WorldWideScience

Sample records for health approaches tcas

  1. TCAS 应用后的管制环境

    Institute of Scientific and Technical Information of China (English)

    吕人力

    1997-01-01

    概论美国最为积极地研制并强制装配 TCAS 是有理由的,数以万计的私人飞机按自行保持飞行间隔的目视飞行规则与航班飞行共同使用着世界最繁忙的天空,同时出于预算的考虑,限制管制员数量的快速增长并设立非管制空域。使得多数航空器相撞事故发生在美国。而对于在我国这样绝大多数空域为完全仪表飞行规则(IFR-only)的管制空域,且

  2. Complementary Health Approaches

    Science.gov (United States)

    ... on some complementary approaches, such as acupuncture and yoga, but there have been fewer studies on other approaches, so much less is known about them. The National Institutes of Health (NIH) is sponsoring research to learn more about ...

  3. Serotonin transporter occupancy with TCAs and SSRIs: a PET study in patients with major depressive disorder.

    Science.gov (United States)

    Lundberg, Johan; Tiger, Mikael; Landén, Mikael; Halldin, Christer; Farde, Lars

    2012-09-01

    The aim of the present clinical positron emission tomography study was to examine if the 5-HTT is a common target, both for tricyclic antidepressants (TCAs) and selective serotonin reuptake inhibitors (SSRIs). Serotonin transporter (5-HTT) occupancy was estimated during treatment with TCA, SSRI and mirtazapine in 20 patients in remission from depression. The patients were recruited from out-patient units and deemed as responders to antidepressive treatment. The radioligand [¹¹C]MADAM was used to determine the 5-HTT binding potential. The mean 5-HTT occupancy was 67% (range 28-86%). There was no significant difference in 5-HTT occupancy between TCA (n=5) and SSRI (n=14). 5-HTT affinity correlated with the recommended clinical dose. Mirtazapine did not occupy the serotonin transporter. The results support that TCAs and SSRIs have a shared mechanism of action by inhibition of 5-HTT.

  4. A Biosemiotic Approach to Health

    DEFF Research Database (Denmark)

    Hoffmeyer, Jesper

    2010-01-01

    By replacing the traditional chemical approach to the understanding of body function by a sign-theoretic or semiotic approach, biosemiotics enters a no-man’s-land between biological and social domains of human life. The aim is not to subsume the social under the biological or vice versa; both...... approaches are invaluable. The aim is to find a common platform that serves in treating human persons as undivided wholes. Since semiosis (viz. the meaningful interpretation of cues, signals, events or states) is vital to communication at both levels, the resulting sign-process is a viable choice...... as the basis for an integrated theory of health....

  5. Health Counseling: An Interdisciplinary Approach.

    Science.gov (United States)

    Childers, John H., Jr.; Guyton, Rick

    1985-01-01

    The Counselor Education and Health Education programs at the University of Arkansas, Fayetteville, recently cooperated in developing a curriculum to prepare health counselors. The goals and objectives of counselor education and of health education are so similar that an interdisciplinary health care specialization is a natural development. (MT)

  6. Health Counseling: An Interdisciplinary Approach.

    Science.gov (United States)

    Childers, John H., Jr.; Guyton, Rick

    1985-01-01

    The Counselor Education and Health Education programs at the University of Arkansas, Fayetteville, recently cooperated in developing a curriculum to prepare health counselors. The goals and objectives of counselor education and of health education are so similar that an interdisciplinary health care specialization is a natural development. (MT)

  7. Complementary and Alternative Approaches to Health

    Science.gov (United States)

    ... Fight Stress / Stress and Your Brain / Can Prolonged Stress Affect Whether Breast Cancer Returns? / Complementary and Alternative Approaches to Health Winter 2008 Issue: Volume 3 Number 1 Page ...

  8. Analyzing public health policy: three approaches.

    Science.gov (United States)

    Coveney, John

    2010-07-01

    Policy is an important feature of public and private organizations. Within the field of health as a policy arena, public health has emerged in which policy is vital to decision making and the deployment of resources. Public health practitioners and students need to be able to analyze public health policy, yet many feel daunted by the subject's complexity. This article discusses three approaches that simplify policy analysis: Bacchi's "What's the problem?" approach examines the way that policy represents problems. Colebatch's governmentality approach provides a way of analyzing the implementation of policy. Bridgman and Davis's policy cycle allows for an appraisal of public policy development. Each approach provides an analytical framework from which to rigorously study policy. Practitioners and students of public health gain much in engaging with the politicized nature of policy, and a simple approach to policy analysis can greatly assist one's understanding and involvement in policy work.

  9. The population health approach in historical perspective.

    Science.gov (United States)

    Szreter, Simon

    2003-03-01

    The origin of the population health approach is an historic debate over the relationship between economic growth and human health. In Britain and France, the Industrial Revolution disrupted population health and stimulated pioneering epidemiological studies, informing the early preventive public health movement. A century-long process of political adjustment between the forces of liberal democracy and propertied interests ensued. The 20th-century welfare states resulted as complex political mechanisms for converting economic growth into enhanced population health. However, the rise of a "neoliberal" agenda, denigrating the role of government, has once again brought to the fore the importance of prevention and a population health approach to map and publicize the health impacts of this new phase of "global" economic growth.

  10. FAO and the One Health approach.

    Science.gov (United States)

    Lubroth, Juan

    2013-01-01

    The Food and Agriculture Organization (FAO) of the United Nation's view on One Health is broad as it extends from human, animal-domestic and wildlife-and environmental health. Though the nidus of work originated within FAO's animal health service of the Agriculture and Consumer Protection Department, it is clearly an area of work that would include other departments such as Natural Resources Management and the Environment, Forestry, Fisheries and Aquaculture, Economic and Social Development, Legal Services, and communication. In terms of risk assessment and risk mitigation to health threats at the human-animal-ecosystem interface FAO works closely with its global partners, World Health Organisation and the World Organisation for animal health (the "Tripartite"). FAO's animal health service sees its work in One Health as contributing to all eight Millennium Development Goals, recognising the importance of animal health to human health, food safety, nutrition and food security, ameliorating poverty and hunger, natural resource management and partnerships. Some examples of FAO's operationalising One Health approaches or principles are introduced.

  11. 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.

  12. Approach for Estimating Exposures and Incremental Health ...

    Science.gov (United States)

    Approach for Estimating Exposures and Incremental Health Effects from Lead During Renovation, Repair, and Painting Activities in Public and Commercial Buildings” (Technical Approach Document). Also available for public review and comment are two supplementary documents: the detailed appendices for the Technical Approach Document and a supplementary report entitled “Developing a Concentration-Response Function for Pb Exposure and Cardiovascular Disease-Related Mortality.” Together, these documents describes an analysis for estimating exposures and incremental health effects created by renovations of public and commercial buildings (P&CBs). This analysis could be used to identify and evaluate hazards from renovation, repair, and painting activities in P&CBs. A general overview of how this analysis can be used to inform EPA’s hazard finding is described in the Framework document that was previously made available for public comment (79 FR 31072; FRL9910-44). The analysis can be used in any proposed rulemaking to estimate the reduction in deleterious health effects that would result from any proposed regulatory requirements to mitigate exposure from P&CB renovation activities. The Technical Approach Document describes in detail how the analyses under this approach have been performed and presents the results – expected changes in blood lead levels and health effects due to lead exposure from renovation activities.

  13. A Population Health Management Approach to Oral Health.

    Science.gov (United States)

    Hummel, Jeff; Phillips, Kathryn E

    2016-03-01

    Clinical outcomes have been shown to be better, and total costs lower, when patients with chronic illness such as diabetes are managed using a population health strategy in a primary care setting that includes structured coordination of care with specialty services. This "population health management approach" offers a promising new vision for addressing oral disease as a chronic illness through a collaborative partnership between primary care teams and dental professionals.

  14. Weighing SSRIs and TCAs

    African Journals Online (AJOL)

    This review was prompted by a comment on the l

  15. Population health diagnosis with an ecohealth approach

    Directory of Open Access Journals (Sweden)

    Luz Arenas-Monreal

    2015-01-01

    Full Text Available OBJECTIVE To analyze the characteristics of health diagnosis according to the ecohealth approach in rural and urban communities in Mexico.METHODS Health diagnosis were conducted in La Nopalera, from December 2007 to October 2008, and in Atlihuayan, from December 2010 to October 2011. The research was based on three principles of the ecohealth approach: transdisciplinarity, community participation, gender and equity. To collect information, a joint methodology and several techniques were used to stimulate the participation of inhabitants. The diagnostic exercise was carried out in five phases that went from collecting information to prioritization of problems.RESULTS The constitution of the transdisciplinary team, as well as the participation of the population and the principle of gender/equity were differentials between the communities. In the rural community, the active participation of inhabitants and authorities was achieved and the principles of transdisciplinarity and gender/equity were incorporated.CONCLUSIONS With all the difficulties that entails the boost in participation, the incorporation of gender/equity and transdisciplinarity in health diagnosis allowed a holistic public health approach closer to the needs of the population.

  16. Population health diagnosis with an ecohealth approach.

    Science.gov (United States)

    Arenas-Monreal, Luz; Cortez-Lugo, Marlene; Parada-Toro, Irene; Pacheco-Magaña, Lilian E; Magaña-Valladares, Laura

    2015-01-01

    To analyze the characteristics of health diagnosis according to the ecohealth approach in rural and urban communities in Mexico. Health diagnosis were conducted in La Nopalera, from December 2007 to October 2008, and in Atlihuayan, from December 2010 to October 2011. The research was based on three principles of the ecohealth approach: transdisciplinarity, community participation, gender and equity. To collect information, a joint methodology and several techniques were used to stimulate the participation of inhabitants. The diagnostic exercise was carried out in five phases that went from collecting information to prioritization of problems. The constitution of the transdisciplinary team, as well as the participation of the population and the principle of gender/equity were differentials between the communities. In the rural community, the active participation of inhabitants and authorities was achieved and the principles of transdisciplinarity and gender/equity were incorporated. With all the difficulties that entails the boost in participation, the incorporation of gender/equity and transdisciplinarity in health diagnosis allowed a holistic public health approach closer to the needs of the population.

  17. Population health diagnosis with an ecohealth approach

    Science.gov (United States)

    Arenas-Monreal, Luz; Cortez-Lugo, Marlene; Parada-Toro, Irene; Pacheco-Magaña, Lilian E; Magaña-Valladares, Laura

    2015-01-01

    OBJECTIVE To analyze the characteristics of health diagnosis according to the ecohealth approach in rural and urban communities in Mexico. METHODS Health diagnosis were conducted in La Nopalera, from December 2007 to October 2008, and in Atlihuayan, from December 2010 to October 2011. The research was based on three principles of the ecohealth approach: transdisciplinarity, community participation, gender and equity. To collect information, a joint methodology and several techniques were used to stimulate the participation of inhabitants. The diagnostic exercise was carried out in five phases that went from collecting information to prioritization of problems. RESULTS The constitution of the transdisciplinary team, as well as the participation of the population and the principle of gender/equity were differentials between the communities. In the rural community, the active participation of inhabitants and authorities was achieved and the principles of transdisciplinarity and gender/equity were incorporated. CONCLUSIONS With all the difficulties that entails the boost in participation, the incorporation of gender/equity and transdisciplinarity in health diagnosis allowed a holistic public health approach closer to the needs of the population. PMID:26538099

  18. 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.

  19. 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.

  20. 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).

  1. Health information exchange: national and international approaches.

    Science.gov (United States)

    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.

  2. Public health approach to address maternal mortality.

    Science.gov (United States)

    Rai, Sanjay K; Anand, K; Misra, Puneet; Kant, Shashi; Upadhyay, Ravi Prakash

    2012-01-01

    Reducing maternal mortality is one of the major challenges to health systems worldwide, more so in developing countries that account for nearly 99% of these maternal deaths. Lack of a standard method for reporting of maternal death poses a major hurdle in making global comparisons. Currently much of the focus is on documenting the "number" of maternal deaths and delineating the "medical causes" behind these deaths. There is a need to acknowledge the social correlates of maternal deaths as well. Investigating and in-depth understanding of each maternal death can provide indications on practical ways of addressing the problem. Death of a mother has serious implications for the child as well as other family members and to prevent the same, a comprehensive approach is required. This could include providing essential maternal care, early management of complications and good quality intrapartum care through the involvement of skilled birth attendants. Ensuring the availability, affordability, and accessibility of quality maternal health services, including emergency obstetric care (EmOC) would prove pivotal in reducing the maternal deaths. To increase perceived seriousness of the community regarding maternal health, a well-structured awareness campaign is needed with importance be given to avoid adolescent pregnancy as well. Initiatives like Janani Surakhsha Yojna (JSY) that have the potential to improve maternal health needs to be strengthened. Quality assessments should form an essential part of all services that are directed toward improving maternal health. Further, emphasis needs to be given on research by involving multiple allied partners, with the aim to develop a prioritized, coordinated, and innovative research agenda for women's health.

