention effects on health outcomes or focused on equity in health care delivery. Future implementation and evaluation efforts need to assess innovations' effects on health outcomes and provide evidence on potential for scale-up, considering cost, feasibility, appropriateness, and acceptability. Measuring equity is an important aspect to identify and target population groups at risk of service inequity. Innovative MNH interventions will need innovative

'Changing climate, changing health, changing stories' profile: using an EcoHealth approach to explore impacts of climate change on inuit health.

Science.gov (United States)

Harper, S L; Edge, V L; Cunsolo Willox, A

2012-03-01

Global climate change and its impact on public health exemplify the challenge of managing complexity and uncertainty in health research. The Canadian North is currently experiencing dramatic shifts in climate, resulting in environmental changes which impact Inuit livelihoods, cultural practices, and health. For researchers investigating potential climate change impacts on Inuit health, it has become clear that comprehensive and meaningful research outcomes depend on taking a systemic and transdisciplinary approach that engages local citizens in project design, data collection, and analysis. While it is increasingly recognised that using approaches that embrace complexity is a necessity in public health, mobilizing such approaches from theory into practice can be challenging. In 2009, the Rigolet Inuit Community Government in Rigolet, Nunatsiavut, Canada partnered with a transdisciplinary team of researchers, health practitioners, and community storytelling facilitators to create the Changing Climate, Changing Health, Changing Stories project, aimed at developing a multi-media participatory, community-run methodological strategy to gather locally appropriate and meaningful data to explore climate-health relationships. The goal of this profile paper is to describe how an EcoHealth approach guided by principles of transdisciplinarity, community participation, and social equity was used to plan and implement this climate-health research project. An overview of the project, including project development, research methods, project outcomes to date, and challenges encountered, is presented. Though introduced in this one case study, the processes, methods, and lessons learned are broadly applicable to researchers and communities interested in implementing EcoHealth approaches in community-based research.

Mobile Health Approaches to Non-Communicable Diseases in ...

African Journals Online (AJOL)

Mobile Health Approaches to Non-Communicable Diseases in Rwanda ... child health, it would be cost-effective to leverage this infrastructure and adapt it for the NCD domain. .... gram currently exists in Rwanda that simultaneously ad-.

A Social Work Approach to Policy: Implications for Population Health

Science.gov (United States)

Bazzi, Angela R.; Allen, Heidi L.; Martinson, Melissa L.; Salas-Wright, Christopher P.; Jantz, Kathryn; Crevi, Katherine; Rosenbloom, David L.

2017-01-01

The substantial disparities in health and poorer outcomes in the United States relative to peer nations suggest the need to refocus health policy. Through direct contact with the most vulnerable segments of the population, social workers have developed an approach to policy that recognizes the importance of the social environment, the value of social relationships, and the significance of value-driven policymaking. This approach could be used to reorient health, health care, and social policies. Accordingly, social workers can be allies to public health professionals in efforts to eliminate disparities and improve population health. PMID:29236535

A life-course approach to health: synergy with sustainable development goals.

Science.gov (United States)

Kuruvilla, Shyama; Sadana, Ritu; Montesinos, Eugenio Villar; Beard, John; Vasdeki, Jennifer Franz; Araujo de Carvalho, Islene; Thomas, Rebekah Bosco; Drisse, Marie-Noel Brunne; Daelmans, Bernadette; Goodman, Tracey; Koller, Theadora; Officer, Alana; Vogel, Joanna; Valentine, Nicole; Wootton, Emily; Banerjee, Anshu; Magar, Veronica; Neira, Maria; Bele, Jean Marie Okwo; Worning, Anne Marie; Bustreo, Flavia

2018-01-01

A life-course approach to health encompasses strategies across individuals' lives that optimize their functional ability (taking into account the interdependence of individual, social, environmental, temporal and intergenerational factors), thereby enabling well-being and the realization of rights. The approach is a perfect fit with efforts to achieve universal health coverage and meet the sustainable development goals (SDGs). Properly applied, a life-course approach can increase the effectiveness of the former and help realize the vision of the latter, especially in ensuring health and well-being for all at all ages. Its implementation requires a shared understanding by individuals and societies of how health is shaped by multiple factors throughout life and across generations. Most studies have focused on noncommunicable disease and ageing populations in high-income countries and on epidemiological, theoretical and clinical issues. The aim of this article is to show how the life-course approach to health can be extended to all age groups, health topics and countries by building on a synthesis of existing scientific evidence, experience in different countries and advances in health strategies and programmes. A conceptual framework for the approach is presented along with implications for implementation in the areas of: (i) policy and investment; (ii) health services and systems; (iii) local, multisectoral and multistakeholder action; and (iv) measurement, monitoring and research. The SDGs provide a unique context for applying a holistic, multisectoral approach to achieving transformative outcomes for people, prosperity and the environment. A life-course approach can reinforce these efforts, particularly given its emphasis on rights and equity.

One Health and EcoHealth in Ontario: a qualitative study exploring how holistic and integrative approaches are shaping public health practice in Ontario.

Science.gov (United States)

Leung, Zee; Middleton, Dean; Morrison, Karen

2012-05-16

There is a growing recognition that many public health issues are complex and can be best understood by examining the relationship between human health and the health of the ecosystems in which people live. Two approaches, One Health and Ecosystem Approaches to Health (EcoHealth), can help us to better understand these intricate and complex connections, and appear to hold great promise for tackling many modern public health dilemmas. Although both One Health and EcoHealth have garnered recognition from numerous health bodies in Canada and abroad, there is still a need to better understand how these approaches are shaping the practice of public health in Ontario.The purpose of this study was to characterize how public health actors in Ontario are influenced by the holistic principles which underlie One Health and EcoHealth, and to identify important lessons from their experiences. Ten semi-structured interviews were conducted with ten participants from the public health sphere in Ontario. Participants encompassed diverse perspectives including infectious disease, food systems, urban agriculture, and environmental health. Interviews were recorded, transcribed and analyzed using qualitative content analysis to identify major themes and patterns. Four major themes emerged from the interviews: the importance of connecting human health with the environment; the role of governance in promoting these ideas; the value of partnerships and collaborations in public health practice; and the challenge of operationalizing holistic approaches to public health. Overall study participants were found to be heavily influenced by concepts couched in EcoHealth and One Health literature, despite a lack of familiarity with these fields. Although One Health and EcoHealth are lesser known approaches in the public health sphere, their holistic and systems-based principles were found to influence the thoughts, values and experiences of public health actors interviewed in this study. This

Ecosystem Approaches to Human Health Graduate Training Awards ...

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

IDRC's Ecosystem Approaches to Human Health (Ecohealth) program initiative ... Each grant will consist of CA $15 000 for field research and up to CA $4 000 for ... Nutrition, health policy, and ethics in the age of public-private partnerships.

Taking health needs seriously: against a luck egalitarian approach to justice in health.

Science.gov (United States)

Nielsen, Lasse

2013-08-01

In recent works, Shlomi Segall suggests and defends a luck egalitarian approach to justice in health. Concurring with G. A. Cohen's mature position he defends the idea that people should be compensated for "brute luck", i.e. the outcome of actions that it would be unreasonable to expect them to avoid. In his defense of the luck egalitarian approach he seeks to rebut the criticism raised by Norman Daniels that luck egalitarianism is in some way too narrow and in another too wide to uphold justice in health and health care distribution. He points out that a pluralistic outline of luck egalitarianism taking into account the moral requirement of meeting everyone's basic needs can avoid this line of criticism. In this article I argue against the application of such pluralistic luck egalitarianism in matters of health distribution. First of all, Segall has not shown that luck egalitarianism handles well health distributions above a threshold of basic needs. Secondly, his way of avoiding Elizabeth Anderson's abandonment objection is theoretically problematic. Finally, I argue that luck egalitarianism in general fails to acknowledge the moral foundation of health and health care as a basic human entitlement. Thus I conclude that luck egalitarianism fails to take health needs seriously and that it cannot therefore uphold justice in health.

The Public Health Exposome: A Population-Based, Exposure Science Approach to Health Disparities Research

Directory of Open Access Journals (Sweden)

Paul D. Juarez

2014-12-01

Full Text Available The lack of progress in reducing health disparities suggests that new approaches are needed if we are to achieve meaningful, equitable, and lasting reductions. Current scientific paradigms do not adequately capture the complexity of the relationships between environment, personal health and population level disparities. The public health exposome is presented as a universal exposure tracking framework for integrating complex relationships between exogenous and endogenous exposures across the lifespan from conception to death. It uses a social-ecological framework that builds on the exposome paradigm for conceptualizing how exogenous exposures “get under the skin”. The public health exposome approach has led our team to develop a taxonomy and bioinformatics infrastructure to integrate health outcomes data with thousands of sources of exogenous exposure, organized in four broad domains: natural, built, social, and policy environments. With the input of a transdisciplinary team, we have borrowed and applied the methods, tools and terms from various disciplines to measure the effects of environmental exposures on personal and population health outcomes and disparities, many of which may not manifest until many years later. As is customary with a paradigm shift, this approach has far reaching implications for research methods and design, analytics, community engagement strategies, and research training.

The Public Health Exposome: A Population-Based, Exposure Science Approach to Health Disparities Research

Science.gov (United States)

Juarez, Paul D.; Matthews-Juarez, Patricia; Hood, Darryl B.; Im, Wansoo; Levine, Robert S.; Kilbourne, Barbara J.; Langston, Michael A.; Al-Hamdan, Mohammad Z.; Crosson, William L.; Estes, Maurice G.; Estes, Sue M.; Agboto, Vincent K.; Robinson, Paul; Wilson, Sacoby; Lichtveld, Maureen Y.

2014-01-01

The lack of progress in reducing health disparities suggests that new approaches are needed if we are to achieve meaningful, equitable, and lasting reductions. Current scientific paradigms do not adequately capture the complexity of the relationships between environment, personal health and population level disparities. The public health exposome is presented as a universal exposure tracking framework for integrating complex relationships between exogenous and endogenous exposures across the lifespan from conception to death. It uses a social-ecological framework that builds on the exposome paradigm for conceptualizing how exogenous exposures “get under the skin”. The public health exposome approach has led our team to develop a taxonomy and bioinformatics infrastructure to integrate health outcomes data with thousands of sources of exogenous exposure, organized in four broad domains: natural, built, social, and policy environments. With the input of a transdisciplinary team, we have borrowed and applied the methods, tools and terms from various disciplines to measure the effects of environmental exposures on personal and population health outcomes and disparities, many of which may not manifest until many years later. As is customary with a paradigm shift, this approach has far reaching implications for research methods and design, analytics, community engagement strategies, and research training. PMID:25514145

An evidence-based algorithm for the treatment of neuropathic pain

DEFF Research Database (Denmark)

Finnerup, Nanna Brix; Otto, Marit; Jensen, Troels Staehelin

2007-01-01

in the analysis assessed tricyclic antidepressants (TCAs) and antiepileptic drugs (AEDs). RESULTS: TCAs had the lowest NNT followed by opioids and AEDs, such as gabapentin and pregabalin. The nature of the retrospective calculation of the NNT and NNH involves obvious limitations because of the pooling of studies...

An integrated approach to preventing cardiovascular disease: community-based approaches, health system initiatives, and public health policy

Directory of Open Access Journals (Sweden)

Tina Karwalajtys

2010-09-01

Full Text Available Tina Karwalajtys1, Janusz Kaczorowski2,31Department of Family Medicine, McMaster University, Hamilton, ON, Canada; 2Primary Care & Community Research, Child & Family Research Institute, Vancouver, BC, Canada; 3Department of Family Practice, University of British Columbia, Vancouver, BC, CanadaAbstract: Cardiovascular disease (CVD is largely the product of interactions among modifiable risk factors that are common in developed nations and increasingly of concern in developing countries. Hypertension is an important precursor to the development of CVD, and although detection and treatment rates have improved in recent years in some jurisdictions, effective strategies and policies supporting a shift in distribution of risk factors at the population level remain paramount. Challenges in managing cardiovascular health more effectively include factors at the patient, provider, and system level. Strategies to reduce hypertension and CVD should be population based, incorporate multilevel, multicomponent, and socioenvironmental approaches, and integrate community resources with public health and clinical care. There is an urgent need to improve monitoring and management of risk factors through community-wide, primary care-linked initiatives, increase the evidence base for community-based prevention strategies, further develop and evaluate promising program components, and develop new approaches to support healthy lifestyle behaviors in diverse age, socioeconomic, and ethnocultural groups. Policy and system changes are critical to reduce risk in populations, including legislation and public education to reduce dietary sodium and trans-fatty acids, food pricing policies, and changes to health care delivery systems to explicitly support prevention and management of CVD.Keywords: risk factors, blood pressure determination, community health services, community health planning, public health practice

Measuring health indicators and allocating health resources: a DEA-based approach.

Science.gov (United States)

Yang, Chih-Ching

2016-02-03

This paper suggests new empirical DEA models for the measurement of health indicators and the allocation of health resources. The proposed models were developed by first suggesting a population-based health indicator. By introducing the suggested indicator into DEA models, a new approach that solves the problem of health resource allocation has been developed. The proposed models are applied to an empirical study of Taiwan's health system. Empirical findings show that the suggested indicator can successfully accommodate the differences in health resource demands between populations, providing more reliable performance information than traditional indicators such as physician density. Using our models and a commonly used allocation mechanism, capitation, to allocate medical expenditures, it is found that the proposed model always obtains higher performance than those derived from capitation, and the superiority increases as allocated expenditures rise.

How to achieve a collaborative approach in health promotion: preferences and ideas of users of mental health services.

Science.gov (United States)

Pals, Regitze Anne Saurbrey; Hempler, Nana Folmann

2018-02-12

Collaborative approaches to consensus building or decision-making are beneficial in health-promoting activities targeting users of mental health services (users). However, little is known about how to achieve a collaborative approach in practice. The purpose of this study was to explore: (1) users' preferences and ideas related to achieving a collaborative approach in health-related communication and (2) perspectives of healthcare and social work professionals and family members on users' ideas and preferences. Data were collected through interactive workshops with users (n = 15), professionals (n = 21) and users' family members (n = 12). Data were analysed using systematic text condensation. Users provided three recommendations for establishing a collaborative approach in communication about health: (1) involving users in deciding the agenda and setting for health-promoting activities; (2) exchanging knowledge between users and professionals about health and values; and (3) exploring users' motivation for change. Users and professionals had diverging perceptions of the value of establishing a collaborative approach. Professionals regarded relationship building and health promotion as separate phenomena, whereas users perceived relationship building as inherently health promoting. Family members of users requested specific guidance and support with regard to clarifying and fulfilling the best possible support role as a family member. The findings suggest that a collaborative approach in health promotion may be difficult to achieve without a focus on professional development for healthcare and social work professionals. © 2018 Nordic College of Caring Science.

New approaches in human health risk assessment.

Science.gov (United States)

Abass, Khaled; Carlsen, Anders; Rautio, Arja

2016-01-01

Studies on the precise impact of environmental pollutants on human health are difficult to undertake and interpret, because many genetic and environmental factors influence health at the same time and to varying degrees. Our chapter in the AMAP report was based on new approaches to describe risks and future needs. In this paper, we will introduce the issues associated with risk assessment of single chemicals, and present suggestions for future studies as well as a summary of lessons learned during the health-related parts of the European Union-funded FP7 project ArcRisk (Arctic Health Risks: Impacts on health in the Arctic and Europe owing to climate-induced changes in contaminant cycling, 2009-2014; www.arcrisk.eu).

Family-Based Approaches to Cardiovascular Health Promotion.

Science.gov (United States)

Vedanthan, Rajesh; Bansilal, Sameer; Soto, Ana Victoria; Kovacic, Jason C; Latina, Jacqueline; Jaslow, Risa; Santana, Maribel; Gorga, Elio; Kasarskis, Andrew; Hajjar, Roger; Schadt, Eric E; Björkegren, Johan L; Fayad, Zahi A; Fuster, Valentin

2016-04-12

Cardiovascular disease is the leading cause of mortality in the world, and the increasing burden is largely a consequence of modifiable behavioral risk factors that interact with genomics and the environment. Continuous cardiovascular health promotion and disease prevention throughout the lifespan is critical, and the family is a central entity in this process. In this review, we describe the potential rationale and mechanisms that contribute to the importance of family for cardiovascular health promotion, focusing on: 1) mutual interdependence of the family system; 2) shared environment; 3) parenting style; 4) caregiver perceptions; and 5) genomics. We conclude that family-based approaches that target both caregivers and children, encourage communication among the family unit, and address the structural and environmental conditions in which families live and operate are likely to be the most effective approach to promote cardiovascular health. We describe lessons learned, future implications, and applications to ongoing and planned studies. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

Cost approach of health care entity intangible asset valuation.

Science.gov (United States)

Reilly, Robert F

2012-01-01

degree of marketability; and The degree of variation in the range of value indications. Valuation analysts value health care intangible assets for a number of reasons. In addition to regulatory compliance reasons, these reasons include various transaction, taxation, financing, litigation, accounting, bankruptcy, and planning purposes. The valuation analyst should consider all generally accepted intangible asset valuation approaches, methods, and procedures. Many valuation analysts are more familiar with market approach and income approach valuation methods. However, there are numerous instances when cost approach valuation methods are also applicable to the health care intangible asset valuation. This discussion summarized the analyst's procedures and considerations with regard to the cost approach. The cost approach is often applicable to the valuation of intangible assets in the health care industry. However, the cost approach is only applicable if the valuation analyst (1) appropriately considers all of the cost components and (2) appropriately identifies and quantifies all obsolescence allowances. Regardless of the health care intangible asset or the reason for the valuation, the analyst should be familiar with all generally accepted valuation approaches and methods. And, the valuation analyst should have a clear, convincing, and cogent rationale for (1) accepting each approach and method applied and (2) rejecting each approach and method not applied. That way, the valuation analyst will best achieve the purpose and objective of the health care intangible asset valuation.

Designing eHealth that Matters via a Multidisciplinary Requirements Development Approach.

Science.gov (United States)

Van Velsen, Lex; Wentzel, Jobke; Van Gemert-Pijnen, Julia Ewc

2013-06-24

Requirements development is a crucial part of eHealth design. It entails all the activities devoted to requirements identification, the communication of requirements to other developers, and their evaluation. Currently, a requirements development approach geared towards the specifics of the eHealth domain is lacking. This is likely to result in a mismatch between the developed technology and end user characteristics, physical surroundings, and the organizational context of use. It also makes it hard to judge the quality of eHealth design, since it makes it difficult to gear evaluations of eHealth to the main goals it is supposed to serve. In order to facilitate the creation of eHealth that matters, we present a practical, multidisciplinary requirements development approach which is embedded in a holistic design approach for eHealth (the Center for eHealth Research roadmap) that incorporates both human-centered design and business modeling. Our requirements development approach consists of five phases. In the first, preparatory, phase the project team is composed and the overall goal(s) of the eHealth intervention are decided upon. Second, primary end users and other stakeholders are identified by means of audience segmentation techniques and our stakeholder identification method. Third, the designated context of use is mapped and end users are profiled by means of requirements elicitation methods (eg, interviews, focus groups, or observations). Fourth, stakeholder values and eHealth intervention requirements are distilled from data transcripts, which leads to phase five, in which requirements are communicated to other developers using a requirements notation template we developed specifically for the context of eHealth technologies. The end result of our requirements development approach for eHealth interventions is a design document which includes functional and non-functional requirements, a list of stakeholder values, and end user profiles in the form of

75 FR 11439 - Airworthiness Directives; Airbus Model A319, A320, and A321 Series Airplanes

Science.gov (United States)

2010-03-11

... the needle colour and thickness and an increase in width of the TCAS green band. For the reasons... the erasable programmable read only memory (EPROM) (for certain configurations) in addition to... the case of TCAS Resolution Advisory. This modification consists of a change in the needle colour and...

The common risk factor approach: a rational basis for promoting oral health.

Science.gov (United States)

Sheiham, A; Watt, R G

2000-12-01

Conventional oral health education is not effective nor efficient. Many oral health programmes are developed and implemented in isolation from other health programmes. This often leads, at best to a duplication of effort, or worse, conflicting messages being delivered to the public. In addition, oral health programmes tend to concentrate on individual behaviour change and largely ignore the influence of socio-political factors as the key determinants of health. Based upon the general principles of health promotion this paper presents a rationale for an alternative approach for oral health policy. The common risk factor approach addresses risk factors common to many chronic conditions within the context of the wider socio-environmental milieu. Oral health is determined by diet, hygiene, smoking, alcohol use, stress and trauma. As these causes are common to a number of other chronic diseases, adopting a collaborative approach is more rational than one that is disease specific. The common risk factor approach can be implemented in a variety of ways. Food policy development and the Health Promoting Schools initiative are used as examples of effective ways of promoting oral health.

A Global Public Goods Approach to the Health of Migrants.

Science.gov (United States)

Widdows, Heather; Marway, Herjeet

2015-07-01

This paper explores a global public goods approach to the health of migrants. It suggests that this approach establishes that there are a number of health goods which must be provided to migrants not because these are theirs by right (although this may independently be the case), but because these goods are primary goods which fit the threefold criteria of global public goods. There are two key advantages to this approach: first, it is non-confrontational and non-oppositional, and second, it provides self-interested arguments to provide at least some health goods to migrants and thus appeals to those little moved by rights-based arguments.

Taking Health Needs Seriously: Against a Luck Egalitarian Approach to Justice in Health

DEFF Research Database (Denmark)

Nielsen, Lasse

2013-01-01

In recent works, Shlomi Segall suggests and defends a luck egalitarian approach to justice in health. Concurring with G. A. Cohen’s mature position he defends the idea that people should be compensated for “brute luck”, i.e. the outcome of actions that it would be unreasonable to expect them...... to avoid. In his defense of the luck egalitarian approach he seeks to rebut the criticism raised by Norman Daniels that luck egalitarianism is in some way too narrow and in another too wide to uphold justice in health and health care distribution. He points out that a pluralistic outline of luck...... egalitarianism taking into account the moral requirement of meeting everyone’s basic needs can avoid this line of criticism. In this article I argue against the application of such pluralistic luck egalitarianism in matters of health distribution. First of all, Segall has not shown that luck egalitarianism...

Critical interactionism: an upstream-downstream approach to health care reform.

Science.gov (United States)

Martins, Diane Cocozza; Burbank, Patricia M

2011-01-01

Currently, per capita health care expenditures in the United States are more than 20% higher than any other country in the world and more than twice the average expenditure for European countries, yet the United States ranks 37th in life expectancy. Clearly, the health care system is not succeeding in improving the health of the US population with its focus on illness care for individuals. A new theoretical approach, critical interactionism, combines symbolic interactionism and critical social theory to provide a guide for addressing health care problems from both an upstream and downstream approach. Concepts of meaning from symbolic interactionism and emancipation from critical perspective move across system levels to inform and reform health care for individuals, organizations, and societies. This provides a powerful approach for health care reform, moving back and forth between the micro and macro levels. Areas of application to nursing practice with several examples (patients with obesity; patients who are lesbian, gay, bisexual, and transgender; workplace bullying and errors), nursing education, and research are also discussed.

Integrated approach for managing health risks at work--the role of occupational health nurses.

Science.gov (United States)

Marinescu, Luiza G

2007-02-01

Currently, many organizations are using a department-centered approach to manage health risks at work. In such a model, segregated departments are providing employee benefits such as health insurance, workers' compensation, and short- and long-term disability or benefits addressing work-life issues. In recent years, a new model has emerged: health and productivity management (HPM). This is an employee-centered, integrated approach, designed to increase efficiency, reduce competition for scarce resources, and increase employee participation in prevention activities. Evidence suggests that corporations using integrated HPM programs achieve better health outcomes for their employees, with consequent increased productivity and decreased absenteeism. Occupational health nurses are well positioned to assume leadership roles in their organizations by coordinating efforts and programs across departments that offer health, wellness, and safety benefits. To assume their role as change agents to improve employees' health, nurses should start using the language of business more often by improving their communication skills, computer skills, and ability to quantify and articulate results of programs and services to senior management.

MD Anderson's Population Health Approaches to Cancer Prevention.

Science.gov (United States)

Foxhall, Lewis; Moreno, Mark; Hawk, Ernest

2018-02-01

Texas's size and unique population demographics present challenges to addressing the state's cancer burden. The University of Texas MD Anderson Cancer Center is one of 69 National Cancer Institute-designated cancer centers across the United States. While these centers traditionally have focused on research, education and training, and providing research-driven patient care, they are in a unique position to collaboratively advance population health through cancer control. Unlike the traditional academic model of a three-legged stool representing research, education, and patient care, MD Anderson's mission includes a fourth leg that incorporates population health approaches. MD Anderson has leveraged state- and national-level data and freely available resources to develop population-health priorities and a set of evidence-based actions across policy, public and professional education, and community-based clinical service domains to address these priorities. Population health approaches complement dissemination and implementation research and treatment, and will be increasingly needed to address the growing cancer burden in Texas and the nation.

The Case for "Environment in All Policies": Lessons from the "Health in All Policies" Approach in Public Health.

Science.gov (United States)

Browne, Geoffrey R; Rutherfurd, Ian D

2017-02-01

Both public health, and the health of the natural environment, are affected by policy decisions made across portfolios as diverse as finance, planning, transport, housing, education, and agriculture. A response to the interdependent character of public health has been the "health in all policies" (HiAP) approach. With reference to parallels between health and environment, this paper argues that lessons from HiAP are useful for creating a new integrated environmental management approach termed "environment in all polices" (EiAP). This paper covers the theoretical foundations of HiAP, which is based on an understanding that health is strongly socially determined. The paper then highlights how lessons learned from HiAP's implementation in Finland, California, and South Australia might be applied to EiAP. It is too early to learn from evaluations of HiAP, but it is apparent that there is no single tool kit for its application. The properties that are likely to be necessary for an effective EiAP approach include a jurisdiction-specific approach, ongoing and strong leadership from a central agency, independent analysis, and a champion. We then apply these properties to Victoria (Australia) to demonstrate how EiAP might work. We encourage further exploration of the feasibility of EiAP as an approach that could make explicit the sometimes surprising environmental implications of a whole range of strategic policies. Citation: Browne GR, Rutherfurd ID. 2017. The case for "environment in all policies": lessons from the "health in all policies" approach in public health. Environ Health Perspect 125:149-154; http://dx.doi.org/10.1289/EHP294.

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

NARCIS (Netherlands)

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

2014-01-01

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

Optimization of human, animal, and environmental health by using the One Health approach.

Science.gov (United States)

Sleeman, Jonathan M; DeLiberto, Thomas; Nguyen, Natalie

2017-08-31

Emerging diseases are increasing burdens on public health, negatively affecting the world economy, causing extinction of species, and disrupting ecological integrity. One Health recognizes that human, domestic animal, and wildlife health are interconnected within ecosystem health and provides a framework for the development of multidisciplinary solutions to global health challenges. To date, most health-promoting interventions have focused largely on single-sector outcomes. For example, risk for transmission of zoonotic pathogens from bush-meat hunting is primarily focused on human hygiene and personal protection. However, bush-meat hunting is a complex issue promoting the need for holistic strategies to reduce transmission of zoonotic disease while addressing food security and wildlife conservation issues. Temporal and spatial separation of humans and wildlife, risk communication, and other preventative strategies should allow wildlife and humans to co-exist. Upstream surveillance, vaccination, and other tools to prevent pathogen spillover are also needed. Clear multi-sector outcomes should be defined, and a systems-based approach is needed to develop interventions that reduce risks and balance the needs of humans, wildlife, and the environment. The ultimate goal is long-term action to reduce forces driving emerging diseases and provide interdisciplinary scientific approaches to management of risks, thereby achieving optimal outcomes for human, animal, and environmental health.

Optimization of human, animal, and environmental health by using the One Health approach

Science.gov (United States)

Sleeman, Jonathan M.; DeLiberto, Thomas; Nguyen, Natalie T.

2017-01-01

Emerging diseases are increasing burdens on public health, negatively affecting the world economy, causing extinction of species, and disrupting ecological integrity. One Health recognizes that human, domestic animal, and wildlife health are interconnected within ecosystem health and provides a framework for the development of multidisciplinary solutions to global health challenges. To date, most health-promoting interventions have focused largely on single-sector outcomes. For example, risk for transmission of zoonotic pathogens from bush-meat hunting is primarily focused on human hygiene and personal protection. However, bush-meat hunting is a complex issue promoting the need for holistic strategies to reduce transmission of zoonotic disease while addressing food security and wildlife conservation issues. Temporal and spatial separation of humans and wildlife, risk communication, and other preventative strategies should allow wildlife and humans to co-exist. Upstream surveillance, vaccination, and other tools to prevent pathogen spillover are also needed. Clear multi-sector outcomes should be defined, and a systems-based approach is needed to develop interventions that reduce risks and balance the needs of humans, wildlife, and the environment. The ultimate goal is long-term action to reduce forces driving emerging diseases and provide interdisciplinary scientific approaches to management of risks, thereby achieving optimal outcomes for human, animal, and environmental health.

New approaches in human health risk assessment

Directory of Open Access Journals (Sweden)

Khaled Abass

2016-12-01

Full Text Available Studies on the precise impact of environmental pollutants on human health are difficult to undertake and interpret, because many genetic and environmental factors influence health at the same time and to varying degrees. Our chapter in the AMAP report was based on new approaches to describe risks and future needs. In this paper, we will introduce the issues associated with risk assessment of single chemicals, and present suggestions for future studies as well as a summary of lessons learned during the health-related parts of the European Union-funded FP7 project ArcRisk (Arctic Health Risks: Impacts on health in the Arctic and Europe owing to climate-induced changes in contaminant cycling, 2009–2014; www.arcrisk.eu.

"GIS, Biostatistics, meteo, m-health and e-health approaches for tailored informed evidence-based agricultural, environment and health interventions in Rwanda"

Science.gov (United States)

Karame, P., Sr.; Dushimiyimana, V.

2016-12-01

" Championing GIS-Biostatistics-Meteo for Health (GBMH), A consolidated approach"The environmental vulnerability rate due to human-induced threats and climate change has exceeded the capacity of ecosystems and species to adapt naturally. Drastic changes in seasonal and weather patterns have led to a severely intriguing imbalance ecosystem equilibrium, associated to habitat degradation, environmental pollution, shortage of ecosystem services production and shift in species distribution, food insecurity, invasive species and complex species associations. The consequences are particularly disturbing regarding health and wellbeing of human populations. Especially to Sub-Saharan Africa, informed evidence-based statistics are inappropriately if not at all used for developing and implementing coping measures. This makes a regrettable scenario for Rwanda, a research-driven economic transformation country in which mostly expensive long-term interventions remain meaningless and unknowingly approved effective. More important, no single sector can ultimately afford the most informative approaches providing evidence and guiding policy and decisions, due to limited resources. Rwanda dedicates substantial investment to sustain a conducive, robust and flourishing environment promoting research priorities most likely to deliver improved health outcomes. In this framework, the above mentioned approach supports cross-sectoral analyses to evaluate health care quality improvements through impact assessments, policy analysis and forecasting. This approach "Consolidating GIS, Biostatistics, meteo, mobile and e-health approaches (GBMH)" tailors disaster, disease control and prevention, farming options, effective planning, interventions and communication for safe health in sound environment. Under GBMH models, Integrated Time Series analysis completed in R Studio on health interventions from HMIS and DHS and DHSS systems (on environment and disaster management, farming practices and health

[Concept analysis of a participatory approach to occupational safety and health].

Science.gov (United States)

Yoshikawa, Etsuko

2013-01-01

The purpose of this study was to analyze a participatory approach to occupational safety and health, and to examine the possibility of applying the concept to the practice and research of occupational safety and health. According to Rodger's method, descriptive data concerning antecedents, attributes and consequences were qualitatively analyzed. A total of 39 articles were selected for analysis. Attributes with a participatory approach were: "active involvement of both workers and employers", "focusing on action-oriented low-cost and multiple area improvements based on good practices", "the process of emphasis on consensus building", and "utilization of a local network". Antecedents of the participatory approach were classified as: "existing risks at the workplace", "difficulty of occupational safety and health activities", "characteristics of the workplace and workers", and "needs for the workplace". The derived consequences were: "promoting occupational safety and health activities", "emphasis of self-management", "creation of safety and healthy workplace", and "contributing to promotion of quality of life and productivity". A participatory approach in occupational safety and health is defined as, the process of emphasis on consensus building to promote occupational safety and health activities with emphasis on self-management, which focuses on action-oriented low-cost and multiple area improvements based on good practices with active involvement of both workers and employers through utilization of local networks. We recommend that the role of the occupational health professional be clarified and an evaluation framework be established for the participatory approach to promote occupational safety and health activities by involving both workers and employers.

An integrated approach to preventing cardiovascular disease: community-based approaches, health system initiatives, and public health policy.

Science.gov (United States)

Karwalajtys, Tina; Kaczorowski, Janusz

2010-01-01

Cardiovascular disease (CVD) is largely the product of interactions among modifiable risk factors that are common in developed nations and increasingly of concern in developing countries. Hypertension is an important precursor to the development of CVD, and although detection and treatment rates have improved in recent years in some jurisdictions, effective strategies and policies supporting a shift in distribution of risk factors at the population level remain paramount. Challenges in managing cardiovascular health more effectively include factors at the patient, provider, and system level. Strategies to reduce hypertension and CVD should be population based, incorporate multilevel, multicomponent, and socioenvironmental approaches, and integrate community resources with public health and clinical care. There is an urgent need to improve monitoring and management of risk factors through community-wide, primary care-linked initiatives, increase the evidence base for community-based prevention strategies, further develop and evaluate promising program components, and develop new approaches to support healthy lifestyle behaviors in diverse age, socioeconomic, and ethnocultural groups. Policy and system changes are critical to reduce risk in populations, including legislation and public education to reduce dietary sodium and trans-fatty acids, food pricing policies, and changes to health care delivery systems to explicitly support prevention and management of CVD.

Health approaches in a widely adopted Brazilian high school biology textbook

Directory of Open Access Journals (Sweden)

Liziane Martins

2012-05-01

Full Text Available Considering the long tradition of discussing health in the Brazilian school curriculum, it is important to investigate how this topic is addressed by the textbooks, the main resource used by most schools in the country. In particular, it is relevant to verify if this content is presented in a manner that contributes to the development of the students as active and critical members of the society. We analyze how health is treated in the textbook Biology, by Laurence (2005, which has been the high school Biology textbook most chosen by public school teachers among those certified by the National Program for High School Textbooks (PNLEM/2007, sponsored by the Brazilian Ministry of Education (MEC. We used categorical content analysis techniques, involving the decomposition of the texts into units of analysis, the categories, which were built in this work through analogical regroupings, by using semantic criteria. In order to investigate the treatment given to health, we applied an analytical table to the units of recording, which consist of sentences, paragraphs, and sections of the textbook that discuss contents related to health and disease. This table systematizes eight health indicators, seeking to identify three health approaches: biomedical, behavioral, and socioecological. We found 267 units of recording in the textbook and, based on their analysis, it was possible to categorize the textbook as one in which the biomedical approach prevails. Our findings are consistent with other works that indicate the prevalence of this approach in Brazilian education, and Brazilian and international textbooks. Another important finding of the work is that the behavioral approach does not hold, at least for the analyzed textbook, as a view of health different from the biomedical and socioecological approaches. After all, when the book mentions behaviors and habits of life associated with health, it generally emphasizes biological dimensions, aligning with a

Evaluating interventions in health: a reconciliatory approach.

Science.gov (United States)

Wolff, Jonathan; Edwards, Sarah; Richmond, Sarah; Orr, Shepley; Rees, Geraint

2012-11-01

Health-related Quality of Life measures have recently been attacked from two directions, both of which criticize the preference-based method of evaluating health states they typically incorporate. One attack, based on work by Daniel Kahneman and others, argues that 'experience' is a better basis for evaluation. The other, inspired by Amartya Sen, argues that 'capability' should be the guiding concept. In addition, opinion differs as to whether health evaluation measures are best derived from consultations with the general public, with patients, or with health professionals. And there is disagreement about whether these opinions should be solicited individually and aggregated, or derived instead from a process of collective deliberation. These distinctions yield a wide variety of possible approaches, with potentially differing policy implications. We consider some areas of disagreement between some of these approaches. We show that many of the perspectives seem to capture something important, such that it may be a mistake to reject any of them. Instead we suggest that some of the existing 'instruments' designed to measure HR QoLs may in fact successfully already combine these attributes, and with further refinement such instruments may be able to provide a reasonable reconciliation between the perspectives. © 2011 Blackwell Publishing Ltd.

Improving low health literacy and patient engagement: A social ecological approach.

Science.gov (United States)

McCormack, Lauren; Thomas, Veronica; Lewis, Megan A; Rudd, Rima

2017-01-01

This article posits four principal objectives related to the overarching goal of broadening the conceptualization of health literacy. We propose a social ecological approach to health literacy and patient engagement by illustrating how this multilevel approach offers an array of strategic options for interventions. A social ecological approach supports a broader understanding of health literacy that aligns with increased patient engagement. The ecological model highlights the importance of context, demonstrates how health literacy and patient engagement are inextricably connected, and gives rise to strategies to enhance them both. We illustrate the five multilevel intervention strategies for addressing low health literacy and promoting patient engagement: accumulation, amplification, facilitation, cascade, and convergence strategies. In addition, we provide a theoretical foundation to facilitate the development of interventions to enhance health literacy and ultimately increase patient engagement. The practice implications of adopting a broader social ecological perspective to address low health literacy shifts the field from thinking about individual educational interventions to how individual interventions may be augmented or supported by interventions at additional levels of influence. The potential benefit of adopting a multilevel intervention approach is that combining interventions could produce synergies that are greater than interventions that only utilize one level of influence. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

[Environment and the "Health in All Policies" approach-an overview].

Science.gov (United States)

Zeeb, Hajo; Hilderink, Henk; Forberger, Sarah

2018-06-01

One quarter of the global disease burden could be avoided with management strategies for environmental risk factors such as air and water pollution, food contamination, injuries and poor road safety. Many decisions influencing health are made outside the health sector; thus, the joint consideration and implementation of health and environmental factors in the relevant policies are becoming increasingly important. By means of a selective literature search, we identified important policy documents and selected research articles as a basis for the introduction and current discussion of the Health in All Policies (HiAP) approach. Parallels with the Environment in All Policies (EIAP) approach are debated. The consideration and reinforcement of environmental topics in HiAP and the link with health in the EiAP approach increase the chances of policies with mutually positive effects, especially with regard to the significance of social factors for health and the environment. The UN Sustainable Development Goals provide a good starting point for a joint strategy for reinforcing health and environmental aspects. Health and Environmental Impact Assessments are accepted procedures in many countries. The HiAP strategy implemented in South Australia provides a well-documented institutional approach to the integration and linkage of health and environmental issues. These examples can be used as well-established starting points for a definition of HiAP incorporating the equitable involvement of environmental issues. Barriers to this goal relate, for example, to the particular interests of the various participating sectors.

[The "health promotion" approach, a strategic alternative to teenagers' health in the Democratic Republic of Congo?].

Science.gov (United States)

Nsakala, Gabriel Vodiena; Coppieters, Yves

2014-01-01

This paper describes a review of the possibilities of improving HIV/AIDS prevention and reproductive health of teenagers and adolescents in the Democratic Republic of Congo (DRC). This approach was based on compilation of institutional, political, legislative and national strategy data. The document review was completed by information collected from 15 key informants and by direct observation of the work of peer educators and community workers, allowing evaluation of the possibilities of development of the priority domains of the Ottawa Charter for Health Promotion in young adolescents. Health promotion interventions for adolescents are globally ensured institutionally by three specialized programmes of the Ministry of Health, in collaboration with numerous national and international partners. Organized operationally outside of the primary health care circuit, strategic actions are more specifically directed towards acquisition of knowledge than individual skills by means of IEC (information, education and communication) and (BCC) (behaviour change communication) approaches, but with disappointing results. Although traces of these five priority domains of the Ottawa Charter are perceptible in the national response to the health problems of adolescents, the work of the various actors is not coordinated and organized in compliance with health promotion guidelines. The training of health workers appears to be a major determinant to structure this response around a dynamic federating the actions of all stakeholders to orient them towards the options of the health promotion approach.

Investigation of Chemical and Radiochemical Fingerprints of Water Resources in Siwa Oasis, Western Desert, Egypt

International Nuclear Information System (INIS)

El-Sayed, S.A.; Allam, Kh.A.; Salama, M.H.; El Begawy, H.

2017-01-01

Water resources in Siwa oasis, Egypt; included the Nubian sandstone aquifer system (NSSAS), Tertiary carbonate aquifer system (TCAS) as well as springs and lakes. Existing chemical and radiochemical fingerprints of these resources in the central and western parts of the oasis were examined based on the analyses of 30 water samples collected in 2015. In each sample, the analyzed chemical and radioisotopic constituents were Cl"-, SO_4"2"- , CO_3"2"-, HCO"3 "-, Na"+, K"+, Ca"2"+ and Mg"2"+, Al, B, Ba, Cd, Co, Fe, Cu, Mn, Mo, Ni, Pb, Sr, V, Zn, Si and Cr, "2"2"6 Ra, "2"3"2Th and "4"0K. Other physical properties included ph and TDS were measured in the field. The chemical analysis was carried out following the ASTM methods, while the radiochemical measurements were done using a hyper pure germanium (HPGe) gamma ray spectrometry. Results of this work may be advantage ous to promote the hydrologic database in the oasis, where levels of the natural radioactivity in groundwater resources were established for the first time. Water resources were classified based on their contents of TDS into fresh water for the NSSAS, brackish to salty water for TCAS, brackish water for springs and brine water for lakes. The artesian water of the NSSAS and TCAS and water of the springs were alkaline, while the water of the lakes was acidic. Chemical characters of the ground water of the NSSAS reflected a little response to the processes of water-rock interactions, and the vice versa was observed for the groundwater of the TCAS. The ground water of the NSSAS was dominated by HCO"3"-Na genetic type characterizing the meteoric origin of water. The ground water of the TCAS was characterized by the presence of three genetic types of water (SO"4"-Na, Cl-Mg, and Cl-CA water), indicating the modification of the recharged water from the underlain NSSAS due to the effects of water sediment interactions and mixing with trapped ancient sea water. The chemical properties of spring water were, greatly

Preparing mental health professionals for new directions in mental health practice: Evaluating the sensory approaches e-learning training package.

Science.gov (United States)

Meredith, Pamela; Yeates, Harriet; Greaves, Amanda; Taylor, Michelle; Slattery, Maddy; Charters, Michelle; Hill, Melissa

2018-02-01

The application of sensory modulation approaches in mental health settings is growing in recognition internationally. However, a number of barriers have been identified as limiting the implementation of the approach, including workplace culture and a lack of accessible and effective sensory approaches training. The aim of this project was to investigate the efficacy of providing this training through a custom-designed e-learning package. Participants in the present study were predominately nurses and occupational therapists working in mental health settings in Queensland, Australia. Data were collected from 121 participants using an online survey. Significant improvements were found between pre- and post-training in participants' real and perceived levels of knowledge, their perceived levels of confidence, and their attitudes towards using sensory modulation approaches in mental health settings. The findings of the study suggest that the custom-designed sensory approaches e-learning package is an effective, accessible, acceptable, and usable method to train health professionals in sensory modulation approaches. As this study is the first to analyse the efficacy of an e-learning sensory approaches package, the results are considered preliminary, and further investigation is required. © 2017 Australian College of Mental Health Nurses Inc.

Effect of tricyclic antidepressants on transmitter-stimulated inositol phosphate production in rat brain cortex in vitro

International Nuclear Information System (INIS)

Nomura, S.; Enna, S.J.

1986-01-01

Tricyclic antidepressants (TCAs) have anticholinergic and α-adrenergic blocking properties. The present study was undertaken to examine the effects of amitriptyline, imipramine, and desipramine on inositol phosphate accumulation, a brain second messenger system associated with cholinergic and adrenergic receptors. Whereas the TCAs were 28 to 400-fold weaker than atropine as inhibitors of 3 H-QNB binding to brain cholinergic receptors, they were 600 to 2000-fold less active than atropine as inhibitors of carbachol-stimulated IP accumulation in brain. In contrast, the relative potencies of the TCAs and prazosin to inhibit norepinephrine-stimulated IP accumulation and 3 H-prazosin binding appeared to be similar in the two assays. The results suggest pharmacological differences between the cholinergic receptors labeled in the ONB binding assay and those mediating the IP response, whereas the α 1 -adrenergic receptors appear to be similar in the two systems. Since atropine is considered a nonselective muscarinic antagonist, it is possible that the TCAs may differentiate between cholinergic receptor subtypes, which may be an important component of their clinical response

School health approach to teaching and learning of students

Directory of Open Access Journals (Sweden)

Yu.S. Lukianova

2015-01-01

Full Text Available Purpose: disclosure of health-ways for teaching and learning of students. Material: analysis of the publications of domestic and foreign authors. Results: The article is devoted to the implementation of healthy way approach to the educational process, namely, the rational organization of training aimed at keeping the dynamics of human health, the prevention of mental fatigue and overload, increase adaptive reserves of the body of the person; intensification of teaching and learning of students (application-is controversial dialogue, training, game forms and methods of training, participation in project activities, the work of pedagogical workshops that stimulates emotional accommodation and understanding of knowledge, helps students acquire personal-relevant knowledge and experience; use of health effect of artistic and practical (music, painting activities of students. Conclusions: highlights the key towards the implementation of health-promoting approach to the educational process.

"Championing GIS, Biostatistics, meteo, m-health and e-health approaches for tailored informed evidence-based agricultural, environment and health interventions in Rwanda"

Science.gov (United States)

Karame, P., Sr.

2016-12-01

"GIS-Biostatistics-Meteo for Health (GBMH), A consolidated approach"The environmental vulnerability rate due to human-induced threats and climate change has exceeded the capacity of ecosystems and species to adapt naturally. Drastic changes in seasonal and weather patterns have led to a severely intriguing imbalance ecosystem equilibrium, associated to habitat degradation, environmental pollution, shortage of ecosystem services production and shift in species distribution, food insecurity, invasive species and complex species associations. The consequences are particularly disturbing regarding health and wellbeing of human populations. Especially to Sub-Saharan Africa, informed evidence-based statistics are inappropriately if not at all used for developing and implementing coping measures. This makes a regrettable scenario for Rwanda, a research-driven economic transformation country in which mostly expensive long-term interventions remain meaningless and unknowingly approved effective. More important, no single sector can ultimately afford the most informative approaches providing evidence and guiding policy and decisions, due to limited resources. Rwanda dedicates substantial investment to sustain a conducive, robust and flourishing environment promoting research priorities most likely to deliver improved health outcomes. In this framework, the above mentioned approach supports cross-sectoral analyses to evaluate health care quality improvements through impact assessments, policy analysis and forecasting. This approach "Consolidating GIS, Biostatistics, meteo, mobile and e-health approaches (GBMH)" tailors disaster, disease control and prevention, farming options, effective planning, interventions and communication for safe health in sound environment. Under GBMH models, Integrated Time Series analysis completed in R Studio on health interventions from HMIS and DHS and DHSS systems (on environment and disaster management, farming practices and health sector

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.

A diagnostic approach to understanding entrepreneurship in health care.

Science.gov (United States)

McCleary, Karl J; Rivers, Patrick A; Schneller, Eugene S

2006-01-01

Health care is quite different from other industries because of its organizational structure, service delivery, and financing of health services. Balancing costs, quality, and access presents unique challenges for each stakeholder group committed to promoting the health and healing of its citizens. Using the diagnostic approach to health care entrepreneurship, we created a framework from research in the field to understand the predisposing, enabling, and reinforcing factors most relevant to successful entrepreneurship.

Integrated Approaches to Occupational Health and Safety: A Systematic Review.

Science.gov (United States)

Cooklin, A; Joss, N; Husser, E; Oldenburg, B

2017-09-01

The study objective was to conduct a systematic review of the effectiveness of integrated workplace interventions that combine health promotion with occupational health and safety. Electronic databases (n = 8), including PsychInfo and MEDLINE, were systematically searched. Studies included were those that reported on workplace interventions that met the consensus definition of an "integrated approach," published in English, in the scientific literature since 1990. Data extracted were occupation, worksite, country, sample size, intervention targets, follow-up period, and results reported. Quality was assessed according to American College of Occupational and Environmental Medicine Practice Guidelines. Heterogeneity precluded formal meta-analyses. Results were classified according to the outcome(s) assessed into five categories (health promotion, injury prevention, occupational health and safety management, psychosocial, and return-on-investment). Narrative synthesis of outcomes was performed. A total of 31 eligible studies were identified; 23 (74%) were (quasi-)experimental trials. Effective interventions were most of those aimed at improving employee physical or mental health. Less consistent results were reported from integrated interventions targeting occupational health and safety management, injury prevention, or organizational cost savings. Integrated approaches have been posed as comprehensive solutions to complex issues. Empirical evidence, while still emerging, provides some support for this. Continuing investment in, and evaluation of, integrated approaches are worthwhile.

An evidence-based public health approach to climate change adaptation.

Science.gov (United States)

Hess, Jeremy J; Eidson, Millicent; Tlumak, Jennifer E; Raab, Kristin K; Luber, George

2014-11-01

Public health is committed to evidence-based practice, yet there has been minimal discussion of how to apply an evidence-based practice framework to climate change adaptation. Our goal was to review the literature on evidence-based public health (EBPH), to determine whether it can be applied to climate change adaptation, and to consider how emphasizing evidence-based practice may influence research and practice decisions related to public health adaptation to climate change. We conducted a substantive review of EBPH, identified a consensus EBPH framework, and modified it to support an EBPH approach to climate change adaptation. We applied the framework to an example and considered implications for stakeholders. A modified EBPH framework can accommodate the wide range of exposures, outcomes, and modes of inquiry associated with climate change adaptation and the variety of settings in which adaptation activities will be pursued. Several factors currently limit application of the framework, including a lack of higher-level evidence of intervention efficacy and a lack of guidelines for reporting climate change health impact projections. To enhance the evidence base, there must be increased attention to designing, evaluating, and reporting adaptation interventions; standardized health impact projection reporting; and increased attention to knowledge translation. This approach has implications for funders, researchers, journal editors, practitioners, and policy makers. The current approach to EBPH can, with modifications, support climate change adaptation activities, but there is little evidence regarding interventions and knowledge translation, and guidelines for projecting health impacts are lacking. Realizing the goal of an evidence-based approach will require systematic, coordinated efforts among various stakeholders.

Human Rights-Based Approaches to Mental Health: A Review of Programs.

Science.gov (United States)

Porsdam Mann, Sebastian; Bradley, Valerie J; Sahakian, Barbara J

2016-06-01

The incidence of human rights violations in mental health care across nations has been described as a "global emergency" and an "unresolved global crisis." The relationship between mental health and human rights is complex and bidirectional. Human rights violations can negatively impact mental health. Conversely, respecting human rights can improve mental health. This article reviews cases where an explicitly human rights-based approach was used in mental health care settings. Although the included studies did not exhibit a high level of methodological rigor, the qualitative information obtained was considered useful and informative for future studies. All studies reviewed suggest that human-rights based approaches can lead to clinical improvements at relatively low costs. Human rights-based approaches should be utilized for legal and moral reasons, since human rights are fundamental pillars of justice and civilization. The fact that such approaches can contribute to positive therapeutic outcomes and, potentially, cost savings, is additional reason for their implementation. However, the small sample size and lack of controlled, quantitative measures limit the strength of conclusions drawn from included studies. More objective, high quality research is needed to ascertain the true extent of benefits to service users and providers.

Closing the Health Care Gap in Communities: A Safety Net System Approach.

Science.gov (United States)

Gabow, Patricia A

2016-10-01

The goal of U.S. health care should be good health for every American. This daunting goal will require closing the health care gap in communities with a particular focus on the most vulnerable populations and the safety net institutions that disproportionately serve these communities. This Commentary describes Denver Health's (DH's) two-pronged approach to achieving this goal: (1) creating an integrated system that focuses on the needs of vulnerable populations, and (2) creating an approach for financial viability, quality of care, and employee engagement. The implementation and outcomes of this approach at DH are described to provide a replicable model. An integrated delivery system serving vulnerable populations should go beyond the traditional components found in most integrated health systems and include components such as mental health services, school-based clinics, and correctional health care, which address the unique and important needs of, and points of access for, vulnerable populations. In addition, the demands that a safety net system experiences from an open-door policy on access and revenue require a disciplined approach to cost, quality of care, and employee engagement. For this, DH chose Lean, which focuses on reducing waste to respect the patients and employees within its health system, as well as all citizens. DH's Lean effort produced almost $195 million of financial benefit, impressive clinical outcomes, and high employee engagement. If this two-pronged approach were widely adopted, health systems across the United States would improve their chances of giving better care at costs they can afford for every person in society.

Some Innovative Approaches for Public Health and Epidemiology Informatics.

Science.gov (United States)

Toubiana, L; Griffon, N

2016-11-10

Summarize excellent current research published in 2015 in the field of Public Health and Epidemiology Informatics. The complete 2015 literature concerning public health and epidemiology informatics has been searched in PubMed and Web of Science, and the returned references were reviewed by the two section editors to select 14 candidate best papers. These papers were then peer-reviewed by external reviewers to allow the editorial team an enlightened selection of the best papers. Among the 1,272 references retrieved from PubMed and Web of Science, three were finally selected as best papers. The first one presents a language agnostic approach for epidemic event detection in news articles. The second paper describes a system using big health data gathered by a statewide system to forecast emergency department visits. The last paper proposes a rather original approach that uses machine learning to solve the old issue of outbreak detection and prediction. The increasing availability of data, now directly from health systems, will probably lead to a boom in public health surveillance systems and in large-scale epidemiologic studies.

Alcoholism and its Effects: an Approach Based on Health Psychology

Directory of Open Access Journals (Sweden)

Maria de las Mercedes Pretel Olite

2014-11-01

Full Text Available Alcoholism is a complex biopsychosocial disorder that requires a specialised and multidisciplinary approach focusing on both the patient and the family. Alcohol consumption is the most important addiction worldwide due to its prevalence and impact. Therefore, the main objective of a primary care physician should be to facilitate the referral of patients and their families to a structured treatment, support and guidance program during the whole detoxification process. In every health area in Cienfuegos, there are community mental health centers with a staff trained to deal with these disorders in addicts and their family. A literature review was conducted to establish the relationship between alcohol consumption and its harmful effects on health, family and society, using an approach based on Health Psychology.

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...

[The Common Risk Factor Approach - An Integrated Population- and Evidence-Based Approach for Reducing Social Inequalities in Oral Health].

Science.gov (United States)

Heilmann, A; Sheiham, A; Watt, R G; Jordan, R A

2016-10-01

Worldwide, non-communicable diseases including dental caries and periodontal diseases, remain a major public health problem. Moreover, there is a social gradient in health across society that runs from the top to the bottom in a linear, stepwise fashion. Health promoting behaviours become more difficult to sustain further down the social ladder. Oral health inequalities also exist in Germany. Earlier explanations of social inequalities have mainly focused on individual lifestyle factors, ignoring the broader social determinants of health and disease. Until recently, the dominant approaches to general health promotion focused on actions to reduce specific diseases, separating oral health from general health. An alternative approach is the common risk factor approach (CRFA) where risk factors common to a number of major chronic diseases, including diseases of the mouth and teeth, are tackled. The CRFA focuses on the common underlying determinants of health to improve the overall health of populations, thereby reducing social inequalities. The main implication of the CRFA for oral health policies is to work in partnership with a range of other sectors and disciplines. Oral health issues need to be integrated with recommendations to promote general health. Improvements in oral health and a reduction in oral health inequalities are more likely by working in partnership across sectors and disciplines using strategies that focus upstream on the underlying determinants of oral diseases. © Georg Thieme Verlag KG Stuttgart · New York.

A stage of change approach to reducing occupational ill health.

Science.gov (United States)

Whysall, Z; Haslam, C; Haslam, R

2006-11-01

Interventions targeted by stage of change have been shown to improve the efficacy of public health promotion initiatives in areas such as smoking cessation, alcohol reduction, and mammography screening. Targeted interventions are designed to tackle the key attitudes, beliefs, and intentions that underpin an individual's health-related behavior. Work-related ill health is an increasingly serious issue, the most common cause of which in both the UK and the US is musculoskeletal disorders. This study examined whether the stage approach could be applied to workplace interventions aimed at improving occupational health. A total of 24 multi-component occupational interventions aimed at reducing musculoskeletal disorders were monitored over a period of 4-6 months. In half of these cases, approaches were targeted according to workers' stage of change. Targeted interventions were found to be significantly more effective in promoting risk awareness and desired behavior change among workers. Significant reductions were also found in self-reported musculoskeletal discomfort among workers having received targeted interventions. No significant differences were found in self-reported musculoskeletal discomfort among workers following standard interventions. Stage-matched approaches may offer scope for substantially improving the efficacy of occupational health and safety interventions by increasing the uptake, implementation, and maintenance of risk-reducing measures.

[Academic review of global health approaches: an analytical framework].

Science.gov (United States)

Franco-Giraldo, Alvaro

2015-09-01

In order to identify perspectives on global health, this essay analyzes different trends from academia that have enriched global health and international health. A database was constructed with information from the world's leading global health centers. The search covered authors on global diplomacy and global health and was performed in PubMed, LILACS, and Google Scholar with the key words "global health" and "international health". Research and training centers in different countries have taken various academic approaches to global health; various interests and ideological orientations have emerged in relation to the global health concept. Based on the mosaic of global health centers and their positions, the review concludes that the new concept reflects the construction of a paradigm of renewal in international health and global health, the pre-paradigmatic stage of which has still not reached a final version.

Innovative Approaches to Task Shifting in Mental Health | CRDI ...

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

Innovative Approaches to Task Shifting in Mental Health. Across the world, it is estimated that mental disorders account for 12% of disability-adjusted life years. This proportion is still increasing and projected to reach 15% by 2020. However, provision of mental health services has not matched the need, especially in ...

Developing an evidence-based approach to Public Health Nutrition: translating evidence into policy.

Science.gov (United States)

Margetts, B; Warm, D; Yngve, A; Sjöström, M

2001-12-01

The aim of this paper is to highlight the importance of an evidence-based approach to the development, implementation and evaluation of policies aimed at improving nutrition-related health in the population. Public Health Nutrition was established to realise a population-level approach to the prevention of the major nutrition-related health problems world-wide. The scope is broad and integrates activity from local, national, regional and international levels. The aim is to inform and develop coherent and effective policies that address the key rate-limiting steps critical to improving nutrition-related public health. This paper sets out the rationale for an evidence-based approach to Public Health Nutrition developed under the umbrella of the European Network for Public Health Nutrition.

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.

State mental health policy: Maryland's shared leadership approach to mental health transformation: partnerships that work.

Science.gov (United States)

Semansky, Rafael M

2012-07-01

In 2005, Maryland received a mental health transformation grant from the Substance Abuse and Mental Health Services Administration. Maryland's transformation efforts have differed from those in other grantee states and have evolved into a shared leadership approach that harnesses the power of leaders from all sectors of the community. This column describes Maryland's reform efforts, focusing in particular on the development of the position of a peer employment specialist to improve placement of consumers in employment. This shared leadership approach has the potential to enhance long-term sustainability of reform initiatives and uses fewer state resources.

Complementary Health Approaches for Smoking Cessation: What the Science Says

Science.gov (United States)

... health professionals Complementary Health Approaches for Smoking Cessation: What the Science Says Share: November 2017 Mind and Body Practices ... as a smoking cessation treatment, authorizing Achieve Life Science, Inc. to proceed with clinical ... What Does the Research Show? A 2016 Cochrane review ...

Applying discursive approaches to health psychology.

Science.gov (United States)

Seymour-Smith, Sarah

2015-04-01

The aim of this paper is to outline the contribution of two strands of discursive research, glossed as 'macro' and 'micro,' to the field of health psychology. A further goal is to highlight some contemporary debates in methodology associated with the use of interview data versus more naturalistic data in qualitative health research. Discursive approaches provide a way of analyzing talk as a social practice that considers how descriptions are put together and what actions they achieve. A selection of recent examples of discursive research from one applied area of health psychology, studies of diet and obesity, are drawn upon in order to illustrate the specifics of both strands. 'Macro' discourse work in psychology incorporates a Foucauldian focus on the way that discourses regulate subjectivities, whereas the concept of interpretative repertoires affords more agency to the individual: both are useful for identifying the cultural context of talk. Both 'macro' and 'micro' strands focus on accountability to varying degrees. 'Micro' Discursive Psychology, however, pays closer attention to the sequential organization of constructions and focuses on naturalistic settings that allow for the inclusion of an analysis of the health professional. Diets are typically depicted as an individual responsibility in mainstream health psychology, but discursive research highlights how discourses are collectively produced and bound up with social practices. (c) 2015 APA, all rights reserved).

General health workers' description of mental health problems and treatment approaches used in Papua New Guinea.

Science.gov (United States)

Koka, Betty E; Deane, Frank P; Lyons, Geoffrey Cb; Lambert, Gordon

2014-11-01

Papua New Guinea is a developing country with limited resources for specialist mental health services. Little is known about the mental health and treatment services of Papua New Guinea. The aim of this study was to clarify the presenting mental health problems encountered by Papua New Guinean health workers and the common treatment approaches used. A total of 203 Papua New Guinean health workers completed a retrospective quantitative survey about their three most recent mental health patients. The survey asked about presenting symptomatology, diagnoses (including culture-bound diagnoses) and treatment approaches. The major presenting mental health problems for males included schizophrenia, substance use disorder, sorcery and spirit possession. Depression was the most common diagnoses for women, followed by sorcery and somatisation. Over 65% of patients were prescribed psychotropic medication, over 50% received some form of psychological intervention and 28% were receiving traditional treatments. Somatic symptoms are common among both male and female Papua New Guineans; however, males may be more likely to present with psychotic symptoms and females with mood-related problems. Schizophrenia and depression are commonly identified with substance use disorder more problematic among males. Culture-specific explanations and treatment are commonly used. © The Author(s) 2013.

[Towards a social determinants-oriented approach to public health: workshop report].

Science.gov (United States)

Rojo, Elena González; Álvarez-Dardet, Carlos; Fernández, Luis Andrés López

2017-12-01

This article is the result of a workshop with public health experts held in Granada (Spain) in October 2015 in order to reflect upon the components of the framework that should be part of a public health approach based on the social determinants of health. Advocacy and training professionals in health advocacy were identified as key elements where this was needed. During the workshop, it was agreed that the gender perspective, the salutogenic approach, interdisciplinary work and particular attention to disadvantaged groups are crucial. The importance of working from a human rights' framework and promoting legislative changes were also mentioned. Moreover, the group mentioned that even though much progress has been made identifying social determinants of health and creating conceptual frameworks, there is limited knowledge about how to intervene to reduce health inequality gaps in our societies. Copyright © 2017 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

Halting the obesity epidemic: a public health policy approach.

Science.gov (United States)

Nestle, M; Jacobson, M F

2000-01-01

Traditional ways of preventing and treating overweight and obesity have almost invariably focused on changing the behavior of individuals, an approach that has proven woefully inadequate, as indicated by the rising rates of both conditions. Considering the many aspects of American culture that promote obesity, from the proliferation of fast-food outlets to almost universal reliance on automobiles, reversing current trends will require a multifaceted public health policy approach as well as considerable funding. National leadership is needed to ensure the participation of health officials and researchers, educators and legislators, transportation experts and urban planners, and businesses and nonprofit groups in formulating a public health campaign with a better chance of success. The authors outline a broad range of policy recommendations and suggest that an obesity prevention campaign might be funded, in part, with revenues from small taxes on selected products that provide "empty" calories-such as soft drinks-or that reduce physical activity-such as automobiles.

[Individuals and changes in health organizations: a psychosociological approach].

Science.gov (United States)

Azevedo, Creuza da Silva; Braga Neto, Francisco Campos; Sá, Marilene de Castilho

2002-01-01

The Brazilian health sector has undergone a severe crisis, affecting the case-resolving capacity, efficiency and governability of the health system as a whole and health organizations in particular. Although innovative management systems and tools have been encouraged, such innovations are limited in their ability to spawn organizational change, especially with regard to the challenge of enabling individual adherence to institutional projects and relations involving individuals and organizations. This paper focuses on the French psychosociological approach for analyzing and intervening in organizations, one of whose main thinkers is Eugène Enriquez. In its view of contemporary organizations, this approach focuses on the conflict between reproduction and creation as the main problem to be solved by management processes. While an organization is essentially seen as a place of order and repetition, organizational change implies the challenge of bringing creative individuals into the organization's project, avoiding the trap of controlling their minds and behavior.

Security and privacy preserving approaches in the eHealth clouds with disaster recovery plan.

Science.gov (United States)

Sahi, Aqeel; Lai, David; Li, Yan

2016-11-01

Cloud computing was introduced as an alternative storage and computing model in the health sector as well as other sectors to handle large amounts of data. Many healthcare companies have moved their electronic data to the cloud in order to reduce in-house storage, IT development and maintenance costs. However, storing the healthcare records in a third-party server may cause serious storage, security and privacy issues. Therefore, many approaches have been proposed to preserve security as well as privacy in cloud computing projects. Cryptographic-based approaches were presented as one of the best ways to ensure the security and privacy of healthcare data in the cloud. Nevertheless, the cryptographic-based approaches which are used to transfer health records safely remain vulnerable regarding security, privacy, or the lack of any disaster recovery strategy. In this paper, we review the related work on security and privacy preserving as well as disaster recovery in the eHealth cloud domain. Then we propose two approaches, the Security-Preserving approach and the Privacy-Preserving approach, and a disaster recovery plan. The Security-Preserving approach is a robust means of ensuring the security and integrity of Electronic Health Records, and the Privacy-Preserving approach is an efficient authentication approach which protects the privacy of Personal Health Records. Finally, we discuss how the integrated approaches and the disaster recovery plan can ensure the reliability and security of cloud projects. Copyright © 2016 Elsevier Ltd. All rights reserved.

A multi-method approach to evaluate health information systems.

Science.gov (United States)

Yu, Ping

2010-01-01

Systematic evaluation of the introduction and impact of health information systems (HIS) is a challenging task. As the implementation is a dynamic process, with diverse issues emerge at various stages of system introduction, it is challenge to weigh the contribution of various factors and differentiate the critical ones. A conceptual framework will be helpful in guiding the evaluation effort; otherwise data collection may not be comprehensive and accurate. This may again lead to inadequate interpretation of the phenomena under study. Based on comprehensive literature research and own practice of evaluating health information systems, the author proposes a multimethod approach that incorporates both quantitative and qualitative measurement and centered around DeLone and McLean Information System Success Model. This approach aims to quantify the performance of HIS and its impact, and provide comprehensive and accurate explanations about the casual relationships of the different factors. This approach will provide decision makers with accurate and actionable information for improving the performance of the introduced HIS.

The Good Life: A Holistic Approach to the Health of the Population

OpenAIRE

Shahtahmasebi, Said

2006-01-01

The idea of a holistic approach towards public health planning presented itself through a food-related and trivial curiosity. It is, however, emphasized that food and nutrition are only one aspect of public health. The aim is to reintroduce a holistic approach to achieve sustainable public health with emphasis on the interpretation of the term “holistic”. Holistic decision making is not a new phenomenon and has historical basis. In line with shifts in social norms, decision making has evolved...

Implementing a Public Health Approach to Addressing Mental Health Needs in a University Setting: Lessons and Challenges

Science.gov (United States)

Parcover, Jason; Mays, Sally; McCarthy, Amy

2015-01-01

The mental health needs of college students are placing increasing demands on counseling center resources, and traditional outreach efforts may be outdated or incomplete. The public health model provides an approach for reaching more students, decreasing stigma, and addressing mental health concerns before they reach crisis levels. Implementing a…

Integrating relationship- and research-based approaches in Australian health promotion practice.

Science.gov (United States)

Klinner, Christiane; Carter, Stacy M; Rychetnik, Lucie; Li, Vincy; Daley, Michelle; Zask, Avigdor; Lloyd, Beverly

2015-12-01

We examine the perspectives of health promotion practitioners on their approaches to determining health promotion practice, in particular on the role of research and relationships in this process. Using Grounded Theory methods, we analysed 58 semi-structured interviews with 54 health promotion practitioners in New South Wales, Australia. Practitioners differentiated between relationship-based and research-based approaches as two sources of knowledge to guide health promotion practice. We identify several tensions in seeking to combine these approaches in practice and describe the strategies that participants adopted to manage these tensions. The strategies included working in an evidence-informed rather than evidence-based way, creating new evidence about relationship-based processes and outcomes, adopting 'relationship-based' research and evaluation methods, making research and evaluation useful for communities, building research and evaluation skills and improving collaboration between research and evaluation and programme implementation staff. We conclude by highlighting three systemic factors which could further support the integration of research-based and relationship-based health promotion practices: (i) expanding conceptions of health promotion evidence, (ii) developing 'relationship-based' research methods that enable practitioners to measure complex social processes and outcomes and to facilitate community participation and benefit, and (iii) developing organizational capacity. © The Author (2014). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Towards an integrated approach to health and medicine in Africa

African Journals Online (AJOL)

2016-08-18

Aug 18, 2016 ... As such, a social approach to health-seeking behaviour questions how decisions ... In conclusion, the paper proposes that medicine and the humanities should engage seriously .... mental questions: What story does the integration or separation .... approach which has taken an interest in traditional healing.

Capabilities and Incapabilities of the Capabilities Approach to Health Justice.

Science.gov (United States)

Selgelid, Michael J

2016-01-01

This first part of this article critiques Sridhar Venkatapuram's conception of health as a capability. It argues that Venkatapuram relies on the problematic concept of dignity, implies that those who are unhealthy lack lives worthy of dignity (which seems politically incorrect), sets a low bar for health, appeals to metaphysically problematic thresholds, fails to draw clear connections between appealed-to capabilities and health, and downplays the importance/relevance of health functioning. It concludes by questioning whether justice entitlements should pertain to the capability for health versus health achievements, challenging Venkatapuram's claims about the strength of health entitlements, and demonstrating that the capabilities approach is unnecessary to address social determinants of health. © 2016 John Wiley & Sons Ltd.

Bajenu Gox: A Community Approach to Maternal and Child Health in ...

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

Bajenu Gox: A Community Approach to Maternal and Child Health in ... the Bajenu Gox Initiative's contribution to improving maternal and child health across Senegal. ... Canada's International Development Research Centre (IDRC), and the ...

People-centred health systems, a bottom-up approach: where theory meets empery.

Science.gov (United States)

Sturmberg, Joachim P; Njoroge, Alice

2017-04-01

Health systems are complex and constantly adapt to changing demands. These complex-adaptive characteristics are rarely considered in the current bureaucratic top-down approaches to health system reforms aimed to constrain demand and expenditure growth. The economic focus fails to address the needs of patients, providers and communities, and ultimately results in declining effectiveness and efficiency of the health care system as well as the health of the wider community. A needs-focused complex-adaptive health system can be represented by the 'healthcare vortex' model; how to build a needs-focused complex-adaptive health system is illustrated by Eastern Deanery AIDS Relief Program approaches in the poor neighbourhoods of Nairobi, Kenya. A small group of nurses and community health workers focused on the care of terminally ill HIV/AIDS patients. This work identified additional problems: tuberculosis (TB) was underdiagnosed and undertreated, a local TB-technician was trained to run a local lab, a courier services helped to reach all at need, collaboration with the Ministry of Health established local TB and HIV treatment programmes and philanthropists helped to supplement treatment with nutrition support. Maternal-to-child HIV-prevention and adolescent counselling services addressed additional needs. The 'theory of the healthcare vortex' indeed matches the 'empery of the real world experiences'. Locally developed and delivered adaptive, people-centred health systems, a bottom-up community and provider initiated approach, deliver highly effective and sustainable health care despite significant resource constraints. © 2016 John Wiley & Sons, Ltd.

Beyond Techno-Utopia: Critical Approaches to Digital Health Technologies

Directory of Open Access Journals (Sweden)

Deborah Lupton

2014-12-01

Full Text Available This editorial presents an overview of digital health technologies, discusses previous research and introduces the contributions to the special issue “Beyond Techno-Utopia: Critical Approaches to Digital Health Technologies”. It is argued that thus far, few critical analyses of digital health technologies have been published in the social science literature, particularly in relation to the newest technologies. While the articles collected here in this special issue have gone some way in offering a critical response to digital health technologies, they represent only a beginning. Many more compelling topics remain to be investigated. The editorial ends with outlining directions for future research in this area.

The effects of terrorism on adult mental health: a public health preparedness approach

Directory of Open Access Journals (Sweden)

Sameera S. Karnik

2014-01-01

Full Text Available Terrorism is a disruptive man-made disaster event challenging human health and wellbeing. It is a hostile activity which brings about much casualty, even death. It not only causes physical casualties but also brings about psychological morbidity and can lead to long term mental disorders. The effects of terrorist attacks on people’s psychological health covers a wide range such as acute stress symptoms to long term disorders like Post-traumatic Stress Disorder (PTSD. The psychological disorder due to traumatic distress is treated with psychotherapies such as psychosocial intervention, psychological debriefing, psychological first aid care, psychological counseling services, and psychoeducation. Government is supporting state and local public health departments to develop efficient public health preparedness planning programs in case of emergency situations. There are some newer approaches working towards enhancing health security and managing responses to a psychological impact of a disaster event like a terrorist attack.

A knowledge translation project on community-centred approaches in public health.

Science.gov (United States)

Stansfield, J; South, J

2018-03-01

This article examines the development and impact of a national knowledge translation project aimed at improving access to evidence and learning on community-centred approaches for health and wellbeing. Structural changes in the English health system meant that knowledge on community engagement was becoming lost and a fragmented evidence base was seen to impact negatively on policy and practice. A partnership started between Public Health England, NHS England and Leeds Beckett University in 2014 to address these issues. Following a literature review and stakeholder consultation, evidence was published in a national guide to community-centred approaches. This was followed by a programme of work to translate the evidence into national strategy and local practice.The article outlines the key features of the knowledge translation framework developed. Results include positive impacts on local practice and national policy, for example adoption within National Institute for Health and Care Evidence (NICE) guidance and Local Authority public health plans and utilization as a tool for local audit of practice and commissioning. The framework was successful in its non-linear approach to knowledge translation across a range of inter-connected activity, built on national leadership, knowledge brokerage, coalition building and a strong collaboration between research institute and government agency.

A novel approach for evaluating the risk of health care failure modes.

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Chang, Dong Shang; Chung, Jenq Hann; Sun, Kuo Lung; Yang, Fu Chiang

2012-12-01

Failure mode and effects analysis (FMEA) can be employed to reduce medical errors by identifying the risk ranking of the health care failure modes and taking priority action for safety improvement. The purpose of this paper is to propose a novel approach of data analysis. The approach is to integrate FMEA and a mathematical tool-Data envelopment analysis (DEA) with "slack-based measure" (SBM), in the field of data analysis. The risk indexes (severity, occurrence, and detection) of FMEA are viewed as multiple inputs of DEA. The practicality and usefulness of the proposed approach is illustrated by one case of health care. Being a systematic approach for improving the service quality of health care, the approach can offer quantitative corrective information of risk indexes that thereafter reduce failure possibility. For safety improvement, these new targets of the risk indexes could be used for management by objectives. But FMEA cannot provide quantitative corrective information of risk indexes. The novel approach can surely overcome this chief shortcoming of FMEA. After combining DEA SBM model with FMEA, the two goals-increase of patient safety, medical cost reduction-can be together achieved.

A self-cognizant dynamic system approach for prognostics and health management

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Bai, Guangxing; Wang, Pingfeng; Hu, Chao

2015-03-01

Prognostics and health management (PHM) is an emerging engineering discipline that diagnoses and predicts how and when a system will degrade its performance and lose its partial or whole functionality. Due to the complexity and invisibility of rules and states of most dynamic systems, developing an effective approach to track evolving system states becomes a major challenge. This paper presents a new self-cognizant dynamic system (SCDS) approach that incorporates artificial intelligence into dynamic system modeling for PHM. A feed-forward neural network (FFNN) is selected to approximate a complex system response which is challenging task in general due to inaccessible system physics. The trained FFNN model is then embedded into a dual extended Kalman filter algorithm to track down system dynamics. A recursive computation technique used to update the FFNN model using online measurements is also derived. To validate the proposed SCDS approach, a battery dynamic system is considered as an experimental application. After modeling the battery system by a FFNN model and a state-space model, the state-of-charge (SoC) and state-of-health (SoH) are estimated by updating the FFNN model using the proposed approach. Experimental results suggest that the proposed approach improves the efficiency and accuracy for battery health management.

Urbanism, climate change and health: systems approaches to governance.

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Capon, Anthony G; Synnott, Emma S; Holliday, Sue

2009-01-01

Effective action on climate change health impacts and vulnerability will require systems approaches and integrated policy and planning responses from a range of government agencies. Similar responses are needed to address other complex problems, such as the obesity epidemic. Local government, with its focus on the governance of place, will have a key role in responding to these convergent agendas. Industry can also be part of the solution - indeed it must be, because it has a lead role in relevant sectors. Understanding the co-benefits for health of climate mitigation actions will strengthen the case for early action. There is a need for improved decision support tools to inform urban governance. These tools should be based on a systems approach and should incorporate a spatial perspective.

Milnacipran: a unique antidepressant?

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Siegfried Kasper

2010-08-01

Full Text Available Siegfried Kasper, Gerald PailDepartment of Psychiatry and Psychotherapy, Medical University of Vienna, AustriaAbstract: Tricyclic antidepressants (TCAs are among the most effective antidepressants available, although their poor tolerance at usual recommended doses and toxicity in ­overdose make them difficult to use. While selective serotonin reuptake inhibitors (SSRIs are ­better tolerated than TCAs, they have their own specific problems, such as the aggravation of sexual dysfunction, interaction with coadministered drugs, and for many, a discontinuation syndrome. In addition, some of them appear to be less effective than TCAs in more severely depressed patients. Increasing evidence of the importance of norepinephrine in the etiology of depression has led to the development of a new generation of antidepressants, the serotonin and ­norepinephrine reuptake inhibitors (SNRIs. Milnacipran, one of the pioneer SNRIs, was designed from theoretic considerations to be more effective than SSRIs and better tolerated than TCAs, and with a simple pharmacokinetic profile. Milnacipran has the most balanced potency ratio for reuptake inhibition of the two neurotransmitters compared with other SNRIs (1:1.6 for milnacipran, 1:10 for duloxetine, and 1:30 for venlafaxine, and in some studies milnacipran has been shown to inhibit norepinephrine uptake with greater potency than serotonin (2.2:1. Clinical studies have shown that milnacipran has efficacy comparable with the TCAs and is superior to SSRIs in severe depression. In addition, milnacipran is well tolerated, with a low potential for pharmacokinetic drug–drug interactions. Milnacipran is a first-line therapy suitable for most depressed patients. It is frequently successful when other treatments fail for reasons of efficacy or tolerability.Keywords: milnacipran, SNRI, antidepressant efficacy, tolerability

A Dynamic Health Assessment Approach for Shearer Based on Artificial Immune Algorithm

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Zhongbin Wang

2016-01-01

Full Text Available In order to accurately identify the dynamic health of shearer, reducing operating trouble and production accident of shearer and improving coal production efficiency further, a dynamic health assessment approach for shearer based on artificial immune algorithm was proposed. The key technologies such as system framework, selecting the indicators for shearer dynamic health assessment, and health assessment model were provided, and the flowchart of the proposed approach was designed. A simulation example, with an accuracy of 96%, based on the collected data from industrial production scene was provided. Furthermore, the comparison demonstrated that the proposed method exhibited higher classification accuracy than the classifiers based on back propagation-neural network (BP-NN and support vector machine (SVM methods. Finally, the proposed approach was applied in an engineering problem of shearer dynamic health assessment. The industrial application results showed that the paper research achievements could be used combining with shearer automation control system in fully mechanized coal face. The simulation and the application results indicated that the proposed method was feasible and outperforming others.

Obesity and outpatient rehabilitation using mobile technologies: the potential mHealth approach.

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Gianluca eCastelnuovo

2014-06-01

Full Text Available Obesity is currently an important public health problem of epidemic proportions (globesity. Inpatient rehabilitation interventions that aim at improving weight-loss, reducing obesity-related complications and changing dysfunctional behaviors, should ideally be carried out in a multidisciplinary context with a clinical team composed of psychologists, dieticians, psychiatrists, endocrinologists, nutritionists, physiotherapists, etc. Long-term outpatient multidisciplinary treatments are likely to constitute an essential aspect of rehabilitation. Internet-based technologies can improve long-term obesity rehabilitation within a collaborative approach by enhancing the steps specified by psychological and medical treatment protocols. These outcomes may be augmented further by the mHealth approach, through creating new treatment delivery methods to increase compliance and engagement. mHealth (m-health, mobile health can be defined as the practice of medicine and public health, supported by mobile communication devices for health services and information. mHealth applications which can be implemented in weight loss protocols and obesity rehabilitation are discussed, taking into account future research directions in this promising area.

The Good Life: A Holistic Approach to the Health of the Population

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Shahtahmasebi, Said

2006-01-01

The idea of a holistic approach towards public health planning presented itself through a food-related and trivial curiosity. It is, however, emphasized that food and nutrition are only one aspect of public health. The aim is to reintroduce a holistic approach to achieve sustainable public health with emphasis on the interpretation of the term “holistic”. Holistic decision making is not a new phenomenon and has historical basis. In line with shifts in social norms, decision making has evolved. In particular, various complex models for public health have been proposed to respond to ever-increasing health issues. The advancement in mathematical sciences and technology has led to the quantification of health models. However, mathematical representations pose a major limitation on the holistic approach. Due to its evolutionary nature, human health is dynamically related to social, environmental, and other processes. With the current knowledge, it is difficult to quantify the evolution and feedback effects in holistic models. In this paper, the individual's and public's health is viewed as a dynamic process, but not independent of other dynamic processes (e.g., agriculture, economy, politics) that are all part of a much bigger process. Furthermore, it is argued that it is not merely sufficient to account for all known factors to be holistic. In this paper, the holistic conceptual model is illustrated, using public health as the central issue. The application of the conceptual model is also discussed using two practical examples. PMID:17370007

Gesundes Kinzigtal Integrated Care: improving population health by a shared health gain approach and a shared savings contract

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H. Hildebrandt

2010-06-01

Full Text Available Introduction: Integrated care solutions need supportive financial incentives. In this paper we describe the financial architecture and operative details of the integrated pilot Gesundes Kinzigtal.Description of integrated care case: Located in Southwest Germany, Gesundes Kinzigtal is one of the few population-based integrated care approaches in Germany, organising care across all health service sectors and indications. The system serving around half of the population of the region is run by a regional health management company (Gesundes Kinzigtal GmbH in coope­ration with the physicians' network in the region (MQNK, a German health care management company with a background in medical sociology and health economics (OptiMedis AG and with two statutory health insurers (among them is the biggest health insurer in Southwest Germany: AOK Baden-Württemberg.Discussion and (preliminary conclusion: The shared savings contract between Gesundes Kinzigtal GmbH and the two health insurers, providing financial incentives for managers and health care providers to realize a sub­stantial efficiency gain, could be an appropriate contractual base of Gesundes Kinzigtal's population health gain approach. This approach is based on the assumption that a more effective trans-sector organisation of Germany's health care system and increased investments in well-designed preventive programmes will lead to a reduction in  morbidity, and in particular to a reduced incidence and prevalence of chronic diseases. This, in turn, is to lead to a comparative reduction in health care cost. Although the comparative cost in the Kinzigtal region has been reduced from the onset of Gesundes Kinzigtal Integrated Care, only future research will have to demonstrate whether - and to what extent - cost reduction may be attributed to a real population health gain.

Gesundes Kinzigtal Integrated Care: improving population health by a shared health gain approach and a shared savings contract

Directory of Open Access Journals (Sweden)

H. Hildebrandt

2010-06-01

Full Text Available Introduction: Integrated care solutions need supportive financial incentives. In this paper we describe the financial architecture and operative details of the integrated pilot 'Gesundes Kinzigtal'. Description of integrated care case: Located in Southwest Germany, 'Gesundes Kinzigtal' is one of the few population-based integrated care approaches in Germany, organising care across all health service sectors and indications. The system serving around half of the population of the region is run by a regional health management company (Gesundes Kinzigtal GmbH in coope­ration with the physicians' network in the region (MQNK, a German health care management company with a background in medical sociology and health economics (OptiMedis AG and with two statutory health insurers (among them is the biggest health insurer in Southwest Germany: AOK Baden-Württemberg. Discussion and (preliminary conclusion: The shared savings contract between Gesundes Kinzigtal GmbH and the two health insurers, providing financial incentives for managers and health care providers to realize a sub­stantial efficiency gain, could be an appropriate contractual base of Gesundes Kinzigtal's population health gain approach. This approach is based on the assumption that a more effective trans-sector organisation of Germany's health care system and increased investments in well-designed preventive programmes will lead to a reduction in  morbidity, and in particular to a reduced incidence and prevalence of chronic diseases. This, in turn, is to lead to a comparative reduction in health care cost. Although the comparative cost in the Kinzigtal region has been reduced from the onset of Gesundes Kinzigtal Integrated Care, only future research will have to demonstrate whether - and to what extent - cost reduction may be attributed to a real population health gain.

Operationalizing the One Health approach: the global governance challenges.

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Lee, Kelley; Brumme, Zabrina L

2013-10-01

While there has been wide-ranging commitment to the One Health approach, its operationalisation has so far proven challenging. One Health calls upon the human, animal and environmental health sectors to cross professional, disciplinary and institutional boundaries, and to work in a more integrated fashion. At the global level, this paper argues that this vision is hindered by dysfunctions characterising current forms of global health governance (GHG), namely institutional proliferation, fragmentation, competition for scarce resources, lack of an overarching authority, and donor-driven vertical programmes. This has contributed, in part, to shortcomings in how One Health has been articulated to date. An agreed operational definition of One Health among key global institutions, efforts to build One Health institutions from the ground up, comparative case studies of what works or does not work institutionally, and high-level global support for research, training and career opportunities would all help to enable One Health to help remedy, and not be subsumed by, existing dysfunctions in GHG.

Out-of-Pocket Expenditures on Complementary Health Approaches Associated with Painful Health Conditions in a Nationally Representative Adult Sample

Science.gov (United States)

Nahin, Richard L.; Stussman, Barbara J.; Herman, Patricia M.

2015-01-01

National surveys suggest that millions of adults in the United States use complementary health approaches such as acupuncture, chiropractic manipulation, and herbal medicines to manage painful conditions such as arthritis, back pain and fibromyalgia. Yet, national and per person out-of-pocket (OOP) costs attributable to this condition-specific use are unknown. In the 2007 National Health Interview Survey, use of complementary health approaches, reasons for this use, and associated OOP costs were captured in a nationally representative sample of 5,467 adults. Ordinary least square regression models that controlled for co-morbid conditions were used to estimate aggregate and per person OOP costs associated with 14 painful health conditions. Individuals using complementary approaches spent a total of $14.9 billion (S.E. $0.9 billion) OOP on these approaches to manage these painful conditions. Total OOP expenditures seen in those using complementary approaches for their back pain ($8.7 billion, S.E. $0.8 billion) far outstripped that of any other condition, with the majority of these costs ($4.7 billion, S.E. $0.4 billion) resulting from visits to complementary providers. Annual condition-specific per-person OOP costs varied from a low of $568 (SE $144) for regular headaches, to a high of $895 (SE $163) for fibromyalgia. PMID:26320946

The odd couple: using biomedical and intersectional approaches to address health inequities.

Science.gov (United States)

Hankivsky, Olena; Doyal, Lesley; Einstein, Gillian; Kelly, Ursula; Shim, Janet; Weber, Lynn; Repta, Robin

Better understanding and addressing health inequities is a growing global priority. In this paper, we contribute to the literature examining complex relationships between biological and social dimensions in the field of health inequalities. Specifically, we explore the potential of intersectionality to advance current approaches to socio-biological entwinements. We provide a brief overview of current approaches to combining both biological and social factors in a single study, and then investigate the contributions of an intersectional framework to such work. We offer a number of concrete examples of how intersectionality has been used empirically to bring both biological and social factors together in the areas of HIV, post-traumatic stress disorder, female genital circumcision/mutilation/cutting, and cardiovascular disease. We argue that an intersectional approach can further research that integrates biological and social aspects of human lives and human health and ultimately generate better and more precise evidence for effective policies and practices aimed at tackling health inequities.

[Environmental justice as an approach to tackle environmental health inequalities].