  3. Public health approach to address maternal mortality

    Directory of Open Access Journals (Sweden)

    Sanjay K Rai

    2012-01-01

    Full Text Available Reducing maternal mortality is one of the major challenges to health systems worldwide, more so in developing countries that account for nearly 99% of these maternal deaths. Lack of a standard method for reporting of maternal death poses a major hurdle in making global comparisons. Currently much of the focus is on documenting the "number" of maternal deaths and delineating the "medical causes" behind these deaths. There is a need to acknowledge the social correlates of maternal deaths as well. Investigating and in-depth understanding of each maternal death can provide indications on practical ways of addressing the problem. Death of a mother has serious implications for the child as well as other family members and to prevent the same, a comprehensive approach is required. This could include providing essential maternal care, early management of complications and good quality intrapartum care through the involvement of skilled birth attendants. Ensuring the availability, affordability, and accessibility of quality maternal health services, including emergency obstetric care (EmOC would prove pivotal in reducing the maternal deaths. To increase perceived seriousness of the community regarding maternal health, a well-structured awareness campaign is needed with importance be given to avoid adolescent pregnancy as well. Initiatives like Janani Surakhsha Yojna (JSY that have the potential to improve maternal health needs to be strengthened. Quality assessments should form an essential part of all services that are directed toward improving maternal health. Further, emphasis needs to be given on research by involving multiple allied partners, with the aim to develop a prioritized, coordinated, and innovative research agenda for women′s health.

  4. Different approaches to contracting in health systems.

    Science.gov (United States)

    Perrot, Jean

    2006-11-01

    Contracting is one of the tools increasingly being used to enhance the performance of health systems in both developed and developing countries; it takes different forms and cannot be limited to the mere purchase of services. Actors adopt contracting to formalize all kinds of relations established between them. A typology for this approach will demonstrate its diversity and provide a better understanding of the various issues raised by contracting. In recent years the way health systems are organized has changed significantly. To remedy the under-performance of their health systems, most countries have undertaken reforms that have resulted in major institutional overhaul, including decentralization of health and administrative services, autonomy for public service providers, separation of funding bodies and service providers, expansion of health financing options and the development of the profit or nonprofit private sector. These institutional reshuffles lead not only to multiplication and diversification of the actors involved, but also to greater separation of the service provision and administrative functions. Health systems are becoming more complex and can no longer operate in isolation. Actors are gradually realizing that they need to forge relations. The simplest way to do that is through dialogue, although some prefer a more formal commitment. Interaction between actors may take various forms and be on different scales. There are several types of contractual relations: some are based on the nature of the contract (public or private), others on the parties involved and yet others on the scope of the contract. Here they are classified into three categories according to the object of the contract: delegation of responsibility, act of purchase of services, or cooperation.

  5. 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.

  6. Comparing Health Education Approaches in Textbooks of Sixteen Countries

    Science.gov (United States)

    Carvalho, Graca S.; Dantas, Catarina; Rauma, Anna-Liisa; Luzi, Daniela; Ruggieri, Roberta; Bogner, Franz; Geier, Christine; Caussidier, Claude; Berger, Dominique; Clement, Pierre

    2008-01-01

    Classically, health education has provided mainly factual knowledge about diseases and their prevention. This educational approach is within the so called Biomedical Model (BM). It is based on pathologic (Pa), curative (Cu) and preventive (Pr) conceptions of health. In contrast, the Health Promotion (HP) approach of health education intends to…

  7. 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

  8. Health Promotion as Part of a Holistic Approach to Community ...

    African Journals Online (AJOL)

    Health Promotion as Part of a Holistic Approach to Community Mental Health Care in Sierra Leone. ... of service is probably plagued by the strong stigma that prevails in society. Reliable quantitative data on mental illness is extremely minimal.

  9. [risks To Health Of Intensive Care Unity Nursing Staff: Proposal Of Integral Approach Of Health].

    OpenAIRE

    Miranda,Erique José Peixoto de; Stancato,Kátia

    2015-01-01

    In this study we discuss about risks to health of intensive care unity staff and suggest a proposal of integral approach of health. Literature review, from 1997 to 2007, at Bireme database about health education, intensive care unity, nursing and occupational health, regardless of design of study. All studies show that the environment of intensive care unity is unhealthy, which is also due to habits and attitudes of ICU health professionals. An approach to health education would be beneficial...

  10. 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.

  11. [Health work in MERCOSUR: a Brazilian approach].

    Science.gov (United States)

    Machado, Maria Helena; Paula, Aïda El-Khoury de; Aguiar Filho, Wilson

    2007-01-01

    MERCOSUR Member Countries (Brazil, Argentina, Paraguay, Uruguay, and Venezuela) have viewed the regional integration process and management of work and education in health as a concern for government, considering the health sector's specificities. Key issues are professional accreditation and harmonization of current legislation. This article discusses initiatives in the Permanent MERCOSUR Forum related to work in the health field. The Forum serves as a space for dialogue between various actors: Ministry of Health, health workers, and professional boards, with the aim of supporting the work by the Sub-Commission on Professional Development and Practice, under MERCOSUR Working Sub-Group 11, Health, aiding in the formulation of health management and education policies. The current challenge involves the creation of mechanisms for implementing joint actions to solve problems in the regulation of professional practice, especially in municipalities along the borders between MERCOSUR countries.

  12. Allina Health System's approach to high tech and high touch.

    Science.gov (United States)

    Tam, T A

    1997-01-01

    All health care providers, regardless of their integration status, must meet customer expectations to maintain market share and viability. The balance between high tech and high touch customer interactions is not a fad or trend. For integrated health systems with the full continuum of medical care, additional challenges are presented by the organization's competing health care delivery and financing components. Allina Health System describes its integrated health system approach to satisfying customer high tech and high touch needs.

  13. Developing a complex approach to health phenomena (step 1)

    Science.gov (United States)

    Cifuentes, Myriam Patricia

    Health is a complex object for science and operative levels, partly because there are many approaches defining it but not scientifically sufficient or operatively accepted. This is relevant for health understanding but also for decision making on health related problems. "Determinants of Health" as a widely accepted theoretical proposal, identifies as problematic the reductionist view of health as the disease opposite, attempting to develop it positively according to WHO's definition, proposing a set of factors determining health outcomes. Though this allows a larger comprehension of health causes and effects, still has insufficiently defined theoretical statements and unproved assumptions which difficult understanding and effective actions orientation. Complexity deductive modeling since the insufficiently formalized frameworks, implies incorporating unmanageable object assumptions or reducing health broadness. Taking profit of Bogotá government adherence to DH proposal leading a health information system development, was possible inductive modeling since a systemic massive database (690.000 registries). In this way, DH theoretical statements about health components connectedness were explored by classic statistic approach, and by learning Bayesian networks from data (data mining). First approach showed understanding difficulties. Second was advantageous in approximating within and between determinants relationship structure. However, though DH introduces a systemic approach in considering diverse interacting elements is not empirically satisfactory to exhibit all the meaning of health complexity, because just matches analytic fashioned constructs depending on data expression. A strong networked model developing health complexity, needs the orientation by theoretical constructs as human agency and organization, to explore and understand emergent patterns of health.

  14. A TRANSDISCIPLINARY APPROACH TO HEALTH POLICY RESEARCH AND EVALUATION.

    Science.gov (United States)

    Wan, Thomas T H

    2014-01-01

    An integrated perspective consists of macro- and micro-level approaches to health policy research and evaluation is presented. Analytical strategies are suggested for policy analysis, targeting on health disparities at individual and population levels. This systems approach enables investigators to view how scientific public policy analysis can be implemented to assess policy impacts. In this special issue, five papers are introduced.

  15. Health leadership and management competencies: a systemic approach.

    Science.gov (United States)

    Holder, Reynaldo; Ramagem, Caroline

    2012-01-01

    The achievement of national and international health goals requires better-performing health systems. Strengthening leadership and management of health systems thus becomes essential for achieving greater efficiency and responsiveness, ultimately improving health outcomes. Building a global framework of core competencies for leadership and management needs to be approached with systems thinking and methodologies akin to complexity science that takes into account all components and levels of the health system and the possible interactions between them that influence outcomes. The results will have important policy implications for national health authorities seeking to strengthen management capacity and building transformational leadership in health systems.

  16. Climate change and human health: a One Health approach.

    Science.gov (United States)

    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.

  17. ECONOMIC AND MANAGERIAL APPROACH OF HEALTH INSURANCES

    Directory of Open Access Journals (Sweden)

    Georgeta Dragomir

    2007-05-01

    Full Text Available The paper represents an analysis in the domain of the social insurances for health care. It emphasizesthe necessity and the opportunity of creating in Romania a medical service market based on the competingsystem. In Romania, the social insurances for health care are at their very beginning. The development of thedomain of the private insurances for health care is prevented even by its legislation, due to the lack of anormative act that may regulate the management of the private insurances for health care. The establishment ofthe legislation related to the optional insurances for health care might lead to some activity norms for thecompanies which carry out optional insurances for health care. The change of the legislation is made in order tocreate normative and financial opportunities for the development of the optional medical insurances. Thischange, as part of the social protection of people, will positively influence the development of the medicalinsurance system. The extension of the segment of the optional insurances into the medical insurance segmentincreases the health protection budget with the value of the financial sources which do not belong to thebudgetary funds.

  18. Economic and Managerial Approach of Health Insurances

    Directory of Open Access Journals (Sweden)

    Marinela BOBOC

    2005-10-01

    Full Text Available The paper represents an analysis in the domain of the social insurances for health care. It emphasizes the necessity and the opportunity ofcreating in Romania a medical service market based on the competing system. In Romania, the social insurances for health care are at their verybeginning. The development of the domain of the private insurances for health care is prevented even by its legislation, due to the lack of a normativeact that may regulate the management of the private insurances for health care. The establishment of the legislation related to the optional insurancesfor health care might lead to some activity norms for the companies which carry out optional insurances for health care. The change of the legislationis made in order to create normative and financial opportunities for the development of the optional medical insurances. This change, as part of thesocial protection of people, will positively influence the development of the medical insurance system. The extension of the segment of the optionalinsurances into the medical insurance segment increases the health protection budget with the value of the financial sources which do not belong tothe budgetary funds.

  19. Translating science into action: periodontal health through public health approaches.

    Science.gov (United States)

    Jürgensen, Nanna; Petersen, Poul E; Ogawa, Hiroshi; Matsumoto, Sayaka

    2012-10-01

    Clinical and public health research data have shown that a number of individual, professional and community health measures may be valuable in preventing the major oral diseases. The fundamental gap in knowledge, however, is not confined to 'what to do' but rather 'how' to translate the scientific findings into effective and sustainable programs for groups and populations. The advances in oral health science have not yet benefitted the poor and disadvantaged population groups around the world to the fullest extent possible and this has led to inequalities in periodontal health as well as in other chronic diseases. Research on the causative role of tobacco use in periodontal disease is strong because of the fact that tobacco-induced disease ultimately may lead to the loss of teeth. Studies also indicate that wound healing may be negatively affected by the use of tobacco. Likewise, research has shown that extreme use of alcohol, poor diet and nutrition, and psychological stress all have negative effects on periodontal health. Research on sociobehavioral risk factors has great implication to prevent periodontal disease. The case for tobacco is illustrated in this report. The global exposure to tobacco use in adults and adolescents is outlined. Because of the global Framework Convention for Tobacco Control (2003), the solid research on the harmful effect of tobacco is now being widely used for public health. The importance of tobacco prevention within the context of health-promoting schools is emphasized. Research on other population-directed strategies and their implications on public health would be instrumental to integrated prevention of chronic disease and periodontal disease. Community interventions and delivery of preventive oral care by oral health services may have positive outcomes for periodontal health but periodontal research needs to be further strengthened by the provision of sound evidence. It is somewhat remarkable that research on true population

  20. A "Bioethics" Approach to Teaching Health Law.

    Science.gov (United States)

    Capron, Alexander Morgan

    1988-01-01

    The reasons for offering a course in bioethics to law students and some approaches to take in addressing controversial issues are examined. The use of hypothetical vs. real cases, emphasis on clinical problems, and overall course objectives are discussed. (MSE)

  1. Sleep Disorders and Complementary Health Approaches

    Science.gov (United States)

    ... R S T U V W X Y Z Sleep Disorders: In Depth Share: On This Page What’s ... know about the usefulness of complementary approaches for sleep disorders? Relaxation techniques can be helpful for insomnia. ...

  2. Phenomenological approaches in psychology and health sciences

    DEFF Research Database (Denmark)

    Davidsen, A.

    2013-01-01

    A whole family of qualitative methods is informed by phenomenological philosophy. When applying these methods, the material is analyzed using concepts from this philosophy to interrogate the findings and to enable greater theoretical analysis. However, the phenomenological approach represents dif...

  3. Spirituality and health: A narrativepastoral approach

    Directory of Open Access Journals (Sweden)

    C.J. Truter

    2005-10-01

    Full Text Available Health is much more than the absence of illness; it is rather a “high level wellness” and a life with “meaningful life-possibilities”. This article indicates how meaningful life-possibilities and a high level of wellness can be socially constructed within a process of narrativepastoral therapy for a patient who is chronically ill and therefore cannot be cured. Pastoral care as a spiritual and religious act can play an important role in giving sense and meaning to people’s lives, and can play a preventive role in living with illness. This article furthermore shows how patients’ stories of illness can be centralised by means of narrative therapy and how a pastoral and ethical attitude of love and respect can create a climate conducive to better health and well being. We share how patients’ richer descriptions of their illness can produce a spiritual climate which can contribute to their better health.