Science.gov (United States)

Bolte, Gabriele; Bunge, Christiane; Hornberg, Claudia; Köckler, Heike

2018-06-01

Current international studies show that environment-related diseases disproportionately affect vulnerable people. This is a case of environmental injustice. Environmental justice goes beyond the mere description of environment- and health-related social inequalities by comprising two dimensions of justice as a normative approach: distributional and procedural justice. Attempts to explain the link between social circumstances, the environment and health deal with both the socially unequal distribution of environmental hazards and environmental resources (exposure variation) and social differences in vulnerability to the health effects of environmental exposures (effect modification). Integrated monitoring approaches provide the basis for deriving interventions under various aspects of environmental justice. Parting from public health research and embedded in the Health in All Policies (HiAP) concept, environmental justice has now been taken up in a number of fields, including politics, administration and practice. There are strategic considerations and attempts to anchor it in politics at the federal, state and the communal level, both by government and non-government groups. Health-promoting urban development is a core field for intervention. The Soziale Stadt (Social City) programme for promoting urban planning and construction as well as place oriented sectoral planning make an important contribution by helping to focus on urban spaces with multiple health hazards and to implement target group-oriented participation processes. There continues to be a need to develop methods and systematically implemented evaluations of political strategies and corresponding interventions regarding their effects on inequalities in health and environmental justice.

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

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Mykytiuk S.A.

2012-12-01

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

A case-based, problem-based learning approach to prepare master of public health candidates for the complexities of global health.

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Leon, Juan S; Winskell, Kate; McFarland, Deborah A; del Rio, Carlos

2015-03-01

Global health is a dynamic, emerging, and interdisciplinary field. To address current and emerging global health challenges, we need a public health workforce with adaptable and collaborative problem-solving skills. In the 2013-2014 academic year, the Hubert Department of Global Health at the Rollins School of Public Health-Emory University launched an innovative required core course for its first-year Master of Public Health students in the global health track. The course uses a case-based, problem-based learning approach to develop global health competencies. Small teams of students propose solutions to these problems by identifying learning issues and critically analyzing and synthesizing new information. We describe the course structure and logistics used to apply this approach in the context of a large class and share lessons learned.

What should health insurance cover? A comparison of Israeli and US approaches to benefit design under national health reform.

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Nissanholtz Gannot, Rachel; Chinitz, David P; Rosenbaum, Sara

2018-04-01

What health insurance should cover and pay for represents one of the most complex questions in national health policy. Israel shares with the US reliance on a regulated insurance market and we compare the approaches of the two countries regarding determining health benefits. Based on review and analysis of literature, laws and policy in the United States and Israel. The Israeli experience consists of selection of a starting point for defining coverage; calculating the expected cost of covered benefits; and creating a mechanism for updating covered benefits within a defined budget. In implementing the Affordable Care Act, the US rejected a comprehensive and detailed approach to essential health benefits. Instead, federal regulators established broadly worded minimum standards that can be supplemented through more stringent state laws and insurer discretion. Notwithstanding differences between the two systems, the elements of the Israeli approach to coverage, which has stood the test of time, may provide a basis for the United States as it renews its health reform debate and considers delegating decisions about coverage to the states. Israel can learn to emulate the more forceful regulation of supplemental and private insurance that characterizes health policy in the United States.

A Service Design Thinking Approach for Stakeholder-Centred eHealth.

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Lee, Eunji

2016-01-01

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

A novel surveillance approach for disaster mental health.

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Oliver Gruebner

Full Text Available Disasters have substantial consequences for population mental health. Social media data present an opportunity for mental health surveillance after disasters to help identify areas of mental health needs. We aimed to 1 identify specific basic emotions from Twitter for the greater New York City area during Hurricane Sandy, which made landfall on October 29, 2012, and to 2 detect and map spatial temporal clusters representing excess risk of these emotions.We applied an advanced sentiment analysis on 344,957 Twitter tweets in the study area over eleven days, from October 22 to November 1, 2012, to extract basic emotions, a space-time scan statistic (SaTScan and a geographic information system (QGIS to detect and map excess risk of these emotions.Sadness and disgust were among the most prominent emotions identified. Furthermore, we noted 24 spatial clusters of excess risk of basic emotions over time: Four for anger, one for confusion, three for disgust, five for fear, five for sadness, and six for surprise. Of these, anger, confusion, disgust and fear clusters appeared pre disaster, a cluster of surprise was found peri disaster, and a cluster of sadness emerged post disaster.We proposed a novel syndromic surveillance approach for mental health based on social media data that may support conventional approaches by providing useful additional information in the context of disaster. We showed that excess risk of multiple basic emotions could be mapped in space and time as a step towards anticipating acute stress in the population and identifying community mental health need rapidly and efficiently in the aftermath of disaster. More studies are needed to better control for bias, identify associations with reliable and valid instruments measuring mental health, and to explore computational methods for continued model-fitting, causal relationships, and ongoing evaluation. Our study may be a starting point also for more fully elaborated models that can

Fellowship Program in Health System Improvement: A novel approach integrating leadership development and patient-centred health system transformation.

Science.gov (United States)

Philippon, Donald J; Montesanti, Stephanie; Stafinski, Tania

2018-03-01

This article highlights a novel approach to professional development, integrating leadership, development and patient-centred health system transformation in the new Fellowship Program in Health System Improvement offered by the School of Public Health at the University of Alberta. Early assessment of the program is also provided.

Integrated approach to assess ecosystem health in harbor areas.

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Bebianno, M J; Pereira, C G; Rey, F; Cravo, A; Duarte, D; D'Errico, G; Regoli, F

2015-05-01

Harbors are critical environments with strategic economic importance but with potential environmental impact: health assessment criteria are a key issue. An ecosystem health status approach was carried out in Portimão harbor as a case-study. Priority and specific chemical levels in sediments along with their bioavailability in mussels, bioassays and a wide array of biomarkers were integrated in a biomarker index (IBR index) and the overall data in a weight of evidence (WOE) model. Metals, PAHs, PCBs and HCB were not particularly high compared with sediment guidelines and standards for dredging. Bioavailability was evident for Cd, Cu and Zn. Biomarkers proved more sensitive namely changes of antioxidant responses, metallothioneins and vittellogenin-like proteins. IBR index indicated that site 4 was the most impacted area. Assessment of the health status by WOE approach highlighted the importance of integrating sediment chemistry, bioaccumulation, biomarkers and bioassays and revealed that despite some disturbance in the harbor area, there was also an impact of urban effluents from upstream. Environmental quality assessment in harbors. Copyright © 2015 Elsevier B.V. All rights reserved.

Public health policy research: making the case for a political science approach.

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Bernier, Nicole F; Clavier, Carole

2011-03-01

The past few years have seen the emergence of claims that the political determinants of health do not get due consideration and a growing demand for better insights into public policy analysis in the health research field. Several public health and health promotion researchers are calling for better training and a stronger research culture in health policy. The development of these studies tends to be more advanced in health promotion than in other areas of public health research, but researchers are still commonly caught in a naïve, idealistic and narrow view of public policy. This article argues that the political science discipline has developed a specific approach to public policy analysis that can help to open up unexplored levers of influence for public health research and practice and that can contribute to a better understanding of public policy as a determinant of health. It describes and critiques the public health model of policy analysis, analyzes political science's specific approach to public policy analysis, and discusses how the politics of research provides opportunities and barriers to the integration of political science's distinctive contributions to policy analysis in health promotion.

A Systems Approach to Evaluate One Health Initiatives

DEFF Research Database (Denmark)

Rüegg, Simon R.; Nielsen, Liza Rosenbaum; Buttigieg, Sandra C.

2018-01-01

(1) and (3) including ready-to-use Microsoft Excel spreadsheets for the assessment of “the One-Health-ness”. We also provide an overview of Element (2), and refer to the NEOH handbook for further details, also regarding Element (4) (http://neoh.onehealthglobal.net). The presented approach helps...

Understanding men's health and illness: a gender-relations approach to policy, research, and practice.

Science.gov (United States)

Schofield, T; Connell, R W; Walker, L; Wood, J F; Butland, D L

2000-05-01

Men's health has emerged as an important public concern that may require new kinds of healthcare interventions and increased resources. Considerable uncertainty and confusion surround prevailing understandings of men's health, particularly those generated by media debate and public policy, and health research has often operated on oversimplified assumptions about men and masculinity. A more useful way of understanding men's health is to adopt a gender-relations approach. This means examining health concerns in the context of men's and women's interactions with each other, and their positions in the larger, multidimensional structure of gender relations. Such an approach raises the issue of differences among men, which is a key issue in recent research on masculinity and an important health issue. The gender-relations approach offers new ways of addressing practical issues of healthcare for men in college environments.

Applying the health action process approach (HAPA) to the choice of health products: An exploratory study

DEFF Research Database (Denmark)

Krutulyte, Rasa; Grunert, Klaus G.; Scholderer, Joachim

This paper presents the results of a qualitative pilot study that aimed to uncovering Danish consumers' motives for choosing health food. Schwarzer's (1992) health action process approach (HAPA) was applied to understand the process by which people chose health products. The research focused...... on the role of the behavioural intention predictors such as risk perception, outcome expectations and self-efficacy. The model has been proved to be a useful framework for understanding consumer choosing health food and is substantial in the further application of dietary choice issues....

Pushing the boundaries of research on human resources for health: fresh approaches to understanding health worker motivation.

Science.gov (United States)

Bhatnagar, Aarushi; Scott, Kerry; Govender, Veloshnee; George, Asha

2018-04-01

A country's health workforce plays a vital role not only in serving the health needs of the population but also in supporting economic prosperity. Moreover, a well-funded and well-supported health workforce is vital to achieving universal health coverage and Sustainable Development Goal 3 to ensure healthy lives and promote well-being for all at all ages. This perspective article highlights the potential of underutilized health policy and systems research (HPSR) approaches for developing more effective human resources for health policy. The example of health worker motivation is used to showcase four types of HPSR (exploratory, influence, explanatory and emancipatory) that move beyond describing the extent of a problem. Most of the current literature aiming to understand determinants and dynamics of motivation is descriptive in nature. While this is an important basis for all research pursuits, it often gives little information about mechanisms to improve motivation and strategies for intervention. Motivation is an essential determinant of health worker performance, particularly for those working in difficult conditions, such as those facing many health workers in low- and middle-income countries. Motivation mediates health workforce performance in multiple ways: internally governing health worker behaviour; informing decisions on becoming a health worker; workplace location and ability to perform; and influencing willingness to engage politically. The four fresh research approaches described can help policy-makers better understand why health workers behave the way they do, how interventions can improve performance, the mechanisms that lead to change, and strategies for empowering health workers to be agents of change themselves.

[Child health and international cooperation: A paediatric approach].

Science.gov (United States)

Sobrino Toro, M; Riaño Galan, I; Bassat, Q; Perez-Lescure Picarzo, J; de Aranzabal Agudo, M; Krauel Vidal, X; Rivera Cuello, M

2015-05-01

The international development cooperation in child health arouses special interest in paediatric settings. In the last 10 10 years or so, new evidence has been presented on factors associated with morbidity and mortality in the first years of life in the least developed countries. This greater knowledge on the causes of health problems and possible responses in the form of interventions with impact, leads to the need to disseminate this information among concerned professional pediatricians. Serious efforts are needed to get a deeper insight into matters related to global child health and encourage pediatricians to be aware and participate in these processes. This article aims to provide a social pediatric approach towards international cooperation and child health-related matters. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

Best practices for online Canadian prenatal health promotion: A public health approach.

Science.gov (United States)

Chedid, Rebecca A; Terrell, Rowan M; Phillips, Karen P

2017-11-04

Prenatal health promotion provides information regarding pregnancy risks, protective behaviours and clinical and community resources. Typically, women obtain prenatal health information from health care providers, prenatal classes, peers/family, media and increasingly, Internet sites and mobile apps. Barriers to prenatal health promotion and related services include language, rural/remote location, citizenship and disability. Online public health platforms represent the capacity to reach underserved women and can be customised to address the needs of a heterogeneous population of pregnant women. Canadian government-hosted websites and online prenatal e-classes were evaluated to determine if accessible, inclusive, comprehensive and evidence-based prenatal health promotion was provided. Using a multijurisdictional approach, federal, provincial/territorial, municipal and public health region-hosted websites, along with affiliated prenatal e-classes, were evaluated based on four criteria: comprehensiveness, evidence-based information, accessibility and inclusivity. Online prenatal e-classes, federal, provincial/territorial and public health-hosted websites generally provided comprehensive and evidence-based promotion of essential prenatal topics, in contrast to municipal-hosted websites which provided very limited prenatal health information. Gaps in online prenatal health promotion were identified as lack of French and multilingual content, targeted information and representations of Indigenous peoples, immigrants and women with disabilities. Canadian online prenatal health promotion is broadly comprehensive and evidence-based, but fails to address the needs of non-Anglophones and represent the diverse population of Canadian pregnant women. It is recommended that agencies enhance the organisation of website pregnancy portals/pages and collaborate with other jurisdictions and community groups to ensure linguistically accessible, culturally-competent and inclusive

Multivariate determinants of self-management in Health Care: assessing Health Empowerment Model by comparison between structural equation and graphical models approaches

Directory of Open Access Journals (Sweden)

Filippo Trentini

2015-03-01

Full Text Available Backgroung. In public health one debated issue is related to consequences of improper self-management in health care.  Some theoretical models have been proposed in Health Communication theory which highlight how components such general literacy and specific knowledge of the disease might be very important for effective actions in healthcare system.  Methods. This  paper aims at investigating the consistency of Health Empowerment Model by means of both graphical models approach, which is a “data driven” method and a Structural Equation Modeling (SEM approach, which is instead “theory driven”, showing the different information pattern that can be revealed in a health care research context.The analyzed dataset provides data on the relationship between the Health Empowerment Model constructs and the behavioral and health status in 263 chronic low back pain (cLBP patients. We used the graphical models approach to evaluate the dependence structure in a “blind” way, thus learning the structure from the data.Results. From the estimation results dependence structure confirms links design assumed in SEM approach directly from researchers, thus validating the hypotheses which generated the Health Empowerment Model constructs.Conclusions. This models comparison helps in avoiding confirmation bias. In Structural Equation Modeling, we used SPSS AMOS 21 software. Graphical modeling algorithms were implemented in a R software environment.

The antimicrobial resistance containment and surveillance approach--a public health tool.

Science.gov (United States)

Simonsen, Gunnar S.; Tapsall, John W.; Allegranzi, Benedetta; Talbot, Elizabeth A.; Lazzari, Stefano

2004-01-01

Antimicrobial drug resistance (AMR) is widely recognized as a global public health threat because it endangers the effectiveness of treatment of infectious diseases. In 2001 WHO issued the Global Strategy for Containment of Antimicrobial Resistance, but it has proved difficult to translate the recommendations of the Global Strategy into effective public health actions. The purpose of the Antimicrobial Resistance Containment and Surveillance (ARCS) approach is to facilitate the formulation of public health programmes and the mobilization of human and financial resources for the containment of AMR. The ARCS approach highlights the fundamental link between rational drug use and containment of AMR. Clinical management of human and animal infections should be improved through better disease control and prevention, high quality diagnostic testing, appropriate treatment regimens and consumer health education. At the same time, systems for supplying antimicrobial drugs should include appropriate regulations, lists of essential drugs, and functional mechanisms for the approval and delivery of drugs. Containment of AMR is defined in the ARCS approach as the continuous application of this package of core interventions. Surveillance of the extent and trends of antimicrobial resistance as well as the supply, selection and use of antimicrobial drugs should be established to monitor the process and outcome of containment of AMR. The ARCS approach is represented in the ARCS diagram (Fig. 2) which provides a simplified, but comprehensive illustration of the complex problem of containment and monitoring of AMR. PMID:15654407

Social representations: a theoretical approach in health

Directory of Open Access Journals (Sweden)

Isaiane Santos Bittencourt

2011-03-01

Full Text Available Objective: To present the theory of social representations, placing its epistemology and knowing the basic concepts of its approach as a structural unit of knowledge for health studies. Justification: The use of this theory comes from the need to understand social eventsunder the lens of the meanings constructed by the community. Data Synthesis: This was a descriptive study of literature review, which used as a source of data collection the classical authors of social representations supported by articles from electronic search at Virtual Health Library (VHL. The definition and discussion of collected data enabled to introduce two themes, versed on the history and epistemology of representations and on the structuralapproach of representations in health studies. Conclusion: This review allowed highlight the importance of locating the objects of study with regard to contextual issues of individual and collective histories, valuing the plurality of relations, to come closer to reality that is represented by the subjects.

Reframing women's health in nursing education: a feminist approach.

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Morse, G G

1995-01-01

To operate from a feminist paradigm is a new way of thinking for nurse educators. Feminist perspectives in nursing provide a new stage of consciousness--one that values women's voices, their way of knowing, and their life experiences, and, most important, one that challenges traditional patriarchal practices. Furthermore, nursing curricula with feminist perspectives provides a biopsychosocial approach that encourages the full recognition of variables that can influence women's health, such as socioeconomic status, racial and ethnic background, and biobehavioral factors. The debate in medicine over a specialty in women's health is not unique. The history of academia abounds with descriptions of struggles to establish new fields and disciplines. Recent specialties, such as pediatrics and gerontology, which are distinguished by age rather than specific organ or system, struggled for establishment and recognition. Historically, nursing curricula has emulated the biomedical model that is reductionistic and contradictory to nursing's holistic mission. Rather than classifying women's health into a separate entity, women's health may be introduced into present curricula by employing feminist ideals and pedagogy throughout the curriculum. This approach would provide a mechanism to explore women's health issues that were previously minimally addressed at best, or not addressed at all. More important, students would be provided with an opportunity to examine the societal effects of racism, sexism, and classism, and this education would potentially lead to a growing awareness of concerns specific to women and minorities.

Defining ‘sensitive’ health status: a systematic approach using health code terminologies.

Directory of Open Access Journals (Sweden)

Andy Boyd

2017-04-01

We have demonstrated a systematic and partially interoperable approach to defining ‘sensitive’ health information. However, any such exercise is likely to include decisions which will be open to interpretation and open to change over time. As such, the application of this technique should be embedded within an appropriate governance framework which can accommodate misclassification while minimising potential patient harm.

Employing a Qualitative Description Approach in Health Care Research.

Science.gov (United States)

Bradshaw, Carmel; Atkinson, Sandra; Doody, Owen

2017-01-01

A qualitative description design is particularly relevant where information is required directly from those experiencing the phenomenon under investigation and where time and resources are limited. Nurses and midwives often have clinical questions suitable to a qualitative approach but little time to develop an exhaustive comprehension of qualitative methodological approaches. Qualitative description research is sometimes considered a less sophisticated approach for epistemological reasons. Another challenge when considering qualitative description design is differentiating qualitative description from other qualitative approaches. This article provides a systematic and robust journey through the philosophical, ontological, and epistemological perspectives, which evidences the purpose of qualitative description research. Methods and rigor issues underpinning qualitative description research are also appraised to provide the researcher with a systematic approach to conduct research utilizing this approach. The key attributes and value of qualitative description research in the health care professions will be highlighted with the aim of extending its usage.

A queer-theoretical approach to community health psychology.

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Easpaig, Bróna R Nic Giolla; Fryer, David M; Linn, Seònaid E; Humphrey, Rhianna H

2014-01-01

Queer-theoretical resources offer ways of productively rethinking how central concepts such as 'person-context', 'identity' and 'difference' may be understood for community health psychologists. This would require going beyond consideration of the problems with which queer theory is popularly associated to cautiously engage with the aspects of this work relevant to the promotion of collective practice and engaging with processes of marginalisation. In this article, we will draw upon and illustrate the queer-theoretical concepts of 'performativity' and 'cultural intelligibility' before moving towards a preliminary mapping of what a queer-informed approach to community health psychology might involve.

Priorities and approaches to investigating Asian youth health: perspectives of young Asian New Zealanders.

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Wong, Agnes; Peiris-John, Roshini; Sobrun-Maharaj, Amritha; Ameratunga, Shanthi

2015-12-01

The proportion of young people in New Zealand identifying with Asian ethnicities has increased considerably. Despite some prevalent health concerns, Asian youth are less likely than non-Asian peers to seek help. As preparatory research towards a more nuanced approach to service delivery and public policy, this qualitative study aimed to identify young Asian New Zealanders' perspectives on best approaches to investigate health issues of priority concern to them. Three semi-structured focus group discussions were conducted with 15 Asian youth leaders aged 18-24 years. Using an inductive approach for thematic analysis, key themes were identified and analysed. Study participants considered ethno-cultural identity, racism and challenges in integration to play significant roles influencing the health of Asian youth (especially mental health) and their access to health services. While emphasising the importance of engaging young Asians in research and service development so that their needs and aspirations are met, participants also highlighted the need for approaches that are cognisant of the cultural, contextual and intergenerational dimensions of issues involved in promoting youth participation. Research that engages Asian youth as key agents using methods that are sensitive to their cultural and sociological contexts can inform more responsive health services and public policy. This is of particular relevance in primary health care where culturally competent services can mitigate risks of unmet health needs and social isolation.

Use of ethnographic approaches to the study of health experiences in relation to natural landscapes.

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O'Brien, Liz; Varley, Pete

2012-11-01

This paper discusses the use of ethnographic approaches to explore how engagement with natural landscapes might benefit people's health. Drawing on a selected review of empirical research we identified 30 relevant research papers that utilised qualitative methods to explore health issues and engagement with nature. Three examples of 'alternative' - i.e. non-mainstream qualitative approaches - are used to illustrate how different methods can be used to explore people's experiences of engaging with nature for health. While quantitative methods are dominant in health research, qualitative approaches are becoming more widely used. Approaches such as autoethnography can add value to nature and health studies by providing opportunities for researchers to be self-critical of their role as a researcher. Accompanied visits and visual ethnography can afford the researcher rich data about bodily movement, facial expressions and journeys, as well as dialogues associated with the meanings of nature for health. The paper concludes by suggesting that ethnographic methods can provide useful and important insights into why people engage with the natural environment and the range of health benefits they may gain from contact with nature.

An innovative approach to interdisciplinary occupational safety and health education.

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Rosen, Mitchel A; Caravanos, Jack; Milek, Debra; Udasin, Iris

2011-07-01

The New York and New Jersey Education and Research Center (ERC) provides a range of graduate continuing education for occupational safety and health (OSH) professionals in training. A key element of the education is to provide interdisciplinary training to industrial hygienists, ergonomists, occupational medicine physicians and other health and safety trainees to prepare them for the collaboration required to solve the complex occupational health and safety problems they will face in their careers. This center has developed an innovative interdisciplinary training approach that provides an historical aspect, while allowing the graduate students to identify solutions to occupational issues from a multi-disciplinary approach. The ERC developed a tour that brings students to sites of historical and/or contemporary significance in the occupational safety and health and environmental fields. The ERC has conducted five tours, and has included 85 students and residents as participants. 80% of participants rated the tour as providing a high amount of OSH knowledge gained. 98% of the participants felt the goal of providing interdisciplinary education was achieved. This tour has been successful in bridging the OSH fields to better understand how occupational and environmental exposures have occurred, in order to prevent future exposures so that workplace conditions and health can be improved. Copyright © 2011 Wiley-Liss, Inc.

Varying Levels of Automation on UAS Operator Responses to Traffic Resolution Advisories in Civil Airspace

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Kenny, Caitlin; Fern, Lisa

2012-01-01

Continuing demand for the use of Unmanned Aircraft Systems (UAS) has put increasing pressure on operations in civil airspace. The need to fly UAS in the National Airspace System (NAS) in order to perform missions vital to national security and defense, emergency management, and science is increasing at a rapid pace. In order to ensure safe operations in the NAS, operators of unmanned aircraft, like those of manned aircraft, may be required to maintain separation assurance and avoid loss of separation with other aircraft while performing their mission tasks. This experiment investigated the effects of varying levels of automation on UAS operator performance and workload while responding to conflict resolution instructions provided by the Tactical Collision Avoidance System II (TCAS II) during a UAS mission in high-density airspace. The purpose of this study was not to investigate the safety of using TCAS II on UAS, but rather to examine the effect of automation on the ability of operators to respond to traffic collision alerts. Six licensed pilots were recruited to act as UAS operators for this study. Operators were instructed to follow a specified mission flight path, while maintaining radio contact with Air Traffic Control and responding to TCAS II resolution advisories. Operators flew four, 45 minute, experimental missions with four different levels of automation: Manual, Knobs, Management by Exception, and Fully Automated. All missions included TCAS II Resolution Advisories (RAs) that required operator attention and rerouting. Operator compliance and reaction time to RAs was measured, and post-run NASA-TLX ratings were collected to measure workload. Results showed significantly higher compliance rates, faster responses to TCAS II alerts, as well as less preemptive operator actions when higher levels of automation are implemented. Physical and Temporal ratings of workload were significantly higher in the Manual condition than in the Management by Exception and

A new complementary approach for oral health and diabetes management

DEFF Research Database (Denmark)

Cinar, Ayse Basak; Freeman, Ruth; Schou, Lone

2018-01-01

BACKGROUND: Health coaching (HC) is based on 'partnering with clients in a thought-provoking and creative process that inspires them to maximise their personal and professional potential' to adopt healthy lifestyles through 'building awareness and empowerment'. This study's objective is to assess......, for the first time to our knowledge, the effectiveness of HC compared with health education (HE) using clinical and subjective measures among type 2 diabetes (DM2) patients in Turkey and Denmark. METHODS: This stratified random prospective study selected type 2 diabetes patients in Turkey (n = 186) (TR) (2010...... management and health outcomes. There is a need for common health promotion strategies with behavioural interventions such as health coaching for the management of type 2 diabetes that focus on multidisciplinary approaches including oral health....

Evaluation of a 'virtual' approach to commissioning health research.

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McCourt, Christine A; Morgan, Philip A; Youll, Penny

2006-10-18

The objective of this study was to evaluate the implementation of a 'virtual' (computer-mediated) approach to health research commissioning. This had been introduced experimentally in a DOH programme--the 'Health of Londoners Programme'--in order to assess whether is could enhance the accessibility, transparency and effectiveness of commissioning health research. The study described here was commissioned to evaluate this novel approach, addressing these key questions. A naturalistic-experimental approach was combined with principles of action research. The different commissioning groups within the programme were randomly allocated to either the traditional face-to-face mode or the novel 'virtual' mode. Mainly qualitative data were gathered including observation of all (virtual and face-to-face) commissioning meetings; semi-structured interviews with a purposive sample of participants (n = 32/66); structured questionnaires and interviews with lead researchers of early commissioned projects. All members of the commissioning groups were invited to participate in collaborative enquiry groups which participated actively in the analysis process. The virtual process functioned as intended, reaching timely and relatively transparent decisions that participants had confidence in. Despite the potential for greater access using a virtual approach, few differences were found in practice. Key advantages included physical access, a more flexible and extended time period for discussion, reflection and information gathering and a more transparent decision-making process. Key challenges were the reduction of social cues available in a computer-mediated medium that require novel ways of ensuring appropriate dialogue, feedback and interaction. However, in both modes, the process was influenced by a range of factors and was not technology driven. There is potential for using computer-mediated communication within the research commissioning process. This may enhance access

Melding Infant Mental Health and Multisystemic Therapy Approaches to Community-Based Treatment

Science.gov (United States)

Willoughby, Jay C.; Carubia, Beau A.; Murgolo, Marisa A.; Carter, Debbie R.; Frankel, Karen A.

2013-01-01

A recent partnership between the Irving Harris Program in Child Development and Infant Mental Health and the Community Based Psychiatry Program at University of Colorado Hospital joined two different approaches to child mental health treatment: infant mental health and multisystemic therapy (MST). This article illustrates the compatibility of…

Reducing Technology-Induced Errors: Organizational and Health Systems Approaches.

Science.gov (United States)

Borycki, Elizabeth M; Senthriajah, Yalini; Kushniruk, Andre W; Palojoki, Sari; Saranto, Kaija; Takeda, Hiroshi

2016-01-01

Technology-induced errors are a growing concern for health care organizations. Such errors arise from the interaction between healthcare and information technology deployed in complex settings and contexts. As the number of health information technologies that are used to provide patient care rises so will the need to develop ways to improve the quality and safety of the technology that we use. The objective of the panel is to describe varying approaches to improving software safety from and organizational and health systems perspective. We define what a technology-induced error is. Then, we discuss how software design and testing can be used to improve health information technologies. This discussion is followed by work in the area of monitoring and reporting at a health district and national level. Lastly, we draw on the quality, safety and resilience literature. The target audience for this work are nursing and health informatics researchers, practitioners, administrators, policy makers and students.

Toward a national health risk management approach in Australia.

Science.gov (United States)

O'Donnell, Carol

2002-01-01

There has been increasing international consensus about the importance of competition for achieving national growth and community well-being. The Australian government accordingly has introduced policies to promote such competition. Major legislative review and many public inquiries have assisted implementation of national competition policy and the development of national goals and standards related to international agreements to promote health and sustainable development. Since the 1980s, Australia has had legislation that requires the identification and control of health risks arising at work. The management structures necessary for coordinated delivery of national programs designed for effective identification and control of health risks arising in communities to achieve national health and development goals are still being developed, however. Major difficulties related to this development are discussed. National health development programs should be approached primarily through establishment of regional partnerships between bodies responsible for managing community health, local government, and employment placement, in consultation with other relevant organizations and the community. Related research and evaluation programs are required.

Testing a user-driven approach in health promotion activities targeting users of psychiatric services

DEFF Research Database (Denmark)

Folmann Hempler, Nana; Saurbrey Pals, Regitze; Oest, Lone

2017-01-01

Compared to the general population, users of psychiatric services (users) are at higher risk of developing type 2 diabetes, which is associated with lifestyle behaviours. The aim of this study was to pilot test a new collaborative approach in health promotion targeting users. The approach is based...... with course participants and users. Professionals had to test at least one tool in a health promoting activity such as health checks, exercise etc. Data were collected through observations of health promoting activities (n=15) and questionnaires (n=54). Data were analysed using systematic text condensation...... and descriptive statistics. The majority of professionals found that the new approach to a moderate/high degree had improved their collaborative skills (89.3%) and Research Center of Health Promotionwas well-suited for their practice (93.5%). Observations showed that professionals successfully integrated...

Standardized Approach to Quantitatively Measure Residual Limb Skin Health in Individuals with Lower Limb Amputation.

Science.gov (United States)

Rink, Cameron L; Wernke, Matthew M; Powell, Heather M; Tornero, Mark; Gnyawali, Surya C; Schroeder, Ryan M; Kim, Jayne Y; Denune, Jeffrey A; Albury, Alexander W; Gordillo, Gayle M; Colvin, James M; Sen, Chandan K

2017-07-01

Objective: (1) Develop a standardized approach to quantitatively measure residual limb skin health. (2) Report reference residual limb skin health values in people with transtibial and transfemoral amputation. Approach: Residual limb health outcomes in individuals with transtibial ( n  = 5) and transfemoral ( n  = 5) amputation were compared to able-limb controls ( n  = 4) using noninvasive imaging (hyperspectral imaging and laser speckle flowmetry) and probe-based approaches (laser doppler flowmetry, transcutaneous oxygen, transepidermal water loss, surface electrical capacitance). Results: A standardized methodology that employs noninvasive imaging and probe-based approaches to measure residual limb skin health are described. Compared to able-limb controls, individuals with transtibial and transfemoral amputation have significantly lower transcutaneous oxygen tension, higher transepidermal water loss, and higher surface electrical capacitance in the residual limb. Innovation: Residual limb health as a critical component of prosthesis rehabilitation for individuals with lower limb amputation is understudied in part due to a lack of clinical measures. Here, we present a standardized approach to measure residual limb health in people with transtibial and transfemoral amputation. Conclusion: Technology advances in noninvasive imaging and probe-based measures are leveraged to develop a standardized approach to quantitatively measure residual limb health in individuals with lower limb loss. Compared to able-limb controls, resting residual limb physiology in people that have had transfemoral or transtibial amputation is characterized by lower transcutaneous oxygen tension and poorer skin barrier function.

Prevalence and use of complementary health approaches among women with chronic pelvic pain in a prospective cohort study.

Science.gov (United States)

Chao, Maria T; Abercrombie, Priscilla D; Nakagawa, Sanae; Gregorich, Steven E; Learman, Lee A; Kuppermann, Miriam

2015-02-01

The aim of this study was to examine the prevalence of and factors associated with use of complementary health approaches among women with chronic pelvic pain (CPP). We analyzed data from the Study of Pelvic Problems, Hysterectomy, and Intervention Alternatives, a prospective cohort study of women seeking care for noncancerous pelvic problems with intact uteri at enrollment. Among a subset of 699 participants who reported having CPP, we analyzed the prevalence of complementary health approaches used and associated patient sociodemographic and clinical characteristics, health-related quality of life, attitudes and beliefs, and conventional health care practices. At baseline, slightly over one-half (51%) of women with CPP used at least one complementary health approach in the past year, including acupuncture (8%), special foods or diets (22%), herbs (27%), and vitamins and minerals (29%). During follow-up surveys conducted annually for 4 years, a substantial proportion of women (44.8%) used complementary health approaches at more than half of the assessments. Users of complementary health approaches were more likely to undergo a hysterectomy or oophorectomy or to use gonadotropin-releasing hormone agonists or opioids during the study compared with nonusers. Women with CPP who used complementary health approaches also had more optimal health-related quality of life measured by the Pelvic Problem Impact Questionnaire (31.6 vs 25.6, P complementary health approaches. The substantial interest in and high prevalence of complementary health approaches used alongside conventional medical approaches highlight the need for better understanding of multimodal approaches to address the complex condition of CPP. Wiley Periodicals, Inc.

How to achieve a collaborative approach in health promotion

DEFF Research Database (Denmark)

Pals, Regitze Anne Saurbrey; Hempler, Nana Folmann

2018-01-01

(n = 15), professionals (n = 21) and users' family members (n = 12). Data were analysed using systematic text condensation. RESULTS: Users provided three recommendations for establishing a collaborative approach in communication about health: (1) involving users in deciding the agenda and setting...

Ethics education for health professionals: a values based approach.

Science.gov (United States)

Godbold, Rosemary; Lees, Amanda

2013-11-01

It is now widely accepted that ethics is an essential part of educating health professionals. Despite a clear mandate to educators, there are differing approaches, in particular, how and where ethics is positioned in training programmes, underpinning philosophies and optimal modes of assessment. This paper explores varying practices and argues for a values based approach to ethics education. It then explores the possibility of using a web-based technology, the Values Exchange, to facilitate a values based approach. It uses the findings of a small scale study to signal the potential of the Values Exchange for engaging, meaningful and applied ethics education. Copyright © 2013 Elsevier Ltd. All rights reserved.

Employing a Qualitative Description Approach in Health Care Research

Science.gov (United States)

Bradshaw, Carmel; Atkinson, Sandra; Doody, Owen

2017-01-01

A qualitative description design is particularly relevant where information is required directly from those experiencing the phenomenon under investigation and where time and resources are limited. Nurses and midwives often have clinical questions suitable to a qualitative approach but little time to develop an exhaustive comprehension of qualitative methodological approaches. Qualitative description research is sometimes considered a less sophisticated approach for epistemological reasons. Another challenge when considering qualitative description design is differentiating qualitative description from other qualitative approaches. This article provides a systematic and robust journey through the philosophical, ontological, and epistemological perspectives, which evidences the purpose of qualitative description research. Methods and rigor issues underpinning qualitative description research are also appraised to provide the researcher with a systematic approach to conduct research utilizing this approach. The key attributes and value of qualitative description research in the health care professions will be highlighted with the aim of extending its usage. PMID:29204457

Policy directions in urban health in developing countries--the slum improvement approach.

Science.gov (United States)

Harpham, T; Stephens, C

1992-07-01

The urban development, or housing, sector has a longer experience of addressing the problems of the urban poor in developing countries than the health sector. In recent years the policy of 'slum improvement', which involves both sectors, has attracted the support of international donors. This article documents the development of the slum improvement approach and addresses key issues of the approach which have implications for health planning: covering the poorest dwellers; relocation; land tenure; gentrification; debt burdens and the impact on women. Questions about the approach which still need answering are defined and a summary of the constraints in slum improvement and potential solutions is presented.

[Ethnographic approaches to research and intervention in mental health].

Science.gov (United States)

Nunes, Mônica de Oliveira; de Torrenté, Maurice

2013-10-01

The specifics of ethnographic approaches to mental health research are examined, highlighting the motives why the type of knowledge produced by ethnography is relevant to the context of Psychiatric Reform and the biomedicalization of existence. The discussion is focused on interpretation-based ethnography in the field of mental health, stressing the theoretical and methodological foundations of a comprehensive form of apprehending the scope of mental health as an object akin to a clinic of the individual. The centrality of social and cultural aspects in the ethnographic approach and the inflexions mediated by the type of ethnographic methodological undertaking is stressed. Lastly, the ethnography of madness is seen as a fitting example that substantiates some of these characteristics. The contention is that accessing psychotic persons (and others who may speak about these experiences) from varied areas of their daily life, situated in their various social inscriptions, while confronting these interpretations with other interpretative dimensions of their social reality and within the logic linked to local psychologies, is a pertinent procedure, from whence certain aspects of an understanding of madness (or causes of its incomprehension) can emerge.

Multi-criteria decision making--an approach to setting priorities in health care.

Science.gov (United States)

Nobre, F F; Trotta, L T; Gomes, L F

1999-12-15

The objective of this paper is to present a multi-criteria decision making (MCDM) approach to support public health decision making that takes into consideration the fuzziness of the decision goals and the behavioural aspect of the decision maker. The approach is used to analyse the process of health technology procurement in a University Hospital in Rio de Janeiro, Brazil. The method, known as TODIM, relies on evaluating alternatives with a set of decision criteria assessed using an ordinal scale. Fuzziness in generating criteria scores and weights or conflicts caused by dealing with different viewpoints of a group of decision makers (DMs) are solved using fuzzy set aggregation rules. The results suggested that MCDM models, incorporating fuzzy set approaches, should form a set of tools for public health decision making analysis, particularly when there are polarized opinions and conflicting objectives from the DM group. Copyright 1999 John Wiley & Sons, Ltd.

Lessons Learned from the Whole Child and Coordinated School Health Approaches

Science.gov (United States)

Rasberry, Catherine N.; Slade, Sean; Lohrmann, David K.; Valois, Robert F.

2015-01-01

Background: The new Whole School, Whole Community, Whole Child (WSCC) model, designed to depict links between health and learning, is founded on concepts of coordinated school health (CSH) and a whole child approach to education. Methods: The existing literature, including scientific articles and key publications from national agencies and…

A systemic approach to understanding mental health and services.

Science.gov (United States)

Cohen, Mark

2017-10-01

In the UK mental health and associated NHS services face considerable challenges. This paper aims to form an understanding both of the complexity of context in which services operate and the means by which services have sought to meet these challenges. Systemic principles as have been applied to public service organisations with reference to interpersonal relations, the wider social culture and its manifestation in service provision. The analysis suggests that the wider culture has shaped service demand and the approaches adopted by services resulting in a number of unintended consequences, reinforcing loops, increased workload demands and the limited value of services. The systemic modelling of this situation provides a necessary overview prior to future policy development. The paper concludes that mental health and attendant services requires a systemic understanding and a whole system approach to reform. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

An integrated public health and criminal justice approach to gangs: What can research tell us?

Directory of Open Access Journals (Sweden)

Erika Gebo

2016-12-01

Full Text Available There has been a call to better link public health and criminal justice approaches to best address crime problems generally, and youth and gang violence in particular. Importantly, there has yet to be a systematic examination of how criminal justice approaches can be integrated within a public health framework. This paper examines the strengths and challenges with mapping gang research and evidence-informed practices onto a public health approach. Conceptual examination reveals benefits to utilizing an integrated framework, but it also exposes core problems with identification and prediction of gang joining and gang membership. The gang label as a master status is called into question. It is argued that a public health framework can inform public policy approaches as to when the focus should be youth violence versus gangs and gang violence.

The past, present, and future of health development campaigns: reflexivity and the critical-cultural approach.

Science.gov (United States)

Dutta, Mohan Jyoti; de Souza, Rebecca

2008-07-01

In contemporary society, health issues have gained increasing urgency in both political and academic spheres. Looking back at the failure of the modernist development initiatives, there is the need to realize that we live in a time of increasing sociopolitical complexity. The present moment is perhaps best understood in terms of a complex tension and linkage between the past and present, global and local, modern and postmodern. The critical-cultural approach to health campaigns is an approach that, through the reflexive interrogation of modernist assumptions underlying health communication campaigns, attempts to foreground the tensions inherent in the practice of health campaigns. This essay discusses the manner in which the critical-cultural approach interrogates modernist assumptions and provides an alternative paradigm for approaching the theory and practice of health campaigns by suggesting the necessity for reflexivity. Specifically, we discuss how the perspective interrogates the role of the media in development, the significance of culture, the locus of health responsibility, the impact of structural conditions, and the politics of knowledge, providing examples of campaigns that illustrate this reflexivity.

Equity in health care financing in Palestine: the value-added of the disaggregate approach.

Science.gov (United States)

Abu-Zaineh, Mohammad; Mataria, Awad; Luchini, Stéphane; Moatti, Jean-Paul

2008-06-01

This paper analyzes the redistributive effect and progressivity associated with the current health care financing schemes in the Occupied Palestinian Territory, using data from the first Palestinian Household Health Expenditure Survey conducted in 2004. The paper goes beyond the commonly used "aggregate summary index approach" to apply a more detailed "disaggregate approach". Such an approach is borrowed from the general economic literature on taxation, and examines redistributive and vertical effects over specific parts of the income distribution, using the dominance criterion. In addition, the paper employs a bootstrap method to test for the statistical significance of the inequality measures. While both the aggregate and disaggregate approaches confirm the pro-rich and regressive character of out-of-pocket payments, the aggregate approach does not ascertain the potential progressive feature of any of the available insurance schemes. The disaggregate approach, however, significantly reveals a progressive aspect, for over half of the population, of the government health insurance scheme, and demonstrates that the regressivity of the out-of-pocket payments is most pronounced among the worst-off classes of the population. Recommendations are advanced to improve the performance of the government insurance schemes to enhance its capacity in limiting inequalities in health care financing in the Occupied Palestinian Territory.

Stakeholder participation in health impact assessment: A multicultural approach

International Nuclear Information System (INIS)

Negev, Maya; Davidovitch, Nadav; Garb, Yaakov; Tal, Alon

2013-01-01

The literature on impact assessment (HIA) registers the importance of stakeholder participation in the assessment process, but still lacks a model for engaging stakeholders of diverse ethnic, professional and sectorial backgrounds. This paper suggests that the multicultural approach can contribute to HIA through a revision of the generic 5-step HIA model, and its implementation in a metropolitan plan in Southern Israel. The health issue scoped by the stakeholders in the HIA is related to land uses in the vicinity of the national hazardous industry and hazardous waste site. The stakeholders were representatives of the diverse populations at stake, including rural Bedouins and Jewish city dwellers, as well as representatives from the public sector, private sector, non-governmental organizations and academia. The case study revealed that a multicultural stakeholder participation process helps to uncover health issues known to the community which were not addressed in the original plan, and provides local knowledge regarding health conditions that is especially valuable when scientific data is uncertain or absent. It enables diverse stakeholders to prioritize the health issues that will be assessed. The case study also reveals ways in which the model needs revisions and improvements such as in recruitment of diverse participants. This paper presents a multicultural model of HIA and discusses some of the challenges that are faced when HIA is implemented in the context of current decision-making culture. -- Highlights: • We revised the generic HIA model in light of the multicultural approach. • We tested the model in a case study of zoning a hazardous industry site. • Multicultural stakeholder participation uncovers health issues known to communities. • It enables community prioritization of health issues. • We present a model for multicultural stakeholder participation in HIA

Stakeholder participation in health impact assessment: A multicultural approach

Energy Technology Data Exchange (ETDEWEB)

Negev, Maya, E-mail: mayane@tau.ac.il [Hartog School of Government and Policy, Faculty of Social Sciences, Tel Aviv University, P.O.B. 39040, Tel Aviv 69978 (Israel); Davidovitch, Nadav, E-mail: nadavd@bgu.ac.il [Department of Health Systems Management, Faculty of Health Sciences, Ben-Gurion University, P.O.B. 653, Be' er Sheva 84105 (Israel); Garb, Yaakov, E-mail: ygarb@bgu.ac.il [Swiss Institute for Dryland Environmental Research, The Jacob Blaustein Institutes for Desert Research, Ben-Gurion University of the Negev, Sede Boqer 84990 (Israel); Tal, Alon, E-mail: alontal@bgu.ac.il [Mitrani Department of Dryland Ecology, Swiss Institute for Dryland Environmental Research, The Jacob Blaustein Institutes for Desert Research, Ben-Gurion University of the Negev, Sede Boqer 84990 (Israel)

2013-11-15

The literature on impact assessment (HIA) registers the importance of stakeholder participation in the assessment process, but still lacks a model for engaging stakeholders of diverse ethnic, professional and sectorial backgrounds. This paper suggests that the multicultural approach can contribute to HIA through a revision of the generic 5-step HIA model, and its implementation in a metropolitan plan in Southern Israel. The health issue scoped by the stakeholders in the HIA is related to land uses in the vicinity of the national hazardous industry and hazardous waste site. The stakeholders were representatives of the diverse populations at stake, including rural Bedouins and Jewish city dwellers, as well as representatives from the public sector, private sector, non-governmental organizations and academia. The case study revealed that a multicultural stakeholder participation process helps to uncover health issues known to the community which were not addressed in the original plan, and provides local knowledge regarding health conditions that is especially valuable when scientific data is uncertain or absent. It enables diverse stakeholders to prioritize the health issues that will be assessed. The case study also reveals ways in which the model needs revisions and improvements such as in recruitment of diverse participants. This paper presents a multicultural model of HIA and discusses some of the challenges that are faced when HIA is implemented in the context of current decision-making culture. -- Highlights: • We revised the generic HIA model in light of the multicultural approach. • We tested the model in a case study of zoning a hazardous industry site. • Multicultural stakeholder participation uncovers health issues known to communities. • It enables community prioritization of health issues. • We present a model for multicultural stakeholder participation in HIA.