  4. Workplace mental health: developing an integrated intervention approach.

    Science.gov (United States)

    LaMontagne, Anthony D; Martin, Angela; Page, Kathryn M; Reavley, Nicola J; Noblet, Andrew J; Milner, Allison J; Keegel, Tessa; Smith, Peter M

    2014-05-09

    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. 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. 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.

  5. A versatile approach to health system evaluation.

    Science.gov (United States)

    Beghin, D; Dujardin, B; Wollast, E

    1989-01-01

    Although problems in the relationships between different levels of health care systems in developing countries have a significant influence on efficiency, they have not been clearly defined. In the present article a simple method is described for assessing certain aspects of these problems. It is shown that data collected in a hospital can be used not only to highlight inadequate management of patients at the community level, but also to identify deficiencies at the community/hospital interface. The method is inexpensive and easy to understand, and could easily be adapted for every interface in a system and for all stages of health service development.

  6. Methodological approaches to estimation of teenagers' health

    Directory of Open Access Journals (Sweden)

    Shudro S.A.

    2013-06-01

    Full Text Available On the basis of International classification of functioning, limitations of vital activity and health, model of estimation of teenagers' health considering these changes from positions of functioning of the organism and context factors was developed. According to this model five groups of health of school-children of secondary schools were distinguished. Teenagers with sufficient level of structure and function of organism, structure of personality and mental functions, activity and participation in general educational processes compose group I A. Teenagers with sufficient level of structure and function of organism, mental functions and disorders of structure of personality, activity and participation in social life compose group I B. Teena¬gers with sufficient level of structure of the organism and personality, activity and participation in social life, disorders of organism functions and psychic functions compose group II. III A group - teenagers with disorders of structure of the organism and personality, functions of the organism and sufficient mental functions, participation in the social life. III B group - teenagers with disorders of structure and functions of the organism, structure of personality and psychic functions, low level of activity and participation in social life. The model, advanced methods and the software made it possible to create information technology of estimation of teenagers' health; this raises quality of diagnostics by 20,3%.

  7. Freedom, responsibility and power: contrasting approaches to health psychology.

    Science.gov (United States)

    Marks, David F

    2002-01-01

    In Health Psychology in Context it was argued that, if we are to make any sense of it, the subject matter of health psychology must be understood in the context of social, political and economic forces. That theme is continued here with a brief examination of how freedom, responsibility and power enter into the generation of conflicts, including the recent outbreak of war. The interplay of commercial and state interests in academic and health research settings is then discussed. The assumptions, values and meanings of work in health psychology are examined in that light. These are divided between four evolving approaches in health psychology: clinical, public, community and critical health psychology. A framework is presented for positioning these approaches within a system for the production of health and social care.

  8. Approaches in Health Human Resource Forecasting: A Roadmap for Improvement.

    Science.gov (United States)

    Rafiei, Sima; Mohebbifar, Rafat; Hashemi, Fariba; Ezzatabadi, Mohammad Ranjbar; Farzianpour, Fereshteh

    2016-09-01

    Forecasting the demand and supply of health manpower in an accurate manner makes appropriate planning possible. The aim of this paper was to review approaches and methods for health manpower forecasting and consequently propose the features that improve the effectiveness of this important process of health manpower planning. A literature review was conducted for studies published in English from 1990-2014 using Pub Med, Science Direct, Pro Quest, and Google Scholar databases. Review articles, qualitative studies, retrospective and prospective studies describing or applying various types of forecasting approaches and methods in health manpower forecasting were included in the review. The authors designed an extraction data sheet based on study questions to collect data on studies' references, designs, and types of forecasting approaches, whether discussed or applied, with their strengths and weaknesses. Forty studies were included in the review. As a result, two main categories of approaches (conceptual and analytical) for health manpower forecasting were identified. Each approach had several strengths and weaknesses. As a whole, most of them were faced with some challenges, such as being static and unable to capture dynamic variables in manpower forecasting and causal relationships. They also lacked the capacity to benefit from scenario making to assist policy makers in effective decision making. An effective forecasting approach is supposed to resolve all the deficits that exist in current approaches and meet the key features found in the literature in order to develop an open system and a dynamic and comprehensive method necessary for today complex health care systems.

  9. A Discursive Approach to Organizational Health Communication

    DEFF Research Database (Denmark)

    Kjær, Peter; Reff Pedersen, Anne; Svejgaard Pors, Anja

    2016-01-01

    With the increased interest in communication in the fields of healthcare and healthcare management research, it is important to begin to explore and consider the consequences of this engagement with new ideas in communication. In this chapter we describe the expansion of organisational health...... communication, identifying three distinct types of communication ideas and tools: clinical communication, extra-clinical communication and corporate communication. In order to assess the wider implications of health communication, we elaborate a discursive perspective, illustrated by presenting exemplary...... analyses of a) the institutionalisation of communication ideals, b) the communicative management of meaning and c) communication tools as organising technologies. The discursive perspective highlights that organisations and individual healthcare providers should not only look for the desired outcomes...

  10. A discursive approach to organizational health communication

    DEFF Research Database (Denmark)

    Kjær, Peter; Reff Pedersen, Anne; Pors, Anja Svejgaard

    2016-01-01

    With the increased interest in communication in the fields of healthcare and healthcare management research, it is important to begin to explore and consider the consequences of this engagement with new ideas in communication. In this chapter we describe the expansion of organisational health...... communication, identifying three distinct types of communication ideas and tools: clinical communication, extra-clinical communication and corporate communication. In order to assess the wider implications of health communication, we elaborate a discursive perspective, illustrated by presenting exemplary...... analyses of a) the institutionalisation of communication ideals, b) the communicative management of meaning and c) communication tools as organising technologies. The discursive perspective highlights that organisations and individual healthcare providers should not only look for the desired outcomes...

  11. Investigation of Integrated Vehicle Health Management Approaches

    Science.gov (United States)

    Paris, Deidre

    2005-01-01

    This report is to present the work that was performed during the summer in the Advance Computing Application office. The NFFP (NASA Faculty Fellow Program) had ten summer faculty members working on IVHM (Integrated Vehicle Health Management) technologies. The objective of this project was two-fold: 1) to become familiar with IVHM concepts and key demonstrated IVHM technologies; and 2) to integrate the research that has been performed by IVHM faculty members into the MASTLAB (Marshall Avionic Software Test Lab). IVHM is a NASA-wide effort to coordinate, integrate and apply advanced software, sensors and design technologies to increase the level of intelligence, autonomy, and health state of future vehicles. IVHM is an important concept because it is consistent with the current plan for NASA to go to the moon, mars, and beyond. In order for NASA to become more involved in deep exploration, avionic systems will need to be highly adaptable and autonomous.

  12. A Discursive Approach to Organizational Health Communication

    DEFF Research Database (Denmark)

    Kjær, Peter; Reff Pedersen, Anne; Pors, Anja Svejgaard

    2016-01-01

    With the increased interest in communication in the fields of healthcare and healthcare management research, it is important to begin to explore and consider the consequences of this engagement with new ideas in communication. In this chapter we describe the expansion of organisational health com...... of communication initiatives but also focus on unintended consequences in terms of changes to management roles, challenges to professional values and the reshaping of demands on patients. Attention to those implications is a key task for healthcare managers....

  13. Public Health Platforms: An Emerging Informatics Approach to Health Professional Learning and Development.

    Science.gov (United States)

    Gray, Kathleen

    2016-04-26

    Health informatics has a major role to play in optimising the management and use of data, information and knowledge in health systems. As health systems undergo digital transformation, it is important to consider informatics approaches not only to curriculum content but also to the design of learning environments and learning activities for health professional learning and development. An example of such an informatics approach is the use of large-scale, integrated public health platforms on the Internet as part of health professional learning and development. This article describes selected examples of such platforms, with a focus on how they may influence the direction of health professional learning and development. Significance for public healthThe landscape of healthcare systems, public health systems, health research systems and professional education systems is fragmented, with many gaps and silos. More sophistication in the management of health data, information, and knowledge, based on public health informatics expertise, is needed to tackle key issues of prevention, promotion and policy-making. Platform technologies represent an emerging large-scale, highly integrated informatics approach to public health, combining the technologies of Internet, the web, the cloud, social technologies, remote sensing and/or mobile apps into an online infrastructure that can allow more synergies in work within and across these systems. Health professional curricula need updating so that the health workforce has a deep and critical understanding of the way that platform technologies are becoming the foundation of the health sector.

  14. Probabilities and health risks: a qualitative approach.

    Science.gov (United States)

    Heyman, B; Henriksen, M; Maughan, K

    1998-11-01

    Health risks, defined in terms of the probability that an individual will suffer a particular type of adverse health event within a given time period, can be understood as referencing either natural entities or complex patterns of belief which incorporate the observer's values and knowledge, the position adopted in the present paper. The subjectivity inherent in judgements about adversity and time frames can be easily recognised, but social scientists have tended to accept uncritically the objectivity of probability. Most commonly in health risk analysis, the term probability refers to rates established by induction, and so requires the definition of a numerator and denominator. Depending upon their specification, many probabilities may be reasonably postulated for the same event, and individuals may change their risks by deciding to seek or avoid information. These apparent absurdities can be understood if probability is conceptualised as the projection of expectation onto the external world. Probabilities based on induction from observed frequencies provide glimpses of the future at the price of acceptance of the simplifying heuristic that statistics derived from aggregate groups can be validly attributed to individuals within them. The paper illustrates four implications of this conceptualisation of probability with qualitative data from a variety of sources, particularly a study of genetic counselling for pregnant women in a U.K. hospital. Firstly, the official selection of a specific probability heuristic reflects organisational constraints and values as well as predictive optimisation. Secondly, professionals and service users must work to maintain the facticity of an established heuristic in the face of alternatives. Thirdly, individuals, both lay and professional, manage probabilistic information in ways which support their strategic objectives. Fourthly, predictively sub-optimum schema, for example the idea of AIDS as a gay plague, may be selected because

  15. Ecosystem approaches to health for a global sustainability agenda.

    Science.gov (United States)

    Charron, Dominique Frances

    2012-09-01

    International research agendas are placing greater emphasis on the need for more sustainable development to achieve gains in global health. Research using ecosystem approaches to health, and the wider field of ecohealth, contribute to this goal, by addressing health in the context of inter-linked social and ecological systems. We review recent contributions to conceptual development of ecosystem approaches to health, with insights from their application in international development research. Various similar frameworks have emerged to apply the approach. Most predicate integration across disciplines and sectors, stakeholder participation, and an articulation of sustainability and equity to achieve relevant actions for change. Drawing on several frameworks and on case studies, a model process for application of ecosystem approaches is proposed, consisting of an iterative cycles of participatory study design, knowledge generation, intervention, and systematization of knowledge. The benefits of the research approach include innovations that improve health, evidence-based policies that reduce health risks; empowerment of marginalized groups through knowledge gained, and more effective engagement of decision makers. With improved tools to describe environmental and economic dimensions, and explicit strategies for scaling-up the use and application of research results, the field of ecohealth will help integrate both improved health and sustainability into the development agenda.

  16. Probiotics: a comprehensive approach toward health foods.

    Science.gov (United States)

    Sharma, Monika; Devi, Mridula

    2014-01-01

    Food products containing probiotics and prebiotics are an important development in Health foods, which enhance health promoting microbial flora in the intestine. Probiotic refers to viable microorganism that promotes or support a beneficial balance of the autochthonous microbial population of the gastrointestinal tract. A number of genera of bacteria (and yeast) are used as probiotics, including Lactobacillus, Leuconostoc, Pediococcus, Bifidobacterium, Saccharomyces, and Enterococcus, but the main species believed to have probiotic characteristics are Lactobacillus acidophilus, Bifidobacterium spp., and L. casei. Probiotics can reduce diarrheal incidence, lactose intolerance, lower serum cholesterol, stimulate the immune system, control infections, act as antibiotics, suppress tumors, and protect against colon or bladder cancer by maintaining a healthy intestinal microflora balance. Lactic acid bacteria produce biopreservatives such as lactic acid, hydrogen peroxide, and bacteriocins that are used to retard both spoilage and the growth of pathogenic bacteria. Food, particularly dairy products are considered as an ideal vehicle for delivering probiotic bacteria to the human gastrointestinal tract. Cereals being rich source of prebiotics such as β-glucan and arabinoxylan, galacto-, and fructooligosaccharides are considered for development of probiotic foods. Good manufacturing practices must be applied in the manufacture of probiotic foods with quality assurance, and shelf-life conditions established.

  17. Interpreting the International Right to Health in a Human Rights-Based Approach to Health.

    Science.gov (United States)

    Hunt, Paul

    2016-12-01

    This article tracks the shifting place of the international right to health, and human rights-based approaches to health, in the scholarly literature and United Nations (UN). From 1993 to 1994, the focus began to move from the right to health toward human rights-based approaches to health, including human rights guidance adopted by UN agencies in relation to specific health issues. There is a compelling case for a human rights-based approach to health, but it runs the risk of playing down the right to health, as evidenced by an examination of some UN human rights guidance. The right to health has important and distinctive qualities that are not provided by other rights-consequently, playing down the right to health can diminish rights-based approaches to health, as well as the right to health itself. Because general comments, the reports of UN Special Rapporteurs, and UN agencies' guidance are exercises in interpretation, I discuss methods of legal interpretation. I suggest that the International Covenant on Economic, Social and Cultural Rights permits distinctive interpretative methods within the boundaries established by the Vienna Convention on the Law of Treaties. I call for the right to health to be placed explicitly at the center of a rights-based approach and interpreted in accordance with public international law and international human rights law.

  18. Public health terminology: Hindrance to a Health in All Policies approach?

    Science.gov (United States)

    Synnevåg, Ellen S; Amdam, Roar; Fosse, Elisabeth

    2017-09-01

    National public health policies in Norway are based on a Health in All Policies (HiAP) approach. At the local level, this means that public health, as a cross-sectional responsibility, should be implemented in all municipal sectors by integrating public health policies in municipal planning and management systems. The paper investigates these local processes, focusing on the use of public health terminology and how this terminology is translated from national to local contexts. We ask whether the terms 'public health' and 'public health work' are suitable when implementing an HiAP approach. A qualitative case study based on analyses of interviews and planning documents was performed in three Norwegian municipalities. The results present dilemmas associated with using public health terminology when implementing an HiAP approach. On the one hand, the terms are experienced as wide, complex, advanced and unnecessary. On the other hand, the terms are experienced as important for a systematic approach towards understanding public health ideology and cross-sectional responsibility. One municipality used alternative terminology. This paper promotes debate about the appropriateness of using the terms 'public health' and 'public health work' at the local level. It suggests that adaptation is suitable and necessary, unless it compromises knowledge, responsibility and a systematic approach. This study concludes that the use of terminology is a central factor when implementing the Norwegian Public Health Act at the local level.

  19. A Community Health Approach to Asthma in the Schools

    Science.gov (United States)

    Weiss-Randall, Debra

    2014-01-01

    Asthma is a leading cause of school absenteeism in the United States, especially in poor and minority communities, where prevalence and hospitalization rates are significantly higher than average. A community health approach can help poorer school districts hire full-time nurses and access other health resources.

  20. Innovative Approaches to Management Health Needed to Make Ecosanogenesis

    Directory of Open Access Journals (Sweden)

    Nicolae Ipate

    2015-02-01

    Full Text Available In this study we analysed the field of ecosanogenesis in correlation the health workplace, the health of consumers, and the health of the environment. Concerns of this vast area are primarily related to the implications of technology and various health products, because their effects are far more extensive and more generalized. This concept involves man to major issues, human actions and their results, nature and society, material and spiritual culture in a global relational context. If health depends on the relation human - product - nature, and promote better health will depend on optimal functionality of this relationship. Innovation as a result of research and inventions, in the service ecosanogenesis, offers a balance and sustainable development progress for sure, we could call it positive progress.Health classic resources financing, general taxes or health insurance contributions, are becoming increasingly inadequate, regardless of the type of health system, national health system or health insurance system. From increasingly many factors adversely affect the health of the population impersonal, that are not the result of human action or inaction in terms of his daily activities eg: environmental pollution, deforestation, use of non-biodegradable products etc. In conclusion we descript the innovative approaches to management health in context of ecosanogensis.

  1. Health Care as Commons: An Indigenous Approach to Universal Health Coverage

    Directory of Open Access Journals (Sweden)

    Young Soon Wong

    2014-06-01

    Full Text Available Modern health care systems of today are predominantly derived from Western models and are either state owned or under private ownership. Government, through their health policies, generally aim to facilitate access for the majority of the population through the design of their health systems. However, there are communities, such as Indigenous peoples, who do not necessarily fall under the formal protection of state systems. Throughout history, these societies have developed different ways to provide health care to its population. These health care systems are held and managed under different property regimes with their attendant advantages and disadvantages. This article investigates the gaps in health coverage among Indigenous peoples using the Malaysian Indigenous peoples as a case study. It conceptually examines a commons approach to health care systems through a study of the traditional health care system of indigenous peoples and suggests how such an approach can help close this gap in the remaining gaps of universal health coverage.

  2. Managing US-Mexico "border health": an organizational field approach.

    Science.gov (United States)

    Collins-Dogrul, Julie

    2006-12-01

    During World War II Mexican and US health professionals and organizations constructed a transnational organizational field to manage the border's public health problems. Despite barriers to inter-organizational cooperation, including disparate administrative structures and North-South stratification, the field's transnational approach to health on the border has continued for 60 years. Using archival data to track changes in the number and types of organizations, this article argues that the field practitioners call "border health" reconfigured during the North American Free Trade Association (NAFTA) decade from an era of loosely organized professionals to a specialized bureaucracies era. This change brought new vitality to border health, with transnational ties increasing and diversifying, but has not weakened entrenched cross-border inequalities. The organizational history of the US-Mexico border health field demonstrates how macro-politics and inter-organizational stratification shape transnational public health problems.

  3. [Challenges for knowledge generation in environmental health: an ecosystemic approach].

    Science.gov (United States)

    Weihs, Marla; Mertens, Frédéric

    2013-05-01

    This article examines opportunities and limitations regarding knowledge generation in the field of environmental health. The contention is that understanding the complexity of factors that determine the health of humans and ecosystems requires a redefinition of the traditional distribution of roles and responsibilities in scientific research. These research practices involve inter and transdisciplinary approaches and the application of an ecosystemic approach (ecohealth). Challenges and opportunities associated to the application of inter and transdisciplinarity in environmental health problems are discussed and illustrated by two case studies that use an ecohealth approach: a project on the contamination and exposure to mercury in the Brazilian Amazon, and another on the urban transmission of echinococcosis in Nepal. In the conclusion, the potential benefits of using an ecohealth approach in overcoming the limitations of unidisciplinary practices and in taking advantage of local knowledge and participation is stressed.

  4. A system dynamics approach to understanding the One Health concept.

    Science.gov (United States)

    Xie, Tai; Liu, Wenbao; Anderson, Benjamin D; Liu, Xiaorong; Gray, Gregory C

    2017-01-01

    There have been many terms used to describe the One Health concept, including movement, strategy, framework, agenda, approach, among others. However, the inter-relationships of the disciplines engaged in the One Health concept have not been well described. To identify and better elucidate the internal feedback mechanisms of One Health, we employed a system dynamics approach. First, a systematic literature review was conducted via searches in PubMed, Web of Knowledge, and ProQuest with the search terms: 'One Health' and (concept* or approach*). In addition, we used the HistCite® tool to add significant articles on One Health to the library. Then, of the 2368 articles identified, 19 were selected for evaluating the inter-relationships of disciplines engaged in One Health. Herein, we report a visually rich, theoretical model regarding interactions of various disciplines and complex problem descriptors engaged in One Health problem solving. This report provides a conceptual framework for future descriptions of the interdisciplinary engagements involved in One Health.

  5. Considering children and health literacy: a theoretical approach.

    Science.gov (United States)

    Borzekowski, Dina L G

    2009-11-01

    The theoretical approaches of Paulo Freire, Jean Piaget, and Lev Vygotsky frame the consideration of children and health literacy. This article includes a general discussion of literacy from the Freirian perspective. A definition of health literacy is then presented; first, the established meaning is introduced, but then a Freirian extension is proposed. Next, the theories of cognitive development by Piaget and Vygotsky are discussed, and examples related to children's health literacy are given. Finally, there is a discussion of why it is important to encourage and enable health literacy among children and adolescents.

  6. Approaches in Health Human Resource Forecasting: A Roadmap for Improvement

    Science.gov (United States)

    Rafiei, Sima; Mohebbifar, Rafat; Hashemi, Fariba; Ezzatabadi, Mohammad Ranjbar; Farzianpour, Fereshteh

    2016-01-01

    Introduction Forecasting the demand and supply of health manpower in an accurate manner makes appropriate planning possible. The aim of this paper was to review approaches and methods for health manpower forecasting and consequently propose the features that improve the effectiveness of this important process of health manpower planning. Methods A literature review was conducted for studies published in English from 1990–2014 using Pub Med, Science Direct, Pro Quest, and Google Scholar databases. Review articles, qualitative studies, retrospective and prospective studies describing or applying various types of forecasting approaches and methods in health manpower forecasting were included in the review. The authors designed an extraction data sheet based on study questions to collect data on studies’ references, designs, and types of forecasting approaches, whether discussed or applied, with their strengths and weaknesses Results Forty studies were included in the review. As a result, two main categories of approaches (conceptual and analytical) for health manpower forecasting were identified. Each approach had several strengths and weaknesses. As a whole, most of them were faced with some challenges, such as being static and unable to capture dynamic variables in manpower forecasting and causal relationships. They also lacked the capacity to benefit from scenario making to assist policy makers in effective decision making. Conclusions An effective forecasting approach is supposed to resolve all the deficits that exist in current approaches and meet the key features found in the literature in order to develop an open system and a dynamic and comprehensive method necessary for today complex health care systems. PMID:27790343

  7. 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....... of Oral and General Health Promotion, Health Behavior Theories and Children'.This book provides further evidence that children's general and oral health are interrelated by common lifestyle and family factors, and both should be supported by holistic health promotion strategies and empowerment of families...

  8. A rhetorical approach to discussions about health and vegetarianism.

    Science.gov (United States)

    Wilson, Marc Stewart; Weatherall, Ann; Butler, Carly

    2004-07-01

    Typically, research on vegetarianism has sought to identify the psychological characteristics that distinguish vegetarians from meat-eaters. Health concerns have been identified as a motivation for meat abstention. In this article, rhetorical analysis of Internet discussions about health and vegetarianism highlights the argumentative orientation of explanations for meat consumption, with the various constructions of health serving a rhetorical function. We show the dilemmatic nature of arguments about the relationship between food and health: food can promote health and cause ill-health, and suggest that meat-eating as a dominant practice is supported by the rhetorical use of notions of 'balance', implying moderation, inclusion and rationality. This rhetorical approach represents a radical critique of past work that assumes opinions given in response to questions about vegetarian practices represent 'causes' of dietary practice.

  9. Health Workforce Planning: An overview and suggested approach in Oman.

    Science.gov (United States)

    Al-Sawai, Abdulaziz; Al-Shishtawy, Moeness M

    2015-02-01

    In most countries, the lack of explicit health workforce planning has resulted in imbalances that threaten the capacity of healthcare systems to attain their objectives. This has directed attention towards the prospect of developing healthcare systems that are more responsive to the needs and expectations of the population by providing health planners with a systematic method to effectively manage human resources in this sector. This review analyses various approaches to health workforce planning and presents the Six-Step Methodology to Integrated Workforce Planning which highlights essential elements in workforce planning to ensure the quality of services. The purpose, scope and ownership of the approach is defined. Furthermore, developing an action plan for managing a health workforce is emphasised and a reviewing and monitoring process to guide corrective actions is suggested.

  10. Health Workforce Planning: An overview and suggested approach in Oman

    Directory of Open Access Journals (Sweden)

    Abdulaziz Al-Sawai

    2015-01-01

    Full Text Available In most countries, the lack of explicit health workforce planning has resulted in imbalances that threaten the capacity of healthcare systems to attain their objectives. This has directed attention towards the prospect of developing healthcare systems that are more responsive to the needs and expectations of the population by providing health planners with a systematic method to effectively manage human resources in this sector. This review analyses various approaches to health workforce planning and presents the Six-Step Methodology to Integrated Workforce Planning which highlights essential elements in workforce planning to ensure the quality of services. The purpose, scope and ownership of the approach is defined. Furthermore, developing an action plan for managing a health workforce is emphasised and a reviewing and monitoring process to guide corrective actions is suggested.

  11. School health approach to teaching and learning of students

    Directory of Open Access Journals (Sweden)

    Lukianova Yu.S.

    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.

  12. 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.

  13. Assessing community health among indigenous populations in Ecuador with a participatory approach: implications for health reform.

    Science.gov (United States)

    Puertas, B; Schlesser, M

    2001-04-01

    Health reform is an important movement in countries throughout the region of the Americas, which could profoundly influence how basic health services are provided and who receives them. Goals of health sector reform include to improve quality, correct inefficiencies, and reduce inequities in current systems. The latter may be especially important in countries with indigenous populations, which are thought to suffer from excess mortality and morbidity related to poverty. The purpose of this paper is to report the results of a community health assessment conducted in 26 indigenous communities in the Province of Cotopaxi in rural Ecuador. It is hoped that this information will inform the health reform movement by adding to the current understanding of the health and socioeconomic situation of indigenous populations in the region while emphasizing a participatory approach toward understanding the social forces impacting upon health. This approach may serve as a model for empowering people through collective action. Recommended health reform strategies include: 1) Develop a comprehensive plan for health improvement in conjunction with stakeholders in the general population, including representatives of minority groups; 2) Conduct research on the appropriate mix between traditional medicine, primary health care strategies, and high technology medical services in relation to the needs of the general population; 3) Train local health personnel and traditional healers in primary health care techniques; 4) Improve access to secondary and tertiary health services for indigenous populations in times of emergency; and 5) Advocate for intersectoral collaboration among government institutions as well as non-governmental organizations and the private sector.

  14. Holism and a health-promoting approach to palliative care.

    Science.gov (United States)

    Buckley, Jenny

    2002-10-01

    This article draws on Illich's definition of health and explores the perspective of facing death as a process of adaptation. Research into psychoneuroimmunology is discussed. This focuses on using one's own resources, which the author sees as a central tenet of holism. A key aspect of this approach is not only empowerment of patients, but also of nurses, allowing them to be self-aware, self-valuing and to practise self-care. The article mentions an educational strategy to encourage a health-promoting approach. This course uses the concept of holism as a framework for teaching and practice of palliative care.