Critiquing the response to the Ebola epidemic through a Primary Health Care Approach.

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Scott, Vera; Crawford-Browne, Sarah; Sanders, David

2016-05-17

The 2014/2015 West Africa Ebola epidemic has caused the global public health community to engage in difficult self-reflection. First, it must consider the part it played in relation to an important public health question: why did this epidemic take hold and spread in this unprecedented manner? Second, it must use the lessons learnt to answer the subsequent question: what can be done now to prevent further such outbreaks in the future? These questions remain relevant, even as scientists announce that the Guinea Phase III efficacy vaccine trial shows that rVSV-EBOV (Merck, Sharp & Dohme) is highly efficacious in individuals. This is a major breakthrough in the fight against Ebola virus disease (EVD). It does not replace but may be a powerful adjunct to current strategies of EVD management and control. We contribute to the current self-reflection by presenting an analysis using a Primary Health Care (PHC) approach. This approach is appropriate as African countries in the region affected by EVD have recommitted themselves to PHC as a framework for organising health systems and the delivery of health services. The approach suggests that, in an epidemic made complex by weak pre-existing health systems, lack of trust in authorities and mobile populations, a broader approach is required to engage affected communities. In the medium-term health system development with attention to primary level services and community-based programmes to address the major disease burden of malaria, diarrhoeal disease, meningitis, tuberculosis and malnutrition is needed. This requires the development of local management and an investment in human resources for health. Crucially this has to be developed ahead of, and not in parallel with, future outbreaks. In the longer-term a commitment is required to address the underlying social determinants which make these countries so vulnerable, and limit their capacity to respond effectively to, epidemics such as EVD. The PHC approach offers an

Critiquing the response to the Ebola epidemic through a Primary Health Care Approach

Directory of Open Access Journals (Sweden)

Vera Scott

2016-05-01

Full Text Available Abstract Background The 2014/2015 West Africa Ebola epidemic has caused the global public health community to engage in difficult self-reflection. First, it must consider the part it played in relation to an important public health question: why did this epidemic take hold and spread in this unprecedented manner? Second, it must use the lessons learnt to answer the subsequent question: what can be done now to prevent further such outbreaks in the future? These questions remain relevant, even as scientists announce that the Guinea Phase III efficacy vaccine trial shows that rVSV-EBOV (Merck, Sharp & Dohme is highly efficacious in individuals. This is a major breakthrough in the fight against Ebola virus disease (EVD. It does not replace but may be a powerful adjunct to current strategies of EVD management and control. Discussion We contribute to the current self-reflection by presenting an analysis using a Primary Health Care (PHC approach. This approach is appropriate as African countries in the region affected by EVD have recommitted themselves to PHC as a framework for organising health systems and the delivery of health services. The approach suggests that, in an epidemic made complex by weak pre-existing health systems, lack of trust in authorities and mobile populations, a broader approach is required to engage affected communities. In the medium-term health system development with attention to primary level services and community-based programmes to address the major disease burden of malaria, diarrhoeal disease, meningitis, tuberculosis and malnutrition is needed. This requires the development of local management and an investment in human resources for health. Crucially this has to be developed ahead of, and not in parallel with, future outbreaks. In the longer-term a commitment is required to address the underlying social determinants which make these countries so vulnerable, and limit their capacity to respond effectively to, epidemics

Health information exchange: national and international approaches.

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Vest, Joshua R

2012-01-01

Health information exchange (HIE), the process of electronically moving patient-level information between different organizations, is viewed as a solution to the fragmentation of data in health care. This review provides a description of the current state of HIE in seven nations, as well was three international HIE efforts, with a particular focus on the relation of exchange efforts to national health care systems, common challenges, and the implications of cross-border information sharing. National and international efforts highlighted in English language informatics journals, professional associations, and government reports are described. Fully functioning HIE is not yet a common phenomenon worldwide. However, multiple nations see the potential benefits of HIE and that has led to national and international efforts of varying scope, scale, and purview. National efforts continue to work to overcome the challenges of interoperability, record linking, insufficient infrastructures, governance, and interorganizational relationships, but have created architectural strategies, oversight agencies, and incentives to foster exchange. The three international HIE efforts reviewed represent very different approaches to the same problem of ensuring the availability of health information across borders. The potential of HIE to address many cost and quality issues will ensure HIE remains on many national agendas. In many instances, health care executives and leaders have opportunities to work within national programs to help shape local exchange governance and decide technology partners. Furthermore, HIE raises policy questions concerning the role of centralized planning, national identifiers, standards, and types of information exchanged, each of which are vital issues to individual health organizations and worthy of their attention.

A public health approach to eating disorders prevention: it's time for public health professionals to take a seat at the table.

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Austin, S Bryn

2012-10-09

The societal burden of eating disorders is clear, and though there is a compelling need for a public health approach to eating disorders prevention, public health professionals have yet to take up the challenge. The article lays out an argument for what steps need to be taken to bring a public health approach to eating disorders prevention. First, stock is taken of what the field has achieved so far, using tools from the prevention science literature, and, second, a research plan of action is offered that plays to the unique strengths of public health, drawing on a triggers-to-action framework from public health law. Minimal participation was found from public health professionals in eating disorders prevention research, and the vast majority of prevention research to date was found to be concentrated within the disciplines of psychology and psychiatry. Extreme disciplinary concentration of the research has led to a preponderance of individually targeted prevention strategies with little research focused on environmental targets, particularly at the macro level. New environmental initiatives are now emerging, such as a government-sponsored mass media anti-dieting campaign, and legal bans on extremely thin models in advertising, but for the most part, they have yet to be evaluated. A triggers-to-action framework, which focuses on evidentiary base, practical considerations, and political will, developed in public health law provides a basis for a strategic research plan for a public health approach to eating disorders prevention. There is enormous potential for growth in the scope and diversity of eating disorder prevention research strategies, particularly those targeting the macro environment. A public health approach will require a strategic plan for research that leverages the macro environment for prevention. The full engagement of public health professionals will bring to the field the much broader range of preventive strategies and perspectives needed to

NGO management and health care financing approaches in the Eastern Democratic Republic of the Congo.

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Dijkzeul, D; Lynch, C A

2006-01-01

The role of cost-sharing in health care is a crucial, yet contentious issue. In conflict situations, cost-sharing becomes even more controversial as health and other institutions are failing. In such situations, NGOs manage health programmes which aim to aid populations in crisis and improve or at least sustain a deteriorating health system. This study looks at the issue of cost-sharing in the wider context of utilization rates and management approaches of three NGOs in the chronic, high-mortality crisis of the eastern DRC. Approaches to increase access to health care were found to exist, yet cost-recovery, even on the basis of maximum utilization rates, would only partially sustain the health system in the eastern DRC. Factors external to the direct management of NGO health programs, such as the wider economic and security situation, local management structures, and international donor policies, need to be taken into account for establishing more integrated management and financing approaches.

Soil Health Assessment Approaches and the Cornell Framework

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van Es, Harold

2016-04-01

Soil health constraints beyond nutrient limitations and excesses currently limit agroecosystem productivity and sustainability, resilience to drought and extreme rainfall, and progress in soil and water conservation. With mounting pressure to produce food, feed, fiber, and even fuel for an increasing population, the concept of soil health is gaining national and international attention. Multiple regional, national, and global efforts are now leveraging that work to reach new stakeholder audiences, so that soil health management is expanding into mainstream agriculture. Each grower is generally faced with a unique situation in the choice of management options to address soil health constraints and each system affords its own set of opportunities or limitations to soil management. A more comprehensive understanding of soil health status can better guide farmers' management decisions. Until recently, there has not been a formalized decision making process for implementing a soil health management system that alleviates field-specific constrains identified through standard measurements and then maintains improved soil health. This presentation will discuss current US-based efforts related to soil health assessment, including efforts to build national consensus on appropriate methods for simple (inexpensive) and comprehensive tests. This includes the Cornell Soil Health Management Planning and Implementation Framework. The most relevant components of the framework are 1) measurement of indicators that represent critical soil processes, 2) scoring of measured values that allows for interpretation, and 3) linkage of identified constraints with management practices. Land managers can monitor changes over time through further assessment, and adapt management practices to achieve chosen goals. We will discuss the full tests and approaches for simplification.

Microcredit and the social determinants of health: a conceptual approach.

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Salt, Rebekah

2011-01-01

Social determinants of health, such as human behavior, environment, and socioeconomics, contribute to health disparities at the individual and population levels. The association between socioeconomics and health is established, and it is acknowledged that people with a lower socioeconomic status experience poorer health. The impetus of microcredit programs is to provide financial alternatives for low-income populations, the majority of whom are women with limited or no access to traditional lending, to start small businesses, generate income, and progress toward self-sufficiency. The income-health link within the context of microcredit has been internationally acknowledged; however, there is scarce research in this area in the United States. This article presents a review of the conceptual approach used to explore the microcredit and health link from a public health nursing perspective. Establishing conceptual foundations can enhance research focused on targeted interventions aimed at lasting change in social and health status. Exploring the link between microcredit and health can enrich research efforts and may offer innovative strategies and interventions to improve health-promoting capacity in impoverished groups. © 2011 Wiley Periodicals, Inc.

An innovative approach to participatory health policy development in Bulgaria: The conception and first achievements of the Partnership for Health.

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Dimova, Antoniya; Rohova, Maria; Hasardzhiev, Stanimir; Spranger, Anne

2018-02-01

The Bulgarian Partnership for Health was established in 2015 as a new forum for health policy formulation and discussion. The Partnership presents a new approach of structured and sustained stakeholder involvement to overcome the lack of public participation in health policy development and implementation. Constituted as a permanent consultative body to the Council of Ministers, the Partnership engages a wide variety of stakeholders and professionals to shape and improve health policies. The shared governance of the Partnership between the Minister of Health and a patient organisation supports the elaboration of legislative acts based on the stakeholders' collaboration in priority areas. The governance and organisational structure of the Partnership assures capacity building, fast mobilisation of experts, continuity of stakeholder involvement, and increased responsibility in health policy development and implementation. This type of participatory approach may help reconcile initially opposing positions and foster reforms often impeded by political antagonism. Persisting challenges are a rather slow process of policy development and different perceptions of key concepts among the stakeholders. As policy-making in many countries in Eastern Europe suffers from political distrust, the Partnership's approach of involving experts - and not only politicians - could provide inspiration also to other countries, which have struggled with inconsistency of health policies pursued by different governments. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

A review on the state-of-the-art privacy-preserving approaches in the e-health clouds.

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Abbas, Assad; Khan, Samee U

2014-07-01

Cloud computing is emerging as a new computing paradigm in the healthcare sector besides other business domains. Large numbers of health organizations have started shifting the electronic health information to the cloud environment. Introducing the cloud services in the health sector not only facilitates the exchange of electronic medical records among the hospitals and clinics, but also enables the cloud to act as a medical record storage center. Moreover, shifting to the cloud environment relieves the healthcare organizations of the tedious tasks of infrastructure management and also minimizes development and maintenance costs. Nonetheless, storing the patient health data in the third-party servers also entails serious threats to data privacy. Because of probable disclosure of medical records stored and exchanged in the cloud, the patients' privacy concerns should essentially be considered when designing the security and privacy mechanisms. Various approaches have been used to preserve the privacy of the health information in the cloud environment. This survey aims to encompass the state-of-the-art privacy-preserving approaches employed in the e-Health clouds. Moreover, the privacy-preserving approaches are classified into cryptographic and noncryptographic approaches and taxonomy of the approaches is also presented. Furthermore, the strengths and weaknesses of the presented approaches are reported and some open issues are highlighted.

A network approach for researching partnerships in health.

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Lewis, Jenny M

2005-10-07

The last decade has witnessed a significant move towards new modes of governing that are based on coordination and collaboration. In particular, local level partnerships have been widely introduced around the world. There are few comprehensive approaches for researching the effects of these partnerships. The aim of this paper is to outline a network approach that combines structure and agency based explanations to research partnerships in health. Network research based on two Primary Care Partnerships (PCPs) in Victoria is used to demonstrate the utility of this approach. The paper examines multiple types of ties between people (structure), and the use and value of relationships to partners (agency), using interviews with the people involved in two PCPs--one in metropolitan Melbourne and one in a rural area. Network maps of ties based on work, strategic information and policy advice, show that there are many strong connections in both PCPs. Not surprisingly, PCP staff are central and highly connected. Of more interest are the ties that are dependent on these dedicated partnership staff, as they reveal which actors become weakly linked or disconnected without them. Network measures indicate that work ties are the most dispersed and strategic information ties are the most concentrated around fewer people. Divisions of general practice are weakly linked, while local government officials and Department of Human Services (DHS) regional staff appear to play important bridging roles. Finally, the relationships between partners have changed and improved, and most of those interviewed value their new or improved links with partners. Improving service coordination and health promotion planning requires engaging people and building strong relationships. Mapping ties is a useful means for assessing the strengths and weaknesses of partnerships, and network analysis indicates concentration and dispersion, the importance of particular individuals, and the points at which they

The Mind-Body Connection - Complementary and Alternative Approaches to Health

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... Navigation Bar Home Current Issue Past Issues The Mind-Body Connection Complementary and Alternative Approaches to Health ... Also, a 2007 study found that Tai Chi boosts resistance to the shingles virus in older adults." ...

Sleep Disorders and Complementary Health Approaches : What the Science Says

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... Sleep Disorders and Complementary Health Approaches: What the Science Says Share: April 2014 Clinical Guidelines, Scientific Literature, ... five randomized controlled trials evaluating the efficacy of music-assisted relaxation for sleep quality in adults found ...

Virtual Acoustics, Aeronautics and Communications

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Begault, Durand R.; Null, Cynthia H. (Technical Monitor)

1996-01-01

An optimal approach to auditory display design for commercial aircraft would utilize both spatialized ("3-D") audio techniques and active noise cancellation for safer operations. Results from several aircraft simulator studies conducted at NASA Ames Research Center are reviewed, including Traffic alert and Collision Avoidance System (TCAS) warnings, spoken orientation "beacons" for gate identification and collision avoidance on the ground, and hardware for improved speech intelligibility. The implications of hearing loss amongst pilots is also considered.

Mapping an appropriate health promotion approach for crèches in an informal settlement.

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Brijlal, P; Gordon, N

2005-02-01

People living in informal settlements in South Africa experience the double burden of poverty and ill health. Wallacedene, an informal settlement was highlighted in the media as being a socially and otherwise deprived community, with many accompanying health problems. It was against this background that this study was conducted to gain a better understanding of the health and oral health status of children attending crèches in Wallacedene. It was designed to inform the mapping of an appropriate approach to develop a health promotion programme for crèches. Baseline data were collected through oral and general health examinations, site observations, a structured questionnaire and interviews with key people working with the children at two crèches. The results indicate poor oral and general health. Gingival inflammation (82.8%), caries (81.5%), and moderate to abundant plaque deposits (95.7%), fungal infections (33.9%), runny nose (51.4%), lymphadenopathy (45.7%) and itchy skin (5.7%) were found. Caregivers were not well informed about oral health. However, they were enthusiastic to engage in new interventions. The community was impoverished; public health interventions were limited with minimal resources such as health centres and voluntary service providers. The limited resources were not coordinated and did not adequately address the health and educational needs of the children. A multi-sectoral approach focusing on community development is an appropriate approach to address the needs of crèche children in this community.

Pacific connections for health, ecosystems and society: new approaches to the land-water-health nexus.

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Parkes, Margot W

2016-03-01

Renewed effort to understand the social-ecological context of health is drawing attention to the dynamics of land and water resources and their combined influence on the determinants of health. A new area of research, education and policy is emerging that focuses on the land-water-health nexus: this orientation is applicable from small wetlands through to large-scale watersheds or river basins, and draws attention to the benefits of combined land and water governance, as well as the interrelated implications for health, ecological and societal concerns. Informed by research precedents, imperatives and collaborations emerging in Canada and parts of Oceania, this review profiles three integrative, applied approaches that are bringing attention to the importance the land-water-health nexus within the Pacific Basin: wetlands and watersheds as intersectoral settings to address land-water-health dynamics; tools to integrate health, ecological and societal dynamics at the land-water-health nexus; and indigenous leadership that is linking health and well-being with land and water governance. Emphasis is given to key characteristics of a new generation of inquiry and action at the land-water-health nexus, as well as capacity-building, practice and policy opportunities to address converging environmental, social and health objectives linked to the management and governance of land and water resources.

Integrated System Health Management: Foundational Concepts, Approach, and Implementation.

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Figueroa, Fernando; Schmalzel, John; Walker, Mark; Venkatesh, Meera; Kapadia, Ravi; Morris, Jon; Turowski, Mark; Smith, Harvey

2009-01-01

Implementation of integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. It is akin to having a team of experts who are all individually and collectively observing and analyzing a complex system, and communicating effectively with each other in order to arrive to an accurate and reliable assessment of its health. We present concepts, procedures, and a specific approach as a foundation for implementing a credible ISHM capability. The capability stresses integration of DIaK from all elements of a system. The intent is also to make possible implementation of on-board ISHM capability, in contrast to a remote capability. The information presented is the result of many years of research, development, and maturation of technologies, and of prototype implementations in operational systems (rocket engine test facilities). The paper will address the following topics: 1. ISHM Model of a system 2. Detection of anomaly indicators. 3. Determination and confirmation of anomalies. 4. Diagnostic of causes and determination of effects. 5. Consistency checking cycle. 6. Management of health information 7. User Interfaces 8. Example implementation ISHM has been defined from many perspectives. We define it as a capability that might be achieved by various approaches. We describe a specific approach that has been matured throughout many years of development, and pilot implementations. ISHM is a capability that is achieved by integrating data, information, and knowledge (DIaK) that might be distributed throughout the system elements (which inherently implies capability to manage DIaK associated with distributed sub-systems). DIaK must be available to any element of a system at the right time and in accordance with a meaningful context. ISHM Functional Capability Level (FCL) is measured by how well a system performs the following

Integration of the primary health care approach into a community nursing science curriculum.

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Vilakazi, S S; Chabeli, M M; Roos, S D

2000-12-01

The purpose of this article is to explore and describe guidelines for integration of the primary health care approach into a Community Nursing Science Curriculum in a Nursing College in Gauteng. A qualitative, exploratory, descriptive and contextual research design was utilized. The focus group interviews were conducted with community nurses and nurse educators as respondents. Data were analysed by a qualitative descriptive method of analysis as described in Creswell (1994: 155). Respondents in both groups held similar perceptions regarding integration of primary health care approach into a Community Nursing Science Curriculum. Five categories, which are in line with the curriculum cycle, were identified as follows: situation analysis, selection and organisation of objectives/goals, content, teaching methods and evaluation. Guidelines and recommendations for the integration of the primary health care approach into a Community Nursing Science Curriculum were described.

Integration of the primary health care approach into a community nursing science curriculum

Directory of Open Access Journals (Sweden)

SS Vilakazi

2000-09-01

Full Text Available The purpose of this article is to explore and describe guidelines for integration of the primary health care approach into a Community Nursing Science Curriculum in a Nursing College in Gauteng. A qualitative, exploratory, descriptive and contextual research design was utilized. The focus group interviews were conducted with community nurses and nurse educators as respondents. Data were analysed by a qualitative descriptive method of analysis as described in Creswell (1994:155. Respondents in both groups held similar perceptions regarding integration of primary health care approach into a Community Nursing Science Curriculum. Five categories, which are in line with the curriculum cycle, were identified as follows: situation analysis, selection and organisation of objectives/ goals, content, teaching methods and evaluation. Guidelines and recommendations for the integration of the primary health care approach into a Community Nursing Science Curriculum were described.

Evaluation of a 'virtual' approach to commissioning health research

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Morgan Philip A

2006-10-01

Full Text Available Abstract Background The objective of this study was to evaluate the implementation of a 'virtual' (computer-mediated approach to health research commissioning. This had been introduced experimentally in a DOH programme – the 'Health of Londoners Programme' – in order to assess whether is could enhance the accessibility, transparency and effectiveness of commissioning health research. The study described here was commissioned to evaluate this novel approach, addressing these key questions. Methods A naturalistic-experimental approach was combined with principles of action research. The different commissioning groups within the programme were randomly allocated to either the traditional face-to-face mode or the novel 'virtual' mode. Mainly qualitative data were gathered including observation of all (virtual and face-to-face commissioning meetings; semi-structured interviews with a purposive sample of participants (n = 32/66; structured questionnaires and interviews with lead researchers of early commissioned projects. All members of the commissioning groups were invited to participate in collaborative enquiry groups which participated actively in the analysis process. Results The virtual process functioned as intended, reaching timely and relatively transparent decisions that participants had confidence in. Despite the potential for greater access using a virtual approach, few differences were found in practice. Key advantages included physical access, a more flexible and extended time period for discussion, reflection and information gathering and a more transparent decision-making process. Key challenges were the reduction of social cues available in a computer-mediated medium that require novel ways of ensuring appropriate dialogue, feedback and interaction. However, in both modes, the process was influenced by a range of factors and was not technology driven. Conclusion There is potential for using computer-mediated communication within

Enhancing evidence informed policymaking in complex health systems: lessons from multi-site collaborative approaches.

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Langlois, Etienne V; Becerril Montekio, Victor; Young, Taryn; Song, Kayla; Alcalde-Rabanal, Jacqueline; Tran, Nhan

2016-03-17

There is an increasing interest worldwide to ensure evidence-informed health policymaking as a means to improve health systems performance. There is a need to engage policymakers in collaborative approaches to generate and use knowledge in real world settings. To address this gap, we implemented two interventions based on iterative exchanges between researchers and policymakers/implementers. This article aims to reflect on the implementation and impact of these multi-site evidence-to-policy approaches implemented in low-resource settings. The first approach was implemented in Mexico and Nicaragua and focused on implementation research facilitated by communities of practice (CoP) among maternal health stakeholders. We conducted a process evaluation of the CoPs and assessed the professionals' abilities to acquire, analyse, adapt and apply research. The second approach, called the Policy BUilding Demand for evidence in Decision making through Interaction and Enhancing Skills (Policy BUDDIES), was implemented in South Africa and Cameroon. The intervention put forth a 'buddying' process to enhance demand and use of systematic reviews by sub-national policymakers. The Policy BUDDIES initiative was assessed using a mixed-methods realist evaluation design. In Mexico, the implementation research supported by CoPs triggered monitoring by local health organizations of the quality of maternal healthcare programs. Health programme personnel involved in CoPs in Mexico and Nicaragua reported improved capacities to identify and use evidence in solving implementation problems. In South Africa, Policy BUDDIES informed a policy framework for medication adherence for chronic diseases, including both HIV and non-communicable diseases. Policymakers engaged in the buddying process reported an enhanced recognition of the value of research, and greater demand for policy-relevant knowledge. The collaborative evidence-to-policy approaches underline the importance of iterations and continuity

Challenges to improvement of oral health in the 21st century--the approach of the WHO Global Oral Health Programme

DEFF Research Database (Denmark)

Petersen, Poul Erik

2004-01-01

Chronic diseases and injuries are overtaking communicable diseases as the leading health problems in all but a few parts of the world. This rapidly changing global disease pattern is closely linked to changing lifestyles, which include diets rich in sugars, widespread use of tobacco and increased...... consumption of alcohol. These lifestyle factors also significantly impact on oral health, and oral diseases qualify as major public health problems owing to their high prevalence and incidence in all regions of the world. Like all diseases, they affect primarily the disadvantaged and socially marginalised...... of noncommunicable diseases and the 'common risk factor approach' offer new ways of managing the prevention and control of oral diseases. This document outlines the current oral health situation and development trends at global level as well as WHO strategies and approaches for better oral health in the 21 st...

Examining the global health arena: strengths and weaknesses of a convention approach to global health challenges.

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Haffeld, Just Balstad; Siem, Harald; Røttingen, John-Arne

2010-01-01

The article comprises a conceptual framework to analyze the strengths and weaknesses of a global health convention. The analyses are inspired by Lawrence Gostin's suggested Framework Convention on Global Health. The analytical model takes a starting-point in events tentatively following a logic sequence: Input (global health funding), Processes (coordination, cooperation, accountability, allocation of aid), Output (definition of basic survival needs), Outcome (access to health services), and Impact (health for all). It then examines to what degree binding international regulations can create order in such a sequence of events. We conclude that a global health convention could be an appropriate instrument to deal with some of the problems of global health. We also show that some of the tasks preceding a convention approach might be to muster international support for supra-national health regulations, negotiate compromises between existing stakeholders in the global health arena, and to utilize WHO as a platform for further discussions on a global health convention. © 2010 American Society of Law, Medicine & Ethics, Inc.

Building policy capacities: an interactive approach for linking knowledge to action in health promotion.

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Rütten, Alfred; Gelius, Peter

2014-09-01

This article outlines a theoretical framework for an interactive, research-driven approach to building policy capacities in health promotion. First, it illustrates how two important issues in the recent public health debate, capacity building and linking scientific knowledge to policy action, are connected to each other theoretically. It then introduces an international study on an interactive approach to capacity building in health promotion policy. The approach combines the ADEPT model of policy capacities with a co-operative planning process to foster the exchange of knowledge between policy-makers and researchers, thus improving intra- and inter-organizational capacities. A regional-level physical activity promotion project involving governmental and public-law institutions, NGOs and university researchers serves as a case study to illustrate the potential of the approach for capacity building. Analysis and comparison with a similar local-level project indicate that the approach provides an effective means of linking scientific knowledge to policy action and to planning concrete measures for capacity building in health promotion, but that it requires sufficiently long timelines and adequate resources to achieve adequate implementation and sustainability. © The Author (2013). Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

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

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

2016-06-01

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

Effects of a blended learning approach on student outcomes in a graduate-level public health course.

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Kiviniemi, Marc T

2014-03-11

Blended learning approaches, in which in-person and online course components are combined in a single course, are rapidly increasing in health sciences education. Evidence for the relative effectiveness of blended learning versus more traditional course approaches is mixed. The impact of a blended learning approach on student learning in a graduate-level public health course was examined using a quasi-experimental, non-equivalent control group design. Exam scores and course point total data from a baseline, "traditional" approach semester (n = 28) was compared to that from a semester utilizing a blended learning approach (n = 38). In addition, student evaluations of the blended learning approach were evaluated. There was a statistically significant increase in student performance under the blended learning approach (final course point total d = 0.57; a medium effect size), even after accounting for previous academic performance. Moreover, student evaluations of the blended approach were very positive and the majority of students (83%) preferred the blended learning approach. Blended learning approaches may be an effective means of optimizing student learning and improving student performance in health sciences courses.

A rights-based approach to accessing health determinants.

Science.gov (United States)

Perkins, Fran

2009-03-01

This commentary summarizes the experience and learnings from a site visit in May 2008 to a drop-in centre for vulnerable women in downtown Cairo run by El-Shehab Institution for Comprehensive Development, which provides street outreach for the prevention of Sexually Transmitted Infection (STI). The Centre successfully provides services and support for women, many of who are displaced or refugees and are from the most marginalized areas in Cairo. Through a rights-based approach to the work, the Centre helps people living in the slums fight and win the right to access clean water, sewerage and electrical power in their communities. An individual-based approach to human rights is also used. In the last year El-Shehab have helped 67 women go to court and win their marriage rights from husbands who have abandoned them. Their approach is an example of a successful way to achieve access to basic health determinants.

A "one health" approach to address emerging zoonoses: the HALI project in Tanzania.

OpenAIRE

Jonna A K Mazet; Deana L Clifford; Peter B Coppolillo; Anil B Deolalikar; Jon D Erickson; Rudovick R Kazwala

2009-01-01

Jonna Mazet and colleagues describe their work in the Tanzania-based HALI Project, which adopts the ?One Health? approach to address emerging zoonoses and that recognizes the interconnectedness of human, animal, and environmental health.

Reproductive health care strategy -- a gender-sensitive approach to family welfare.

Science.gov (United States)

Anita

1996-01-01

The author advocates a reproductive health care strategy to revitalize India's family welfare program. A major shift in focus is needed in population policy and programs to incorporate a gender-sensitive approach. That shift should help to clear the path toward improved health status for women and female children. Consensus reached at the UN's 1994 International Conference on Population and Development supported a change in population and development policies, affording women's empowerment, gender equality, and equity greater priority for a meaningful policy of human-centered sustainable development. Reproductive health care, reproductive health in practice, the quality of care in reproductive health, gender equality as a human right, and empowering women are discussed.

Eliciting ethical and social values in health technology assessment: A participatory approach.

Science.gov (United States)

Bombard, Yvonne; Abelson, Julia; Simeonov, Dorina; Gauvin, Francois-Pierre

2011-07-01

Despite a growing consensus that ethical and social values should be addressed in health technology assessment (HTA) processes, there exist a variety of methods for doing so. There is growing interest in involving citizens in policy development to ensure that decisions are legitimate, and reflect the broad social values of the public. We sought to bring these issues together by employing a participatory approach to elicit ethical and social values in HTA. Our primary objective was to elicit a set of ethical and social values from citizens that could be used to guide Ontario's HTA evidentiary review and appraisal process. A secondary objective was to explore the feasibility of using participatory approaches to elicit these values. A 14-person Citizens' Reference Panel on Health Technologies was established to provide input to the Ontario Health Technology Advisory Committee in developing its recommendations. A mixed methods approach was used where informed, deliberative discussions were combined with pre- and post-questionnaires, which assessed the relative importance of various ethical and social values as well as their stability over time. Over the course of five meetings, panel members progressed toward the identification of a set of core values -universal access, choice and quality care. These values were consistently prioritized as the core values that should be considered in the evaluation of health technologies and ensuing recommendations. Sustained and deliberative methods, like a citizens' panel, offer a promising approach for eliciting ethical and social values into HTA. Copyright © 2011 Elsevier Ltd. All rights reserved.

Comparison of beta-binomial regression model approaches to analyze health-related quality of life data.

Science.gov (United States)

Najera-Zuloaga, Josu; Lee, Dae-Jin; Arostegui, Inmaculada

2017-01-01

Health-related quality of life has become an increasingly important indicator of health status in clinical trials and epidemiological research. Moreover, the study of the relationship of health-related quality of life with patients and disease characteristics has become one of the primary aims of many health-related quality of life studies. Health-related quality of life scores are usually assumed to be distributed as binomial random variables and often highly skewed. The use of the beta-binomial distribution in the regression context has been proposed to model such data; however, the beta-binomial regression has been performed by means of two different approaches in the literature: (i) beta-binomial distribution with a logistic link; and (ii) hierarchical generalized linear models. None of the existing literature in the analysis of health-related quality of life survey data has performed a comparison of both approaches in terms of adequacy and regression parameter interpretation context. This paper is motivated by the analysis of a real data application of health-related quality of life outcomes in patients with Chronic Obstructive Pulmonary Disease, where the use of both approaches yields to contradictory results in terms of covariate effects significance and consequently the interpretation of the most relevant factors in health-related quality of life. We present an explanation of the results in both methodologies through a simulation study and address the need to apply the proper approach in the analysis of health-related quality of life survey data for practitioners, providing an R package.

A public health approach to eating disorders prevention: It’s time for public health professionals to take a seat at the table

OpenAIRE

Austin, S Bryn

2012-01-01

Abstract Background The societal burden of eating disorders is clear, and though there is a compelling need for a public health approach to eating disorders prevention, public health professionals have yet to take up the challenge. Discussion The article lays out an argument for what steps need to be taken to bring a public health approach to eating disorders prevention. First, stock is taken of what the field has achieved so far, using tools from the prevention science literature, and, secon...

The Biopsychosocial-Digital Approach to Health and Disease: Call for a Paradigm Expansion.

Science.gov (United States)

Ahmadvand, Alireza; Gatchel, Robert; Brownstein, John; Nissen, Lisa

2018-05-18

Digital health is an advancing phenomenon in modern health care systems. Currently, numerous stakeholders in various countries are evaluating the potential benefits of digital health solutions at the individual, population, and/or organizational levels. Additionally, driving factors are being created from the customer-side of the health care systems to push health care providers, policymakers, or researchers to embrace digital health solutions. However, health care providers may differ in their approach to adopt these solutions. Health care providers are not assumed to be appropriately trained to address the requirements of integrating digital health solutions into daily everyday practices and procedures. To adapt to the changing demands of health care systems, it is necessary to expand relevant paradigms and to train human resources as required. In this article, a more comprehensive paradigm will be proposed, based on the 'biopsychosocial model' of assessing health and disease, originally introduced by George L Engel. The "biopsychosocial model" must be leveraged to include a "digital" component, thus suggesting a 'biopsychosocial-digital' approach to health and disease. Modifications to the "biopsychosocial" model and transition to the "biopsychosocial-digital" model are explained. Furthermore, the emerging implications of understanding health and disease are clarified pertaining to their relevance in training human resources for health care provision and research. ©Alireza Ahmadvand, Robert Gatchel, John Brownstein, Lisa Nissen. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 18.05.2018.

Pollutants, human health and the environment - A risk-based approach

International Nuclear Information System (INIS)

Plant, Jane A; Bone, James; Ragnarsdottir, Kristin Vala; Voulvoulis, Nickalaos

2011-01-01

Over the last 50 a there has been mounting unease about the risk of synthetic chemicals to human health. Publication of Rachel Carson's Silent Spring in 1962 catalyzed public concern about chemicals. There is now a vast range of synthetic substances in the environment and their potential cocktail as well as the effects of chronic exposure is of concern. Concerns about pollution are not restricted to toxic chemicals, with radioactivity being an issue that continues to be emotive, and exposure to substances such as particulates has been seen to cause health problems. Improved understanding of chemical risks to the environment and human health suggest that a precautionary approach is adopted, with new approaches demonstrating how nature uses thousands of sustainable, non-toxic processes, which can be copied by industry. Policy has evolved from the prevention of local pollution to the holistic management of environmental quality. Regulation is now increasingly underpinned by risk assessment and responsibility for understanding and managing chemical risk is being transferred progressively to manufacturers and users. There is now an increased emphasis on individual responsibilities which requires a debate about the risks and benefits of chemicals in which all members of society can participate.

Mobile health (mHealth) approaches and lessons for increased performance and retention of community health workers in low- and middle-income countries: a review.

Science.gov (United States)

Källander, Karin; Tibenderana, James K; Akpogheneta, Onome J; Strachan, Daniel L; Hill, Zelee; ten Asbroek, Augustinus H A; Conteh, Lesong; Kirkwood, Betty R; Meek, Sylvia R

2013-01-25

Mobile health (mHealth) describes the use of portable electronic devices with software applications to provide health services and manage patient information. With approximately 5 billion mobile phone users globally, opportunities for mobile technologies to play a formal role in health services, particularly in low- and middle-income countries, are increasingly being recognized. mHealth can also support the performance of health care workers by the dissemination of clinical updates, learning materials, and reminders, particularly in underserved rural locations in low- and middle-income countries where community health workers deliver integrated community case management to children sick with diarrhea, pneumonia, and malaria. Our aim was to conduct a thematic review of how mHealth projects have approached the intersection of cellular technology and public health in low- and middle-income countries and identify the promising practices and experiences learned, as well as novel and innovative approaches of how mHealth can support community health workers. In this review, 6 themes of mHealth initiatives were examined using information from peer-reviewed journals, websites, and key reports. Primary mHealth technologies reviewed included mobile phones, personal digital assistants (PDAs) and smartphones, patient monitoring devices, and mobile telemedicine devices. We examined how these tools could be used for education and awareness, data access, and for strengthening health information systems. We also considered how mHealth may support patient monitoring, clinical decision making, and tracking of drugs and supplies. Lessons from mHealth trials and studies were summarized, focusing on low- and middle-income countries and community health workers. The review revealed that there are very few formal outcome evaluations of mHealth in low-income countries. Although there is vast documentation of project process evaluations, there are few studies demonstrating an impact on

A management approach that drives actions strategically: balanced scorecard in a mental health trust case study.

Science.gov (United States)

Schmidt, Stefan; Bateman, Ian; Breinlinger-O'Reilly, Jochen; Smith, Peter

2006-01-01

Achieving excellence is a current preoccupation in U.K. public health organisations. This article aims to use a case study to explain how a mental health trust delivers excellent performance using a balanced scorecard (BSC) management approach. Reports a project to implement a BSC approach in the South West Yorkshire Mental Health NHS Trust to achieve its "excellence" objectives. The authors were participants in the project. The design of the pilot project was informed theoretically by the work of Kaplan and Norton and practically by in-house discussions on a strategy to achieve excellence. Explains the process of building a BSC strategy step-by-step. Discusses how the vision and strategies of a mental health trust can be translated into tangible measures, which are the basis for actions that are driven strategically. There are many possibilities for a BSC management approach and this case study is specific to mental health trusts in the UK, although it is believed that the case has a universally applicable modus operandi. This article will help healthcare managers to evaluate the benefits of a BSC management approach. This article explains how actions can be structured in connection with a BSC management approach.

A Holistic Approach to Climate and Health Research: Respiratory and Infectious Diseases

Science.gov (United States)

Asrar, G.; Alonoso, W.; McCormick, B.; Schuck-Paim, C.; Miller, M.

2014-12-01

The link between climate variability and change, especially extreme conditions, is well documented in both environmental and health literature. The focus of research in the recent past, and current studies, is to understand causal relationships between the disease agents and environmental conditions, based on post-hoc analysis of observed cases to develop predictive models for advance warning of public by health authorities. A combination of the isolated examination of individual diseases and routes of infection (e.g. respiratory system, skin, digestive tract, etc.) and reliance mostly on correlative evidence from past occurrences have restricted public health progress (e.g. compared to experimental evidence of the quantitative balance of different transmission routes) and the utility of knowledge gained from such studies (e.g. reliably predicting seasonal outbreaks is no longer an advance). We propose a shift from focusing on the prediction of individual disease pattern(s) to a more holistic identification and mitigation of broader vulnerabilities within the provision of public health. Such an approach has the potential to account for and reveal health vulnerabilities common to a broader range of health stresses, thus facilitating a more holistic response to health challenges. The human health fragilities associated with respiratory diseases caused by a combination of natural (i.e dust, pollen, etc.) and industrial particulates (i.e. soot, aerosols, etc.) and other infectious airborne agents, for example, and their adverse impact on human health such as respiratory, gastrointestinal, etc. is an ideal candidate for such a holistic approach to environment and health research.

The ecosystem approach to health is a promising strategy in international development: lessons from Japan and Laos.

Science.gov (United States)

Asakura, Takashi; Mallee, Hein; Tomokawa, Sachi; Moji, Kazuhiko; Kobayashi, Jun

2015-02-16

An ecological perspective was prominently present in the health promotion movement in the 1980s, but this seems to have faded. The burden of disease the developing world is facing cannot be addressed solely by reductionist approaches. Holistic approaches are called for that recognize the fundamentally interdependent nature of health and other societal, developmental, and ecosystem related factors in human communities. An ecosystem approach to human health (ecohealth) provides a good starting point to explore these interdependencies. Development assistance is often based on the assumption that developed countries can serve as models for developing ones. Japan has provided lavish assistance to Laos for example, much of it going to the development of transport networks. However, there is little sign that there is an awareness of the potentially negative environmental and health impacts of this assistance. We argue that the health consequences of environmental degradation are not always understood, and that developing countries need to consider these issues. The ecohealth approach is useful when exploring this issue. We highlight three implications of the ecohealth approach: (1) The WHO definition of health as a state of complete physical, mental and social well-being emphasized that health is more than the absence of disease. However, because this approach may involve an unattainable goal, we suggest that health should be defined in the ecosystem context, and the goal should be to attain acceptable and sustainable levels of health through enabling people to realize decent livelihoods, and to pursue their life purpose; (2) The increasing interconnectedness of ecosystems in a globalizing world requires an ethical approach that considers human responsibility for the global biosphere. Here, ecohealth could be a countervailing force to our excessive concentration on economy and technology; and (3) If ecohealth is to become a positive agent of change in the global health

Validity of various epidemiological approaches to assessing radon health risk

International Nuclear Information System (INIS)

Conrath, S.M.

1990-01-01

In this paper various epidemiologic study designs are defined and evaluated for their utility in assessing radon health risk. The strengths and limitations of these approaches are addressed. Common pitfalls and errors of epidemiologic method are delineated with examples of causes and remedies

Machine Learning Approaches for Detecting Diabetic Retinopathy from Clinical and Public Health Records.

Science.gov (United States)

Ogunyemi, Omolola; Kermah, Dulcie

2015-01-01

Annual eye examinations are recommended for diabetic patients in order to detect diabetic retinopathy and other eye conditions that arise from diabetes. Medically underserved urban communities in the US have annual screening rates that are much lower than the national average and could benefit from informatics approaches to identify unscreened patients most at risk of developing retinopathy. Using clinical data from urban safety net clinics as well as public health data from the CDC's National Health and Nutrition Examination Survey, we examined different machine learning approaches for predicting retinopathy from clinical or public health data. All datasets utilized exhibited a class imbalance. Classifiers learned on the clinical data were modestly predictive of retinopathy with the best model having an AUC of 0.72, sensitivity of 69.2% and specificity of 55.9%. Classifiers learned on public health data were not predictive of retinopathy. Successful approaches to detecting latent retinopathy using machine learning could help safety net and other clinics identify unscreened patients who are most at risk of developing retinopathy and the use of ensemble classifiers on clinical data shows promise for this purpose.

New approaches to divorce with children: A problem of public health

Directory of Open Access Journals (Sweden)

Vittorio Carlo Vezzetti

2016-11-01

Full Text Available This broad review elaborates on the most up-to-date knowledge on biochemical and psychobiological aspects of parental loss and other childhood adversities during divorce involving minor children. So far, divorce involving minor children was unfortunately considered by authorities only as a purely juridical problem, and this approach has often allowed a completely different approach according to the Courts. Now, scientific research, also making use of animal models, is demonstrating the biological basis of the problem and the indisputable consequences on the well-being and health of children. The innovative conclusion of this review is that this argument (because of its frequency and gravity is primarily a question of public health and that it is necessary to further harmonize practices in this area.

New approaches to divorce with children: A problem of public health.

Science.gov (United States)

Vezzetti, Vittorio Carlo

2016-07-01

This broad review elaborates on the most up-to-date knowledge on biochemical and psychobiological aspects of parental loss and other childhood adversities during divorce involving minor children. So far, divorce involving minor children was unfortunately considered by authorities only as a purely juridical problem, and this approach has often allowed a completely different approach according to the Courts. Now, scientific research, also making use of animal models, is demonstrating the biological basis of the problem and the indisputable consequences on the well-being and health of children. The innovative conclusion of this review is that this argument (because of its frequency and gravity) is primarily a question of public health and that it is necessary to further harmonize practices in this area.

Dynamic-ETL: a hybrid approach for health data extraction, transformation and loading.