  15. [Relaxation, a complementary approach for mental health nurses].

    Science.gov (United States)

    Besnier, Véronique

    2016-01-01

    Relaxation is arousing growing interest in mental health. Its positive effects are in line with an active approach which brings together body and mind and place the individual back on the path of self-awareness. The relationship with the patient constitutes the "therapeutic we" ensuring its therapeutic importance. It represents a complementary and original approach to caring. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  16. 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.

  17. The MESH approach: strengthening public health systems for the MDGs.

    Science.gov (United States)

    Thomas, Stephen; Mooney, Gavin; Mbatsha, Sandi

    2007-10-01

    This article addresses some of the complexities in the interactions both within the public health system and between that and civil society. It examines what needs to be done to improve the capacity of health systems, primarily through building relevant infrastructure (what is called MESH--management, economic, social and human - infrastructure) where this is lacking. This lack is most likely to occur in poorer communities and health districts. The problem of absorption and appropriate use of funds in disadvantaged areas has been highlighted as a critical bottleneck to the achievement of the millennium development goals (MDGs). MESH is defined as infrastructure which is built to improve the capacity of communities and other entities to implement health service programs efficiently. We employ this concept to determine how best to invest in health in poor areas so that they can better use any additional resources they receive. The article reviews some initial explorations of the relevance of MESH building strategies in South Africa. The research shows the usefulness of the MESH approach which requires inter alia a more developmental approach that goes beyond the vertical silos of much influential prioritization literature over the last two decades. In practice it is clear that MESH will vary from location to location which reflects the fact that investing in successful health strategies must take into account the voices of the local people with respect to what they want from their health services.

  18. Public health situation awareness: toward a semantic approach

    Science.gov (United States)

    Mirhaji, Parsa; Richesson, Rachel L.; Turley, James P.; Zhang, Jiajie; Smith, Jack W.

    2004-04-01

    We propose a knowledge-based public health situation awareness system. The basis for this system is an explicit representation of public health situation awareness concepts and their interrelationships. This representation is based upon the users" (public health decision makers) cognitive model of the world, and optimized towards the efficacy of performance and relevance to the public health situation awareness processes and tasks. In our approach, explicit domain knowledge is the foundation for interpretation of public health data, as apposed to conventional systems where the statistical methods are the essence of the processes. Objectives: To develop a prototype knowledge-based system for public health situation awareness and to demonstrate the utility of knowledge intensive approaches in integration of heterogeneous information, eliminating the effects of incomplete and poor quality surveillance data, uncertainty in syndrome and aberration detection and visualization of complex information structures in public health surveillance settings, particularly in the context of bioterrorism (BT) preparedness. The system employs the Resource Definition Framework (RDF) and additional layers of more expressive languages to explicate the knowledge of domain experts into machine interpretable and computable problem-solving modules that can then guide users and computer systems in sifting through the most "relevant" data for syndrome and outbreak detection and investigation of root cause of the event. The Center for Biosecurity and Public Health Informatics Research is developing a prototype knowledge-based system around influenza, which has complex natural disease patterns, many public health implications, and is a potential agent for bioterrorism. The preliminary data from this effort may demonstrate superior performance in information integration, syndrome and aberration detection, information access through information visualization, and cross-domain investigation of the

  19. 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.

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

    African Journals Online (AJOL)

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

  1. Measuring the health of populations: the veil of ignorance approach.

    Science.gov (United States)

    Pinto-Prades, José-Luis; Abellán-Perpiñán, José-María

    2005-01-01

    We report the results from two surveys designed to explore whether an application of Harsanyi's principle of choice form behind a veil of ignorance (VEI) can be used in order to measure the health of populations. This approach was tentatively recommended by Murray et al. (Bull. World Health Organ 2000; 78: 981-994; Summary Measures of population health: Concepts, Ethics, Measurement and Applications, WHO, 2002.) as an appropriate way of constructing summary measures of population health (SMPH) for comparative purposes. The operationalization of the VEI approach used in this paper was suggested by Nord (Summary Measures of Population Health: Concepts, Ethics, Measurement and Applications, WHO, 2002.). We test if VEI and person trade-off (PTO) methods generate similar quality-of-life weights. In addition, we compare VEI and PTO weights with individual utilities estimated by means of the conventional standard gamble (SG) and a variation of it we call double gamble. Finally, psychometric properties like feasibility, reliability, and consistency are examined. Our main findings are next: (1) VEI and PTO approaches generate very different weights; (2) it seems that differences between PTO and VEI are not due to the 'rule of rescue'; (3) the VEI resembled more a DG than a classical SG; (4) PTO, VEI, and DG exhibited good feasibility, reliability and consistency.

  2. Consumers' perspectives on national health insurance in South Africa: using a mobile health approach.

    Science.gov (United States)

    Weimann, Edda; Stuttaford, Maria C

    2014-10-28

    Building an equitable health system is a cornerstone of the World Health Organization (WHO) health system building block framework. Public participation in any such reform process facilitates successful implementation. South Africa has embarked on a major reform in health policy that aims at redressing inequity and enabling all citizens to have equal access to efficient and quality health services. This research is based on a survey using Mxit as a mobile phone-based social media network. It was intended to encourage comments on the proposed National Health Insurance (NHI) and to raise awareness among South Africans about their rights to free and quality health care. Data were gathered by means of a public e-consultation, and following a qualitative approach, were then examined and grouped in a theme analysis. The WHO building blocks were used as the conceptual framework in analysis and discussion of the identified themes. Major themes are the improvement of service delivery and patient-centered health care, enhanced accessibility of health care providers, and better health service surveillance. Furthermore, health care users demand stronger outcome-based rather than rule-based indicators of the health system's governance. Intersectoral solidarity and collaboration between private and public health care providers are suggested. Respondents also propose a code of ethical values for health care professionals to address corruption in the health care system. It is noteworthy that measures for dealing with corruption or implementing ethical values are neither described in the WHO building blocks nor in the NHI. The policy makers of the new health system for South Africa should address the lack of trust in the health care system that this study has exposed. Furthermore, the study reveals discrepancies between the everyday lived reality of public health care consumers and the intended health policy reform.

  3. Operationalizing the One Health approach: the global governance challenges.

    Science.gov (United States)

    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.

  4. A public health approach to understanding and preventing violent radicalization

    Directory of Open Access Journals (Sweden)

    Bhui Kamaldeep S

    2012-02-01

    Full Text Available Abstract Background Very recent acts of terrorism in the UK were perpetrated by 'homegrown', well educated young people, rather than by foreign Islamist groups; consequently, a process of violent radicalization was proposed to explain how ordinary people were recruited and persuaded to sacrifice their lives. Discussion Counterterrorism approaches grounded in the criminal justice system have not prevented violent radicalization. Indeed there is some evidence that these approaches may have encouraged membership of radical groups by not recognizing Muslim communities as allies, citizens, victims of terrorism, and victims of discrimination, but only as suspect communities who were then further alienated. Informed by public health research and practice, a new approach is proposed to target populations vulnerable to recruitment, rather than rely only on research of well known terrorist groups and individual perpetrators of terrorist acts. Conclusions This paper proposes public health research and practice to guard against violent radicalization.

  5. Practice of One Health approaches: Bridges and barriers in Tanzania

    Directory of Open Access Journals (Sweden)

    Kim A. Kayunze

    2014-04-01

    Full Text Available The practice of one health approaches in human and animal health programmes is influenced by type and scope of bridges and barriers for partnerships. It was thus essential to evaluate the nature and scope of collaborative arrangements among human, animal, and wildlife health experts in dealing with health challenges which demand inter-sectoral partnership. The nature of collaborative arrangement was assessed, and the respective bridges and barriers over a period of 12 months (July 20011 to June 2012 were identified. The specific objectives were to: (1 determine the proportion of health experts who had collaborated with other experts of disciplines different from theirs, (2 rank the general bridges for and barriers against collaboration according to the views of the health experts, and (3 find the actual bridges for and barriers against collaboration among the health experts interviewed. It was found that 27.0% of animal health officers interviewed had collaborated with medical officers while 12.4% of the medical officers interviewed had collaborated with animal health experts. Only 6.7% of the wildlife officers had collaborated with animal health experts. The main bridges for collaboration were instruction by upper level leaders, zoonotic diseases of serious impacts, and availability of funding. The main barriers for collaboration were lack of knowledge about animal/human health issues, lack of networks for collaboration, and lack of plans to collaborate. This thus calls for the need to curb barriers in order to enhance inter-sectoral collaboration for more effective management of risks attributable to infectious diseases of humans and animals.

  6. A "health commons" approach to oral health for low-income populations in a rural state.

    Science.gov (United States)

    Beetstra, Stephen; Derksen, Daniel; Ro, Marguerite; Powell, Wayne; Fry, Donald E; Kaufman, Arthur

    2008-09-01

    Oral health needs are urgent in rural states. Creative, broad-based, and collaborative solutions can alleviate these needs. "Health commons" sites are enhanced, community-based, primary care safety net practices that include medical, behavioral, social, public, and oral health services. Successful intervention requires a comprehensive approach, including attention to enhancing dental service capacity, broadening the scope of the dental skills of locally available providers, expanding the pool of dental providers, creating new interdisciplinary teams in enhanced community-based sites, and developing more comprehensive oral health policy. By incorporating oral health services into the health commons primary care model, access for uninsured and underserved populations is increased. A coalition of motivated stakeholders includes community leaders, safety net providers, legislators, insurers, and medical, dental, and public health providers.

  7. Defining and measuring health inequality: an approach based on the distribution of health expectancy.

    Science.gov (United States)

    Gakidou, E. E.; Murray, C. J.; Frenk, J.

    2000-01-01

    This paper proposes an approach to conceptualizing and operationalizing the measurement of health inequality, defined as differences in health across individuals in the population. We propose that health is an intrinsic component of well-being and thus we should be concerned with inequality in health, whether or not it is correlated with inequality in other dimensions of well-being. In the measurement of health inequality, the complete range of fatal and non-fatal health outcomes should be incorporated. This notion is operationalized through the concept of healthy lifespan. Individual health expectancy is preferable, as a measurement, to individual healthy lifespan, since health expectancy excludes those differences in healthy lifespan that are simply due to chance. In other words, the quantity of interest for studying health inequality is the distribution of health expectancy across individuals in the population. The inequality of the distribution of health expectancy can be summarized by measures of individual/mean differences (differences between the individual and the mean of the population) or inter-individual differences. The exact form of the measure to summarize inequality depends on three normative choices. A firmer understanding of people's views on these normative choices will provide a basis for deliberating on a standard WHO measure of health inequality. PMID:10686732

  8. 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;

    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.......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...

  9. 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....

  10. A queer-theoretical approach to community health psychology.

    Science.gov (United States)

    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.

  11. Implementing One Health as an integrated approach to health in Rwanda.

    Science.gov (United States)

    Nyatanyi, Thierry; Wilkes, Michael; McDermott, Haley; Nzietchueng, Serge; Gafarasi, Isidore; Mudakikwa, Antoine; Kinani, Jean Felix; Rukelibuga, Joseph; Omolo, Jared; Mupfasoni, Denise; Kabeja, Adeline; Nyamusore, Jose; Nziza, Julius; Hakizimana, Jean Leonard; Kamugisha, Julius; Nkunda, Richard; Kibuuka, Robert; Rugigana, Etienne; Farmer, Paul; Cotton, Philip; Binagwaho, Agnes

    2017-01-01

    It is increasingly clear that resolution of complex global health problems requires interdisciplinary, intersectoral expertise and cooperation from governmental, non-governmental and educational agencies. 'One Health' refers to the collaboration of multiple disciplines and sectors working locally, nationally and globally to attain optimal health for people, animals and the environment. One Health offers the opportunity to acknowledge shared interests, set common goals, and drive toward team work to benefit the overall health of a nation. As in most countries, the health of Rwanda's people and economy are highly dependent on the health of the environment. Recently, Rwanda has developed a One Health strategic plan to meet its human, animal and environmental health challenges. This approach drives innovations that are important to solve both acute and chronic health problems and offers synergy across systems, resulting in improved communication, evidence-based solutions, development of a new generation of systems-thinkers, improved surveillance, decreased lag time in response, and improved health and economic savings. Several factors have enabled the One Health movement in Rwanda including an elaborate network of community health workers, existing rapid response teams, international academic partnerships willing to look more broadly than at a single disease or population, and relative equity between female and male health professionals. Barriers to implementing this strategy include competition over budget, poor communication, and the need for improved technology. Given the interconnectedness of our global community, it may be time for countries and their neighbours to follow Rwanda's lead and consider incorporating One Health principles into their national strategic health plans.

  12. 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.

  13. Soil Health Assessment Approaches and the Cornell Framework

    Science.gov (United States)

    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.