Science.gov (United States)

Ong, Toan C; Kahn, Michael G; Kwan, Bethany M; Yamashita, Traci; Brandt, Elias; Hosokawa, Patrick; Uhrich, Chris; Schilling, Lisa M

2017-09-13

Electronic health records (EHRs) contain detailed clinical data stored in proprietary formats with non-standard codes and structures. Participating in multi-site clinical research networks requires EHR data to be restructured and transformed into a common format and standard terminologies, and optimally linked to other data sources. The expertise and scalable solutions needed to transform data to conform to network requirements are beyond the scope of many health care organizations and there is a need for practical tools that lower the barriers of data contribution to clinical research networks. We designed and implemented a health data transformation and loading approach, which we refer to as Dynamic ETL (Extraction, Transformation and Loading) (D-ETL), that automates part of the process through use of scalable, reusable and customizable code, while retaining manual aspects of the process that requires knowledge of complex coding syntax. This approach provides the flexibility required for the ETL of heterogeneous data, variations in semantic expertise, and transparency of transformation logic that are essential to implement ETL conventions across clinical research sharing networks. Processing workflows are directed by the ETL specifications guideline, developed by ETL designers with extensive knowledge of the structure and semantics of health data (i.e., "health data domain experts") and target common data model. D-ETL was implemented to perform ETL operations that load data from various sources with different database schema structures into the Observational Medical Outcome Partnership (OMOP) common data model. The results showed that ETL rule composition methods and the D-ETL engine offer a scalable solution for health data transformation via automatic query generation to harmonize source datasets. D-ETL supports a flexible and transparent process to transform and load health data into a target data model. This approach offers a solution that lowers technical

Econutrition and utilization of food-based approaches for nutritional health.

Science.gov (United States)

Blasbalg, Tanya L; Wispelwey, Bram; Deckelbaum, Richard J

2011-03-01

Macronutrient and micronutrient deficiencies continue to have a detrimental impact in lower-income countries, with significant costs in morbidity, mortality, and productivity. Food is the primary source of the nutrients needed to sustain life, and it is the essential component that links nutrition, agriculture, and ecology in the econutrition framework. To present evidence and analysis of food-based approaches for improving nutritional and health outcomes in lower-income countries. Review of existing literature. The benefits of food-based approaches may include nutritional improvement, food security, cost-effectiveness, sustainability, and human productivity. Food-based approaches require additional inputs, including nutrition education, gender considerations, and agricultural planning. Although some forms of malnutrition can be addressed via supplements, food-based approaches are optimal to achieve sustainable solutions to multiple nutrient deficiencies.

Effects of a blended learning approach on student outcomes in a graduate-level public health course

Science.gov (United States)

2014-01-01

Background Blended learning approaches, in which in-person and online course components are combined in a single course, are rapidly increasing in health sciences education. Evidence for the relative effectiveness of blended learning versus more traditional course approaches is mixed. Method The impact of a blended learning approach on student learning in a graduate-level public health course was examined using a quasi-experimental, non-equivalent control group design. Exam scores and course point total data from a baseline, “traditional” approach semester (n = 28) was compared to that from a semester utilizing a blended learning approach (n = 38). In addition, student evaluations of the blended learning approach were evaluated. Results There was a statistically significant increase in student performance under the blended learning approach (final course point total d = 0.57; a medium effect size), even after accounting for previous academic performance. Moreover, student evaluations of the blended approach were very positive and the majority of students (83%) preferred the blended learning approach. Conclusions Blended learning approaches may be an effective means of optimizing student learning and improving student performance in health sciences courses. PMID:24612923

A reasoned action approach to health promotion.

Science.gov (United States)

Fishbein, Martin

2008-01-01

This article describes the integrative model of behavioral prediction (IM), the latest formulation of a reasoned action approach. The IM attempts to identify a limited set of variables that can account for a considerable proportion of the variance in any given behavior. More specifically, consistent with the original theory of reasoned action, the IM assumes that intentions are the immediate antecedents of behavior, but in addition, the IM recognizes that environmental factors and skills and abilities can moderate the intention-behavior relationship. Similar to the theory of planned behavior, the IM also assumes that intentions are a function of attitudes, perceived normative pressure and self-efficacy, but it views perceived normative pressure as a function of descriptive as well as of injunctive (i.e., subjective) norms. After describing the theory and addressing some of the criticisms directed at a reasoned action approach, the paper illustrates how the theory can be applied to understanding and changing health related behaviors.

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.

Rates of bone loss among women initiating antidepressant medication use in midlife.

Science.gov (United States)

Diem, Susan J; Ruppert, Kristine; Cauley, Jane A; Lian, YinJuan; Bromberger, Joyce T; Finkelstein, Joel S; Greendale, Gail A; Solomon, Daniel H

2013-11-01

Concern has been raised that medications that block serotonin reuptake may affect bone metabolism, resulting in bone loss. The aim of the study was to compare annual bone mineral density (BMD) changes among new users of selective serotonin reuptake inhibitors (SSRIs), new users of tricyclic antidepressants (TCAs), and nonusers of antidepressant medications. We conducted a prospective cohort study at five clinical centers in the United States. The study included 1972 community-dwelling women, aged 42 years and older, enrolled in the Study of Women's Health Across the Nation (SWAN). The use of antidepressant medications was assessed by interview and verified from medication containers at annual visits. Subjects were categorized as nonusers (no SSRI or TCA use at any examination), SSRI users (initiated SSRI use after the baseline SWAN visit), or TCA users (initiated TCA use after the baseline visit), using a computerized dictionary to categorize type of medication. BMD at the lumbar spine, total hip, and femoral neck was measured using dual-energy x-ray absorptiometry at annual visits. BMD was compared among 311 new users of SSRIs, 71 new users of TCAs, and 1590 nonusers. After adjustment for potential confounders, including age, race, body mass index, menopausal status, and hormone therapy use, mean lumbar spine BMD decreased on average 0.68% per year in nonusers, 0.63% per year in SSRI users (P = .37 for comparison to nonusers), and 0.40% per year in TCA users (P = .16 for comparison to nonusers). At the total hip and femoral neck, there was also no evidence that SSRI or TCA users had an increased rate of bone loss compared with nonusers. Results were similar in subgroups of women stratified by the Center for Epidemiologic Studies Depression Scale (women, use of SSRIs and TCAs was not associated with an increased rate of bone loss at the spine, total hip, or femoral neck.

Practice-level approaches for behavioral counseling and patient health behaviors.

Science.gov (United States)

Balasubramanian, Bijal A; Cohen, Deborah J; Clark, Elizabeth C; Isaacson, Nicole F; Hung, Dorothy Y; Dickinson, L Miriam; Fernald, Douglas H; Green, Larry A; Crabtree, Benjamin F

2008-11-01

There is little empirical evidence to show that a practice-level approach that includes identifying patients in need of health behavior advice and linking them to counseling resources either in the practice or in the community results in improvements in patients' behaviors. This study examined whether patients in primary care practices that had practice-level approaches for physical activity and healthy-diet counseling were more likely to have healthier behaviors than patients in practices without practice-level approaches. A cross-sectional study of 54 primary care practices was conducted from July 2005 to January 2007. Practices were categorized into four groups depending on whether they had both identification tools (health risk assessment, registry) and linking strategies (within practice or to community resources); identification tools but no linking strategies; linking strategies but no identification tools; or neither identification tools nor linking strategies. Controlling for patient and practice characteristics, practices that had both identification tools and linking strategies for physical activity counseling were 80% more likely (95% CI=1.25, 2.59) to have patients who reported exercising regularly compared to practices that lacked both. Also, practices that had either identification tools or linking strategies but not both were approximately 50% more likely to have patients who reported exercising regularly. The use of a greater number of practice-level approaches for physical activity counseling was associated with higher odds of patients' reporting exercising regularly (p for trend=0.0002). Use of identification tools and linking strategies for healthy-eating counseling was not associated with patients' reports of healthy diets. This study suggests that practice-level approaches may enable primary care practices to help patients improve physical activity. However, these approaches may have different effects on different behaviors, and merit further

Learning approaches as predictors of academic performance in first year health and science students.

Science.gov (United States)

Salamonson, Yenna; Weaver, Roslyn; Chang, Sungwon; Koch, Jane; Bhathal, Ragbir; Khoo, Cheang; Wilson, Ian

2013-07-01

To compare health and science students' demographic characteristics and learning approaches across different disciplines, and to examine the relationship between learning approaches and academic performance. While there is increasing recognition of a need to foster learning approaches that improve the quality of student learning, little is known about students' learning approaches across different disciplines, and their relationships with academic performance. Prospective, correlational design. Using a survey design, a total of 919 first year health and science students studying in a university located in the western region of Sydney from the following disciplines were recruited to participate in the study - i) Nursing: n = 476, ii) Engineering: n = 75, iii) Medicine: n = 77, iv) Health Sciences: n = 204, and v) Medicinal Chemistry: n = 87. Although there was no statistically significant difference in the use of surface learning among the five discipline groups, there were wide variations in the use of deep learning approach. Furthermore, older students and those with English as an additional language were more likely to use deep learning approach. Controlling for hours spent in paid work during term-time and English language usage, both surface learning approach (β = -0.13, p = 0.001) and deep learning approach (β = 0.11, p = 0.009) emerged as independent and significant predictors of academic performance. Findings from this study provide further empirical evidence that underscore the importance for faculty to use teaching methods that foster deep instead of surface learning approaches, to improve the quality of student learning and academic performance. Copyright © 2013 Elsevier Ltd. All rights reserved.

The productivity of mental health care: an instrumental variable approach.

Science.gov (United States)

Lu, Mingshan

1999-06-01

BACKGROUND: Like many other medical technologies and treatments, there is a lack of reliable evidence on treatment effectiveness of mental health care. Increasingly, data from non-experimental settings are being used to study the effect of treatment. However, as in a number of studies using non-experimental data, a simple regression of outcome on treatment shows a puzzling negative and significant impact of mental health care on the improvement of mental health status, even after including a large number of potential control variables. The central problem in interpreting evidence from real-world or non-experimental settings is, therefore, the potential "selection bias" problem in observational data set. In other words, the choice/quantity of mental health care may be correlated with other variables, particularly unobserved variables, that influence outcome and this may lead to a bias in the estimate of the effect of care in conventional models. AIMS OF THE STUDY: This paper addresses the issue of estimating treatment effects using an observational data set. The information in a mental health data set obtained from two waves of data in Puerto Rico is explored. The results using conventional models - in which the potential selection bias is not controlled - and that from instrumental variable (IV) models - which is what was proposed in this study to correct for the contaminated estimation from conventional models - are compared. METHODS: Treatment effectiveness is estimated in a production function framework. Effectiveness is measured as the improvement in mental health status. To control for the potential selection bias problem, IV approaches are employed. The essence of the IV method is to use one or more instruments, which are observable factors that influence treatment but do not directly affect patient outcomes, to isolate the effect of treatment variation that is independent of unobserved patient characteristics. The data used in this study are the first (1992

Evidence-based approach for continuous improvement of occupational health.

Science.gov (United States)

Manzoli, Lamberto; Sotgiu, Giovanni; Magnavita, Nicola; Durando, Paolo

2015-01-01

It was recognized early on that an Evidence-Based Medicine (EBM) approach could be applied to Public Health (PH), including the area of Occupational Health (OH). The aim of Evidence-Based Occupational Health (EBOH) is to ensure safety, health, and well-being in the workplace. Currently, high-quality research is necessary in order to provide arguments and scientific evidence upon which effective, efficient, and sustainable preventive measures and policies are to be developed in the workplace in Western countries. Occupational physicians need to integrate available scientific evidence and existing recommendations with a framework of national employment laws and regulations. This paper addresses the state of the art of scientific evidence available in the field (i.e., efficacy of interventions, usefulness of education and training of workers, and need of a multidisciplinary strategy integrated within the national PH programs) and the main critical issues for their implementation. Promoting good health is a fundamental part of the smart, inclusive growth objectives of Europe 2020 - Europe's growth strategy: keeping people healthy and active for longer has a positive impact on productivity and competitiveness. It appears clear that health quality and safety in the workplace play a key role for smart, sustainable, and inclusive growth in Western countries.

Public health approach to birth defects: the Argentine experience.

Science.gov (United States)

Bidondo, María Paz; Groisman, Boris; Barbero, Pablo; Liascovich, Rosa

2015-04-01

Birth defects are a global problem, but their impact is particularly severe in low and middle income countries, where the conditions for prevention, treatment, and rehabilitation are more critical. The epidemiological transition in the infant mortality causes, and the concern of the community and the mass media about the teratogenic risk of environmental pollutants, has made health authorities aware of the importance of birth defects in Argentina. The objective of this paper is to outline those actions specifically taken in Argentina aimed at the prevention of birth defects at a national level. Firstly, we focus on birth defects in Argentina on a general basis, and then we present different laws and actions taken in terms of surveillance and public health programs, primary, secondary, and tertiary prevention. Finally, we present the Teratology Information Service "Fetal Health Line", and the genetic services organization and health professionals training by the National Center of Medical Genetics and the National Program of Genetics Network. In conclusion, in the country, several programs focus on different approaches to the problem, and the challenge is to coordinate the teamwork between them. Finally, we list tips to address birth defects from the public health perspective.

A systematic approach to the planning, implementation, monitoring, and evaluation of integrated health services.

Science.gov (United States)

Reynolds, Heidi W; Sutherland, Elizabeth G

2013-05-06

Because of the current emphasis and enthusiasm focused on integration of health systems, there is a risk of piling resources into integrated strategies without the necessary systems in place to monitor their progress adequately or to measure impact, and to learn from these efforts. The rush to intervene without adequate monitoring and evaluation will continue to result in a weak evidence base for decision making and resource allocation. Program planning and implementation are inextricability linked to monitoring and evaluation. Country level guidance is needed to identify country-specific integrated strategies, thereby increasing country ownership. This paper focuses on integrated health services but takes into account how health services are influenced by the health system, managed by programs, and made up of interventions. We apply the principles in existing comprehensive monitoring and evaluation (M&E) frameworks in order to outline a systematic approach to the M&E of integration for the country level. The approach is grounded by first defining the country-specific health challenges that integration is intended to affect. Priority points of contact for care can directly influence health, and essential packages of integration for all major client presentations need to be defined. Logic models are necessary to outline the plausible causal pathways and define the inputs, roles and responsibilities, indicators, and data sources across the health system. Finally, we recommend improvements to the health information system and in data use to ensure that data are available to inform decisions, because changes in the M&E function to make it more integrated will also facilitate integration in the service delivery, planning, and governance components. This approach described in the paper is the ideal, but its application at the country level can help reveal gaps and guide decisions related to what health services to prioritize for integration, help plan for how to

Kaizen: ergonomics approach to occupational health and safety.

Science.gov (United States)

Kumashiro, Masaharu

2011-12-01

Kaizen (work improvement) is the forte of Japanese industry. Kaizen activities were born in the early 20th century under the name efficiency research. These activities were the beginning of industrial engineering (IE). Later on people began to rethink the single-minded devotion to improving productivity. Then the job re-design concept was developed. The main target of kaizen in the area of occupational health and safety in Japanese manufacturing is the improvement of inadequate working posture followed by the improvement of work for transporting and lifting heavy objects. Unfortunately, the kaizen activities undertaken by most Japanese companies are still focused on improving productivity and quality. The know-how for promoting kaizen activities that integrate the three aspects of IE, occupational health, and ergonomics is not being accumulated, however. In particular, the IE techniques should be incorporated into kaizen activities aimed at occupational safety and health, and the quantitative assessment of workload is required. In addition, it is important for on-the-job kaizen training in the ERGOMA Approach for production supervisors, who are the main advocates of IE kaizen.

Health Effects of Digital Textbooks on School-Age Children: A Grounded Theory Approach

OpenAIRE

Seomun, GA; Lee, JA; Kim, EY; Im, MY; Kim, M; Park, SA; Lee, Y

2013-01-01

This qualitative study used the grounded theory approach to analyze digital textbook-related health experiences of school-age children. In-depth interviews were held with 40 elementary school students who had used digital textbooks for at least a year. Data analysis revealed a total of 56 concepts, 20 subcategories, and 11 categories related to digital textbook health issues, the central phenomena being "health-related experiences." Students' health-related experiences were classified into "p...

A systematic approach for analysis and design of secure health information systems.

Science.gov (United States)

Blobel, B; Roger-France, F

2001-06-01

A toolset using object-oriented techniques including the nowadays popular unified modelling language (UML) approach has been developed to facilitate the different users' views for security analysis and design of health care information systems. Paradigm and concepts used are based on the component architecture of information systems and on a general layered security model. The toolset was developed in 1996/1997 within the ISHTAR project funded by the European Commission as well as through international standardisation activities. Analysing and systematising real health care scenarios, only six and nine use case types could be found in the health and the security-related view, respectively. By combining these use case types, the analysis and design of any thinkable system architecture can be simplified significantly. Based on generic schemes, the environment needed for both communication and application security can be established by appropriate sets of security services and mechanisms. Because of the importance and the basic character of electronic health care record (EHCR) systems, the understanding of the approach is facilitated by (incomplete) examples for this application.

An approach for balancing health and ecological risks at hazardous waste sites

International Nuclear Information System (INIS)

Suter, G.W. II; Hull, R.N.; Stack, M.; Cornaby, B.W.; Hadden, C.T.; Zafran, F.A.

1995-01-01

Human health and ecological risks must be balanced at hazardous waste sites in order to ensure that remedial actions prevent unacceptable risks of either type. Actions that are designed to protect humans may fail to protect nonhuman populations and ecosystems or may damage ecosystems. However, there is no common scale of health and ecological risk that would allow comparisons to be performed. This paper presents an approach to addressing this problem based on classifying all risks (i.e., health and ecological risks due contaminants and remediation) as insignificant (de minimis), highly significant (de manifestis), or intermediate. For health risks the classification is based on standard criteria. However, in the absence of national guidance concerning the acceptability of ecological risks, new ecological criteria are proposed based on an analysis of regulatory precedents. Matrices and flow charts are presented to guide the use of these risk categories in remedial decision making. The assessment of mercury contamination of the East Fork Poplar Creek is presented as an example of the implementation of the approach. 15 refs., 3 figs., 3 tabs

A public health approach to eating disorders prevention: It’s time for public health professionals to take a seat at the table

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Austin S

2012-10-01

Full Text Available Abstract Background The societal burden of eating disorders is clear, and though there is a compelling need for a public health approach to eating disorders prevention, public health professionals have yet to take up the challenge. Discussion The article lays out an argument for what steps need to be taken to bring a public health approach to eating disorders prevention. First, stock is taken of what the field has achieved so far, using tools from the prevention science literature, and, second, a research plan of action is offered that plays to the unique strengths of public health, drawing on a triggers-to-action framework from public health law. Minimal participation was found from public health professionals in eating disorders prevention research, and the vast majority of prevention research to date was found to be concentrated within the disciplines of psychology and psychiatry. Extreme disciplinary concentration of the research has led to a preponderance of individually targeted prevention strategies with little research focused on environmental targets, particularly at the macro level. New environmental initiatives are now emerging, such as a government-sponsored mass media anti-dieting campaign, and legal bans on extremely thin models in advertising, but for the most part, they have yet to be evaluated. A triggers-to-action framework, which focuses on evidentiary base, practical considerations, and political will, developed in public health law provides a basis for a strategic research plan for a public health approach to eating disorders prevention. Summary There is enormous potential for growth in the scope and diversity of eating disorder prevention research strategies, particularly those targeting the macro environment. A public health approach will require a strategic plan for research that leverages the macro environment for prevention. The full engagement of public health professionals will bring to the field the much broader

The Impact on Anxiety and Depression of a Whole School Approach to Health Promotion: Evidence from a Canadian Comprehensive School Health (CSH) Initiative

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Dassanayake, Wijaya; Springett, Jane; Shewring, Tania

2017-01-01

In this paper, we examine the impact of adopting a comprehensive school health (CSH) approach on reducing anxiety and depression of school-age children. We use the data from 245 schools that received government funding support to adopt a CSH approach in order to build health promoting school environments in Alberta. Using a linear multi-level…

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

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Lindsay McCallum

2016-08-01

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

The Weight-Inclusive versus Weight-Normative Approach to Health: Evaluating the Evidence for Prioritizing Well-Being over Weight Loss

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Tracy L. Tylka

2014-01-01

Full Text Available Using an ethical lens, this review evaluates two methods of working within patient care and public health: the weight-normative approach (emphasis on weight and weight loss when defining health and well-being and the weight-inclusive approach (emphasis on viewing health and well-being as multifaceted while directing efforts toward improving health access and reducing weight stigma. Data reveal that the weight-normative approach is not effective for most people because of high rates of weight regain and cycling from weight loss interventions, which are linked to adverse health and well-being. Its predominant focus on weight may also foster stigma in health care and society, and data show that weight stigma is also linked to adverse health and well-being. In contrast, data support a weight-inclusive approach, which is included in models such as Health at Every Size for improving physical (e.g., blood pressure, behavioral (e.g., binge eating, and psychological (e.g., depression indices, as well as acceptability of public health messages. Therefore, the weight-inclusive approach upholds nonmaleficience and beneficience, whereas the weight-normative approach does not. We offer a theoretical framework that organizes the research included in this review and discuss how it can guide research efforts and help health professionals intervene with their patients and community.

Enriching health-professional programs in global health: Development and implementation of an interdisciplinary and integrated approach

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Carol Valois

2017-04-01

Conclusion: While this unique approach is proving to be a major challenge, the preliminary results are well worth the effort. The project’s tangible impacts on health-sciences teaching, the GH competence of graduates, and care delivery are topics of interest for future investigation.

Measuring population health: costs of alternative survey approaches in the Nouna Health and Demographic Surveillance System in rural Burkina Faso

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Henrike Lietz

2015-08-01

Full Text Available Background: There are more than 40 Health and Demographic Surveillance System (HDSS sites in 19 different countries. The running costs of HDSS sites are high. The financing of HDSS activities is of major importance, and adding external health surveys to the HDSS is challenging. To investigate the ways of improving data quality and collection efficiency in the Nouna HDSS in Burkina Faso, the stand-alone data collection activities of the HDSS and the Household Morbidity Survey (HMS were integrated, and the paper-based questionnaires were consolidated into a single tablet-based questionnaire, the Comprehensive Disease Assessment (CDA. Objective: The aims of this study are to estimate and compare the implementation costs of the two different survey approaches for measuring population health. Design: All financial costs of stand-alone (HDSS and HMS and integrated (CDA surveys were estimated from the perspective of the implementing agency. Fixed and variable costs of survey implementation and key cost drivers were identified. The costs per household visit were calculated for both survey approaches. Results: While fixed costs of survey implementation were similar for the two survey approaches, there were considerable variations in variable costs, resulting in an estimated annual cost saving of about US$45,000 under the integrated survey approach. This was primarily because the costs of data management for the tablet-based CDA survey were considerably lower than for the paper-based stand-alone surveys. The cost per household visit from the integrated survey approach was US$21 compared with US$25 from the stand-alone surveys for collecting the same amount of information from 10,000 HDSS households. Conclusions: The CDA tablet-based survey method appears to be feasible and efficient for collecting health and demographic data in the Nouna HDSS in rural Burkina Faso. The possibility of using the tablet-based data collection platform to improve the quality

Approaches based on behavioral economics could help nudge patients and providers toward lower health spending growth.

Science.gov (United States)

King, Dominic; Greaves, Felix; Vlaev, Ivo; Darzi, Ara

2013-04-01

Policies that change the environment or context in which decisions are made and "nudge" people toward particular choices have been relatively ignored in health care. This article examines the role that approaches based on behavioral economics could play in "nudging" providers and patients in ways that could slow health care spending growth. The basic insight of behavioral economics is that behavior is guided by the very fallible human brain and greatly influenced by the environment or context in which choices are made. In policy arenas such as pensions and personal savings, approaches based on behavioral economics have provided notable results. In health care, such approaches have been used successfully but in limited ways, as in the use of surgical checklists that have increased patient safety and reduced costs. With health care spending climbing at unsustainable rates, we review the role that approaches based on behavioral economics could play in offering policy makers a potential set of new tools to slow spending growth.

Exploring a model-driven architecture (MDA) approach to health care information systems development.

Science.gov (United States)

Raghupathi, Wullianallur; Umar, Amjad

2008-05-01

To explore the potential of the model-driven architecture (MDA) in health care information systems development. An MDA is conceptualized and developed for a health clinic system to track patient information. A prototype of the MDA is implemented using an advanced MDA tool. The UML provides the underlying modeling support in the form of the class diagram. The PIM to PSM transformation rules are applied to generate the prototype application from the model. The result of the research is a complete MDA methodology to developing health care information systems. Additional insights gained include development of transformation rules and documentation of the challenges in the application of MDA to health care. Design guidelines for future MDA applications are described. The model has the potential for generalizability. The overall approach supports limited interoperability and portability. The research demonstrates the applicability of the MDA approach to health care information systems development. When properly implemented, it has the potential to overcome the challenges of platform (vendor) dependency, lack of open standards, interoperability, portability, scalability, and the high cost of implementation.

Adult Learning in Health and Safety: Some Issues and Approaches.

Science.gov (United States)

O Fathaigh, Mairtin

This document, which was developed for presentation at a seminar on adult learning and safety, examines approaches to occupational safety and health (OSH) learning/training in the workplace. Section 1 examines selected factors affecting adults' learning in workplace OSH programs. The principal dimensions along which individual adult learners will…

Assessment of safety and health of storage workers - a psychosocial approach

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Joanna Sadłowska-Wrzesińska

2016-03-01

Full Text Available Background: Although there is still a lot to do as far as prevention and elimination of traditional health and work safety hazards is concerned, the problem of psychosocial risk prevention is extremely important nowadays. It is crucial to take into consideration the health of workers and promotion of health in the workplace, as the occupational stress epidemics is getting more and more widespread. Methods: The article is based on the statistic analysis of accidents at work as well as the analysis of health problems resulting from the job itself. The latest work safety reports have been reviewed and special attention has been paid to psychosocial risk analysis. The author has tried to explicate the terms of new and emerging risks as regards storage work. Results: Various threat aspects of storage work have been evaluated. Deficits in psychosocial hazard identification have been indicated. What is more, no correlation between occupational tasks of storage workers and their knowledge about psychosocial risks has been emphasized.  An exemplified approach to warehouse psychosocial threat identification has been presented. The approach is based on the diagnosis of the current situation.  Conclusions: The psychosocial risk of storage work may lead to health deterioration, greater accident risk and worse performance at work. Such consequences mean that the psychosocial risks affect both an individual and the organization. Therefore, we should expect more intense efforts to increase psychosocial risk awareness of both employers and employees.

Achieving universal health coverage in South Africa through a district health system approach: conflicting ideologies of health care provision.

Science.gov (United States)

Fusheini, Adam; Eyles, John

2016-10-07

Universal Health Coverage (UHC) has emerged as a major goal for health care delivery in the post-2015 development agenda. It is viewed as a solution to health care needs in low and middle countries with growing enthusiasm at both national and global levels. Throughout the world, however, the paths of countries to UHC have differed. South Africa is currently reforming its health system with UHC through developing a national health insurance (NHI) program. This will be practically achieved through a decentralized approach, the district health system, the main vehicle for delivering services since democracy. We utilize a review of relevant documents, conducted between September 2014 and December 2015 of district health systems (DHS) and UHC and their ideological underpinnings, to explore the opportunities and challenges, of the district health system in achieving UHC in South Africa. Review of data from the NHI pilot districts suggests that as South Africa embarks on reforms toward UHC, there is a need for a minimal universal coverage and emphasis on district particularity and positive discrimination so as to bridge health inequities. The disparities across districts in relation to health profiles/demographics, health delivery performance, management of health institutions or district management capacity, income levels/socio-economic status and social determinants of health, compliance with quality standards and above all the burden of disease can only be minimised through positive discrimination by paying more attention to underserved and disadavantaged communities. We conclude that in South Africa the DHS is pivotal to health reform and UHC may be best achieved through minimal universal coverage with positive discrimination to ensure disparities across districts in relation to disease burden, human resources, financing and investment, administration and management capacity, service readiness and availability and the health access inequalities are consciously

Improvement of fungal disease identification and management: combined health systems and public health approaches.

Science.gov (United States)

Cole, Donald C; Govender, Nelesh P; Chakrabarti, Arunaloke; Sacarlal, Jahit; Denning, David W

2017-12-01

More than 1·6 million people are estimated to die of fungal diseases each year, and about a billion people have cutaneous fungal infections. Fungal disease diagnosis requires a high level of clinical suspicion and specialised laboratory testing, in addition to culture, histopathology, and imaging expertise. Physicians with varied specialist training might see patients with fungal disease, yet it might remain unrecognised. Antifungal treatment is more complex than treatment for bacterial or most viral infections, and drug interactions are particularly problematic. Health systems linking diagnostic facilities with therapeutic expertise are typically fragmented, with major elements missing in thousands of secondary care and hospital settings globally. In this paper, the last in a Series of eight papers, we describe these limitations and share responses involving a combined health systems and public health framework illustrated through country examples from Mozambique, Kenya, India, and South Africa. We suggest a mainstreaming approach including greater integration of fungal diseases into existing HIV infection, tuberculosis infection, diabetes, chronic respiratory disease, and blindness health programmes; provision of enhanced laboratory capacity to detect fungal diseases with associated surveillance systems; procurement and distribution of low-cost, high-quality antifungal medicines; and concomitant integration of fungal disease into training of the health workforce. Copyright © 2017 Elsevier Ltd. All rights reserved.

Why health care corruption needs a new approach.

Science.gov (United States)

Radin, Dagmar

2016-07-01

While corruption has been at the center of academic studies and on the agenda of international organizations for a couple of decades, in the health care sector corruption has not generated much interest or progress. At the centre of this issue is the lack of an interdisciplinary approach, which is warranted given the complexity of the issue and the lack of cooperation between STET scientifically rigorous academics and policy-makers, leaving room for more cooperation and progress. © The Author(s) 2015.

Performance-Based Financing to Strengthen the Health System in Benin: Challenging the Mainstream Approach

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Elisabeth Paul

2018-01-01

Full Text Available Background Performance-based financing (PBF is often proposed as a way to improve health system performance. In Benin, PBF was launched in 2012 through a World Bank-supported project. The Belgian Development Agency (BTC followed suit through a health system strengthening (HSS project. This paper analyses and draws lessons from the experience of BTC-supported PBF alternative approach – especially with regards to institutional aspects, the role of demand-side actors, ownership, and cost-effectiveness – and explores the mechanisms at stake so as to better understand how the “PBF package” functions and produces effects. Methods An exploratory, theory-driven evaluation approach was adopted. Causal mechanisms through which PBF is hypothesised to impact on results were singled out and explored. This paper stems from the co-authors’ capitalisation of experiences; mixed methods were used to collect, triangulate and analyse information. Results are structured along Witter et al framework. Results Influence of context is strong over PBF in Benin; the policy is donor-driven. BTC did not adopt the World Bank’s mainstream PBF model, but developed an alternative approach in line with its HSS support programme, which is grounded on existing domestic institutions. The main features of this approach are described (decentralised governance, peer review verification, counter-verification entrusted to health service users’ platforms, as well as its adaptive process. PBF has contributed to strengthen various aspects of the health system and led to modest progress in utilisation of health services, but noticeable improvements in healthcare quality. Three mechanisms explaining observed outcomes within the context are described: comprehensive HSS at district level; acting on health workers’ motivation through a complex package of incentives; and increased accountability by reinforcing dialogue with demand-side actors. Cost-effectiveness and

Assessing the Department of Defense’s Approach to Reducing Mental Health Stigma

Science.gov (United States)

2016-01-18

C O R P O R A T I O N RESE ARCH BR IEF Assessing the Department of Defense’s Approach to Reducing Mental Health Stigma When facing mental health ...problems, many service members choose not to seek needed help because of the stigma associated with mental health dis- orders and treatment. Not seeking...mem- bers. The stigma of seeking mental health treatment in the military persists despite the efforts of both the U.S. Depart- ment of Defense (DoD

[The systemic approach to the health protection in the workers of industrial enterprises].

Science.gov (United States)

Oransky, I E; Razumov, A N; Fedorov, A A

This paper presents the results of the systemic approach to the protection of health and prophylaxis of disability in the workers of industrial enterprises. The leading role in the technologies of rehabilitation (both short-term and long-term one) is played by the natural and physical therapeutic factors. The priority in the implementation of the therapeutic and health-promoting measures is given to the treatment based on the spa and health resort facilities as well as the factory health centers.

A novel system architecture for the national integration of electronic health records: a semi-centralized approach.

Science.gov (United States)

AlJarullah, Asma; El-Masri, Samir

2013-08-01

The goal of a national electronic health records integration system is to aggregate electronic health records concerning a particular patient at different healthcare providers' systems to provide a complete medical history of the patient. It holds the promise to address the two most crucial challenges to the healthcare systems: improving healthcare quality and controlling costs. Typical approaches for the national integration of electronic health records are a centralized architecture and a distributed architecture. This paper proposes a new approach for the national integration of electronic health records, the semi-centralized approach, an intermediate solution between the centralized architecture and the distributed architecture that has the benefits of both approaches. The semi-centralized approach is provided with a clearly defined architecture. The main data elements needed by the system are defined and the main system modules that are necessary to achieve an effective and efficient functionality of the system are designed. Best practices and essential requirements are central to the evolution of the proposed architecture. The proposed architecture will provide the basis for designing the simplest and the most effective systems to integrate electronic health records on a nation-wide basis that maintain integrity and consistency across locations, time and systems, and that meet the challenges of interoperability, security, privacy, maintainability, mobility, availability, scalability, and load balancing.

Towards an integrated approach to health and medicine in Africa.

Science.gov (United States)

Batisai, Kezia

2016-12-01

This article frames the intersections of medicine and humanities as intrinsic to understanding the practice of health care in Africa. Central to this manuscript, which draws on empirical findings on the interplay between HIV and AIDS and alternative medicine in Zimbabwe is the realisation that very limited research has been undertaken to examine 'HIV/AIDS patient behaviour' with respect to choice of therapy on the continent [Bene, M. & Darkoh, M. B. K. (2014). The Constraints of Antiretroviral Uptake in Rural Areas: The Case of Thamaga and Surrounding Villages, Botswana. Journal of Social Aspects of HIV/AIDS, 11(1), 167-177. doi: 10.1080/17290376.2014.972057 ; Chavunduka, G. (1998). Professionalisation of Traditional Medicine in Zimbabwe, Harare, Jongwe Printers; O'Brien, S. & Broom, A. (2014). HIV in (and out of) the Clinic: Biomedicine, Traditional Medicine and Spiritual Healing in Harare. Journal of Social Aspects of HIV/AIDS, 11(1), 94-104. doi: 10.1080/17290376.2014.938102 ]. As such, a social approach to health-seeking behaviour questions how decisions about alternative therapies including herbal remedies, traditional healing and faith healing are made. The paper unpacks the realities around how people living with HIV and AIDS - who span different age groups and profess various religious backgrounds, faced with an insurmountable health challenge against a background of limited resources and no cure for the virus - often experience shifts in health-seeking behaviour. Grappling with seemingly simple questions about 'when, where and how to seek medical attention', the paper provides pointers to therapy choices and health-seeking behaviour; and it serves as a route into deeper and intense healthcare practice explorations. In conclusion, the paper proposes that medicine and the humanities should engage seriously with those social aspects of HIV and AIDS which call for an integrated approach to healthcare practice in Africa. If combined, medicine and the humanities

Primary health services at district level in South Africa: a critique of the primary health care approach

Directory of Open Access Journals (Sweden)

Dookie Sunitha

2012-07-01

Full Text Available Abstract Background The rhetoric of primary health care philosophy in the district health system is widely cited as a fundamental component of the health transformation process in post-apartheid South Africa. Despite South Africa’s progress and attempts at implementing primary health care, various factors still limit its success. Discussion Inconsistencies and poor understanding of primary care and primary health care raises unrealistic expectations in service delivery and health outcomes, and blame is apportioned when expectations are not met. It is important for all health practitioners to consider the contextual influences on health and ill-health and to recognise the role of the underlying determinants of ill-health, namely, social, economic and environmental influences. The primary health care approach provides a strong framework for this delivery but it is not widely applied. There is a need for renewed political and policy commitments toward quality primary health care delivery, re-orientation of health care workers, integration of primary health care activities into other community-based development, improved management skills and effective coordination at all levels of the health system. There should also be optimal capacity building, and skills development in problem-solving, communication, networking and community participation. Summary A well-functioning district health system is required for the re-engineering of primary health care. This strategy requires a strong leadership, a strengthening of the current district heath system and a greater emphasis on health promotion, prevention, and community participation and empowerment.

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

Science.gov (United States)

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

2018-03-01

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

Where the Mind Meets the Mouth – an integrated and collaborative health care approach

OpenAIRE

Martin, Rachel Ellen; Calache, Hanny; Richardson, Jessie; Krouskos, Demos; Hall, Martin; Bettega, Alyson; Chalmers-Robinson, Emily; Christian, Bradley

2018-01-01

Background: The majority of the cost of oral health care in Australia is borne by individuals, hence many miss out on early, cost-effective care. 63,000 Australians are hospitalised annually for preventable oral conditions. Current approaches separate the provision of oral from general health care. Australia’s National Oral Health Plan recognises oral health as everyone’s business and a role for health care workers and carers to intervene early in oral disease.Objectives: To present an innova...

How should health service organizations respond to diversity? A content analysis of six approaches.

Science.gov (United States)

Seeleman, Conny; Essink-Bot, Marie-Louise; Stronks, Karien; Ingleby, David

2015-11-16

Health care organizations need to be responsive to the needs of increasingly diverse patient populations. We compared the contents of six publicly available approaches to organizational responsiveness to diversity. The central questions addressed in this paper are: what are the most consistently recommended issues for health care organizations to address in order to be responsive to the needs of diverse groups that differ from the majority population? How much consensus is there between various approaches? We purposively sampled six approaches from the US, Australia and Europe and used qualitative textual analysis to categorize the content of each approach into domains (conceptually distinct topic areas) and, within each domain, into dimensions (operationalizations). The resulting classification framework was used for comparative analysis of the content of the six approaches. We identified seven domains that were represented in most or all approaches: organizational commitment, empirical evidence on inequalities and needs, a competent and diverse workforce, ensuring access for all users, ensuring responsiveness in care provision, fostering patient and community participation, and actively promoting responsiveness. Variations in the operationalization of these domains related to different scopes, contexts and types of diversity. For example, approaches that focus on ethnic diversity mostly provide recommendations to handle cultural and language differences; approaches that take an intersectional approach and broaden their target population to vulnerable groups in a more general sense also pay attention to factors such as socio-economic status and gender. Despite differences in labeling, there is a broad consensus about what health care organizations need to do in order to be responsive to patient diversity. This opens the way to full scale implementation of organizational responsiveness in healthcare and structured evaluation of its effectiveness in improving

Prioritization of strategies to approach the judicialization of health in Latin America and the Caribbean

Directory of Open Access Journals (Sweden)

Carlos Eduardo Pinzón-Flórez

2016-01-01

Full Text Available ABSTRACT OBJECTIVE To describe strategies that contribute to the comprehensive approach to the judicialization of health in countries of Latin America and the Caribbean. METHODS A search was structured to identify articles presenting strategies to approach the judicialization of health. A survey was designed, which included actors of the health system and judiciary sector. We prioritized the strategies qualified by more than the 50.0% of the participants as “very relevant”. Strategies were categorized according to: governance, provision of services, human resources, information systems, financing, and medical products. RESULTS We included 64 studies, which identified 50 strategies, related to the sub-functions and components of health systems. Of the 165 people who answered the survey, 80.0% were aged 35-64 years. The distribution of men and women was homogeneous. Half of the respondents were from Colombia (20.0%, Uruguay (16.9%, and Argentina (12.7%. We prioritized strategies that addressed aspects of generation of useful scientific evidence for decision making according to the health needs of the population, empowerment for the society, and creating spaces for discussion of measures of inclusion or exclusion of health technologies. The executive and judiciary decision makers prioritized questions that dealt with strategies that would ensure accountability. CONCLUSIONS The results of this study contribute to the identification of effective strategies to approach the phenomenon of judicialization of health, guaranteeing the right to health.

Risk assessment and management approaches on mental health units.

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Woods, P

2013-11-01

This exploratory and descriptive study took place in one Canadian province. The study aimed to: (1) to identify and describe the nature and extent of current risk assessment and management approaches used in the adult inpatient mental health and forensic units; and (2) to identify good practice and shortfalls in the nature and extent of the approaches currently utilized. Data were collected from 48 participants through nine focus groups. Participants reported that they used a clinical approach to risk assessment. They had also not considered risk assessment and management as a proactive structured process. Education and training was also limited and skills were developed over time through practice. Five keys issues are discussed as important: reliance on clinical judgement alone is not the best choice to make; the need to consider risk as a whole concept; risk management being more reactive than proactive; education and training; and client involvement in risk assessment. © 2012 John Wiley & Sons Ltd.

Toward a Holistic Approach to Spiritual Health Care for People With Schizophrenia.

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Ho, Rainbow T H; Wan, Adrian H Y; Chan, Caitlin K P

2016-01-01

Medical and behavioral treatments are the predominant types of rehabilitation services for people with schizophrenia. Spirituality in people with schizophrenia remains poorly conceptualized, thereby limiting knowledge advancement in the area of spiritual health care services. To provide a framework for better clinical and research practices, we advocate a holistic approach to investigating spirituality and its application in spiritual health care services of people with schizophrenia.

Harmonization of ethics in health technology assessment: a revision of the Socratic approach.

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Hofmann, Bjørn; Droste, Sigrid; Oortwijn, Wija; Cleemput, Irina; Sacchini, Dario

2014-01-01

Ethics has been part of health technology assessment (HTA) from its beginning in the 1970s, and is currently part of HTA definitions. Several methods in ethics have been used in HTA. Some approaches have been developed especially for HTA, such as the Socratic approach, which has been used for a wide range of health technologies. The Socratic approach is used in several ways, and there is a need for harmonization to promote its usability and the transferability of its results. Accordingly, the objective of this study was to stimulate experts in ethics and HTA to revise the Socratic approach. Based on the current literature and experiences in applying methods in ethics, a panel of ethics experts involved in HTA critically analyzed the limitations of the Socratic approach during a face-to-face workshop. On the basis of this analysis a revision of the Socratic approach was agreed on after deliberation in several rounds through e-mail correspondence. Several limitations with the Socratic approach are identified and addressed in the revised version which consists of a procedure of six steps, 7 main questions and thirty-three explanatory and guiding questions. The revised approach has a broader scope and provides more guidance than its predecessor. Methods for information retrieval have been elaborated. The presented revision of the Socratic approach is the result of a joint effort of experts in the field of ethics and HTA. Consensus is reached in the expert panel on an approach that is considered to be more clear, comprehensive, and applicable for addressing ethical issues in HTA.

An integrated approach to health care costs: the case of American Can.

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Silvers, J B; Haslinger, J

1984-01-01

Faced with numerous health care options, corporations are searching for plans which provide necessary benefits while containing costs. This article examines the case of the American Can Company where, since 1978, a new approach has produced mutual economic gains and employee satisfaction. American Can's efforts involved differential pricing and encouraged responsible selection by employees. The company was one of several studied by the Health Systems Management Center at Case Western Reserve University under contract with the Business Roundtable Health Initiatives Task Force. Such studies provide insight for other companies seeking ways to attack burgeoning corporate health care costs. This article is one of a series reporting the results of these studies.

Increasing the public health impact of evidence-based interventions in behavioral medicine: new approaches and future directions.

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Buscemi, Joanna; Janke, E Amy; Kugler, Kari C; Duffecy, Jenna; Mielenz, Thelma J; St George, Sara M; Sheinfeld Gorin, Sherri N

2017-02-01

The dissemination and implementation of evidence-based behavioral medicine interventions into real world practice has been limited. The purpose of this paper is to discuss specific limitations of current behavioral medicine research within the context of the RE-AIM framework, and potential opportunities to increase public health impact by applying novel intervention designs and data collection approaches. The MOST framework has recently emerged as an alternative approach to development and evaluation that aims to optimize multicomponent behavioral and bio-behavioral interventions. SMART designs, imbedded within the MOST framework, are an approach to optimize adaptive interventions. In addition to innovative design strategies, novel data collection approaches that have the potential to improve the public-health dissemination include mHealth approaches and considering environment as a potential data source. Finally, becoming involved in advocacy via policy related work may help to improve the impact of evidence-based behavioral interventions. Innovative methods, if increasingly implemented, may have the ability to increase the public health impact of evidence-based behavioral interventions to prevent disease.