  14. From "one medicine" to "one health" and systemic approaches to health and well-being.

    Science.gov (United States)

    Zinsstag, J; Schelling, E; Waltner-Toews, D; Tanner, M

    2011-09-01

    Faced with complex patterns of global change, the inextricable interconnection of humans, pet animals, livestock and wildlife and their social and ecological environment is evident and requires integrated approaches to human and animal health and their respective social and environmental contexts. The history of integrative thinking of human and animal health is briefly reviewed from early historical times, to the foundation of universities in Europe, up to the beginning of comparative medicine at the end of the 19th century. In the 20th century, Calvin Schwabe coined the concept of "one medicine". It recognises that there is no difference of paradigm between human and veterinary medicine and both disciplines can contribute to the development of each other. Considering a broader approach to health and well-being of societies, the original concept of "one medicine" was extended to "one health" through practical implementations and careful validations in different settings. Given the global health thinking in recent decades, ecosystem approaches to health have emerged. Based on complex ecological thinking that goes beyond humans and animals, these approaches consider inextricable linkages between ecosystems and health, known as "ecosystem health". Despite these integrative conceptual and methodological developments, large portions of human and animal health thinking and actions still remain in separate disciplinary silos. Evidence for added value of a coherent application of "one health" compared to separated sectorial thinking is, however, now growing. Integrative thinking is increasingly being considered in academic curricula, clinical practice, ministries of health and livestock/agriculture and international organizations. Challenges remain, focusing around key questions such as how does "one health" evolve and what are the elements of a modern theory of health? The close interdependence of humans and animals in their social and ecological context relates to the

  15. A small business approach to nanomaterial environment, health, and safety.

    Science.gov (United States)

    Gause, Charles B; Layman, Rachel M; Small, Aaron C

    2011-06-01

    Integral to the commercialization process for nanotechnology enabled products is the methodology for protecting workers potentially exposed to nanomaterials during product development. Occupational health surveillance is a key aspect of protecting employees and involves both hazard identification and surveillance of known medical data. However, when the health effects and exposure pathways of both new and existing "nano-scale" chemical substances are not yet well understood, conservative hazard controls and baseline data collection can facilitate both immediate and long-term worker protection. Luna Innovations uses a conservative approach based on risk assessment and the OSHA General Duty Clause. To date, Luna's approach has been effective for our business model. Understanding and managing potential hazards to our nanotechnology workers is key to the success and acceptance of nanotechnology enabled products.

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

    Science.gov (United States)

    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.

  17. Governance and mental health: contributions for public policy approach

    Science.gov (United States)

    Díaz-Castro, Lina; Arredondo, Armando; Pelcastre-Villafuerte, Blanca Estela; Hufty, Marc

    2017-01-01

    ABSTRACT OBJECTIVE To analyze the conceptualization of the term governance on public mental health programs. METHODS In this systematic review, we analyzed the scientific literature published in the international scenario during 15 years (from 2000 to 2015). The databases analyzed were: Medline, CINAHL, PsycINFO and PubMed. Governance and mental health were the descriptors. We included relevant articles according to our subject of study and levels of analysis: (i) the concept of governance in mental health; (ii) process and decision spaces; (iii) strategic and pertinent actors who operate in the functioning of the health system, and (iv) social regulations. We excluded letters to the editor, news articles, comments and case reports, incomplete articles and articles whose approach did not include the object of study of this review. RESULTS We have found five conceptualizations of the term governance on mental health in the area of provision policies and service organization. The agents were both those who offer and those who receive the services: we identified several social norms. CONCLUSIONS The concept of governance in mental health includes standards of quality and attention centered on the patient, and incorporates the consumers of mental healthcare in the decision-making process. PMID:28146159

  18. 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.

  19. A dynamic approach to communication in health literacy education.

    Science.gov (United States)

    Veenker, Herman; Paans, Wolter

    2016-10-21

    -Message-Receiver Model; and b) only a few interventions in curricula are available for providing the acquisition of interaction skills in supporting autonomy. The proposal of Huber and others to change the emphasis in the definition of the WHO definition on health towards "to adapt and self manage" has impact on the training of medical students and practioners in dealing with patients with low levels of health literacy. From the present study it can be concluded that a dynamic approach to communication can be linked to theoretical constructs on self-management. In such an approach interaction techniques like scaffolding can increase the level of HL of the patient.

  20. A novel surveillance approach for disaster mental health.

    Science.gov (United States)

    Gruebner, Oliver; Lowe, Sarah R; Sykora, Martin; Shankardass, Ketan; Subramanian, S V; Galea, Sandro

    2017-01-01

    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 either

  1. PREVENTING SCHOOL SHOOTINGS : A PUBLIC HEALTH APPROACH TO GUN VIOLENCE

    OpenAIRE

    Welch, Edward

    2013-01-01

    CHDS State/Local Gun violence in America must be addressed at the highest levels of society. Newtown, Aurora, and Virginia Tech were attacks on the very fabric of America. School shootings represent attacks on our nations future. A public health approach to gun violence focuses on prevention. Public safety professionals, educators and community leaders are squandering opportunities to prevent horrific acts of extreme violence. Preparedness is derived by planning, which is critical to mobil...

  2. Use of Complementary Health Approaches in Individuals With Parkinson's Disease.

    Science.gov (United States)

    Shin, Ju Young; Pohlig, Ryan T; Habermann, Barbara

    2017-02-01

    Parkinson's disease (PD) is neurodegenerative and requires ongoing therapy. The purpose of the current study was two-fold: to (a) describe the prevalence, types, and associated factors of complementary health approaches (CHA) used in individuals with PD; and (b) explore reasons for CHA use. A self-administered, cross-sectional survey was used. The response rate was 61.9% (N = 135), and 74.1% of participants used CHA for either PD or general health. The most widely used CHA included exercise, yoga, massage, vitamins, coenzyme Q10, and coconut oil. Higher levels of education and treatment by a movement disorder specialist were significantly related to CHA use. Nurses and other health care professionals may have a role in providing safe care for individuals with PD. Further studies on effectiveness and safety of commonly used CHA are warranted. [Journal of Gerontological Nursing, 43(2), 46-54.].

  3. [An hermeneutic approach to health-disease relationship].

    Science.gov (United States)

    Caprara, Andrea

    2003-01-01

    This work aims to contribute to the current discussion on the relationship between health and disease, taking a hermeneutic perspective on the issue. The first section, referring to the discussion among the hermeneutic, phenomenological, and existential lines of philosophy, analyzes the work of two philosophers, Kierkegaard and Heidegger, who profoundly influenced contemporary hermeneutics. The article discusses the concept of anguish, which for Kierkegaard (contrary to the biomedical approach) is a constitutive component of human beings: for Kierkegaard, as subsequently for Heidegger, anxiety is not a pathological symptom but a state that allows for privileged access to self-knowledge. In the second section, we approach how hermeneutics, and especially the work of Gadamer, developed the concepts of health, illness, and suffering; we also analyze how in recent years this perspective has influenced the social sciences (and particularly medical anthropology) in their approach to health problems. The third and final section discusses the implications of hermeneutics for clinical training and practice, demonstrating the applicability of Heidegger's and Gadamer's thinking for work by physicians and nurses.

  4. Tools for thoughtful action: the role of ecosystem approaches to health in enhancing public health.

    Science.gov (United States)

    Webb, Jena C; Mergler, Donna; Parkes, Margot W; Saint-Charles, Johanne; Spiegel, Jerry; Waltner-Toews, David; Yassi, Annalee; Woollard, Robert F

    2010-01-01

    The intimate interdependence of human health and the ecosystems in which we are embedded is now a commonplace observation. For much of the history of public health, this was not so obvious. After over a century of focus on diseases, their biologic causes and the correction of exposures (clean water and air) and facilitation of responses (immunizations and nutrition), public health discourse shifted to embrace the concept of determinants of health as extending to social, economic and environmental realms. This moved the discourse and science of public health into an unprecedented level of complexity just as public concern about the environment heightened. To address multifactorial, dynamic impacts on health, a new paradigm was needed which would overcome the separation of humans and ecosystems. Ecosystem approaches to health arose in the 1990s from a rich background of intellectual ferment as Canada wrestled with diverse problems ranging from Great Lakes contamination to zoonotic diseases. Canada's International Development Research Centre (IDRC) played a lead role in supporting an international community of scientists and scholars who advanced ecosystem approaches to health. These collective efforts have enabled a shift to a research paradigm that embraces transdisciplinarity, social justice, gender equity, multi-stakeholder participation and sustainability.

  5. 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.

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

    DEFF Research Database (Denmark)

    Nielsen, Lasse

    2013-01-01

    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......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...

  7. 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.

  8. Strategic approach to information security and assurance in health research.

    Science.gov (United States)

    Akazawa, Shunichi; Igarashi, Manabu; Sawa, Hirofumi; Tamashiro, Hiko

    2005-09-01

    and certification, risk assessment and audit, monitoring and incident response, awareness and training, and modern protection method and architecture. Governments should enforce a comprehensive scheme, and international health research communities should adopt standardized innovative methods and approaches.

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

    Science.gov (United States)

    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

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

    Directory of Open Access Journals (Sweden)

    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

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

    Directory of Open Access Journals (Sweden)

    Sameera S. Karnik

    2014-05-01

    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.

  12. Toward a Socio-Territorial Approach to Health: Health Equity in West Africa

    Directory of Open Access Journals (Sweden)

    Lucie Vialard

    2017-01-01

    Full Text Available This study contributes to the literature about the effects of space and place on health by introducing a socio-territorial approach to urban health disparities in West Africa. It explores how urban spaces, specifically neighbourhoods, are shaped by social and economic relations and strategies of territorial control. We examine the potential influence of socio-territorial processes on vulnerability to disease, access to medical care, healthscapes, and illness experiences. Our research was conducted in Senegal and relied on a mixed methods design. We identified four neighbourhoods that represent the socio-spatial heterogeneity of the city of Saint-Louis and utilized the following methods: geographic and anthropological field research, household surveys, health knowledge and behaviour surveys, clinical exams, and illness interviews. Our results highlight the socio-territorial processes at work in each neighbourhood, clinical findings on three health measures (overweight, high blood pressure, and hyperglycaemia and health experiences of individuals with hypertension or type II diabetes. We found significant differences in the prevalence of the three health measures in the study sites, while experiences managing hypertension and diabetes were similar. We conclude that a socio-territorial approach offers insight into the complex constellation of forces that produce health disparities in urban settings.

  13. SentiHealth: creating health-related sentiment lexicon using hybrid approach.

    Science.gov (United States)

    Asghar, Muhammad Zubair; Ahmad, Shakeel; Qasim, Maria; Zahra, Syeda Rabail; Kundi, Fazal Masud

    2016-01-01

    The exponential increase in the health-related online reviews has played a pivotal role in the development of sentiment analysis systems for extracting and analyzing user-generated health reviews about a drug or medication. The existing general purpose opinion lexicons, such as SentiWordNet has a limited coverage of health-related terms, creating problems for the development of health-based sentiment analysis applications. In this work, we present a hybrid approach to create health-related domain specific lexicon for the efficient classification and scoring of health-related users' sentiments. The proposed approach is based on the bootstrapping modal, a dataset of health reviews, and corpus-based sentiment detection and scoring. In each of the iteration, vocabulary of the lexicon is updated automatically from an initial seed cache, irrelevant words are filtered, words are declared as medical or non-medical entries, and finally sentiment class and score is assigned to each of the word. The results obtained demonstrate the efficacy of the proposed technique.

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

    Science.gov (United States)

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

    2017-01-01

    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.

  15. Toward a Socio-Territorial Approach to Health: Health Equity in West Africa

    Science.gov (United States)

    Vialard, Lucie; Squiban, Clara; Fournet, Florence; Salem, Gérard; Foley, Ellen E.

    2017-01-01

    This study contributes to the literature about the effects of space and place on health by introducing a socio-territorial approach to urban health disparities in West Africa. It explores how urban spaces, specifically neighbourhoods, are shaped by social and economic relations and strategies of territorial control. We examine the potential influence of socio-territorial processes on vulnerability to disease, access to medical care, healthscapes, and illness experiences. Our research was conducted in Senegal and relied on a mixed methods design. We identified four neighbourhoods that represent the socio-spatial heterogeneity of the city of Saint-Louis and utilized the following methods: geographic and anthropological field research, household surveys, health knowledge and behaviour surveys, clinical exams, and illness interviews. Our results highlight the socio-territorial processes at work in each neighbourhood, clinical findings on three health measures (overweight, high blood pressure, and hyperglycaemia) and health experiences of individuals with hypertension or type II diabetes. We found significant differences in the prevalence of the three health measures in the study sites, while experiences managing hypertension and diabetes were similar. We conclude that a socio-territorial approach offers insight into the complex constellation of forces that produce health disparities in urban settings. PMID:28117751

  16. 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

  17. 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

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

    Science.gov (United States)

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

    2011-12-01

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

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

    Science.gov (United States)

    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.

  20. 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.

  1. [The gender approach in health-related newspaper articles].

    Science.gov (United States)

    Ruiz, María Teresa; Martín, Marta; La Parra, Daniel; Vives, Carmen; Albaladejo, Manuel

    2004-01-01

    To use a gender approach to analyze the content of health-related articles affecting both sexes (cancer, heart attack and smoking) or mainly women (anorexia, domestic violence and abortion), published in newspapers in the 1990s. To provide recommendations for writing news with a gender-sensitive approach. Analysis of the above-mentioned topics in articles published in the national Spanish daily newspapers El País, ABC and El Mundo (1991-1999). computerized databases of the newspapers. Sample of 1358 articles published in the national edition containing selected terms (battering [57], anorexia [79], heart attack [118], abortion [330], smoking [350], cancer [422]). Concepts studied: visibility, empowerment and equality. Interview with key informers. Thirty-eight percent of newspaper articles that identified the sex of journalists were signed by women. As the main protagonists of the feature, men (73%) were more visible than women (40%). Women mainly appeared as patients (14%) whereas men mainly appeared as politicians (29%) and physicians (24%). Despite the efforts made in the 1990s, the gender approach in health-related newspaper articles should be increased.

  2. Research Information System in Health Domain: Comparative Approach

    Directory of Open Access Journals (Sweden)

    Ramezan Ghorbani Nahid

    2015-07-01

    Full Text Available Objective: In recent decades, in low-income developing countries, management has faced serious challenges due to deficient information. An increasing number of dispersed data, concepts, observation of poor outputs, and separate software applications aggravated the situation, too. In order to promote and balance the research environment in the field of health, developing a platform for appropriate interactions is essential. Thus, the basic question is what requirements must be considered for suitable health research information system in Iran? Materials and Methods: The present study is a descriptive-comparative approach conducted in Iran in the years 2010-2011. System requirements of research information in Iran, United States, Australia, Japan and Netherland were reviewed and compared. Checklist was used for data collection. Data was collected from conference and journals papers and relevant manuals/guidelines from websites on their systems. Finally, data collected in the comparative tables were compared and described. Results: The requirement for national health research information system were determined based on the following central axis: structure, content, methods of gathering information, services and capabilities and methods of disseminating information which were assigned base on common and diverse components in countries’ systems. Conclusion: In order to achieve this national system, it is important that there should be a common serious determination for its development, change in attitude and culture of the researcher’s society in the domain of health and also improvement in the country’s information and communications technology (ICT infrastructure.

  3. 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 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  5. 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.

  6. Prevention of Youth Violence: A Public Health Approach.

    Science.gov (United States)

    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.

  7. A nonlinear cointegration approach with applications to structural health monitoring

    Science.gov (United States)

    Shi, H.; Worden, K.; Cross, E. J.

    2016-09-01

    One major obstacle to the implementation of structural health monitoring (SHM) is the effect of operational and environmental variabilities, which may corrupt the signal of structural degradation. Recently, an approach inspired from the community of econometrics, called cointegration, has been employed to eliminate the adverse influence from operational and environmental changes and still maintain sensitivity to structural damage. However, the linear nature of cointegration may limit its application when confronting nonlinear relations between system responses. This paper proposes a nonlinear cointegration method based on Gaussian process regression (GPR); the method is constructed under the Engle-Granger framework, and tests for unit root processes are conducted both before and after the GPR is applied. The proposed approach is examined with real engineering data from the monitoring of the Z24 Bridge.

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

    Science.gov (United States)

    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

  9. Irritable bowel syndrome: Personality and health behaviours: A biopsychosocial approach

    Directory of Open Access Journals (Sweden)

    Anita D Stuart

    1999-01-01

    Full Text Available The goal of this study was to indicate the complex nature of functional gastrointestinal disorders by studying the interaction between Irritable Bowel Syndrome and person personality aspects and health behaviour. An ex post facto design was used to compare two groups of women, the one group with iBS (N = 60 and the other without (N = 60 in terms of the above mentioned variables. The NEO-Personality lnventory (Revised was used to compare the groups on five broad aspects of personality i.e. Neuroticism, Extraversion, Openness for Experience, Agreeableness and Conscientiousness. The Health Behaviour Checklist was used to measure health behaviours as indicated by the foilowing factors: Wellness Maintenance and Enhancement, Accident Control, Traffic Risk Taking and Substance Risk Taking. The results indicate that statistically significant differences do indeed exist between the groups in terms of certain personality aspects (neuroticism, extraversion, openness for experience and certain health aspects (especially wellness maintenance and enhancement and traffic risk taking. It seems then as if IBS sufferers share certain personality characteristics which influence their behaviour related to the maintenance and enhancement of their health. Finally, we recommend a holistic approach to treatment and therapeutic interventions.

    Opsomming
    Die studie het ten doel gehad om die komplekse aard van die Funksionele Maagderm Versteurings aan te dui deur die interaksie tussen Prikkelbare Dermsindroom en persoonlikheidsaspekte en gesondheidsgedrag ("health behavioui' te bestudeer. Daar is gebruik gemaak van 'n ex post facto ontwerp om twee groepe vrouens, die een groep met PDS (N = 60 en die ander daarsonder (N = 60, ten opsigte van die veranderlikes te vergelyk. Die NEO - Personality lnventory (Revised is gebruik om die groepe te vergelyk ten opsigte van vyf brei persoonlikheidsaspekte naamlik, Neurotisme, Ekstraversie, Oopheid vir Ervaring, Welgevalligheid

  10. 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.

  11. 78 FR 12764 - Draft Office of Health Assessment and Translation Approach for Systematic Review and Evidence...

    Science.gov (United States)

    2013-02-25

    ... From the Federal Register Online via the Government Publishing Office DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Draft Office of Health Assessment and Translation Approach... comments on the Draft Office of Health Assessment and Translation (OHAT) Approach for Systematic Review...

  12. Health communication: a media and cultural studies approach

    National Research Council Canada - National Science Library

    Lewis, Belinda; Lewis, Jeff

    2015-01-01

    "This book is about communicating for health and social change. With a clear focus on public health and health promotion practice, it provides a unique introduction to media and cultural studies perspectives on health communication...

  13. Motivational Interviewing Approach Used by a Community Mental Health Team.

    Science.gov (United States)

    Tan, Sharon Chay Huang; Lee, Mindy Wen Hui; Lim, Gentatsu Tan Xiong; Leong, Joseph Jern-Yi; Lee, Cheng

    2015-12-01

    The current study aimed to (a) evaluate the effectiveness of motivational interviewing, as applied by a community mental health team (CMHT) based in Singapore; (b) reduce hospital admissions and length of hospital stay; and (c) improve global functioning and satisfaction of individuals with mental illness. The current study used a quasi-experimental method. A convenience sample of 120 participants was selected from the caseload of the CMHT. Participants received motivational interviewing sessions at least once every month for 1 year. Data on the number of hospital admissions, length of hospitalization, Global Assessment of Functioning, and patient satisfaction were collected at baseline and 6 and 12 months. Participants who underwent the CMHT services with motivational interviewing were more compliant to treatment, resulting in significant reduction in hospitalization and improvement in functionality. Motivational interviewing is effective in facilitating better illness management for patients in the community. Adoption of the motivational interviewing approach may potentially provide significant benefits for psychiatric support services in the community.

  14. NASA's Systems Engineering Approaches for Addressing Public Health Surveillance Requirements

    Science.gov (United States)

    Vann, Timi

    2003-01-01

    NASA's systems engineering has its heritage in space mission analysis and design, including the end-to-end approach to managing every facet of the extreme engineering required for successful space missions. NASA sensor technology, understanding of remote sensing, and knowledge of Earth system science, can be powerful new tools for improved disease surveillance and environmental public health tracking. NASA's systems engineering framework facilitates the match between facilitates the match between partner needs and decision support requirements in the areas of 1) Science/Data; 2) Technology; 3) Integration. Partnerships between NASA and other Federal agencies are diagrammed in this viewgraph presentation. NASA's role in these partnerships is to provide systemic and sustainable solutions that contribute to the measurable enhancement of a partner agency's disease surveillance efforts.

  15. Holistic approach to fraud management in health insurance

    Directory of Open Access Journals (Sweden)

    Štefan Furlan

    2008-12-01

    Full Text Available Fraud present an immense problem for health insurance companies and the only way to fight fraud is by using specialized fraud management systems. The current research community focussed great efforts on different fraud detection techniques while neglecting other also important activities of fraud management. We propose a holistic approach that focuses on all 6 activities of fraud management, namely, (1 deterrence, (2 prevention, (3 detection, (4 investigation, (5 sanction and redress, and (6 monitoring. The main contribution of the paper are 15 key characteristics of a fraud management system, which enable construction of a fraud management system that provides effective and efficient support to all fraud management activities. We base our research on literature review, interviews with experts from different fields, and a case study. The case study provides additional confirmation to expert opinions, as it puts our holistic framework into practice.

  16. Estimating summary measures of health: a structured workbook approach

    Directory of Open Access Journals (Sweden)

    Le Petit Christel

    2005-05-01

    Full Text Available Abstract Background Summary measures of health that combine mortality and morbidity into a single indicator are being estimated in the Canadian context for approximately 200 diseases and conditions. To manage the large amount of data and calculations for this many diseases, we have developed a structured workbook system with easy to use tools. We expect this system will be attractive to researchers from other countries or regions of Canada who are interested in estimating the health-adjusted life years (HALYs lost to premature mortality and year-equivalents lost to reduced functioning, as well as population attributable fractions (PAFs associated with risk factors. This paper describes the workbook system using cancers as an example, and includes the entire system as a free, downloadable package. Methods The workbook system was developed in Excel and runs on a personal computer. It is a database system that stores data on population structure, mortality, incidence, distributions of cases entering a multitude of health states, durations of time spent in health states, preference scores that weight for severity, life table estimates of life expectancies, and risk factor prevalence and relative risks. The tools are Excel files with embedded macro programs. The main tool generates workbooks that estimate HALY, one per disease, by copying data from the database into a pre-defined template. Other tools summarize the HALY results across diseases for easy analysis. Results The downloadable zip file contains the database files initialized with Canadian data for cancers, the tools, templates and workbooks that estimate PAF and a user guide. The workbooks that estimate HALY are generated from the system at a rate of approximately one minute per disease. The resulting workbooks are self-contained and can be used directly to explore the details of a particular disease. Results can be discounted at different rates through simple parameter modification

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

    Directory of Open Access Journals (Sweden)

    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.

  18. Governance and mental health: contributions for public policy approach.

    Science.gov (United States)

    Díaz-Castro, Lina; Arredondo, Armando; Pelcastre-Villafuerte, Blanca Estela; Hufty, Marc

    2017-01-30

    To analyze the conceptualization of the term governance on public mental health programs. In this systematic review, we analyzed the scientific literature published in the international scenario during 15 years (from 2000 to 2015). The databases analyzed were: Medline, CINAHL, PsycINFO and PubMed. Governance and mental health were the descriptors. We included relevant articles according to our subject of study and levels of analysis: (i) the concept of governance in mental health; (ii) process and decision spaces; (iii) strategic and pertinent actors who operate in the functioning of the health system, and (iv) social regulations. We excluded letters to the editor, news articles, comments and case reports, incomplete articles and articles whose approach did not include the object of study of this review. We have found five conceptualizations of the term governance on mental health in the area of provision policies and service organization. The agents were both those who offer and those who receive the services: we identified several social norms. The concept of governance in mental health includes standards of quality and attention centered on the patient, and incorporates the consumers of mental healthcare in the decision-making process. Analizar la conceptualización del término gobernanza en las políticas de salud mental. En esta revisión sistemática se analizó literatura científica publicada en el ámbito internacional durante 15 años (de 2000 hasta 2015). Las bases de datos analizadas fueron: Medline, CINAHL, PsycINFO y PubMed. Los descriptores fueron gobernanza y salud mental. Fueron incluidos artículos relevantes de acuerdo a nuestro objeto de estudio y niveles de análisis: (i) concepto de gobernanza en salud mental; (ii) proceso y espacios de decisión; (iii) actores estratégicos y de interés que intervienen en el funcionamiento del sistema de salud, y (iv) normas sociales. Se excluyeron cartas al editor, noticias, comentarios y reporte de caso

  19. Implementation of the Care Programme Approach across Health and Social Services for Dual Diagnosis Clients

    Science.gov (United States)

    Kelly, Michael; Humphrey, Charlotte

    2013-01-01

    Background: Care for clients with mental health problems and concurrent intellectual disability (dual diagnosis) is currently expected to be provided through the care programme approach (CPA), an approach to provide care to people with mental health problems in secondary mental health services. When CPA was originally introduced into UK mental…

  20. 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…

  1. 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…

  2. Advancing Health Promotion in Dentistry: Articulating an Integrative Approach to Coaching Oral Health Behavior Change in the Dental Setting.

    Science.gov (United States)

    Vernon, Lance T; Howard, Anita R

    2015-09-01

    Oral health is managed based on objective measures such as the presence and severity of dental caries and periodontal disease. In recent years, oral health researchers and practitioners have shown increasing interest in a widened array of physical, psychological, and social factors found to influence patients' oral health. In this article, we introduce a behavior change coaching approach that can be used to enhance psychosocial diagnosis and client-centered delivery of health-promoting interventions. Briefly, this health coaching approach is based on an interactive assessment (both physical and psychological), a non-judgmental exploration of patients' knowledge, attitudes, and beliefs, a mapping of patient behaviors that may contribute to disease progression, gauging patient motivation, and tailoring health communication to encourage health-promoting behavior change. Developed in a clinical setting, this coaching model is supported by interdisciplinary theory, research, and practice on health behavior change. We suggest that, with supervision, this coaching process may be learned.

  3. 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

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

    Directory of Open Access Journals (Sweden)

    Leung Zee

    2012-05-01

    Full Text Available Abstract Background 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. Methods 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. Results 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. Conclusions 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

  5. Integrating a population health approach into healthcare service delivery and decision making.

    Science.gov (United States)

    Neudorf, Cordell

    2012-01-01

    Most regional health authorities include "improving population health and health equity" in their mission, vision, or priority statements, yet few regional health authorities or hospitals have been shown to devote the sufficient time and resources to make significant progress toward this aim. Health system leaders want to act on this priority, but many barriers and challenges conspire to limit their effectiveness. Improving population health requires both population-based and individual-level initiatives aimed at preventing disease and improving health equity. Practical examples for integrating a population health approach into the health system are presented for healthcare leaders.