Model-centric approaches for the development of health information systems.

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Tuomainen, Mika; Mykkänen, Juha; Luostarinen, Heli; Pöyhölä, Assi; Paakkanen, Esa

2007-01-01

Modeling is used increasingly in healthcare to increase shared knowledge, to improve the processes, and to document the requirements of the solutions related to health information systems (HIS). There are numerous modeling approaches which aim to support these aims, but a careful assessment of their strengths, weaknesses and deficiencies is needed. In this paper, we compare three model-centric approaches in the context of HIS development: the Model-Driven Architecture, Business Process Modeling with BPMN and BPEL and the HL7 Development Framework. The comparison reveals that all these approaches are viable candidates for the development of HIS. However, they have distinct strengths and abstraction levels, they require local and project-specific adaptation and offer varying levels of automation. In addition, illustration of the solutions to the end users must be improved.

Integrated Approaches for the Public Health Prioritization of Foodborne and Zoonotic Pathogens

DEFF Research Database (Denmark)

Mangen, Marie-Josée; Batz, Mike; Kassbohrer, Annemarie

2010-01-01

such as cost of illness, willingness to pay, and health-adjusted life years (HALYs). To discuss the similarities and differences in these approaches, to seek consensus on principles, and to improve international collaboration, the E.U. MED-VET-NET and the U.S.-based Food Safety Research Consortium organized......To address the persistent problems of foodborne and zoonotic disease, public health officials worldwide face difficult choices about how to best allocate limited resources and target interventions to reduce morbidity and mortality. Data-driven approaches to informing these decisions have been...... developed in a number of countries. Integrated comparative frameworks generally share three methodological components: estimating incidence of acute illnesses, chronic sequelae, and mortality; attributing pathogen-specific illnesses to foods; and calculating integrated measures of disease burden...

Initial Teacher Education for School Health Promotion in Austria: Does It Support the Implementation of the Health-Promoting School Approach?

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Flaschberger, Edith

2013-01-01

Purpose: School health promotion is said to be most effective when implemented through a comprehensive, settings-based, whole-school approach. The purpose of this paper is to address the current lack of knowledge about the current state of teacher education for health promotion and its potential to further the development of settings-based…

Evaluation of health promotion in schools: a realistic evaluation approach using mixed methods

Science.gov (United States)

2010-01-01

Background Schools are key settings for health promotion (HP) but the development of suitable approaches for evaluating HP in schools is still a major topic of discussion. This article presents a research protocol of a program developed to evaluate HP. After reviewing HP evaluation issues, the various possible approaches are analyzed and the importance of a realistic evaluation framework and a mixed methods (MM) design are demonstrated. Methods/Design The design is based on a systemic approach to evaluation, taking into account the mechanisms, context and outcomes, as defined in realistic evaluation, adjusted to our own French context using an MM approach. The characteristics of the design are illustrated through the evaluation of a nationwide HP program in French primary schools designed to enhance children's social, emotional and physical health by improving teachers' HP practices and promoting a healthy school environment. An embedded MM design is used in which a qualitative data set plays a supportive, secondary role in a study based primarily on a different quantitative data set. The way the qualitative and quantitative approaches are combined through the entire evaluation framework is detailed. Discussion This study is a contribution towards the development of suitable approaches for evaluating HP programs in schools. The systemic approach of the evaluation carried out in this research is appropriate since it takes account of the limitations of traditional evaluation approaches and considers suggestions made by the HP research community. PMID:20109202

Implementing the Health Promoting University approach in culturally different contexts: a systematic review.

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Suárez-Reyes, Mónica; Van den Broucke, Stephan

2016-03-01

Universities represent a valuable opportunity to promote health and well-being. Based on the setting approach, the Health Promoting Universities concept has been developed in different countries and contexts. However, the implementation process remains poorly documented. This systematic review aims to describe how universities have implemented the Health Promoting University concept in different cultural contexts. Pubmed, Medline, Lilacs and Scielo were searched for articles on Health Promoting Universities, published between 1995 and 2015. Studies detailing the implementation of a Health Promoting University approach were included. Selected articles were content analysed paying attention to: (a) the definition of a Health Promoting University; (b) priority areas of action; (c) items of work; (d) coordination of the project; (e) evaluation; and (f) adaptation to the cultural context. Twelve studies were identified for in-depth analysis. Of those, three were theoretical papers, and nine were intervention studies. The programmes described in the selected studies are mostly based on the guidelines of the Edmonton Charter. They incorporated the main areas of action and items of works proposed by the Health Promoting University framework. The implementation of healthy policies and incorporation of health promotion in the curriculum are remaining challenges. Strategies to facilitate adaptation to context include: stakeholder participation in planning and implementation, adaptation of educational material and analysis of needs. The review suggests that most of the universities work towards similar goals, relying on the Health Promoting University framework, yet that the way in which initiatives are implemented depends on the context. © The Author(s) 2015.

Population health-based approaches to utilizing digital technology: a strategy for equity.

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Graham, Garth N; Ostrowski, MaryLynn; Sabina, Alyse B

2016-11-01

Health care disparities and high chronic disease rates burden many communities and disproportionally impact racial/ethnic populations in the United States. These disparities vary geographically, increase health care expenses, and result in shortened lifespans. Digital technologies may be one tool for addressing health disparities and improving population health by increasing individuals' access to health information-especially as most low-income U.S. residents gain access to smartphones. The Aetna Foundation partners with organizations to use digital technologies, including mobile applications, data collection, and related platforms, for learning and sharing. Projects range from the broad-childhood education, lifestyle modification, health IT training, and nutrition education, to the specific-local healthy foods, stroke rehabilitation, and collection of city-level data. We describe our approaches to grantmaking and discuss lessons learned and their implications. When combined with sound policy strategies, emerging, scalable, digital technologies will likely become powerful allies for improving health and reducing health disparities.

A strategic approach to workforce development for local public health.

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Bryant, Beverley; Ward, Megan

2017-11-09

In 2009, Peel Public Health set a vision to transform the work of public health from efficient delivery of public health services as defined by provincial mandate to the robust analysis of the health status of the local population and selection and implementation of programming to achieve best health outcomes. A strategic approach to the workforce was a key enabler. PPH is a public health unit in Ontario that serves 1.4 million people. An organization-wide strategic workforce development program was instituted. It is theory-based, evidence-informed and data-driven. A first step was a conceptual framework, followed by interventions in workforce planning, human resources management, and capacity development. The program was built on evidence reviews, theory, and public health core competencies. Interventions spread across the employee work-life span. Capacity development based on the public health core competencies is a main focus, particularly analytical capacity to support decision-making. Employees gain skill and knowledge in comprehensive population health. Leadership evolves as work shifts to the analysis of health status and development of interventions. Effective human resource processes ensure appropriate job design, recruitment and orientation. Analysis of the workforce leads to vigorous employee development to ensure a strong pool of potential leadership successors. Theory, research evidence, and data provide a robust foundation for workforce development. Competencies are important inputs to job descriptions, recruitment, training, and human resource processes. A comprehensive workforce development strategy enables the development of a skilled workforce capable of responding to the needs of the population it serves.

A participatory action research approach to strengthening health managers' capacity at district level in Eastern Uganda.

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Tetui, Moses; Coe, Anna-Britt; Hurtig, Anna-Karin; Bennett, Sara; Kiwanuka, Suzanne N; George, Asha; Kiracho, Elizabeth Ekirapa

2017-12-28

Many approaches to improving health managers' capacity in poor countries, particularly those pursued by external agencies, employ non-participatory approaches and often seek to circumvent (rather than strengthen) weak public management structures. This limits opportunities for strengthening local health managers' capacity, improving resource utilisation and enhancing service delivery. This study explored the contribution of a participatory action research approach to strengthening health managers' capacity in Eastern Uganda. This was a qualitative study that used open-ended key informant interviews, combined with review of meeting minutes and observations to collect data. Both inductive and deductive thematic analysis was undertaken. The Competing Values Framework of organisational management functions guided the deductive process of analysis and the interpretation of the findings. The framework builds on four earlier models of management and regards them as complementary rather than conflicting, and identifies four managers' capacities (collaborate, create, compete and control) by categorising them along two axes, one contrasting flexibility versus control and the other internal versus external organisational focus. The findings indicate that the participatory action research approach enhanced health managers' capacity to collaborate with others, be creative, attain goals and review progress. The enablers included expanded interaction spaces, encouragement of flexibility, empowerment of local managers, and the promotion of reflection and accountability. Tension and conflict across different management functions was apparent; for example, while there was a need to collaborate, maintaining control over processes was also needed. These tensions meant that managers needed to learn to simultaneously draw upon and use different capacities as reflected by the Competing Values Framework in order to maximise their effectiveness. Improved health manager capacity is

Emerging Ecological Approaches to Prevention, Health Promotion, and Public Health in the School Context: Next Steps from a Community Psychology Perspective

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Trickett, Edison J.; Rowe, Hillary L.

2012-01-01

In recent years, ecological perspectives have become more visible in prevention, health promotion, and public health within the school context. Individually based approaches to understanding and changing behavior have been increasingly challenged by these perspectives because of their appreciation for contextual influences on individual behavior.…

Managing chronic pathologies with a stepped mHealth-based approach in clinical psychology and medicine

Directory of Open Access Journals (Sweden)

Gianluca eCastelnuovo

2015-04-01

Full Text Available Chronic diseases and conditions typically require long-term monitoring and treatment protocols both in traditional settings and in out-patient frameworks. The economic burden of chronic conditions is a key challenge and new and mobile technologies could offer good solutions. mHealth could be considered an evolution of ehealth and could be defined as the practice of medicine and public health supported by mobile communication devices. mHealth approach could overcome limitations linked with the traditional, restricted and highly expensive in-patient treatment of many chronic pathologies. Possible applications include stepped mHealth approach, where patients can be monitored and treated in their everyday contexts. Unfortunately, many barriers for the spread of mHealth are still present. Due the significant impact of psychosocial factors on disease evolution, psychotherapies have to be included into the chronic disease protocols. Existing psychological theories of health behavior change have to be adapted to the new technological contexts and requirements. In conclusion, clinical psychology and medicine have to face the chronic care management challenge in both traditional and mHealth settings.

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

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Ramos, Athena K

2018-01-01

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

An Approach to Integrating Health Disparities within Undergraduate Biomedical Engineering Education.

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Vazquez, Maribel; Marte, Otto; Barba, Joseph; Hubbard, Karen

2017-11-01

Health disparities are preventable differences in the incidence, prevalence and burden of disease among communities targeted by gender, geographic location, ethnicity and/or socio-economic status. While biomedical research has identified partial origin(s) of divergent burden and impact of disease, the innovation needed to eradicate health disparities in the United States requires unique engagement from biomedical engineers. Increasing awareness of the prevalence and consequences of health disparities is particularly attractive to today's undergraduates, who have undauntedly challenged paradigms believed to foster inequality. Here, the Department of Biomedical Engineering at The City College of New York (CCNY) has leveraged its historical mission of access-and-excellence to integrate the study of health disparities into undergraduate BME curricula. This article describes our novel approach in a multiyear study that: (i) Integrated health disparities modules at all levels of the required undergraduate BME curriculum; (ii) Developed opportunities to include impacts of health disparities into undergraduate BME research projects and mentored High School summer STEM training; and (iii) Established health disparities-based challenges as BME capstone design and/or independent entrepreneurship projects. Results illustrate the rising awareness of health disparities among the youngest BMEs-to-be, as well as abundant undergraduate desire to integrate health disparities within BME education and training.

A 21st century approach to assessing the protection of workers' health.

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Rosskam, Ellen

2011-01-01

This article presents a rights-based approach to the way occupational health and safety is understood, departing from medical, engineering, and technocratic approaches that dominated the field throughout the 20th century. Moving toward a 21st century concept of the good society - based on citizenship rights and principles of universalism - a social protection-based system of assessing governments' performance in protecting workers' health and well-being is proffered. A Work Security Index (WSI) is used as a benchmarking system for evaluating national or local level governments' performance in this domain. Data from 95 countries in all regions of the world were used. A pioneering tool the WSI grouped and ranked countries based on governments' protection of workers' health and safety. Data represent findings from 95 national governments, as well as workers and employers. Among 95 countries, most have much work to do to provide the minimum measures to protect their working populations. Results reveal that women workers face particular social and economic insecurities and inequalities. We attempt to inform a broad audience about the WSI, how it can be used at multiple levels in any country for the protection of workers' health, safety, and well-being, and the need to do so.

Generation Y Health Professional Students ’ Preferred Teaching and Learning Approaches: A Systematic Review

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Caroline Mary Hills

2017-01-01

Full Text Available Generation Y or Millennials are descriptors for those born between 1982 and 2000. This cohort has grown up in the digital age and is purported to have different learning preferences from previous generations. Students are important stakeholders in identifying their preferred teaching and learning approaches in health professional programs. This study aimed to identify, appraise, and synthesize the best available evidence regarding the teaching and learning preferences of Generation Y health professional students. The review considered any objectively measured or self-reported outcomes of teaching and learning reported from Generation Y health professional student perspectives. In accordance with a previously published Joanna Briggs Institute Protocol, a three-step search strategy was completed. Two research articles (nursing and dental hygiene students and three dissertations (nursing were critically appraised. All studies were cross-sectional descriptive studies. A range of pedagogical approaches was reported, including lecture, group work, and teaching clinical skills. Based on the Joanna Briggs Institute levels of evidence, reviewers deemed the evidence as Level 3. Some generational differences were reported, but these were inconsistent across the studies reviewed. There is, therefore, insufficient evidence to provide specific recommendations for the preferred educational approaches of health professional students and further research is warranted.

Reducing Urban Violence: A Contrast of Public Health and Criminal Justice Approaches.

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Cerdá, Magdalena; Tracy, Melissa; Keyes, Katherine M

2018-01-01

Cities are investing millions in Cure Violence, a public health approach to reduce urban violence by targeting at-risk youth and redirecting conflict to nonviolent responses. The impact of such a program compared with criminal justice responses is unknown because experiments directly comparing criminal justice and public health approaches to violence prevention are infeasible with observational data. We simulated experiments to test the influence of two interventions on violence: (1) Cure Violence and (2) directed police patrol in violence hot spots. We used an agent-based model to simulate a 5% sample of the New York City (NYC) adult population, with agents placed on a grid representing the land area of NYC, with neighborhood size and population density proportional to land area and population density in each community district. Agent behaviors were governed by parameters drawn from city data sources and published estimates. Under no intervention, 3.87% (95% CI, 3.84, 3.90) of agents were victimized per year. Implementing the violence interrupter intervention for 10 years decreased victimization by 13% (to 3.35% [3.32, 3.39]). Implementing hot-spots policing and doubling the police force for 10 years reduced annual victimization by about 11% (to 3.46% [3.42, 3.49]). Increasing the police force by 40% combined with implementing the violence interrupter intervention for 10 years decreased violence by 19% (to 3.13% [3.09, 3.16]). Combined investment in a public health, community-based approach to violence prevention and a criminal justice approach focused on deterrence can achieve more to reduce population-level rates of urban violence than either can in isolation. See video abstract at, http://links.lww.com/EDE/B298.

Analysis of the Mechanism of Prolonged Persistence of Drug Interaction between Terbinafine and Amitriptyline or Nortriptyline.

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Mikami, Akiko; Hori, Satoko; Ohtani, Hisakazu; Sawada, Yasufumi

2017-01-01

The purpose of the study was to quantitatively estimate and predict drug interactions between terbinafine and tricyclic antidepressants (TCAs), amitriptyline or nortriptyline, based on in vitro studies. Inhibition of TCA-metabolizing activity by terbinafine was investigated using human liver microsomes. Based on the unbound K i values obtained in vitro and reported pharmacokinetic parameters, a pharmacokinetic model of drug interaction was fitted to the reported plasma concentration profiles of TCAs administered concomitantly with terbinafine to obtain the drug-drug interaction parameters. Then, the model was used to predict nortriptyline plasma concentration with concomitant administration of terbinafine and changes of area under the curve (AUC) of nortriptyline after cessation of terbinafine. The CYP2D6 inhibitory potency of terbinafine was unaffected by preincubation, so the inhibition seems to be reversible. Terbinafine competitively inhibited amitriptyline or nortriptyline E-10-hydroxylation, with unbound K i values of 13.7 and 12.4 nM, respectively. Observed plasma concentrations of TCAs administered concomitantly with terbinafine were successfully simulated with the drug interaction model using the in vitro parameters. Model-predicted nortriptyline plasma concentration after concomitant nortriptylene/terbinafine administration for two weeks exceeded the toxic level, and drug interaction was predicted to be prolonged; the AUC of nortriptyline was predicted to be increased by 2.5- or 2.0- and 1.5-fold at 0, 3 and 6 months after cessation of terbinafine, respectively. The developed model enables us to quantitatively predict the prolonged drug interaction between terbinafine and TCAs. The model should be helpful for clinical management of terbinafine-CYP2D6 substrate drug interactions, which are difficult to predict due to their time-dependency.

Interventions to Promote an Integrated Approach to Public Health Problems: An Application to Childhood Obesity

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Anna-Marie Hendriks

2012-01-01

Full Text Available Experts stress the need to bring the childhood obesity epidemic under control by means of an integrated approach. The implementation of such an approach requires the development of integrated enabling policies on public health by local governments. A prerequisite for developing such integrated public health policies is intersectoral collaboration. Since the development of integrated policies is still in its early stages, this study aimed to answer the following research question: “What interventions can promote intersectoral collaboration and the development of integrated health policies for the prevention of childhood obesity?” Data were collected through a literature search and observations of and interviews with stakeholders. Based on a theoretical framework, we categorized potential interventions that could optimize an integrated approach regarding children's physical activity and diet. The intervention categories included education, persuasion, incentivization, coercion, training, restriction, environmental restructuring, modeling, and enablement.

The Transferability of Health Promotion and Education Approaches Between Non-communicable Diseases and Communicable Diseases—an Analysis of Evidence

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McQueen, David V.; Manoncourt, Erma; Cartier, Yuri N.; Dinca, Irina; Nurm, Ülla-Karin

2014-01-01

Background There is a seeming lack within the public health fields of both research and practice of information sharing across so-called “silos of work”. Many professionals in the public health fields dealing with infectious diseases (IDs) are unaware of the programs and approaches taken by their colleagues in the non-communicable diseases (NCDs) arena, and vice versa. A particular instance of this is in the understanding and application of health promotion approaches. This is a problem that needs to be addressed with the goal of producing the most efficient and effective health promotion approaches to the prevention and control of diseases in general. Objectives This project examined health promotion approaches to the prevention of NCDs that could be used in the prevention of IDs. Methods A knowledge synthesis and translation perspective was undertaken. We screened and analyzed a wide range of sources that were considered relevant, with particular emphasis on systematic reviews, published articles and the grey literature. Results The analysis revealed a diverse health promotion knowledge base for application to IDs. Comprehensive health promotion models were found to be useful. Findings suggest that there are profound similarities for health promotion approaches in both NCDs and IDs. Conclusions: This study revealed gaps in knowledge synthesis to translation. The need for development of intervention and implementation research is considered. PMID:29546085

Applying the reasoned action approach to understanding health protection and health risk behaviors.

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Conner, Mark; McEachan, Rosemary; Lawton, Rebecca; Gardner, Peter

2017-12-01

The Reasoned Action Approach (RAA) developed out of the Theory of Reasoned Action and Theory of Planned Behavior but has not yet been widely applied to understanding health behaviors. The present research employed the RAA in a prospective design to test predictions of intention and action for groups of protection and risk behaviors separately in the same sample. To test the RAA for health protection and risk behaviors. Measures of RAA components plus past behavior were taken in relation to eight protection and six risk behaviors in 385 adults. Self-reported behavior was assessed one month later. Multi-level modelling showed instrumental attitude, experiential attitude, descriptive norms, capacity and past behavior were significant positive predictors of intentions to engage in protection or risk behaviors. Injunctive norms were only significant predictors of intention in protection behaviors. Autonomy was a significant positive predictor of intentions in protection behaviors and a negative predictor in risk behaviors (the latter relationship became non-significant when controlling for past behavior). Multi-level modelling showed that intention, capacity, and past behavior were significant positive predictors of action for both protection and risk behaviors. Experiential attitude and descriptive norm were additional significant positive predictors of risk behaviors. The RAA has utility in predicting both protection and risk health behaviors although the power of predictors may vary across these types of health behavior. Copyright © 2017 Elsevier Ltd. All rights reserved.

Gender in health technology assessment: pilot study on agency approaches.

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Panteli, Dimitra; Zentner, Annette; Storz-Pfennig, Philipp; Busse, Reinhard

2011-07-01

Gender as a social construct is a recognized health determinant. Because best practice in reporting health technology assessment (HTA) clearly specifies the need to appraise a technology's social impact within the target population, the extent to which gender issues are taken into account in HTA production is of interest, not only in light of equitable practices but also for reasons of effectiveness. The aim of this study is to provide a first assessment of the degree of gender sensitivity shown by HTA agencies around the world today. The Web sites of sixty HTA agencies were analyzed. The consideration of gender aspects was specifically looked for in each agency's general mission statement, its priority setting process, and its methodological approach. Additionally, specific gender-oriented initiatives not belonging to any of the aforementioned categories were identified. Of the sixty agencies, less than half mention a commitment to addressing the social implication of health technologies. Only fifteen institutions make information on their priority setting principles available on their Web sites and gender was an issue in two of those cases. Data on methodology were obtainable online from 18 agencies, two of which mentioned gender issues explicitly. Finally, gender-oriented initiatives were identified by thirteen agencies. A gender-sensitive approach is apparently rarely adopted in current HTA production. Exceptional practices and relevant tools do exist and could serve as examples to be promoted by international collaborative networks.

An evidence-based approach to interactive health communication: a challenge to medicine in the information age. Science Panel on Interactive Communication and Health.

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Robinson, T N; Patrick, K; Eng, T R; Gustafson, D

1998-10-14

To examine the current status of interactive health communication (IHC) and propose evidence-based approaches to improve the quality of such applications. The Science Panel on Interactive Communication and Health, a 14-member, nonfederal panel with expertise in clinical medicine and nursing, public health, media and instructional design, health systems engineering, decision sciences, computer and communication technologies, and health communication, convened by the Office of Disease Prevention and Health Promotion, US Department of Health and Human Services. Published studies, online resources, expert panel opinions, and opinions from outside experts in fields related to IHC. The panel met 9 times during more than 2 years. Government agencies and private-sector experts provided review and feedback on the panel's work. Interactive health communication applications have great potential to improve health, but they may also cause harm. To date, few applications have been adequately evaluated. Physicians and other health professionals should promote and participate in an evidence-based approach to the development and diffusion of IHC applications and endorse efforts to rigorously evaluate the safety, quality, and utility of these resources. A standardized reporting template is proposed to help developers and evaluators of IHC applications conduct evaluations and disclose their results and to help clinicians, purchasers, and consumers judge the quality of IHC applications.

Studying integrated health care systems with a structurationist approach

Science.gov (United States)

Demers, Louis; Arseneault, Stéphane; Couturier, Yves

2010-01-01

Introduction To implement an integrated health care system is not an easy task and to ensure its sustainability is yet more difficult. Aim Discuss how a structurationist approach can shed light on the stakes of these processes and guide the managers of such endeavours. Theory and method Structuration theory [1] has been used by numerous authors to cast new light on complex organizational phenomena. One of the central tenets of this theory is that social systems, such as integrated health care systems, are recurrent social practices across time-space and are characterized by structural properties which simultaneously constrain and enable the constitutive social actors who reproduce and transform the system through their practices. We will illustrate our theoretical standpoint with empirical material gathered during the study of an integrated health care system for the frail elderly in Quebec, Canada. This system has been implemented in 1997 and is still working well in 2010. Results and conclusion To implement an integrated health care system that is both effective and sustainable, its managers must shrewdly allow for the existing system and progressively introduce changes in the way managers and practitioners at work in the system view their role and act on a daily basis.

Towards an integrated approach to health and medicine in Africa

Directory of Open Access Journals (Sweden)

Kezia Batisai

2016-01-01

Full Text Available This article frames the intersections of medicine and humanities as intrinsic to understanding the practice of health care in Africa. Central to this manuscript, which draws on empirical findings on the interplay between HIV and AIDS and alternative medicine in Zimbabwe is the realisation that very limited research has been undertaken to examine ‘HIV/AIDS patient behaviour’ with respect to choice of therapy on the continent [Bene, M. & Darkoh, M. B. K. (2014. The Constraints of Antiretroviral Uptake in Rural Areas: The Case of Thamaga and Surrounding Villages, Botswana. SAHARA-J: Journal of Social Aspects of HIV/AIDS, 11(1, 167–177. doi:10.1080/17290376.2014.972057; Chavunduka, G. (1998. Professionalisation of Traditional Medicine in Zimbabwe, Harare, Jongwe Printers; O’Brien, S. & Broom, A. (2014. HIV in (and out of the Clinic: Biomedicine, Traditional Medicine and Spiritual Healing in Harare. SAHARA-J: Journal of Social Aspects of HIV/AIDS, 11(1, 94–104. doi:10.1080/17290376.2014.938102]. As such, a social approach to health-seeking behaviour questions how decisions about alternative therapies including herbal remedies, traditional healing and faith healing are made. The paper unpacks the realities around how people living with HIV and AIDS – who span different age groups and profess various religious backgrounds, faced with an insurmountable health challenge against a background of limited resources and no cure for the virus – often experience shifts in health-seeking behaviour. Grappling with seemingly simple questions about ‘when, where and how to seek medical attention’, the paper provides pointers to therapy choices and health-seeking behaviour; and it serves as a route into deeper and intense healthcare practice explorations. In conclusion, the paper proposes that medicine and the humanities should engage seriously with those social aspects of HIV and AIDS which call for an integrated approach to healthcare practice in

Coordination Logic for Repulsive Resolution Maneuvers

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Narkawicz, Anthony J.; Munoz, Cesar A.; Dutle, Aaron M.

2016-01-01

This paper presents an algorithm for determining the direction an aircraft should maneuver in the event of a potential conflict with another aircraft. The algorithm is implicitly coordinated, meaning that with perfectly reliable computations and information, it will in- dependently provide directional information that is guaranteed to be coordinated without any additional information exchange or direct communication. The logic is inspired by the logic of TCAS II, the airborne system designed to reduce the risk of mid-air collisions between aircraft. TCAS II provides pilots with only vertical resolution advice, while the proposed algorithm, using a similar logic, provides implicitly coordinated vertical and horizontal directional advice.

Use of tricyclic antidepressants and risk of glioma

DEFF Research Database (Denmark)

Pottegård, Anton; García Rodríguez, Luis Alberto; Rasmussen, Lotte

2016-01-01

glioma (cases) in Denmark between 2000 and 2012 and matched these 1 : 20 to population controls. Conditional logistic regression was used to estimate adjusted odds ratios (ORs) for glioma associated with long-term (⩾3 years) use of TCAs. Similar analyses were performed for selective serotonin reuptake...... inhibitors (SSRIs). RESULTS: We identified 3767 glioma cases and 75 340 population controls. Long-term use of TCAs was inversely associated with risk of glioma (OR 0.72, 95% CI: 0.41-1.25). Long-term SSRI use was not associated with glioma risk (OR 0.93, 95% CI: 0.75-1.16). CONCLUSIONS: Our study indicated...

Developing the Mental Health Workforce: Review and Application of Training Approaches from Multiple Disciplines

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Lyon, Aaron R.; Stirman, Shannon Wiltsey; Kerns, Suzanne E. U.; Bruns, Eric J.

2011-01-01

Strategies specifically designed to facilitate the training of mental health practitioners in evidence-based practices (EBPs) have lagged behind the development of the interventions themselves. The current paper draws from an interdisciplinary literature (including medical training, adult education, and teacher training) to identify useful training and support approaches as well as important conceptual frameworks that may be applied to training in mental health. Theory and research findings are reviewed, which highlight the importance of continued consultation/ support following training workshops, congruence between the training content and practitioner experience, and focus on motivational issues. In addition, six individual approaches are presented with careful attention to their empirical foundations and potential applications. Common techniques are highlighted and applications and future directions for mental health workforce training and research are discussed. PMID:21190075

A work-based learning approach for clinical support workers on mental health inpatient wards.

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Kemp, Philip; Gilding, Moorene; Seewooruttun, Khooseal; Walsh, Hannah

2016-09-14

Background With a rise in the number of unqualified staff providing health and social care, and reports raising concerns about the quality of care provided, there is a need to address the learning needs of clinical support workers. This article describes a qualitative evaluation of a service improvement project that involved a work-based learning approach for clinical support workers on mental health inpatient wards. Aim To investigate and identify insights in relation to the content and process of learning using a work-based learning approach for clinical support workers. Method This was a qualitative evaluation of a service improvement project involving 25 clinical support workers at the seven mental health inpatient units in South London and Maudsley NHS Foundation Trust. Three clinical skills tutors were appointed to develop, implement and evaluate the work-based learning approach. Four sources of data were used to evaluate this approach, including reflective journals, qualitative responses to questionnaires, three focus groups involving the clinical support workers and a group interview involving the clinical skills tutors. Data were analysed using thematic analysis. Findings The work-based learning approach was highly valued by the clinical support workers and enhanced learning in practice. Face-to-face learning in practice helped the clinical support workers to develop practice skills and reflective learning skills. Insights relating to the role of clinical support workers were also identified, including the benefits of face-to-face supervision in practice, particularly in relation to the interpersonal aspects of care. Conclusion A work-based learning approach has the potential to enhance care delivery by meeting the learning needs of clinical support workers and enabling them to apply learning to practice. Care providers should consider how the work-based learning approach can be used on a systematic, organisation-wide basis in the context of budgetary

Prevention of Youth Violence: A Public Health Approach.

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Sood, Aradhana Bela; Berkowitz, Steven J

2016-04-01

The causes of youth violence are multifactorial and include biological, individual, familial, social, and economic factors. The influence of parents, family members, and important adults can shape the beliefs of the child toward violence in a significant manner. However, the influence of school and the neighborhood also have an important role in attitudes and behaviors of children toward violence. The complexity of factors related to violence requires a comprehensive public health approach. This article focuses on evidence-based models of intervention to reduce violence while emphasizing collective impact as a guiding principle. Copyright © 2016 Elsevier Inc. All rights reserved.

[The approach of sciences of complexity in health services administration].

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Fajardo-Ortiz, Guillermo; Ortiz-Montalvo, Armando

2013-01-01

Historically, health services administration has been managed under a Taylorist, Fayolist, humanist and bureaucratic focus approach. However, today dynamic and competitive behaviors that require others approaches in management are developing. Because of the social, scientific and technological changes that are occurring, it is necessary to abandon hierarchical and authoritarian schemes, "up and down" lines, prescriptive rules and order line up must be left behind. Health services administration is an adapted complex system that is not proportional, neither predictable in direction or magnitude. A new proposal is to focus on the sciences of complexity, where the social factors, materials, economics, human and ethics coincide with order and disorder, reason and unreason, and in which we must accept that the phenomenon that emerges creates different organizing different structures from the addition or subtraction of components. There is distance in the process of cause and direct effect. The mirage from the sciences of complexity are trans-disciplinary and we have accepted this in others branches of knowledge, such as quantum physics, non-linear mathematics and cybernetics, so we have to accept the influence of entropy, non-entropy, attractors, the theory of chaos and fractals.

Toward better public health reporting using existing off the shelf approaches: A comparison of alternative cancer detection approaches using plaintext medical data and non-dictionary based feature selection.

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Kasthurirathne, Suranga N; Dixon, Brian E; Gichoya, Judy; Xu, Huiping; Xia, Yuni; Mamlin, Burke; Grannis, Shaun J

2016-04-01

Increased adoption of electronic health records has resulted in increased availability of free text clinical data for secondary use. A variety of approaches to obtain actionable information from unstructured free text data exist. These approaches are resource intensive, inherently complex and rely on structured clinical data and dictionary-based approaches. We sought to evaluate the potential to obtain actionable information from free text pathology reports using routinely available tools and approaches that do not depend on dictionary-based approaches. We obtained pathology reports from a large health information exchange and evaluated the capacity to detect cancer cases from these reports using 3 non-dictionary feature selection approaches, 4 feature subset sizes, and 5 clinical decision models: simple logistic regression, naïve bayes, k-nearest neighbor, random forest, and J48 decision tree. The performance of each decision model was evaluated using sensitivity, specificity, accuracy, positive predictive value, and area under the receiver operating characteristics (ROC) curve. Decision models parameterized using automated, informed, and manual feature selection approaches yielded similar results. Furthermore, non-dictionary classification approaches identified cancer cases present in free text reports with evaluation measures approaching and exceeding 80-90% for most metrics. Our methods are feasible and practical approaches for extracting substantial information value from free text medical data, and the results suggest that these methods can perform on par, if not better, than existing dictionary-based approaches. Given that public health agencies are often under-resourced and lack the technical capacity for more complex methodologies, these results represent potentially significant value to the public health field. Copyright © 2016 Elsevier Inc. All rights reserved.

The balanced scorecard: an incremental approach model to health care management.

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Pineno, Charles J

2002-01-01

The balanced scorecard represents a technique used in strategic management to translate an organization's mission and strategy into a comprehensive set of performance measures that provide the framework for implementation of strategic management. This article develops an incremental approach for decision making by formulating a specific balanced scorecard model with an index of nonfinancial as well as financial measures. The incremental approach to costs, including profit contribution analysis and probabilities, allows decisionmakers to assess, for example, how their desire to meet different health care needs will cause changes in service design. This incremental approach to the balanced scorecard may prove to be useful in evaluating the existence of causality relationships between different objective and subjective measures to be included within the balanced scorecard.

A herd health approach to dairy cow nutrition and production diseases of the transition cow.

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Mulligan, F J; O'Grady, L; Rice, D A; Doherty, M L

2006-12-01

This paper presents a practical, on-farm approach for the monitoring and prevention of production disease in dairy cattle. This integrated approach, should be used in an interdisciplinary way by farmers, veterinarians, nutrition advisors and other relevant professionals for the improvement of animal health and welfare and producer profitability. The key areas that form the basis for this approach are body condition score management, negative energy balance, hypocalcaemia, rumen health and trace element status. Monitoring criteria are described for each of these key areas, which when considered collectively, will facilitate the assessment of dairy cow health with regard to clinical and subclinical disease. The criteria, which are informed by published scientific literature, are based on farm management and environmental factors, clinical data, milk production records, dietary analysis, and assessment of blood and liver concentrations of various metabolites or trace elements. The aim is to review the efficacy of production disease control measures currently in place, and if necessary to modify them or formulate new ones.

Environmental transport and human exposure: A multimedia approach in health-risk policy

Energy Technology Data Exchange (ETDEWEB)

McKone, T.E.

1992-05-01

In his treatise Air, Water, and Places, the ancient-Greek physician Hippocrates demonstrated that the appearance of disease in human populations is influenced by the quality of air, water, and food; the topography of the land; and general living habits. This approach is still relevant and, indeed, the conerstone of modem efforts to relate public health to environmental factors. What has changed is the precision with which we can measure and model these long-held relationships. Environmental scientists recognize that plants, animals, and humans encounter environmental contaminants via complex transfers through air, water, and food and use multimedia models to evaluate these transfers. In this report, I explore the use of multimedia models both to examine pollution trends and as a basis for characterizing human health risks and ecological risks. The strengths and weaknesses of the approach are discussed.

Adding Perspective: Predicting Adolescent Sunscreen Use with an Extended Health Action Process Approach.

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Schüz, Natalie; Schüz, Benjamin; Eid, Michael

2016-07-01

Diseases such as skin cancer often have a very long latency period. For adolescents, especially, it may be difficult to grasp that current risk behavior is related to future health outcomes. This study examines the role of health-related time perspective (i.e. the degree to which short-term outcomes are discounted over long-time health benefits) within the Health Action Process Approach (HAPA). More specifically, based on expectancy*value theory, we tested whether time perspective interacts with self-efficacy, the central variable in this approach. A longitudinal study with three measurement points across one year assessed 156 high school students. Data were analyzed using structural equation models. While time perspective had no direct association with sunscreen use intentions, there was an interaction effect with self-efficacy; the shorter the time perspective, the smaller the association of self-efficacy with intention. Intention in turn predicted planning and sunscreen use at Time 3 (one year later). In order to maximise the impact of early onset measures for skin cancer prevention targeting the motivation for sunscreen use in adolescents, time perspective should be addressed in comprehensive sun protection interventions. © 2016 The International Association of Applied Psychology.

An effective approach for choosing an electronic health record.

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Rowley, Robert

2009-01-01

With government stimulus money becoming available to encourage healthcare facilities to adopt electronic health record (EHR) systems, the decision to move forward with implementing an EHR system has taken on an urgency not previously seen. The EHR landscape is evolving rapidly and the underlying technology platform is becoming increasingly interconnected. One must make sure that an EHR decision does not lock oneself into technology obsolescence. The best approach for evaluating an EHR is on the basis of:usability, interoperability, and affordability.

The role of personal and competent approach onto health-preserving technologies at the conditions of higher educational institution

Directory of Open Access Journals (Sweden)

Kamaiev O.I.

2012-03-01

Full Text Available The impact of personal and competent approach onto effectiveness of health-forming and health-preserving technologies in higher educational institution conditions was demonstrated. The substance of personal and competent approaches was disclosed. 54 female students took part in the research, from them - 28 in experimental and 26 in control group. It was ascertained that personal oriented approach provide for change of teacher's role and technology of teaching within educational process. Competent approach enables to reorient the teaching technology from the process to the result of education. Educational process gains the active and creative nature by introduction of mentioned approaches.

Primary health care in rural Malawi - a qualitative assessment exploring the relevance of the community-directed interventions approach

DEFF Research Database (Denmark)

Makaula, Peter; Bloch, Paul; Banda, Hastings T.

2012-01-01

Primary Health Care (PHC) is a strategy endorsed for attaining equitable access to basic health care including treatment and prevention of endemic diseases. Thirty four years later, its implementation remains sub-optimal in most Sub-Saharan African countries that access to health interventions...... is still a major challenge for a large proportion of the rural population. Community-directed treatment with ivermectin (CDTi) and community-directed interventions (CDI) are participatory approaches to strengthen health care at community level. Both approaches are based on values and principles associated...

Integrated approaches for the public health prioritization of foodborne and zoonotic pathogens.

NARCIS (Netherlands)

Mangen, M.J.J.; Batz, M.B.; Kasbohrer, S.; Hald, T.; Morris, J.G.; Taylor, M.; Havelaar, A.H.

2010-01-01

To address the persistent problems of foodborne and zoonotic disease, public health officials worldwide face difficult choices about how to best allocate limited resources and target interventions to reduce morbidity and mortality. Data-driven approaches to informing these decisions have been

Psychosocial Approaches for Sexual Health and Intimate Relationships Among Patients With Serious Mental Illness.

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Helu-Brown, Paula; Aranda, Maria

2016-01-01

The sexual health and behavior and the intimate relationships of patients diagnosed with a serious mental illness (SMI) have been described as ongoing and often ignored concerns in mental health treatment. Evidence-based psychosocial interventions have emerged as effective complimentary approaches to address symptoms of SMI in conjunction with psychopharmacology, yet rarely do they address sexual concerns in a targeted manner. This systematic review explores the scope and efficacy of psychosocial interventions designed to address sexual health and behavior and intimate relationship concerns in patients with SMI. The search was conducted in four targeted databases and identified 967 articles with four of those meeting inclusion criteria for this review. The data extracted included setting, study sample, study design, outcome measures, data analysis, and results. The measures utilized in the studies assess mental and sexual health-related outcomes. All four studies reported an improvement in sexual and mental health outcomes. Given the lack of psychosocial approaches and culturally sensitive adaptations, this review highlights a gap in literature that should be addressed, particularly emphasizing their combined treatment with psychotropic medication and efficacy testing with diverse populations. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

Positive approaches to education for sexual health with examples from Asia and Africa.

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Senanayake, P

1992-07-01

Some approaches to health education are presented based on experiences in Asia and Africa. Consideration in project design should be given to methodology, location, timing, and target group. There is no one correct approach. Qualitative evaluations are possible. Outreach to a larger population such as the out-of-school unemployed is an important goal, as well as directing Family Life Education (FLE) to the primary school level, when children are still in school. Sexual health is defined as state of physical and psychological well being including sexuality. FLE is a culturally sensitive approach to sexual health education. The avoidance of sexual terms promotes acceptance in countries such as Sri Lanka. The problem of sexuality and adolescence and the current protracted period is that adults view this period as an inconvenience rather than an inevitability. The needs of youth need to be recognized in spite of the resistance some cultures may feel about sex education encouraging promiscuity. The example is given of the government of Mali, which in conjunction with the International Planned Parenthood Federation, trained 150 workers to mobilize youth and introduce them to FLE. The prerequisite is mental preparation of the adult population through training programs. An example of an effective method of role play presentation by youth of major youth issues was used in creating a positive feeling for youth among World Health Assembly delegates, who are Ministers of Health and Senior Government Health Officials. The Youth Counseling Services and Family Education Project in Ethiopia is described. It was a youth-designed and youth-implemented project which took into consideration working hours, staff attitude, and hospitality toward youths. Other methods described are: 1) drama, 2) songs, 3) role play, 4) literature, 5) videos and film shows, 6) radio, and 7) telephone. Integration of FLE can be positive when it is combined with youth centers, income-generation projects

Integrating community-based participatory research and informatics approaches to improve the engagement and health of underserved populations.

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Unertl, Kim M; Schaefbauer, Chris L; Campbell, Terrance R; Senteio, Charles; Siek, Katie A; Bakken, Suzanne; Veinot, Tiffany C

2016-01-01

We compare 5 health informatics research projects that applied community-based participatory research (CBPR) approaches with the goal of extending existing CBPR principles to address issues specific to health informatics research. We conducted a cross-case analysis of 5 diverse case studies with 1 common element: integration of CBPR approaches into health informatics research. After reviewing publications and other case-related materials, all coauthors engaged in collaborative discussions focused on CBPR. Researchers mapped each case to an existing CBPR framework, examined each case individually for success factors and barriers, and identified common patterns across cases. Benefits of applying CBPR approaches to health informatics research across the cases included the following: developing more relevant research with wider impact, greater engagement with diverse populations, improved internal validity, more rapid translation of research into action, and the development of people. Challenges of applying CBPR to health informatics research included requirements to develop strong, sustainable academic-community partnerships and mismatches related to cultural and temporal factors. Several technology-related challenges, including needs to define ownership of technology outputs and to build technical capacity with community partners, also emerged from our analysis. Finally, we created several principles that extended an existing CBPR framework to specifically address health informatics research requirements. Our cross-case analysis yielded valuable insights regarding CBPR implementation in health informatics research and identified valuable lessons useful for future CBPR-based research. The benefits of applying CBPR approaches can be significant, particularly in engaging populations that are typically underserved by health care and in designing patient-facing technology. © The Authors 2015. Published by Oxford University Press on behalf of the American Medical

Tackling regional health inequalities in france by resource allocation : a case for complementary instrumental and process-based approaches?

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Bellanger, Martine M; Jourdain, Alain

2004-01-01

This article aims to evaluate the results of two different approaches underlying the attempts to reduce health inequalities in France. In the 'instrumental' approach, resource allocation is based on an indicator to assess the well-being or the quality of life associated with healthcare provision, the argument being that additional resources would respond to needs that could then be treated quickly and efficiently. This governs the distribution of regional hospital budgets. In the second approach, health professionals and users in a given region are involved in a consensus process to define those priorities to be included in programme formulation. This 'procedural' approach is employed in the case of the regional health programmes. In this second approach, the evaluation of the results runs parallel with an analysis of the process using Rawlsian principles, whereas the first approach is based on the classical economic model.At this stage, a pragmatic analysis based on both the comparison of regional hospital budgets during the period 1992-2003 (calculated using a 'RAWP [resource allocation working party]-like' formula) and the evolution of regional health policies through the evaluation of programmes for the prevention of suicide, alcohol-related diseases and cancers provides a partial assessment of the impact of the two types of approaches, the second having a greater effect on the reduction of regional inequalities.

A four stage approach for ontology-based health information system design.

Science.gov (United States)

Kuziemsky, Craig E; Lau, Francis

2010-11-01

To describe and illustrate a four stage methodological approach to capture user knowledge in a biomedical domain area, use that knowledge to design an ontology, and then implement and evaluate the ontology as a health information system (HIS). A hybrid participatory design-grounded theory (GT-PD) method was used to obtain data and code them for ontology development. Prototyping was used to implement the ontology as a computer-based tool. Usability testing evaluated the computer-based tool. An empirically derived domain ontology and set of three problem-solving approaches were developed as a formalized model of the concepts and categories from the GT coding. The ontology and problem-solving approaches were used to design and implement a HIS that tested favorably in usability testing. The four stage approach illustrated in this paper is useful for designing and implementing an ontology as the basis for a HIS. The approach extends existing ontology development methodologies by providing an empirical basis for theory incorporated into ontology design. Copyright © 2010 Elsevier B.V. All rights reserved.

Tailored Educational Approaches for Consumer Health: A Model to Address Health Promotion in an Era of Personalized Medicine.

Science.gov (United States)

Cohn, Wendy F; Lyman, Jason; Broshek, Donna K; Guterbock, Thomas M; Hartman, David; Kinzie, Mable; Mick, David; Pannone, Aaron; Sturz, Vanessa; Schubart, Jane; Garson, Arthur T

2018-01-01

To develop a model, based on market segmentation, to improve the quality and efficiency of health promotion materials and programs. Market segmentation to create segments (groups) based on a cross-sectional questionnaire measuring individual characteristics and preferences for health information. Educational and delivery recommendations developed for each group. General population of adults in Virginia. Random sample of 1201 Virginia residents. Respondents are representative of the general population with the exception of older age. Multiple factors known to impact health promotion including health status, health system utilization, health literacy, Internet use, learning styles, and preferences. Cluster analysis and discriminate analysis to create and validate segments. Common sized means to compare factors across segments. Developed educational and delivery recommendations matched to the 8 distinct segments. For example, the "health challenged and hard to reach" are older, lower literacy, and not likely to seek out health information. Their educational and delivery recommendations include a sixth-grade reading level, delivery through a provider, and using a "push" strategy. This model addresses a need to improve the efficiency and quality of health promotion efforts in an era of personalized medicine. It demonstrates that there are distinct groups with clearly defined educational and delivery recommendations. Health promotion professionals can consider Tailored Educational Approaches for Consumer Health to develop and deliver tailored materials to encourage behavior change.

Israeli nurses' attitudes to the holistic approach to health and their use of complementary and alternative therapies.

Science.gov (United States)

Orkaby, Brurya; Greenberger, Chaya

2015-03-01

To examine nurses' attitudes to holistic and biomedical approaches to health care and the correlation between the two and to explore the extent of recommending and using complementary and alternative medicine (CAM) by nurses and its correlation with attitudes toward the holistic approach to care. In this cross-sectional correlational study, a structured questionnaire was completed anonymously by 213 Israeli hospital-based nurses from various departments. Nurses perceived both approaches as critical to optimal health care: a positive correlation emerged of attitudes to the two approaches. Nurses recommended and used CAM extensively; most therapies were recommended and/or used by 70% or more of the respondents. Nurses with more positive attitudes toward holistic care tended to recommend and use CAM to a greater extent. Biomedical and holistic approaches are perceived by nurses to coexist within nursing professional boundaries and form a broad basis for optimal health care. Nurses' attitudes to the holistic approach appear to promote recommendation and/or use of CAM in practice. More training in CAM should be offered in nursing educational frameworks and research should continue to establish evidence for CAM's effectiveness. © The Author(s) 2014.

Task-Sharing Approaches to Improve Mental Health Care in Rural and Other Low-Resource Settings: A Systematic Review.

Science.gov (United States)

Hoeft, Theresa J; Fortney, John C; Patel, Vikram; Unützer, Jürgen

2018-12-01

Rural areas persistently face a shortage of mental health specialists. Task shifting, or task sharing, is an approach in global mental health that may help address unmet mental health needs in rural and other low-resource areas. This review focuses on task-shifting approaches and highlights future directions for research in this area. Systematic review on task sharing of mental health care in rural areas of high-income countries included: (1) PubMed, (2) gray literature for innovations not yet published in peer-reviewed journals, and (3) outreach to experts for additional articles. We included English language articles published before August 31, 2013, on interventions sharing mental health care tasks across a team in rural settings. We excluded literature: (1) from low- and middle-income countries, (2) involving direct transfer of care to another provider, and (3) describing clinical guidelines and shared decision-making tools. The review identified approaches to task sharing focused mainly on community health workers and primary care providers. Technology was identified as a way to leverage mental health specialists to support care across settings both within primary care and out in the community. The review also highlighted how provider education, supervision, and partnerships with local communities can support task sharing. Challenges, such as confidentiality, are often not addressed in the literature. Approaches to task sharing may improve reach and effectiveness of mental health care in rural and other low-resource settings, though important questions remain. We recommend promising research directions to address these questions. © 2017 National Rural Health Association.

Surgery-first orthognathic approach vs traditional orthognathic approach: Oral health-related quality of life assessed with 2 questionnaires.

Science.gov (United States)

Pelo, Sandro; Gasparini, Giulio; Garagiola, Umberto; Cordaro, Massimo; Di Nardo, Francesco; Staderini, Edoardo; Patini, Romeo; de Angelis, Paolo; D'Amato, Giuseppe; Saponaro, Gianmarco; Moro, Alessandro

2017-08-01

The purposes of the study were to investigate and evaluate the differences detected by the patients between the traditional orthognathic approach and the surgery-first one in terms of level of satisfaction and quality of life. A total of 30 patients who underwent orthognathic surgery for correction of malocclusions were selected and included in this study. Fifteen patients were treated with the conventional orthognathic surgery approach, and 15 patients with the surgery-first approach. Variables were assessed through the Orthognathic Quality of Life Questionnaire and the Oral Health Impact Profile questionnaire and analyzed with 2-way repeated-measures analysis of variance. The results showed significant differences in terms of the Orthognathic Quality of Life Questionnaire (P surgery in the surgery-first group and an initial worsening during orthodontic treatment in the traditional approach group followed by postoperative improvement. This study showed that the worsening of the facial profile during the traditional orthognathic surgery approach decompensation phase has a negative impact on the perception of patients' quality of life. Surgeons should consider the possibility of a surgery-first approach to prevent this occurrence. Copyright © 2017 American Association of Orthodontists. Published by Elsevier Inc. All rights reserved.

A socially situated approach to inform ways to improve health and wellbeing.

Science.gov (United States)

Horrocks, Christine; Johnson, Sally

2014-02-01

Mainstream health psychology supports neoliberal notions of health promotion in which self-management is central. The emphasis is on models that explain behaviour as individually driven and cognitively motivated, with health beliefs framed as the favoured mechanisms to target in order to bring about change to improve health. Utilising understandings exemplified in critical health psychology, we take a more socially situated approach, focusing on practicing health, the rhetoric of modernisation in UK health care and moves toward democratisation. While recognising that within these new ways of working there are opportunities for empowerment and user-led health care, there are other implications. How these changes link to simplistic cognitive behavioural ideologies of health promotion and rational decision-making is explored. Utilising two different empirical studies, this article highlights how self-management and expected compliance with governmental authority in relation to health practices position not only communities that experience multiple disadvantage but also more seemingly privileged social actors. The article presents a challenge to self-management and informed choice, in which the importance of navigational networks is evident. Because health care can become remote and inaccessible to certain sections of the community, yet pervasive and deterministic for others, we need multiple levels of analysis and different forms of action. © 2014 The Authors. Sociology of Health & Illness © 2014 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

Tackling Millennium Development Goals (MDGs 4 and 5: the National Health Insurance Scheme (NHIS approach in Nigeria

Directory of Open Access Journals (Sweden)

Shafiu Mohammed

2012-03-01

Full Text Available Developing countries are devising various strategies and mechanisms to accelerate their speed towards the Millennium Development Goals (MDGs by 2015. In Nigeria, different approaches have been used to address the tackling of health-related MDGs. One creative approach has been the implementation of the NHIS Maternal and Child Health (NHIS-MCH Project. The project aims to speed up the achievement of MDGs 4 and 5 (reducing child mortality and improving maternal health in the country. Little is known about the NHISMCH Project’s design and health insurance coverage activities. Project planning and monitoring could be hampered by lack of technical and managerial skills of health insurance most especially at middle and local levels. Challenging debates continue to emanate on the project’s sustainability.

Tackling Millennium Development Goals (MDGs) 4 and 5: The National Health Insurance Scheme (NHIS) Approach in Nigeria.

Science.gov (United States)

Mohammed, Shafiu; Dong, Hengjin

2012-03-07

Developing countries are devising various strategies and mechanisms to accelerate their speed towards the Millennium Development Goals (MDGs) by 2015. In Nigeria, different approaches have been used to address the tackling of health-related MDGs. One creative approach has been the implementation of the NHIS Maternal and Child Health (NHIS-MCH) Project. The project aims to speed up the achievement of MDGs 4 and 5 (reducing child mortality and improving maternal health) in the country. Little is known about the NHIS-MCH Project's design and health insurance coverage activities. Project planning and monitoring could be hampered by lack of technical and managerial skills of health insurance most especially at middle and local levels. Challenging debates continue to emanate on the project's sustainability.

Adopting a critical intercultural communication approach to understanding health professionals' encounter with ethnic minority patients

DEFF Research Database (Denmark)

Jæger, Kirsten

2012-01-01

professionals and their approach to ethnic minority patients influence the accessibility of healthcare and availability of health prevention resources of ethnic minorities. When adapting healthcare practice to minority patients, healthcare professionals draw on insights from intercultural communication...... and anthropology. However, within these disciplines such concepts as culture, interculturality, and ethnicity are subjected to contestation due to co-existing, but competing paradigms. This paper demonstrates how healthcare discourses on ethnic minority patients reflect shifting intercultural communication...... paradigms and advocates the adoption of a critical intercultural communication approach in relation to ethnicity-based health inequality....

A Transformative Approach to Academic Medicine: The Partnership Between the University of Arizona and Banner Health.

Science.gov (United States)

Cairns, Charles B; Bollinger, Kathy; Garcia, Joe G N

2017-01-01

The University of Arizona Health Network (UAHN) was a modestly successful health care delivery organization with a vibrant academic portfolio and stable finances. By 2013, however, market forces, health care financing changes, and the burden of technology and informatics upgrades led to a compromised financial position at UAHN, a situation experienced by many academic medical centers. Concurrently, Banner Health had been interested in forming an academic partnership to enhance innovation, including the incorporation of new approaches into health care delivery, and to recruit high-quality providers to the organization. In 2015, the University of Arizona (UA) and Banner Health entered into a unique partnership known as Banner - University Medicine. The objective was to create a statewide system that provides reliable, compassionate, high-quality health care across all of its providers and facilities and to make a 30-year commitment to UA's College of Medicine in Tucson and the College of Medicine in Phoenix to support the State of Arizona's position as a first-tier research and training destination with world-class physicians. The goal of the Banner - University Medicine partnership is to create a nationally leading organization that transforms health care by delivering better care, enhanced service, and lower costs through new approaches focused on wellness. Key elements of this partnership are highlighted in this Commentary, including the unique governance structure of the Academic Management Council, the creation of the Academic Enhancement Fund to support the UA Colleges of Medicine in Tucson and Phoenix, and novel approaches to medical education, research, innovation, and care.

Interventions to promote an integrated approach to public health problems : an application to childhood obesity

NARCIS (Netherlands)

Hendriks, Anna-Marie; Gubbels, Jessica S; De Vries, Nanne K.; Seidell, Jaap C; Kremers, Stef P J; Jansen, Maria W J

2012-01-01

Experts stress the need to bring the childhood obesity epidemic under control by means of an integrated approach. The implementation of such an approach requires the development of integrated enabling policies on public health by local governments. A prerequisite for developing such integrated

A Peer-Led Approach to Promoting Health Education in Schools: The Views of Peers

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Frantz, J. M.

2015-01-01

Peer-led health promotion strategies in schools have been found to be effective in promoting healthy behaviours amongst youth. This study aimed to evaluate the views of the peer educators in implementing a health education programme using a qualitative approach. Informal discussions and eight in-depth interviews were used to explore the views of…

Health effects of digital textbooks on school-age children: a grounded theory approach.

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Seomun, Gyeongae; Lee, Jung-Ah; Kim, Eun-Young; Im, Meeyoung; Kim, Miran; Park, Sun-A; Lee, Youngjin

2013-10-01

This qualitative study used the grounded theory approach to analyze digital textbook-related health experiences of school-age children. In-depth interviews were held with 40 elementary school students who had used digital textbooks for at least a year. Data analysis revealed a total of 56 concepts, 20 subcategories, and 11 categories related to digital textbook health issues, the central phenomena being "health-related experiences." Students' health-related experiences were classified into "physical" and "psychological" symptoms. Adverse health effects related to digital textbook usage were addressed via both "student-led" and "instructor-led" coping strategies. Students' coping strategies were often inefficient, but instructor-led strategies seemed to prevent health problems. When health issues were well managed, students tended to accept digital textbooks as educational tools. Our findings suggest that students can form healthy computer habits if digital textbook usage is directed in a positive manner.

Review of various approaches for assessing public health risks in regulatory decision making: choosing the right approach for the problem.

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Dearfield, Kerry L; Hoelzer, Karin; Kause, Janell R

2014-08-01

Stakeholders in the public health risk analysis community can possess differing opinions about what is meant by "conduct a risk assessment." In reality, there is no one-size-fits-all risk assessment that can address all public health issues, problems, and regulatory needs. Although several international and national organizations (e.g., Codex Alimentarius Commission, Office International des Epizooties, Food and Agricultural Organization, World Health Organization, National Research Council, and European Food Safety Authority) have addressed this issue, confusion remains. The type and complexity of a risk assessment must reflect the risk management needs to appropriately inform a regulatory or nonregulatory decision, i.e., a risk assessment is ideally "fit for purpose" and directly applicable to risk management issues of concern. Frequently however, there is a lack of understanding by those not completely familiar with risk assessment regarding the specific utility of different approaches for assessing public health risks. This unfamiliarity can unduly hamper the acceptance of risk assessment results by risk managers and may reduce the usefulness of such results for guiding public health policies, practices, and operations. Differences in interpretation of risk assessment terminology further complicate effective communication among risk assessors, risk managers, and stakeholders. This article provides an overview of the types of risk assessments commonly conducted, with examples primarily from the food and agricultural sectors, and a discussion of the utility and limitations of these specific approaches for assessing public health risks. Clarification of the risk management issues and corresponding risk assessment design needs during the formative stages of the risk analysis process is a key step for ensuring that the most appropriate assessment of risk is developed and used to guide risk management decisions.

Developing a mental health care plan in a low resource setting: the theory of change approach.

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Hailemariam, Maji; Fekadu, Abebaw; Selamu, Medhin; Alem, Atalay; Medhin, Girmay; Giorgis, Tedla Wolde; DeSilva, Mary; Breuer, Erica

2015-09-28

Scaling up mental healthcare through integration into primary care remains the main strategy to address the extensive unmet mental health need in low-income countries. For integrated care to achieve its goal, a clear understanding of the organisational processes that can promote and hinder the integration and delivery of mental health care is essential. Theory of Change (ToC), a method employed in the planning, implementation and evaluation of complex community initiatives, is an innovative approach that has the potential to assist in the development of a comprehensive mental health care plan (MHCP), which can inform the delivery of integrated care. We used the ToC approach to develop a MHCP in a rural district in Ethiopia. The work was part of a cross-country study, the Programme for Improving Mental Health Care (PRIME) which focuses on developing evidence on the integration of mental health in to primary care. An iterative ToC development process was undertaken involving multiple workshops with stakeholders from diverse backgrounds that included representatives from the community, faith and traditional healers, community associations, non-governmental organisations, Zonal, Regional and Federal level government offices, higher education institutions, social work and mental health specialists (psychiatrists and psychiatric nurses). The objective of this study is to report the process of implementing the ToC approach in developing mental health care plan. A total of 46 persons participated in four ToC workshops. Four critical path dimensions were identified: community, health facility, administrative and higher level care organisation. The ToC participants were actively engaged in the process and the ToC encouraged strong commitment among participants. Key opportunities and barriers to implementation and how to overcome these were suggested. During the workshops, a map incorporating the key agreed outcomes and outcome indicators was developed and finalized later

Inequalities in health: approaches by health authorities in an English health region.

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McCarron, P; Yates, B

2000-06-01

In 1995 the Department of Health published Variations in health: what can the Department of Health do? This recommended that health authorities should have a comprehensive plan for identifying and tackling variations in health. We investigated how health authorities in the South and West Region were taking forward this work. Semi-structured interviews and reviews of documentation were conducted in all health authorities in the South and West Region of England. All health authorities viewed tackling inequalities in health as important; however, explicit strategies did not exist and Health of the Nation targets were a vehicle for determining priorities of inequalities. Explicit corporate commitment was often weak. Analyses were being conducted to determine the magnitude of local health inequalities and to assist in designing appropriate interventions. The importance of alliance working was highlighted; much work was being done although success was variable. Efforts are being made throughout the South and West region to tackle inequalities in health. Although strategic vision at the corporate level was often lacking, there was evidence of commitment to taking the inequalities agenda forward within public health directorates. Strengthening of primary care and alliance working roles is essential. Recent national strategy documents, forthcoming legislation, and a review of health inequalities recognize the health effects of inequalities and require health authorities to collaborate with local partners to tackle these, and will offer opportunities to improve corporate commitment and alliance working. Uptake and success of these opportunities will have a major influence on progress in tackling health inequalities.

Capacity-building for health research in developing countries: a manager's approach

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Franklin White

2002-09-01

Full Text Available Research may be viewed as rigorous inquiry to advance knowledge and improve practices. An international commission has argued that strengthening research capacity is one of the most powerful, cost-effective, and sustainable means of advancing health and development. However, the global effort to promote research in developing countries has been mostly policy driven, and largely at the initiative of donor agencies based in developed countries. This policy approach, although essential, both contrasts with and is complementary to that of research managers, who must build capacity "from the ground up" in a variety of health service settings within countries and with differing mandates, resources, and constraints. In health organizations the concept of research is broad, and practices vary widely. However, building research capacity is not altogether different from building other kinds of organizational capacity, and it involves two major dimensions: strategic and operational. In organizations in the health field, if reference to research is not in the mission statement, then developing a relevant research capacity is made vastly more difficult. Research capacities that take years to develop can be easily damaged through inadequate support, poor management, or other negative influences associated with both internal and external environments. This paper draws from key international research policy documents and observations on the behavior of research and donor agencies in relation to developing countries. It examines capacity-building primarily as a challenge for research managers, realities underlying operational effectiveness and efficiency, approaches to resource mobilization, and the need for marketing the research enterprise. Selected examples from South Asia and Latin America and the Caribbean are presented.

Finding toxicological information: An approach for occupational health professionals

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Franco Giuliano

2008-08-01

Full Text Available Abstract Background It can be difficult for occupational health professionals to assess which toxicological databases available on the Internet are the most useful for answering their questions. Therefore we evaluated toxicological databases for their ability to answer practical questions about exposure and prevention. We also propose recommended practices for searching for toxicological properties of chemicals. Methods We used a systematic search to find databases available on the Internet. Our criteria for the databases were the following: has a search engine, includes factual information on toxic and hazardous chemicals harmful for human health, and is free of charge. We developed both a qualitative and a quantitative rating method, which was used by four independent assessors to determine appropriateness, the quality of content, and ease of use of the database. Final ratings were based on a consensus of at least two evaluators. Results Out of 822 results we found 21 databases that met our inclusion criteria. Out of these 21 databases 14 are administered in the US, five in Europe, one in Australia, and one in Canada. Nine are administered by a governmental organization. No database achieved the maximum score of 27. The databases GESTIS, ESIS, Hazardous Substances Data Bank, TOXNET and NIOSH Pocket Guide to Chemical Hazards all scored more than 20 points. The following approach was developed for occupational health professionals searching for the toxicological properties of chemicals: start with the identity of the chemical; then search for health hazards, exposure route and measurement; next the limit values; and finally look for the preventive measures. Conclusion A rating system of toxicological databases to assess their value for occupational health professionals discriminated well between databases in terms of their appropriateness, quality of information, and ease of use. Several American and European databases yielded high scores and

Community trust and household health: A spatially-based approach with evidence from rural Honduras.

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Zarychta, Alan

2015-12-01

What is the relationship between community trust and household health? Scholars working to understand the effects of trust and social capital on human health tend to focus on individual characteristics or social environments, frequently without integrating these two dimensions. In light of this, the present paper makes contributions in both conceptualization and measurement. First, I develop a spatially-based approach for operationalizing community trust as the product of individual orientation and social environment. This approach highlights the need for a household to trust its neighbors and for those neighbors to reciprocate trust in order to constitute the psychological and material mechanisms critical for linking social context to individual health. Second, I illustrate the utility of this measure by evaluating the relationship between community trust and self-rated health status using an original population census survey from 2009 to 2010 for two municipalities in western Honduras (approximately 2800 households with a response rate of 94.9%). I implement spatial regression analysis and show that there is a positive and substantively meaningful relationship between community trust and household health; households that are trusting and surrounded by similarly trusting neighbors report better health status, while those in uncertain or mutually distrusting environments report worse health. The theory and results presented here suggest an important link between trust and social capital at the community level, which is particularly salient for rural regions in developing countries where health resources are scarce and community-based interventions are common. Copyright © 2015 Elsevier Ltd. All rights reserved.

The BASE-Program—A Multidimensional Approach for Health Promotion in Companies

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Bettina Wollesen

2016-12-01

Full Text Available Multidimensional assessments for conducting interventions are needed to achieve positive health effects within companies. BASE is an acronym, consisting of B = “Bedarfsbestimmung” (requirements; A = “Arbeitsplatzorganisation” (organisation of work; S = “Schulung des belastungsverträglichen Alltagshandelns” (coaching preventive behaviour at work; E = “Eigenverantwortung und Selbstwirksamkeit” (self-responsibility and self-efficacy. It is a prevention program designed to avoid and reduce work-related musculoskeletal diseases. It was developed to support prevention strategies within companies. It comprises aspects of health protection, ergonomics, exercise and self-efficacy. A comprehensive assessment will identify strain e.g., musculoskeletal discomforts due to body positions or psychological stress. Moreover, the general health status, preferences and barriers for participating in health promotion programs are evaluated. This analysis leads to practical and goal-oriented recommendations and interventions which suit the needs of companies and employees. These are executed onsite in real workplace situations and involve the introduction of first-hand experience in behavioural change. Therefore, this practical approach enhances the employees’ acceptance and self-efficacy for health promotion. This can result in long-term health promoting behaviour. This article presents the outcome and sustainability effects of BASE in three different application fields (logistic, industrial and office workers.

Integrated Care and Connected Health Approaches Leveraging Personalised Health through Big Data Analytics.

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Maglaveras, Nicos; Kilintzis, Vassilis; Koutkias, Vassilis; Chouvarda, Ioanna

2016-01-01

Integrated care and connected health are two fast evolving concepts that have the potential to leverage personalised health. From the one side, the restructuring of care models and implementation of new systems and integrated care programs providing coaching and advanced intervention possibilities, enable medical decision support and personalized healthcare services. From the other side, the connected health ecosystem builds the means to follow and support citizens via personal health systems in their everyday activities and, thus, give rise to an unprecedented wealth of data. These approaches are leading to the deluge of complex data, as well as in new types of interactions with and among users of the healthcare ecosystem. The main challenges refer to the data layer, the information layer, and the output of information processing and analytics. In all the above mentioned layers, the primary concern is the quality both in data and information, thus, increasing the need for filtering mechanisms. Especially in the data layer, the big biodata management and analytics ecosystem is evolving, telemonitoring is a step forward for data quality leverage, with numerous challenges still left to address, partly due to the large number of micro-nano sensors and technologies available today, as well as the heterogeneity in the users' background and data sources. This leads to new R&D pathways as it concerns biomedical information processing and management, as well as to the design of new intelligent decision support systems (DSS) and interventions for patients. In this paper, we illustrate these issues through exemplar research targeting chronic patients, illustrating the current status and trends in PHS within the integrated care and connected care world.

Bring in the social context: towards an integrated approach to health promotion and prevention.

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Thorlindsson, Thorolfur

2011-03-01

In this paper I take up the quest for an integrated approach to health promotion and prevention that incorporates the social context. I suggest that an integrated theory of public health has to rethink the individual society relationships and move beyond the dominance of socialization theory and individual level analysis. A theoretical analysis of key issues in an integrated theory of public health. I maintain that we must shift the attention away from the individual to the social organization and the embeddedness of the social actor in the ongoing social networks and relationships; we must pay attention to the definition of levels of analysis and the relationships between them; we must emphasize the social mechanisms that influence people in social relationships and networks and connect various levels; we must reconsider some of the epistemological and methodological ideas that have been taken for granted and pay attention to issues of emergence and reductionism and the use of multiple methods. I conclude by suggesting that if public health is to move forward and develop better theories, and more efficient ways of prevention and health promotion, it needs to move beyond reductionist models of social behaviour and develop a transdisciplinary approach that integrates various elements from different disciplines and different levels of analysis.

Three Nontraditional Approaches to Improving the Capacity, Accessibility, and Quality of Mental Health Services: An Overview.

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Grant, Kiran L; Simmons, Magenta Bender; Davey, Christopher G

2018-01-16

To provide evidence for wider use of peer workers and other nonprofessionals, the authors examined three approaches to mental health service provision-peer support worker (PSW) programs, task shifting, and mental health first-aid and community advocacy organizations-summarizing their effectiveness, identifying similarities and differences, and highlighting opportunities for integration. Relevant articles obtained from PubMed, MEDLINE, and Google Scholar searches are discussed. Studies indicate that PSWs can achieve outcomes equal to or better than those achieved by nonpeer mental health professionals. PSWs can be particularly effective in reducing hospital admissions and inpatient days and engaging severely ill patients. When certain care tasks are given to individuals with less training than professionals (task shifting), these staff members can provide psychoeducation, engage service users in treatment, and help them achieve symptom reduction and manage risk of relapse. Mental health first-aid and community organizations can reduce stigma, increase awareness of mental health issues, and encourage help seeking. Most PSW programs have reported implementation challenges, whereas such challenges are fewer in task-shifting programs and minimal in mental health first-aid. Despite challenges in scaling and integrating these approaches into larger systems, they hold promise for improving access to and quality of care. Research is needed on how these approaches can be combined to expand a community's capacity to provide care. Because of the serious shortage of mental health providers globally and the rising prevalence of mental illness, utilizing nontraditional providers may be the only solution in both low- and high-resource settings, at least in the short term.

Designing medical technology for resilience: integrating health economics and human factors approaches.

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Borsci, Simone; Uchegbu, Ijeoma; Buckle, Peter; Ni, Zhifang; Walne, Simon; Hanna, George B

2018-01-01

The slow adoption of innovation into healthcare calls into question the manner of evidence generation for medical technology. This paper identifies potential reasons for this including a lack of attention to human factors, poor evaluation of economic benefits, lack of understanding of the existing healthcare system and a failure to recognise the need to generate resilient products. Areas covered: Recognising a cross-disciplinary need to enhance evidence generation early in a technology's life cycle, the present paper proposes a new approach that integrates human factors and health economic evaluation as part of a wider systems approach to the design of technology. This approach (Human and Economic Resilience Design for Medical Technology or HERD MedTech) supports early stages of product development and is based on the recent experiences of the National Institute for Health Research London Diagnostic Evidence Co-operative in the UK. Expert commentary: HERD MedTech i) proposes a shift from design for usability to design for resilience, ii) aspires to reduce the need for service adaptation to technological constraints iii) ensures value of innovation at the time of product development, and iv) aims to stimulate discussion around the integration of pre- and post-market methods of assessment of medical technology.

Machine learning approaches to the social determinants of health in the health and retirement study.

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Seligman, Benjamin; Tuljapurkar, Shripad; Rehkopf, David

2018-04-01

Social and economic factors are important predictors of health and of recognized importance for health systems. However, machine learning, used elsewhere in the biomedical literature, has not been extensively applied to study relationships between society and health. We investigate how machine learning may add to our understanding of social determinants of health using data from the Health and Retirement Study. A linear regression of age and gender, and a parsimonious theory-based regression additionally incorporating income, wealth, and education, were used to predict systolic blood pressure, body mass index, waist circumference, and telomere length. Prediction, fit, and interpretability were compared across four machine learning methods: linear regression, penalized regressions, random forests, and neural networks. All models had poor out-of-sample prediction. Most machine learning models performed similarly to the simpler models. However, neural networks greatly outperformed the three other methods. Neural networks also had good fit to the data ( R 2 between 0.4-0.6, versus learning models, nine variables were frequently selected or highly weighted as predictors: dental visits, current smoking, self-rated health, serial-seven subtractions, probability of receiving an inheritance, probability of leaving an inheritance of at least $10,000, number of children ever born, African-American race, and gender. Some of the machine learning methods do not improve prediction or fit beyond simpler models, however, neural networks performed well. The predictors identified across models suggest underlying social factors that are important predictors of biological indicators of chronic disease, and that the non-linear and interactive relationships between variables fundamental to the neural network approach may be important to consider.

Social representations: a theoretical approach in health - doi:10.5020/18061230.2011.p80

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Isaiane Santos Bittencourt

2012-01-01

Full Text Available Objective: To present the theory of social representations, placing its epistemology and knowing the basic concepts of its approach as a structural unit of knowledge for health studies. Justification: The use of this theory comes from the need to understand social events under the lens of the meanings constructed by the community. Data Synthesis: This was a descriptive study of literature review, which used as a source of data collection the classical authors of social representations supported by articles from electronic search at Virtual Health Library (VHL. The definition and discussion of collected data enabled to introduce two themes, versed on the history and epistemology of representations and on the structural approach of representations in health studies. Conclusion: This review allowed highlight the importance of locating the objects of study with regard to contextual issues of individual and collective histories, valuing the plurality of relations, to come closer to reality that is represented by the subjects.

Estimating the financial resources needed for local public health departments in Minnesota: a multimethod approach.

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Riley, William; Briggs, Jill; McCullough, Mac

2011-01-01

This study presents a model for determining total funding needed for individual local health departments. The aim is to determine the financial resources needed to provide services for statewide local public health departments in Minnesota based on a gaps analysis done to estimate the funding needs. We used a multimethod analysis consisting of 3 approaches to estimate gaps in local public health funding consisting of (1) interviews of selected local public health leaders, (2) a Delphi panel, and (3) a Nominal Group Technique. On the basis of these 3 approaches, a consensus estimate of funding gaps was generated for statewide projections. The study includes an analysis of cost, performance, and outcomes from 2005 to 2007 for all 87 local governmental health departments in Minnesota. For each of the methods, we selected a panel to represent a profile of Minnesota health departments. The 2 main outcome measures were local-level gaps in financial resources and total resources needed to provide public health services at the local level. The total public health expenditure in Minnesota for local governmental public health departments was $302 million in 2007 ($58.92 per person). The consensus estimate of the financial gaps in local public health departments indicates that an additional $32.5 million (a 10.7% increase or $6.32 per person) is needed to adequately serve public health needs in the local communities. It is possible to make informed estimates of funding gaps for public health activities on the basis of a combination of quantitative methods. There is a wide variation in public health expenditure at the local levels, and methods are needed to establish minimum baseline expenditure levels to adequately treat a population. The gaps analysis can be used by stakeholders to inform policy makers of the need for improved funding of the public health system.

The importance of economic, social and cultural capital in understanding health inequalities: using a Bourdieu-based approach in research on physical and mental health perceptions.

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Pinxten, Wouter; Lievens, John

2014-09-01

In this article we adopt a Bourdieu-based approach to study social inequalities in perceptions of mental and physical health. Most research takes into account the impact of economic or social capital on health inequalities. Bourdieu, however, distinguishes between three forms of capital that can determine peoples' social position: economic, social and cultural capital. Health research examining the effects of cultural capital is scarce. By simultaneously considering and modelling indicators of each of Bourdieu's forms of capital, we further the understanding of the dynamics of health inequalities. Using data from a large-scale representative survey (N = 1825) in Flanders, Belgium, we find that each of the forms of capital has a net effect on perceptions of physical and mental health, which persists after controlling for the other forms of capital and for the effects of other correlates of perceived health. The only exception is that the cultural capital indicators are not related to mental health. These results confirm the value of a Bourdieu-based approach and indicate the need to consider economic, social and cultural capital to obtain a better understanding of social inequality in health. © 2014 The Authors. Sociology of Health & Illness © 2014 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

An innovative approach to post-graduate education in veterinary public health.

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Toribio, Jenny-Ann L M L; Forsyth, Hannah; Laxton, Ruth; Whittington, Richard J

2009-01-01

The past decade has seen a substantially increased need for animal health professionals who have advanced education in areas that impact on veterinary public health (VPH). The University of Sydney has made a significant contribution to the international capacity for training in this field by developing an online, distance program in Veterinary Public Health Management. This paper describes the distinctive characteristics of this program, which combines technical material in a range of units that influence VPH with leadership and project management. It then describes the educational model developed for delivery of its course material, including the four modalities that are structured to support engaged learning by busy animal health professionals who are working full-time (self-led, facilitator-led, peer-led, and assessment-led instructional approaches). Finally, having reflected on the efficacy of this model for post-graduate training in VPH, we discuss the progress of the program since its inception in 2002, reflecting on the challenges it has encountered and defining the factors that are critical to the success of this program.

How Effective Is the Health-Promoting School Approach in Building Social Capital in Primary Schools?

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Sun, Jing; Stewart, Donald

2007-01-01

Purpose: The purpose of this paper is to describe a study which investigated the relationship between the "health-promoting school" (HPS) approach and social capital and tested the proposition that the implementation of an HPS intervention leads to a significant improvement in HPS features and social capital. Design/methodology/approach:…

Collaborative Visual Analytics: A Health Analytics Approach to Injury Prevention

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Samar Al-Hajj

2017-09-01

Full Text Available Background: Accurate understanding of complex health data is critical in order to deal with wicked health problems and make timely decisions. Wicked problems refer to ill-structured and dynamic problems that combine multidimensional elements, which often preclude the conventional problem solving approach. This pilot study introduces visual analytics (VA methods to multi-stakeholder decision-making sessions about child injury prevention; Methods: Inspired by the Delphi method, we introduced a novel methodology—group analytics (GA. GA was pilot-tested to evaluate the impact of collaborative visual analytics on facilitating problem solving and supporting decision-making. We conducted two GA sessions. Collected data included stakeholders’ observations, audio and video recordings, questionnaires, and follow up interviews. The GA sessions were analyzed using the Joint Activity Theory protocol analysis methods; Results: The GA methodology triggered the emergence of ‘common ground’ among stakeholders. This common ground evolved throughout the sessions to enhance stakeholders’ verbal and non-verbal communication, as well as coordination of joint activities and ultimately collaboration on problem solving and decision-making; Conclusions: Understanding complex health data is necessary for informed decisions. Equally important, in this case, is the use of the group analytics methodology to achieve ‘common ground’ among diverse stakeholders about health data and their implications.

Collaborative Visual Analytics: A Health Analytics Approach to Injury Prevention.

Science.gov (United States)

Al-Hajj, Samar; Fisher, Brian; Smith, Jennifer; Pike, Ian

2017-09-12

Background : Accurate understanding of complex health data is critical in order to deal with wicked health problems and make timely decisions. Wicked problems refer to ill-structured and dynamic problems that combine multidimensional elements, which often preclude the conventional problem solving approach. This pilot study introduces visual analytics (VA) methods to multi-stakeholder decision-making sessions about child injury prevention; Methods : Inspired by the Delphi method, we introduced a novel methodology-group analytics (GA). GA was pilot-tested to evaluate the impact of collaborative visual analytics on facilitating problem solving and supporting decision-making. We conducted two GA sessions. Collected data included stakeholders' observations, audio and video recordings, questionnaires, and follow up interviews. The GA sessions were analyzed using the Joint Activity Theory protocol analysis methods; Results : The GA methodology triggered the emergence of ' common g round ' among stakeholders. This common ground evolved throughout the sessions to enhance stakeholders' verbal and non-verbal communication, as well as coordination of joint activities and ultimately collaboration on problem solving and decision-making; Conclusion s : Understanding complex health data is necessary for informed decisions. Equally important, in this case, is the use of the group analytics methodology to achieve ' common ground' among diverse stakeholders about health data and their implications.

Primary health care in rural Malawi - a qualitative assessment exploring the relevance of the community-directed interventions approach

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Makaula Peter

2012-09-01

Full Text Available Abstract Background Primary Health Care (PHC is a strategy endorsed for attaining equitable access to basic health care including treatment and prevention of endemic diseases. Thirty four years later, its implementation remains sub-optimal in most Sub-Saharan African countries that access to health interventions is still a major challenge for a large proportion of the rural population. Community-directed treatment with ivermectin (CDTi and community-directed interventions (CDI are participatory approaches to strengthen health care at community level. Both approaches are based on values and principles associated with PHC. The CDI approach has successfully been used to improve the delivery of interventions in areas that have previously used CDTi. However, little is known about the added value of community participation in areas without prior experience with CDTi. This study aimed at assessing PHC in two rural Malawian districts without CDTi experience with a view to explore the relevance of the CDI approach. We examined health service providers’ and beneficiaries’ perceptions on existing PHC practices, and their perspectives on official priorities and strategies to strengthen PHC. Methods We conducted 27 key informant interviews with health officials and partners at national, district and health centre levels; 32 focus group discussions with community members and in-depth interviews with 32 community members and 32 community leaders. Additionally, official PHC related documents were reviewed. Results The findings show that there is a functional PHC system in place in the two study districts, though its implementation is faced with various challenges related to accessibility of services and shortage of resources. Health service providers and consumers shared perceptions on the importance of intensifying community participation to strengthen PHC, particularly within the areas of provision of insecticide treated bed nets, home case management for

ADVANZ – control of neglected zoonotic diseases using one health and ecohealth approaches

DEFF Research Database (Denmark)

Saarnak, Christopher; Mukaratirwa, S.; Johansen, Maria Vang

, echinococcosis, and taeniasis/cysticercosis. Five other diseases have also been declared neglected, i.e. brucellosis, bovine tuberculosis, anthrax, human African trypanosomiasis, and leishmaniasis. The best strategic approach to transmission control and management of these diseases involves integrated One Health...

[Health care innovation from a territorial perspective: a call for a new approach].

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Costa, Laís Silveira; Gadelha, Carlos Augusto Grabois; Maldonado, José

2012-12-01

Innovation plays an increasingly important role in health care, partly because it is responsible for a significant share of national investment in research and development, and partly because of its industrial and service provision base, which provides a conduit to future technology. The relationship between health care and development is also strengthened as a result of the leading role of health care in generating innovation. Nevertheless, Brazil's health care production base is persistently weak, hindering both universal provision of health care services and international competitiveness. This article, based on the theoretical framework of Political Economy and innovation systems, has sought to identify variables in subnational contexts that influence the dynamic of innovation generation in health care. To this end, the theoretical approach used lies on the assumption that innovation is a contextualized social process and that the production base in healthcare will remain weak if new variables involved in the dynamic of innovation are not taken into account.

Educating Masters of Public Health Students on Tobacco Control and Prevention: An Integrated Curriculum Approach

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Lowe, John; Aquilino, Mary; Abramsohn, Erin

2007-01-01

Objectives: Comprehensive training in the area of tobacco control and prevention has not been available to public health students receiving professional degrees. This study describes findings of a project designed to develop and evaluate an integrated approach to the education of Masters of Public Health (MPH) students at the University of Iowa…

[Health promotion effectiveness: developing and testing a system for routine evaluation in health education, workplace health promotion and setting approach supplied by the German statutory health insurance agencies].

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Kliche, T; Riemann, K; Bockermann, C; Niederbühl, K; Wanek, V; Koch, U

2011-04-01

The aim of the study was to develop and test a routine evaluation system for all health promotion and education activities funded by the German statutory health insurance companies. The system aims at measuring both individual health effects and the complex organisational effects of setting projects. Measurement instruments were developed synoptically and tested in three field tests (2003-2008). In order to assess the impact of individual health training, 212 courses of the health insurance companies were evaluated. To assess the setting approach, 56 schools participating in a health-promotion project were included, and for workplace health-promotion 6 projects of different health insurance companies were included. The research design was an observational study. Instead of control groups, individual data were compared to reference values for gender- and age-matched groups from national health surveys. The studies consisted of baseline and final assessment (T1/T2), complemented by a follow-up (T3), all adapted to the time of intervention (i. e., 3-24 months for T1/T2 and 3-18 months for T2/T3). The evaluation system provides multilevel-measurement based upon validated questionnaires for health-related structures and processes in institutions, and for the participating individual's subjective health, health problems, health-related quality of life, workplace and institutional satisfaction. Controlling for central confounders is also possible (input and dosage, age, gender, educational background). Thus, short but valid measurement instruments of high usability are available to evaluate the effectiveness of prevention, health promotion and education. © Georg Thieme Verlag KG Stuttgart · New York.

Improving the Health of Cambodian Americans: Grassroots Approaches and Root Causes.

Science.gov (United States)

Lee, Juliet P; Kirkpatrick, Sean; Rojas-Cheatham, Ann; Sin, Talaya; Moore, Roland S; Tan, Sotheavy; Godoy, Shadia; Ercia, Angelo

2016-01-01

Cambodian Americans experience great disparities in health compared to other Americans, yet may be underserved by conventional healthcare systems. Community-based participatory research (CBPR) is a means to engage underserved communities in health research and programming. We describe results of our efforts to engage the Cambodian grassroots members as well as formal leaders in Oakland, California. In addition to a community advisory group, we convened a Community Work Group (CWG), composed of 10 grassroots community women of varying ages and backgrounds. The project aimed to leverage the lived experiences of these women and their understandings of health and wellness in identifying specific health issues and developing culturally resonant strategies. The CWG met weekly with staff facilitators using methods for collective analysis including theater, body mapping, and other expressive arts. The approach proved logistically challenging, but resulted in novel analyses and strategies. The group identified trauma, along with poor access to education, unemployment and underemployment, social isolation, and generation gap, together with community violence, as root causes of key behavioral health issues, namely, alcohol abuse, gambling, prescription drug misuse, and domestic violence. Strategies proposed and implemented by the group and project staff were a community garden, Cambodian New Year's celebrations, and a museum exhibit on the Cambodian refugee experiences. Grassroots community engagement can support projects in identifying social determinants of health and developing the capacities of community members to conduct research and actions to improve health.

Approaches to ensuring and improving quality in the context of health system strengthening: a cross-site analysis of the five African Health Initiative Partnership programs.

Science.gov (United States)

Hirschhorn, Lisa R; Baynes, Colin; Sherr, Kenneth; Chintu, Namwinga; Awoonor-Williams, John Koku; Finnegan, Karen; Philips, James F; Anatole, Manzi; Bawah, Ayaga A; Basinga, Paulin

2013-01-01

Integrated into the work in health systems strengthening (HSS) is a growing focus on the importance of ensuring quality of the services delivered and systems which support them. Understanding how to define and measure quality in the different key World Health Organization building blocks is critical to providing the information needed to address gaps and identify models for replication. We describe the approaches to defining and improving quality across the five country programs funded through the Doris Duke Charitable Foundation African Health Initiative. While each program has independently developed and implemented country-specific approaches to strengthening health systems, they all included quality of services and systems as a core principle. We describe the differences and similarities across the programs in defining and improving quality as an embedded process essential for HSS to achieve the goal of improved population health. The programs measured quality across most or all of the six WHO building blocks, with specific areas of overlap in improving quality falling into four main categories: 1) defining and measuring quality; 2) ensuring data quality, and building capacity for data use for decision making and response to quality measurements; 3) strengthened supportive supervision and/or mentoring; and 4) operational research to understand the factors associated with observed variation in quality. Learning the value and challenges of these approaches to measuring and improving quality across the key components of HSS as the projects continue their work will help inform similar efforts both now and in the future to ensure quality across the critical components of a health system and the impact on population health.

Towards Principles-Based Approaches to Governance of Health-related Research using Personal Data.

Science.gov (United States)

Laurie, Graeme; Sethi, Nayha

2013-01-01

Technological advances in the quality, availability and linkage potential of health data for research make the need to develop robust and effective information governance mechanisms more pressing than ever before; they also lead us to question the utility of governance devices used hitherto such as consent and anonymisation. This article assesses and advocates a principles-based approach, contrasting this with traditional rule-based approaches, and proposes a model of principled proportionate governance . It is suggested that the approach not only serves as the basis for good governance in contemporary data linkage but also that it provides a platform to assess legal reforms such as the draft Data Protection Regulation.

Towards Principles-Based Approaches to Governance of Health-related Research using Personal Data

Science.gov (United States)

Laurie, Graeme; Sethi, Nayha

2013-01-01

Technological advances in the quality, availability and linkage potential of health data for research make the need to develop robust and effective information governance mechanisms more pressing than ever before; they also lead us to question the utility of governance devices used hitherto such as consent and anonymisation. This article assesses and advocates a principles-based approach, contrasting this with traditional rule-based approaches, and proposes a model of principled proportionate governance. It is suggested that the approach not only serves as the basis for good governance in contemporary data linkage but also that it provides a platform to assess legal reforms such as the draft Data Protection Regulation. PMID:24416087

From Metaphors to Formalism: A Heuristic Approach to Holistic Assessments of Ecosystem Health.

Science.gov (United States)

Fock, Heino O; Kraus, Gerd

2016-01-01

Environmental policies employ metaphoric objectives such as ecosystem health, resilience and sustainable provision of ecosystem services, which influence corresponding sustainability assessments by means of normative settings such as assumptions on system description, indicator selection, aggregation of information and target setting. A heuristic approach is developed for sustainability assessments to avoid ambiguity and applications to the EU Marine Strategy Framework Directive (MSFD) and OSPAR assessments are presented. For MSFD, nineteen different assessment procedures have been proposed, but at present no agreed assessment procedure is available. The heuristic assessment framework is a functional-holistic approach comprising an ex-ante/ex-post assessment framework with specifically defined normative and systemic dimensions (EAEPNS). The outer normative dimension defines the ex-ante/ex-post framework, of which the latter branch delivers one measure of ecosystem health based on indicators and the former allows to account for the multi-dimensional nature of sustainability (social, economic, ecological) in terms of modeling approaches. For MSFD, the ex-ante/ex-post framework replaces the current distinction between assessments based on pressure and state descriptors. The ex-ante and the ex-post branch each comprise an inner normative and a systemic dimension. The inner normative dimension in the ex-post branch considers additive utility models and likelihood functions to standardize variables normalized with Bayesian modeling. Likelihood functions allow precautionary target setting. The ex-post systemic dimension considers a posteriori indicator selection by means of analysis of indicator space to avoid redundant indicator information as opposed to a priori indicator selection in deconstructive-structural approaches. Indicator information is expressed in terms of ecosystem variability by means of multivariate analysis procedures. The application to the OSPAR

From Metaphors to Formalism: A Heuristic Approach to Holistic Assessments of Ecosystem Health

Science.gov (United States)

Kraus, Gerd

2016-01-01

Environmental policies employ metaphoric objectives such as ecosystem health, resilience and sustainable provision of ecosystem services, which influence corresponding sustainability assessments by means of normative settings such as assumptions on system description, indicator selection, aggregation of information and target setting. A heuristic approach is developed for sustainability assessments to avoid ambiguity and applications to the EU Marine Strategy Framework Directive (MSFD) and OSPAR assessments are presented. For MSFD, nineteen different assessment procedures have been proposed, but at present no agreed assessment procedure is available. The heuristic assessment framework is a functional-holistic approach comprising an ex-ante/ex-post assessment framework with specifically defined normative and systemic dimensions (EAEPNS). The outer normative dimension defines the ex-ante/ex-post framework, of which the latter branch delivers one measure of ecosystem health based on indicators and the former allows to account for the multi-dimensional nature of sustainability (social, economic, ecological) in terms of modeling approaches. For MSFD, the ex-ante/ex-post framework replaces the current distinction between assessments based on pressure and state descriptors. The ex-ante and the ex-post branch each comprise an inner normative and a systemic dimension. The inner normative dimension in the ex-post branch considers additive utility models and likelihood functions to standardize variables normalized with Bayesian modeling. Likelihood functions allow precautionary target setting. The ex-post systemic dimension considers a posteriori indicator selection by means of analysis of indicator space to avoid redundant indicator information as opposed to a priori indicator selection in deconstructive-structural approaches. Indicator information is expressed in terms of ecosystem variability by means of multivariate analysis procedures. The application to the OSPAR

Prognostic and health management for engineering systems: a review of the data-driven approach and algorithms

Directory of Open Access Journals (Sweden)

Thamo Sutharssan

2015-07-01

Full Text Available Prognostics and health management (PHM has become an important component of many engineering systems and products, where algorithms are used to detect anomalies, diagnose faults and predict remaining useful lifetime (RUL. PHM can provide many advantages to users and maintainers. Although primary goals are to ensure the safety, provide state of the health and estimate RUL of the components and systems, there are also financial benefits such as operational and maintenance cost reductions and extended lifetime. This study aims at reviewing the current status of algorithms and methods used to underpin different existing PHM approaches. The focus is on providing a structured and comprehensive classification of the existing state-of-the-art PHM approaches, data-driven approaches and algorithms.

EVA – a non-linear Eulerian approach for assessment of health-cost externalities of air pollution

DEFF Research Database (Denmark)

Andersen, Mikael Skou; Frohn, Lise Marie; Nielsen, Jytte Seested

2006-01-01

of the emissions. External cost estimates based on the Eulerian approach, on the other hand, are in mutual conformity. The existence of non-linear dynamics and possible thresholds, both in the atmospheric modelling and in the dose-response functions for health effects, need further attention and should......Integrated models which are used to account for the external costs of air pollution have to a considerable extent ignored the non-linear dynamics of atmospheric science. In order to bridge the gap between economic analysis and environmental modelling an integrated model EVA, based on a Eulerian...... for the final external cost estimates of the Eulerian approach is explored. Uncertainties in the health costs estimates are endemic in particular for mortality, but in order to achieve a common baseline the approach recommended by the OECD has been employed for the valuation part. This approach implies the use...

MediCoordination: a practical approach to interoperability in the Swiss health system.

Science.gov (United States)

Müller, Henning; Schumacher, Michael; Godel, David; Omar, Abu Khaled; Mooser, Francois; Ding, Sandrine

2009-01-01

Interoperability and data exchange between partners in the health sector is seen as one of the important domains that can improve care processes and in the long run also decrease costs of the health care system. Data exchange can assure that the data on the patient are as complete as possible avoiding potential mistreatments, and it can avoid double examinations if the data required are already available. On the other hand, health data is a sensible point for many people and strong protection needs to be implemented to protect patient data against misuse as well as tools to let the patient manage his/her own data. Many countries have eHealth initiatives in preparation or already implemented. However, health data exchange on a large scale still has a fairly long way to go as the political processes for global solutions are often complicated. In the MediCoordination project a pragmatic approach is selected trying to integrate several partners in health care on a regional scale. In parallel with the Swiss eHealth strategy that is currently being elaborated by the Swiss confederation, particularly medium-sized hospitals and external partners are targeted in MediCoordination to implement concrete added-value scenarios of information exchange between hospitals and external medical actors.

Faecal Pathogen Flows and Their Public Health Risks in Urban Environments: A Proposed Approach to Inform Sanitation Planning

Science.gov (United States)

Mills, Freya; Petterson, Susan; Norman, Guy

2018-01-01

Public health benefits are often a key political driver of urban sanitation investment in developing countries, however, pathogen flows are rarely taken systematically into account in sanitation investment choices. While several tools and approaches on sanitation and health risks have recently been developed, this research identified gaps in their ability to predict faecal pathogen flows, to relate exposure risks to the existing sanitation services, and to compare expected impacts of improvements. This paper outlines a conceptual approach that links faecal waste discharge patterns with potential pathogen exposure pathways to quantitatively compare urban sanitation improvement options. An illustrative application of the approach is presented, using a spreadsheet-based model to compare the relative effect on disability-adjusted life years of six sanitation improvement options for a hypothetical urban situation. The approach includes consideration of the persistence or removal of different pathogen classes in different environments; recognition of multiple interconnected sludge and effluent pathways, and of multiple potential sites for exposure; and use of quantitative microbial risk assessment to support prediction of relative health risks for each option. This research provides a step forward in applying current knowledge to better consider public health, alongside environmental and other objectives, in urban sanitation decision making. Further empirical research in specific locations is now required to refine the approach and address data gaps. PMID:29360775

Practical approach to lung health in Nepal: better prescribing and reduction of cost.

NARCIS (Netherlands)

Shrestha, N.; Samir, K.C.; Baltussen, R.M.P.M.; Kafle, K.K.; Bishai, D.; Niessen, L.

2006-01-01

OBJECTIVES: To assess the impact of Practical Approach to Lung Health (PAL) guidelines on prescription behaviour and the total cost of prescription for patients with asthma, chronic obstructive pulmonary disease and pneumonia. METHODS: Pre- and post-intervention comparison in a cluster randomized

Scientific Approach for Optimising Performance, Health and Safety in High-Altitude Observatories

Science.gov (United States)

Böcker, Michael; Vogy, Joachim; Nolle-Gösser, Tanja

2008-09-01

The ESO coordinated study “Optimising Performance, Health and Safety in High-Altitude Observatories” is based on a psychological approach using a questionnaire for data collection and assessment of high-altitude effects. During 2007 and 2008, data from 28 staff and visitors involved in APEX and ALMA were collected and analysed and the first results of the study are summarised. While there is a lot of information about biomedical changes at high altitude, relatively few studies have focussed on psychological changes, for example with respect to performance of mental tasks, safety consciousness and emotions. Both, biomedical and psychological changes are relevant factors in occupational safety and health. The results of the questionnaire on safety, health and performance issues demonstrate that the working conditions at high altitude are less detrimental than expected.

Missing Data Approaches in eHealth Research: Simulation Study and a Tutorial for Nonmathematically Inclined Researchers

NARCIS (Netherlands)

Blankers, Matthijs; Koeter, Maarten W. J.; Schippers, Gerard M.

2010-01-01

Background: Missing data is a common nuisance in eHealth research: it is hard to prevent and may invalidate research findings. Objective: In this paper several statistical approaches to data "missingness" are discussed and tested in a simulation study. Basic approaches (complete case analysis, mean

Meta-Analysis of the Reasoned Action Approach (RAA) to Understanding Health Behaviors.

Science.gov (United States)

McEachan, Rosemary; Taylor, Natalie; Harrison, Reema; Lawton, Rebecca; Gardner, Peter; Conner, Mark

2016-08-01

Reasoned action approach (RAA) includes subcomponents of attitude (experiential/instrumental), perceived norm (injunctive/descriptive), and perceived behavioral control (capacity/autonomy) to predict intention and behavior. To provide a meta-analysis of the RAA for health behaviors focusing on comparing the pairs of RAA subcomponents and differences between health protection and health-risk behaviors. The present research reports a meta-analysis of correlational tests of RAA subcomponents, examination of moderators, and combined effects of subcomponents on intention and behavior. Regressions were used to predict intention and behavior based on data from studies measuring all variables. Capacity and experiential attitude had large, and other constructs had small-medium-sized correlations with intention; all constructs except autonomy were significant independent predictors of intention in regressions. Intention, capacity, and experiential attitude had medium-large, and other constructs had small-medium-sized correlations with behavior; intention, capacity, experiential attitude, and descriptive norm were significant independent predictors of behavior in regressions. The RAA subcomponents have utility in predicting and understanding health behaviors.

Developing the Mental Health Workforce: Review and Application of Training Approaches from Multiple Disciplines

OpenAIRE

Lyon, Aaron R.; Stirman, Shannon Wiltsey; Kerns, Suzanne E. U.; Bruns, Eric J.

2011-01-01

Strategies specifically designed to facilitate the training of mental health practitioners in evidence-based practices (EBPs) have lagged behind the development of the interventions themselves. The current paper draws from an interdisciplinary literature (including medical training, adult education, and teacher training) to identify useful training and support approaches as well as important conceptual frameworks that may be applied to training in mental health. Theory and research findings a...

Applying the Innov8 approach for reviewing national health programmes to leave no one behind: lessons learnt from Indonesia

Science.gov (United States)

Saint, Victoria; Floranita, Rustini; Koemara Sakti, Gita Maya; Pambudi, Imran; Hermawan, Lukas; Villar, Eugenio; Magar, Veronica

2018-01-01

ABSTRACT The World Health Organization’s Innov8 Approach for Reviewing National Health Programmes to Leave No One Behind is an eight-step process that supports the operationalization of the Sustainable Development Goals’ commitment to ‘leave no one behind’. In 2014–2015, Innov8 was adapted and applied in Indonesia to review how the national neonatal and maternal health action plans could become more equity-oriented, rights-based and gender-responsive, and better address critical social determinants of health. The process was led by the Indonesian Ministry of Health, with the support of WHO. It involved a wide range of actors and aligned with/fed into the drafting of the maternal newborn health action plan and the implementation planning of the newborn action plan. Key activities included a sensitization meeting, diagnostic checklist, review workshop and in-country work by the review teams. This ‘methods forum’ article describes this adaptation and application process, the outcomes and lessons learnt. In conjunction with other sources, Innov8 findings and recommendations informed national and sub-national maternal and neonatal action plans and programming to strengthen a ‘leave no one behind’ approach. As follow-up during 2015–2017, components of the Innov8 methodology were integrated into district-level planning processes for maternal and newborn health, and Innov8 helped generate demand for health inequality monitoring and its use in planning. In Indonesia, Innov8 enhanced national capacity for equity-oriented, rights-based and gender-responsive approaches and addressing critical social determinants of health. Adaptation for the national planning context (e.g. decentralized structure) and linking with health inequality monitoring capacity building were important lessons learnt. The pilot of Innov8 in Indonesia suggests that this approach can help operationalize the SDGs’ commitment to leave no one behind, in particular in relation to

Accountable priority setting for trust in health systems--the need for research into a new approach for strengthening sustainable health action in developing countries

DEFF Research Database (Denmark)

Byskov, Jens; Bloch, Paul; Blystad, Astrid

2009-01-01

Despite multiple efforts to strengthen health systems in low and middle income countries, intended sustainable improvements in health outcomes have not been shown. To date most priority setting initiatives in health systems have mainly focused on technical approaches involving information derived...... from burden of disease statistics, cost effectiveness analysis, and published clinical trials. However, priority setting involves value-laden choices and these technical approaches do not equip decision-makers to address a broader range of relevant values - such as trust, equity, accountability...... and fairness - that are of concern to other partners and, not least, the populations concerned. A new focus for priority setting is needed.Accountability for Reasonableness (AFR) is an explicit ethical framework for legitimate and fair priority setting that provides guidance for decision-makers who must...

Training Physicians toward a Dignifying Approach in Adolescents' Health Care: A Promising Simulation-Based Medical Education Program.

Science.gov (United States)

Hardoff, Daniel; Gefen, Assaf; Sagi, Doron; Ziv, Amitai

2016-08-01

Human dignity has a pivotal role within the health care system. There is little experience using simulation-based medical education (SBME) programs that focus on human dignity issues in doctor-patient relationships. To describe and assess a SBME program aimed at improving physicians' competence in a dignifying approach when encountering adolescents and their parents. A total of 97 physicians participated in 8 one-day SMBE workshops that included 7 scenarios of typical adolescent health care dilemmas. These issues could be resolved if the physician used an appropriate dignifying approach toward the patient and the parents. Debriefing discussions were based on video recordings of the scenarios. The effect of the workshops on participants' approach to adolescent health care was assessed by a feedback questionnaire and on 5-point Likert score questionnaires administered before the workshop and 3 months after. All participants completed both the pre-workshop and the feedback questionnaires and 41 (42%) completed the post-workshop questionnaire 3 months later. Practice and competence topics received significantly higher scores in post-workshop questionnaires (P simulation-based workshop may improve physicians' communication skills and sense of competence in addressing adolescents' health care issues which require a dignifying approach toward both the adolescent patients and their parents. This dignity-focused methodology may be expanded to improve communication skills of physicians from various disciplines.

Priority Setting in Indigenous Health: Why We Need an Explicit Decision Making Approach

Directory of Open Access Journals (Sweden)

Michael E. Otim

2015-06-01

Full Text Available Indigenous Australians have significantly poorer health outcomes than the non-Indigenous population worldwide. The Australian government has increased its investment in Indigenous health through the "Closing the Health Gap" initiative. Deciding where to invest scarce resources so as to maximize health outcomes for Indigenous peoples may require improved priority setting processes. Current government practice involves a mix of implicit and explicit processes to varying degrees at the macro and meso decision making levels. In this article, we argue that explicit priority setting should be emphasized in Indigenous health, as it can ensure that the decision making process is accountable, systematic, and transparent. Following a review of the literature, we outline four key issues that need to be considered for explicit priority setting: developing an Indigenous health "constitution," strengthening the evidence base, selecting mechanisms for priority setting, and establishing appropriate incentives and institutional structure. We then summarize our findings into a checklist that can help a decision makers ensure that explicit priority setting is undertaken in Indigenous health. By addressing these key issues, the benefits of an explicit approach, which include increased efficiency, equity, and use of evidence, can be realized, thereby maximizing Indigenous health outcomes.

A One Health approach to antimicrobial resistance surveillance: is there a business case for it?

Science.gov (United States)

Queenan, Kevin; Häsler, Barbara; Rushton, Jonathan

2016-10-01

Antimicrobial resistance is a global problem of complex epidemiology, suited to a broad, integrated One Health approach. Resistant organisms exist in humans, animals, food and the environment, and the main driver of this resistance is antimicrobial usage. A One Health conceptual framework for surveillance is presented to include all of these aspects. Global and European (regional and national) surveillance systems are described, highlighting shortcomings compared with the framework. Policy decisions rely on economic and scientific evidence, so the business case for a fully integrated system is presented. The costs of integrated surveillance are offset by the costs of unchecked resistance and the benefits arising from interventions and outcomes. Current estimates focus on costs and benefits of human health outcomes. A One Health assessment includes wider societal costs of lost labour, changes in health-seeking behaviour, impacts on animal health and welfare, higher costs of animal-origin food production, and reduced consumer confidence in safety and international trade of such food. Benefits of surveillance may take years to realise and are dependent on effective and accepted interventions. Benefits, including the less tangible, such as improved synergies and efficiencies in service delivery and more timely and accurate risk identification, should also be recognised. By including these less tangible benefits to society, animal welfare, ecosystem health and resilience, together with the savings and efficiencies through shared resources and social capital-building, a stronger business case for a One Health approach to surveillance can be made. Copyright © 2016 Elsevier B.V. and International Society of Chemotherapy. All rights reserved.

Holistic approach to human health and disease: life circumstances and inner processing.

Science.gov (United States)

Tomljenović, Andrea

2014-06-01

Human body is dinamic, energetic system under the influences of food intake, environment, interpersonal relationships, inheritance, culture and human activities. The environmental and psychosocioeconomic factors affect the individual's health altering the performance of biological systems effecting disease risk and disease progression. The concerns in modern society are more and more devoted to stress and its influences on health. Life span is extended but the quality of life, well-being and productivity usually do not follow that extention. Body is a flow of energy and dynamic communications with inside and outside environment. The way to improve health is to address its social determinants. Only in sinergy the questions about disease and health could be better understood. It is not enough to diagnose illness, important is to diagnose circumstances and environmental influences that consequently lead to disease. Emotional disruptions make base for physical disruptions. Social gradient and stress involving personal life and work is a significant factor in physical and mental illness. The best indicator of the successful social policy result is the sense of well-being of the inhabitants. Holistic approach to a patient and discussions about the influences in patient's life can lead to a better health outcome. Anthropology studies people's habits, means and conditions of life and can be the bridge between the medicine and the life circumstances that put people's health at risk providing important insights into health and disease and assist in public health policies, preventive measures and health improvement of the populations.

Designing a Model for Trauma System Management Using Public Health Approach: The Case of Iran

Directory of Open Access Journals (Sweden)

Farzad Panahi

2012-01-01

Full Text Available Trauma is a leading cause of death and disability around the world. Injuries are responsible for about six million deaths annually, of which ninety percent occur in developing countries. In Iran, injuries are the most common cause of death among age groups below fifty. Trauma system development is a systematic and comprehensive approach to injury prevention and treatment whose effectiveness has been proved. The present study aims at designing a trauma system management model as the first step toward trauma system establishment in Iran. In this qualitative research, a conceptual framework was developed based on the public health approach and three well-known trauma system models. We used Benchmarks, Indicators and Scoring (BIS to analyze the current situation of Iran trauma care system. Then the trauma system management was designed using the policy development phase of public health approach The trauma system management model, validated by a panel of experts, describes lead agency, trauma system plan, policy-making councils, and data-based control according to the four main functions of management: leading, planning, organizing and controlling. This model may be implemented in two phases: the exclusive phase, focusing on resource integration and the inclusive phase, which concentrates on system development. The model could facilitate the development of trauma system in Iran through pilot studies as the assurance phase of public health approach. Furthermore, the model can provide a practical framework for trauma system management at the international level.

Perceived Benefits and Challenges of Coordinated Approaches to Chronic Disease Prevention in State Health Departments

Science.gov (United States)

Sequeira, Sonia; Best, Leslie; Jones, Ellen; Baker, Elizabeth A.; Brownson, Ross C.

2014-01-01

Introduction Chronic disease prevention efforts have historically been funded categorically according to disease or risk factor. Federal agencies are now progressively starting to fund combined programs to address common risk. The purpose of this study was to inform transitions to coordinated chronic disease prevention by learning views on perceived benefits and challenges of a coordinated approach to funding. Methods A national survey on evidence-based public health was conducted from March through May 2013 among state health department employees working in chronic disease prevention (N = 865). Participants were asked to rank the top 3 benefits and top 3 challenges in coordinating chronic disease approaches from provided lists and could provide additional responses. Descriptive analyses, χ2 tests, and analysis of variance were conducted. Results The most common perceived benefits of coordinated approaches to chronic disease prevention were improved health outcomes, common risk factors better addressed, and reduced duplication of program efforts. The most common perceived challenges were funding restrictions, such as disease-specific performance measures; competing priorities; lack of communication across programs; funding might be reduced; agency not structured for program coordination; and loss of disease-specific partner support. Rankings of benefits and challenges were similar across states and participant roles; the perceived challenges “lack of communication across programs” (P = .02) and “funding might be reduced” differed by program area (P organizational support for coordinated approaches, and create benefits for organizational partners. PMID:24809362

Educational games for brain health: revealing their unexplored potential through a neurocognitive approach

Directory of Open Access Journals (Sweden)

Patrick eFissler

2015-07-01

Full Text Available Educational games link the motivational nature of games with learning of knowledge and skills. Here, we go beyond effects on these learning outcomes. We review two lines of evidence which indicate the currently unexplored potential of educational games to promote brain health: First, gaming with specific neurocognitive demands (e.g., executive control, and second, educational learning experiences (e.g., studying foreign languages improve brain health markers. These markers include cognitive ability, brain function, and brain structure. As educational games allow the combination of specific neurocognitive demands with educational learning experiences, they seem to be optimally suited for promoting brain health. We propose a neurocognitive approach to reveal this unexplored potential of educational games in future research.

The approach of prehospital health care personnel working at emergency stations towards forensic cases.

Science.gov (United States)

Asci, Ozlem; Hazar, Guleser; Sercan, Isa

2015-09-01

The objective of this study is to determine the states of health care personnel, working at 112 emergency stations in the province of Artvin, to encounter with regarding forensic cases and determine their practices aimed at recognizing, protecting, and reporting the evidences that may affect the forensic process. This descriptive study was conducted with nurses and emergency medicine technicians working at 112 emergency stations in Artvin between January 2013 and February 2014. Of 141 health personnel that constituted sample of the study, 48.9% were nurses, 9.9% emergency medicine technicians, and 41.1% ambulance and emergency care technicians. The rate of feeling sufficient in coping with forensic cases and incidents was 20.6%. There was a lower rate of receiving education about the approach towards forensic cases (15.6%). In the study, the frequency of encountering with at least one forensic case was 88.7%. Traffic accidents (72.5%), suicides (41.5%) and assaults (41.5%) were among the most frequent reasons of forensic cases. The practices of nurses were more successful in woundings by firearms compared to other health personnel (p forensic cases. The personnel with higher educational level and nurses have more successful practices in forensic cases. Health personnel have approaches that may negatively affect the solution of forensic cases.

Extracorporeal treatment for tricyclic antidepressant poisoning

DEFF Research Database (Denmark)

Yates, Christopher; Galvao, Tais; Sowinski, Kevin M

2014-01-01

The Extracorporeal Treatments In Poisoning (EXTRIP) workgroup was formed to provide recommendations on the use of extracorporeal treatments (ECTR) in poisoning. Here, the workgroup presents its results for tricyclic antidepressants (TCAs). After an extensive literature search, using a predefined...... methodology, the subgroup responsible for this poison reviewed the articles, extracted the data, summarized findings, and proposed structured voting statements following a predetermined format. A two-round modified Delphi method was chosen to reach a consensus on voting statements and RAND...... yielding a very low quality of evidence for all recommendations. Data on 108 patients, including 12 fatalities, were abstracted. The workgroup concluded that TCAs are not dialyzable and made the following recommendation: ECTR is not recommended in severe TCA poisoning (1D). The workgroup considers...

Gas Path Health Monitoring for a Turbofan Engine Based on a Nonlinear Filtering Approach

Directory of Open Access Journals (Sweden)

Yiqiu Lv

2013-01-01

Full Text Available Different approaches for gas path performance estimation of dynamic systems are commonly used, the most common being the variants of the Kalman filter. The extended Kalman filter (EKF method is a popular approach for nonlinear systems which combines the traditional Kalman filtering and linearization techniques to effectively deal with weakly nonlinear and non-Gaussian problems. Its mathematical formulation is based on the assumption that the probability density function (PDF of the state vector can be approximated to be Gaussian. Recent investigations have focused on the particle filter (PF based on Monte Carlo sampling algorithms for tackling strong nonlinear and non-Gaussian models. Considering the aircraft engine is a complicated machine, operating under a harsh environment, and polluted by complex noises, the PF might be an available way to monitor gas path health for aircraft engines. Up to this point in time a number of Kalman filtering approaches have been used for aircraft turbofan engine gas path health estimation, but the particle filters have not been used for this purpose and a systematic comparison has not been published. This paper presents gas path health monitoring based on the PF and the constrained extend Kalman particle filter (cEKPF, and then compares the estimation accuracy and computational effort of these filters to the EKF for aircraft engine performance estimation under rapid faults and general deterioration. Finally, the effects of the constraint mechanism and particle number on the cEKPF are discussed. We show in this paper that the cEKPF outperforms the EKF, PF and EKPF, and conclude that the cEKPF is the best choice for turbofan engine health monitoring.

New approaches to health promotion and informatics education using Internet in the Czech Republic.

Science.gov (United States)

Zvárová, J

2005-01-01

The paper describes nowadays information technology skills in the Czech Republic. It focuses on informatics education using Internet, ECDL concept and the links between computer literacy among health care professionals and quality of health care. Everyone understands that the main source of wealth of any nation is information management and the efficient transformation of information into knowledge. There appear completely new decisive factors for the economics of the near future based on circulation and exchange information. It is clear that modern health care cannot be built without information and communication technologies. We discuss several approaches how to contribute to some topics of information society in health care, namely the role of electronic health record, structured information, extraction of information from free medical texts and sharing knowledge stored in medical guidelines.

Health care managers' views on and approaches to implementing models for improving care processes.

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Andreasson, Jörgen; Eriksson, Andrea; Dellve, Lotta

2016-03-01

To develop a deeper understanding of health-care managers' views on and approaches to the implementation of models for improving care processes. In health care, there are difficulties in implementing models for improving care processes that have been decided on by upper management. Leadership approaches to this implementation can affect the outcome. In-depth interviews with first- and second-line managers in Swedish hospitals were conducted and analysed using grounded theory. 'Coaching for participation' emerged as a central theme for managers in handling top-down initiated process development. The vertical approach in this coaching addresses how managers attempt to sustain unit integrity through adapting and translating orders from top management. The horizontal approach in the coaching refers to managers' strategies for motivating and engaging their employees in implementation work. Implementation models for improving care processes require a coaching leadership built on close manager-employee interaction, mindfulness regarding the pace of change at the unit level, managers with the competence to share responsibility with their teams and engaged employees with the competence to share responsibility for improving the care processes, and organisational structures that support process-oriented work. Implications for nursing management are the importance of giving nurse managers knowledge of change management. © 2015 John Wiley & Sons Ltd.

Climate change and human health: a One Health approach.

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Patz, Jonathan A; Hahn, Micah B

2013-01-01

Climate change adds complexity and uncertainty to human health issues such as emerging infectious diseases, food security, and national sustainability planning that intensify the importance of interdisciplinary and collaborative research. Collaboration between veterinary, medical, and public health professionals to understand the ecological interactions and reactions to flux in a system can facilitate clearer understanding of climate change impacts on environmental, animal, and human health. Here we present a brief introduction to climate science and projections for the next century and a review of current knowledge on the impacts of climate-driven environmental change on human health. We then turn to the links between ecological and evolutionary responses to climate change and health. The literature on climate impacts on biological systems is rich in both content and historical data, but the connections between these changes and human health is less understood. We discuss five mechanisms by which climate changes impacts on biological systems will be felt by the human population: Modifications in Vector, Reservoir, and Pathogen Lifecycles; Diseases of Domestic and Wild Animals and Plants; Disruption of Synchrony Between Interacting Species; Trophic Cascades; and Alteration or Destruction of Habitat. Each species responds to environmental changes differently, and in order to predict the movement of disease through ecosystems, we have to rely on expertise from the fields of veterinary, medical, and public health, and these health professionals must take into account the dynamic nature of ecosystems in a changing climate.

76 FR 12963 - Request for Information (NOT-ES-11-007): Needs and Approaches for Assessing the Human Health...

Science.gov (United States)

2011-03-09

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Request for Information (NOT-ES-11-007): Needs and Approaches for Assessing the Human Health Impacts of Exposure to Mixtures AGENCY: National Institutes of... analyzes its findings to assess potential hazards to human health from exposure to environmental substances...

[Researches on health and welfare promotion based on an approach of social medicine].

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Kagamimori, Sadanobu

2004-07-01

This article was derived from my memorial talk given when receiving the prize of the Japanese Society for Hygiene at their academic congress. The reader could review my research on health and welfare promotion made by introducing new conceptual health policy based on the approach of social medicine. Through my experience in different research work, the importance of social factors in the etiology of health during childhood, adulthood and old age was discussed. In addition, it was revealed that social factors not only influence the population's health status but also constitute the context within which organized efforts can be made to promote health. For the elderly, the annual health check, stroke patient registration, and insurance for care and spousal bereavement; for adults, the Karoshi and occupational health; and for children, air pollution-atopy predisposition and lifestyles were highlighted as social medicine-related issues. The research on mostly longitudinal population studies showed that health status, including the life expectancy and the prevalence of disability and chronic disorders, are related to one's marital status, social support, psychosocial working conditions and environmental factors as well as to lifestyles such as physical activity and hours of work and sleep at entry. More attention should be directed to independent factors' effects on health, separate from those of adverse health habits and bio-medical situations, under the health and welfare promotion strategy.

A theory-informed approach to mental health care capacity building for pharmacists.

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Murphy, Andrea L; Gardner, David M; Kutcher, Stan P; Martin-Misener, Ruth

2014-01-01

Pharmacists are knowledgeable, accessible health care professionals who can provide services that improve outcomes in mental health care. Various challenges and opportunities can exist in pharmacy practice to hinder or support pharmacists' efforts. We used a theory-informed approach to development and implementation of a capacity-building program to enhance pharmacists' roles in mental health care. Theories and frameworks including the Consolidated Framework for Implementation Research, the Theoretical Domains Framework, and the Behaviour Change Wheel were used to inform the conceptualization, development, and implementation of a capacity-building program to enhance pharmacists' roles in mental health care. The More Than Meds program was developed and implemented through an iterative process. The main program components included: an education and training day; use of a train-the-trainer approach from partnerships with pharmacists and people with lived experience of mental illness; development of a community of practice through email communications, a website, and a newsletter; and use of educational outreach delivered by pharmacists. Theories and frameworks used throughout the program's development and implementation facilitated a means to conceptualize the component parts of the program as well as its overall presence as a whole from inception through evolution in implementation. Using theoretical foundations for the program enabled critical consideration and understanding of issues related to trialability and adaptability of the program. Theory was essential to the underlying development and implementation of a capacity-building program for enhancing services by pharmacists for people with lived experience of mental illness. Lessons learned from the development and implementation of this program are informing current research and evolution of the program.

Assessing privacy risks in population health publications using a checklist-based approach.

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O'Keefe, Christine M; Ickowicz, Adrien; Churches, Tim; Westcott, Mark; O'Sullivan, Maree; Khan, Atikur

2017-11-10

Recent growth in the number of population health researchers accessing detailed datasets, either on their own computers or through virtual data centers, has the potential to increase privacy risks. In response, a checklist for identifying and reducing privacy risks in population health analysis outputs has been proposed for use by researchers themselves. In this study we explore the usability and reliability of such an approach by investigating whether different users identify the same privacy risks on applying the checklist to a sample of publications. The checklist was applied to a sample of 100 academic population health publications distributed among 5 readers. Cohen's κ was used to measure interrater agreement. Of the 566 instances of statistical output types found in the 100 publications, the most frequently occurring were counts, summary statistics, plots, and model outputs. Application of the checklist identified 128 outputs (22.6%) with potential privacy concerns. Most of these were associated with the reporting of small counts. Among these identified outputs, the readers found no substantial actual privacy concerns when context was taken into account. Interrater agreement for identifying potential privacy concerns was generally good. This study has demonstrated that a checklist can be a reliable tool to assist researchers with anonymizing analysis outputs in population health research. This further suggests that such an approach may have the potential to be developed into a broadly applicable standard providing consistent confidentiality protection across multiple analyses of the same data. © The Author 2017. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Effects of a Combined 3-D Auditory/visual Cueing System on Visual Target Detection Using a Helmet-Mounted Display

National Research Council Canada - National Science Library

Pinedo, Carlos; Young, Laurence; Esken, Robert

2005-01-01

..., and the development and evaluation of the NDFR symbology for on/off-boresight viewing. The localized auditory research includes looking at the benefits of augmenting the Terrain Collision Avoidance System (TCAS...

Health status transitions in community-living elderly with complex care needs: a latent class approach.

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Lafortune, Louise; Béland, François; Bergman, Howard; Ankri, Joël

2009-02-03

For older persons with complex care needs, accounting for the variability and interdependency in how health dimensions manifest themselves is necessary to understand the dynamic of health status. Our objective is to test the hypothesis that a latent classification can capture this heterogeneity in a population of frail elderly persons living in the community. Based on a person-centered approach, the classification corresponds to substantively meaningful groups of individuals who present with a comparable constellation of health problems. Using data collected for the SIPA project, a system of integrated care for frail older people (n = 1164), we performed latent class analyses to identify homogenous categories of health status (i.e. health profiles) based on 17 indicators of prevalent health problems (chronic conditions; depression; cognition; functional and sensory limitations; instrumental, mobility and personal care disability) Then, we conducted latent transition analyses to study change in profile membership over 2 consecutive periods of 12 and 10 months, respectively. We modeled competing risks for mortality and lost to follow-up as absorbing states to avoid attrition biases. We identified four health profiles that distinguish the physical and cognitive dimensions of health and capture severity along the disability dimension. The profiles are stable over time and robust to mortality and lost to follow-up attrition. The differentiated and gender-specific patterns of transition probabilities demonstrate the profiles' sensitivity to change in health status and unmasked the differential relationship of physical and cognitive domains with progression in disability. Our approach may prove useful at organization and policy levels where many issues call for classification of individuals into pragmatically meaningful groups. In dealing with attrition biases, our analytical strategy could provide critical information for the planning of longitudinal studies of aging

[Multidisciplinary approach in public health research. The example of accidents and safety at work].

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Lert, F; Thebaud, A; Dassa, S; Goldberg, M

1982-01-01

This article critically analyses the various scientific approaches taken to industrial accidents, particularly in epidemiology, ergonomie and sociology, by attempting to outline the epistemological limitations in each respective field. An occupational accident is by its very nature not only a physical injury but also an economic, social and legal phenomenon, which more so than illness, enables us to examine the problems posed by the need for a multidisciplinary approach in Public Health research.

Role of Soft Computing Approaches in HealthCare Domain: A Mini Review.

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Gambhir, Shalini; Malik, Sanjay Kumar; Kumar, Yugal

2016-12-01

In the present era, soft computing approaches play a vital role in solving the different kinds of problems and provide promising solutions. Due to popularity of soft computing approaches, these approaches have also been applied in healthcare data for effectively diagnosing the diseases and obtaining better results in comparison to traditional approaches. Soft computing approaches have the ability to adapt itself according to problem domain. Another aspect is a good balance between exploration and exploitation processes. These aspects make soft computing approaches more powerful, reliable and efficient. The above mentioned characteristics make the soft computing approaches more suitable and competent for health care data. The first objective of this review paper is to identify the various soft computing approaches which are used for diagnosing and predicting the diseases. Second objective is to identify various diseases for which these approaches are applied. Third objective is to categories the soft computing approaches for clinical support system. In literature, it is found that large number of soft computing approaches have been applied for effectively diagnosing and predicting the diseases from healthcare data. Some of these are particle swarm optimization, genetic algorithm, artificial neural network, support vector machine etc. A detailed discussion on these approaches are presented in literature section. This work summarizes various soft computing approaches used in healthcare domain in last one decade. These approaches are categorized in five different categories based on the methodology, these are classification model based system, expert system, fuzzy and neuro fuzzy system, rule based system and case based system. Lot of techniques are discussed in above mentioned categories and all discussed techniques are summarized in the form of tables also. This work also focuses on accuracy rate of soft computing technique and tabular information is provided for

Exploring complex causal pathways between urban renewal, health and health inequality using a theory-driven realist approach.

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Mehdipanah, Roshanak; Manzano, Ana; Borrell, Carme; Malmusi, Davide; Rodriguez-Sanz, Maica; Greenhalgh, Joanne; Muntaner, Carles; Pawson, Ray

2015-01-01

Urban populations are growing and to accommodate these numbers, cities are becoming more involved in urban renewal programs to improve the physical, social and economic conditions in different areas. This paper explores some of the complexities surrounding the link between urban renewal, health and health inequalities using a theory-driven approach. We focus on an urban renewal initiative implemented in Barcelona, the Neighbourhoods Law, targeting Barcelona's (Spain) most deprived neighbourhoods. We present evidence from two studies on the health evaluation of the Neighbourhoods Law, while drawing from recent urban renewal literature, to follow a four-step process to develop a program theory. We then use two specific urban renewal interventions, the construction of a large central plaza and the repair of streets and sidewalks, to further examine this link. In order for urban renewal programs to affect health and health inequality, neighbours must use and adapt to the changes produced by the intervention. However, there exist barriers that can result in negative outcomes including factors such as accessibility, safety and security. This paper provides a different perspective to the field that is largely dominated by traditional quantitative studies that are not always able to address the complexities such interventions provide. Furthermore, the framework and discussions serve as a guide for future research, policy development and evaluation. Copyright © 2014 Elsevier Ltd. All rights reserved.

A university system's approach to enhancing the educational mission of health science schools and institutions: the University of Texas Academy of Health Science Education

Directory of Open Access Journals (Sweden)

L. Maximilian Buja

2013-03-01

Full Text Available Background: The academy movement developed in the United States as an important approach to enhance the educational mission and facilitate the recognition and work of educators at medical schools and health science institutions. Objectives: Academies initially formed at individual medical schools. Educators and leaders in The University of Texas System (the UT System, UTS recognized the academy movement as a means both to address special challenges and pursue opportunities for advancing the educational mission of academic health sciences institutions. Methods: The UTS academy process was started by the appointment of a Chancellor's Health Fellow for Education in 2004. Subsequently, the University of Texas Academy of Health Science Education (UTAHSE was formed by bringing together esteemed faculty educators from the six UTS health science institutions. Results: Currently, the UTAHSE has 132 voting members who were selected through a rigorous, system-wide peer review and who represent multiple professional backgrounds and all six campuses. With support from the UTS, the UTAHSE has developed and sustained an annual Innovations in Health Science Education conference, a small grants program and an Innovations in Health Science Education Award, among other UTS health science educational activities. The UTAHSE represents one university system's innovative approach to enhancing its educational mission through multi- and interdisciplinary as well as inter-institutional collaboration. Conclusions: The UTAHSE is presented as a model for the development of other consortia-type academies that could involve several components of a university system or coalitions of several institutions.

A Synergistic Approach to Human Rights and Public Health Ethics: Effective or a Source of Conflict?

Directory of Open Access Journals (Sweden)

Steinmetz-Wood, Madeleine

2014-12-01

Full Text Available Concerns over the growing disparities in health and wealth between members of society incited Stephanie Nixon and Lisa Forman, in their 2008 article Exploring synergies between human rights and public health ethics: A whole greater than the sum of its parts, to propose that the principles of human rights and public health ethics should be used in combination to develop norms for health action. This commentary reflects on the benefits as well as the difficulties that could arise from taking such an approach.

Interactions between global processes and local health problems. A human ecology approach to health among indigenous groups in the Amazon

Directory of Open Access Journals (Sweden)

Maj-Lis Follér

Full Text Available This article deals with methodological issues and how to link global processes - social and ecological - with environmental changes and human health in local communities. The discussion concerns how interdisciplinary approaches can help us find tools to develop new knowledge. Scientific knowledge and local knowledge are not seen as opposite epistemological forms, but as socially and culturally constructed. Power and social legitimacy have to be included when analyzing how to deal with the interaction between global processes and local environmental change and the health/disease interface.

Implementing a nationwide quality improvement approach in health services.

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Sahel, Amina; DeBrouwere, Vincent; Dujardin, Bruno; Kegels, Guy; Belkaab, Nejoua; Alaoui Belghiti, Abdelali

2015-01-01

The purpose of this paper is to present an innovative quality improvement intervention developed in Morocco and discuss its implementation. Until 2004, the Moroccan Ministry of Health (MoH) encouraged pilots of quality improvement approaches but none of them were revealed to be sustainable. Internal assessments pinpointed factors such as lack of recognition of the participating team's efforts and lack of pressure on managers to become more accountable. In 2005, Morocco opted for an intervention called "Quality Contest" (QC) targeting health centres, hospitals and health district offices and combining quality measurement with structures ranking, performance disclosure and reward system. The QC is organized every 18 months. After the self-assessment and external audit step, the participating structures are ranked according to their scores. Their performances are then disseminated and the highest performing structures are rewarded. The results showed an improvement in performance among participating structures, constructive exchange of successful experiences between structures, as well as communication of constraints, needs and expectations between MoH managers at central and local levels; the use of peer-auditors was appreciated as it enabled an exchange of best practices between auditors and audited teams but this was mitigated by the difficulty of ensuring their neutrality; and the recognition of efforts was appreciated but seemed insufficient to ensure a sense of justice and maintain motivation. This intervention is an example of MoH leadership that has succeeded in introducing transparency and accountability mechanisms (ranking and performance disclosure) as leverage to change the management culture of the public health services; setting up a reward system to reinforce motivation and adapting continuously the intervention to enhance its sustainability and acceptability.

Primary health care physicians’ approach toward domestic violence in Tehran, Iran

Science.gov (United States)

Rasoulian, Maryam; Shirazi, Mina; Nojomi, Marzieh

2014-01-01

Background: Primary health care physicians (PHCPs) are the first in the clinic to detect and help victims of intimate partner violence (IPV). Therefore, their attitude and practice toward domestic violence (DV) are important to manage this problem. The aim of current study was to compare the behavior and attitude of PHCPs about DV versus other health risk factors in Tehran, Iran. Methods: A convenience sample of 220 PHCPs was evaluated. The study was carried out in April 2012. Two self-administered questionnaires were used to identify physicians’ beliefs and behaviors on screening and intervention of DV and other health risk factors. All analyses were performed using SPSS version 18.0 (SPSS, Inc. Chicago, IL). Results: One hundred and ninety eight questionnaires were analyzed. PHCPs’ mean age was 39.06 (±7.5) years. Participants were just reported 10% screening of regular patients for DV compared with 29% to 48% for other health risk factors. Mean age of PHCPs was not associated with their approach toward the DV. Compared to male physicians, females spared more time for DV victims. Major of physicians (96%) believed that DV is not a private problem and is something that needs to be addressed cautiously. Conclusion: The results of this study indicated that DV screening occurs less than that of other health risk factors. Attitude of majority of PHCPs was positive for addressing this problem PMID:25695006