  6. Bananas, pesticides and health in southwestern Ecuador: A scalar narrative approach to targeting public health responses.

    Science.gov (United States)

    Brisbois, Benjamin

    2016-02-01

    Public health responses to agricultural pesticide exposure are often informed by ethnographic or other qualitative studies of pesticide risk perception. In addition to highlighting the importance of structural determinants of exposure, such studies can identify the specific scales at which pesticide-exposed individuals locate responsibility for their health issues, with implications for study and intervention design. In this study, an ethnographic approach was employed to map scalar features within explanatory narratives of pesticides and health in Ecuador's banana-producing El Oro province. Unstructured observation, 14 key informant interviews and 15 in-depth semi-structured interviews were carried out during 8 months of fieldwork in 2011-2013. Analysis of interview data was informed by human geographic literature on the social construction of scale. Individual-focused narratives of some participants highlighted characteristics such as carelessness and ignorance, leading to suggestions for educational interventions. More structural explanations invoked farm-scale processes, such as uncontrolled aerial fumigations on plantations owned by elites. Organization into cooperatives helped to protect small-scale farmers from 'deadly' banana markets, which in turn were linked to the Ecuadorian nation-state and actors in the banana-consuming world. These scalar elements interacted in complex ways that appear linked to social class, as more well-off individuals frequently attributed the health problems of other (poorer) people to individual behaviours, while providing more structural explanations of their own difficulties. Such individualizing narratives may help to stabilize inequitable social structures. Research implications of this study include the possibility of using scale-focused qualitative research to generate theory and candidate levels for multi-level models. Equity implications include a need for public health researchers planning interventions to engage with

  7. Improving the health of Missouri communities: a process approach.

    Science.gov (United States)

    Stafford-Alewine, S

    1997-12-01

    It is important to note that while many states have communities involved in processes similar to CHART, few, if any, offer a team of professionals to support these initiatives, and none have a statewide partnership that is as committed to the process as Missouri does. The relationship between the key partner organizations is a unique phenomenon, and is certainly a key success factor for the process. CHART is an active member of the Coalition for Healthier Cities and Communities, a national network that exists as a multi-sector partnership to service the widespread communities movement in the U.S. The Coalition serves as both a link to resources, and as a voice for policy and action. The issues and concerns, as well as the successes, of Missouri communities are carried to this national Coalition to present a unified voice for communities nationwide. CHART is an innovative approach to empowered community development. It provides communities the opportunity to participate in the process of change. The CHART process provides a vehicle for communities to take charge of the future, to determine locally how issues are addressed, and to set a course that assures improved health, quality of life, and sustainable community systems for the 21st century.

  8. An approach to the understanding of equity in health

    Directory of Open Access Journals (Sweden)

    Sergio Antonio Clavijo Clavijo

    2014-02-01

    Full Text Available The world health should be considered a social welfareof human beings, since this is a prerequisite for thedevelopment of humanity. In the context of human rights,health equity is an inherent principle based on social justice,looking for all individuals regardless of their social, entitledto the same opportunities. Historically, have developedhealth services that provide social welfare to individuals, butthe concept has prevailed mercantilist, which has reducedhealth systems to simple utilities, ignoring the underlyingproblems of the population. It is proposed Primary HealthCare as an alternative, speaking as population includes theresponsibility to ensure health services accessibility and apossible response to the inequalities inherent in a systemfocused on health insurance. For this study was conductedreflects on the concept of equity, carrying out searches withthe terms equity, health, equity in health, health economics,quality health, public health, public health policy, healthhistory, primary health care with the aim of being able tocollect partial abstracts or full text. Additional to search forelectronic journals, books that will argue the importance ofequity in the companies were consulted, different economicmodels, the history of health and disease; nature relatingbills that argument on these definitions were consulted.

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

    African Journals Online (AJOL)

    premature deaths due to NCDs such as diabetes and hypertension are increasing, accounting for 30% of all deaths ... ity of health system infrastructure, poor health literacy, .... assessments, the research designs are not usually robust.

  10. Workplace mental health: developing an integrated intervention approach

    National Research Council Canada - National Science Library

    LaMontagne, Anthony D; Martin, Angela; Page, Kathryn M; Reavley, Nicola J; Noblet, Andrew J; Milner, Allison J; Keegel, Tessa; Smith, Peter M

    2014-01-01

    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...

  11. Decision-making process and health management councils: theoretical approaches

    National Research Council Canada - National Science Library

    Wendhausen, Agueda; Cardoso, Sandra de Mello

    2007-01-01

    With the institutionalization of participation in health, through conferences and management councils at national, state, municipal and local levels, a process of democratization is initiated in the health area...

  12. Considerations in Applying the General Equilibrium Approach to Environmental Health Assessment

    Institute of Scientific and Technical Information of China (English)

    YUE WAN; HONG-WEI YANG; TOSHIHIKO MASUI

    2005-01-01

    There are currently two commonly used approaches to assessing economic impacts of health damage resulting from environmental pollution: human capital approach (HCA) and willingness-to-pay (WTP). WTP can be further divided into averted expenditure approach (AEA), hedonic wage approach (HWA), contingent valuation approach (CVA) and hedonic price approach (HPA). A general review of the principles behind these approaches by the authors indicates that these methods are incapable of unveiling the mechanism of health impact from the point of view of national economy. On a basis of economic system, the shocks brought about by health effects of environmental pollution change the labor supply and medical expenditure, which in turn affects the level of production activity in each sector and the total final consumption pattern of the society. The general equilibrium approach within the framework of macroeconomic theory is able to estimate the health impact on national economy comprehensively and objectively. Its mechanism and applicability are discussed in detail by the authors.

  13. Considerations in applying the general equilibrium approach to environmental health assessment.

    Science.gov (United States)

    Wan, Yue; Yang, Hong-Wei; Masui, Toshihiko

    2005-10-01

    There are currently two commonly used approaches to assessing economic impacts of health damage resulting from environmental pollution: human capital approach (HCA) and willingness-to-pay (WTP). WTP can be further divided into averted expenditure approach (AEA), hedonic wage approach (HWA), contingent valuation approach (CVA) and hedonic price approach (HPA). A general review of the principles behind these approaches by the authors indicates that these methods are incapable of unveiling the mechanism of health impact from the point of view of national economy. On a basis of economic system, the shocks brought about by health effects of environmental pollution change the labor supply and medical expenditure, which in turn affects the level of production activity in each sector and the total final consumption pattern of the society. The general equilibrium approach within the framework of macroeconomic theory is able to estimate the health impact on national economy comprehensively and objectively. Its mechanism and applicability are discussed in detail by the authors.

  14. Collaboration, Competencies and the Classroom: A Public Health Approach

    Science.gov (United States)

    Waller, Lauren E.; Papadopoulos, Andrew

    2015-01-01

    The University of Guelph Master of Public Health program is a professional degree program that seeks to prepare graduates to meet complex public health needs by developing their proficiency in the 36 public health core competencies. Provision of experiential learning opportunities, such as a semester-long practicum, is part of student development.…

  15. The Humanistic Approach: A Model For Dental Health Curriculums.

    Science.gov (United States)

    Beall, Sue; Hurley, Robert S.

    1982-01-01

    A special dental health curriculum, called the Tattletooth Curriculum, demonstrates the use of the humanistic model in health education and its concern for the learner as a total person. The main concept in the development of this curriculum is that the prospect for changing behavior is unlikely unless the health information is personally…

  16. [Intensify the development of public policy has the health: approaches strategic for the authorities of health public].

    Science.gov (United States)

    Guyon, Ak'ingabe

    2012-11-06

    Health promotion is one of the essential functions of public health authorities. The first pillar of health promotion is the elaboration of healthy public policy. Using the theoretical foundations of the healthy public policy concept, it can be demonstrated that public health authorities are able to develop, at their own scale, healthy public policies. Three strategic approaches are proposed in order to support public health authorities in strengthening their healthy public policy actions. First, better understand the tools or policy instruments (economic, regulation, information and persuasion) at their disposal. Second, take stock of the many types of legitimacy (theoretical, legislative, administrative and scientific) available to public health authorities as they develop healthy public policy. Third, consider the potential scientific roles that can be adopted while using the various policy instruments. These approaches can represent a pragmatic and structuring support for public health authorities wanting to strengthen their healthy public policy actions.

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

    Science.gov (United States)

    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.

  18. 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.

  19. Population health promotion 2.0: An eco-social approach to public health in the Anthropocene.

    Science.gov (United States)

    Hancock, Trevor

    2015-07-08

    Humanity is both an animal species that evolved within and is dependent upon natural ecosystems and a social animal that exists within the social systems we have created. Our health is dependent upon both these systems - natural and social - functioning well, and indeed upon their interactions. Yet our approach to improving the health of the population over the past few decades has been largely, if not exclusively, focused on the social determinants of health. A recent Canadian Public Health Association (CPHA) Discussion Document and the technical report on which it is based seek to strike a more balanced approach. First, they document the dramatic and rapid global ecological changes that humans have created and argue that they are a significant threat to the health of the population in the 21st century. Second, they identify the underlying social, cultural and economic forces that are driving these changes. Third, they argue that we need to take an eco-social approach in population health promotion, recognizing the interactions between the ecological and social determinants of health. Such an approach could be considered to be 'Population health promotion 2.0', and it has profound implications for the practice of public health.

  20. '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.

  1. Quality systems in health care: A sociotechnical approach

    NARCIS (Netherlands)

    P.P.M. Harteloh (Peter)

    2003-01-01

    textabstractIn this paper, we explore a sociotechnical approach to construct quality systems as an alternative to the traditional, ISO orientated approach. A sociotechnical approach is characterised as bottom-up, incremental, information technology facilitated and indicator driven. Its purpose is to

  2. A strategic approach of E-health initiatives.

    Science.gov (United States)

    Asoh, Derek A; Rivers, Patrick A; Shih, Stephen C; Tsai, Kai-Li

    2008-01-01

    The Internet is transforming the US economy. Though it continues to lag behind other industries, healthcare has begun to incorporate this technology on a wider scale to reduce costs and more effectively address quality and patient-choice issues. This article presents the background of the US healthcare system, examines the application of e-health, advocates for the integration of e-health components and discusses the roles of major stakeholders in e-health as the basis for the strategic planning, initiation and implementation of integrated e-health systems. Strategic planning provides the opportunity for an insightful view and consideration of the impacts, expectations and responses of e-health stakeholders while implementing integrated e-health solutions for access to more cost-effective and better patient care delivery.

  3. Marketing in home health care. A practical approach.

    Science.gov (United States)

    Freitag, E M

    1988-06-01

    Home health marketing brings special problems and opportunities. One cannot rely on physical factors such as the physical plant and food service of a hospital or on the durability of a consumer product to judge home health. Opportunities exist within home health to identify activities that carry marketing value. Applying marketing principles to activities such as intake, customer service and public relations allows the home health agency to build referrals by meeting the wants and needs of the market. The home health organization needs to consider different wants and needs of those involved in the home health transaction: the decision maker, the purchaser, and the user. The success of the marketing function in meeting the organization's objectives will be aided by the placement of marketing at the senior management level.

  4. A Community Oriented Approach to Primary Health Care

    OpenAIRE

    Lee, Leslie

    1983-01-01

    A broader perspective is needed in family medicine. The traditional nuclear family is in transition; extended, single parent, reconstituted and surrogate families and couples living together without marrying, are becoming more common. The community is therefore replacing the family as the functional unit of society, and has become a significant determinant of health. Also, there are still social and economic barriers to health care. Those of lower socioeconomic status have poorer health and u...

  5. Reproductive rights approach to reproductive health in developing countries

    OpenAIRE

    2011-01-01

    Background: Research on reproductive health in developing countries focuses mostly on the role of economic development on various components of reproductive health. Cross-sectional and empirical research studies in particular on the effects of non-economic factors such as reproductive rights remain few and far between. Objective: This study investigates the influence of two components of an empowerment strategy, gender equality, and reproductive rights on women’s reproductive health in develo...

  6. A new axiomatic approach to the evaluation of population health

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Moreno-Ternero, Juan D.; Østerdal, Lars Peter Raahave

    functions, which represent social preferences, as a result of combinations of those axioms. Our results provide rationale for popular theories in health economics (such as the unweighted aggregation of QALYs or HYEs, and generalizations of the two, aimed to capture concerns for distributive justice) without......We explore in this paper the implications of ethical and operational principles for the evaluation of population health. We formalize those principles as axioms for social preferences over distributions of health for a given population. We single out several focal population health evaluation...

  7. Health, sport and nutritional information: tailoring your approach.

    Science.gov (United States)

    Grant, Maria J

    2012-06-01

    One of the intended legacies of the London 2012 Olympics is to increase the level of physical activity amongst the general population. Health information on the positive health benefits of sport and nutrition can assist in this goal and its positive benefit can been seen in communities within and beyond the United Kingdom, particularly within an educational context. In the United States, young people view their teachers as a valuable source of health information, and in Taiwan, teachers have been key collaborators in the development of a national Health e-Learning Network providing multimedia-learning modules for use in the classroom. However, classrooms are not the only source of health information and, with the reported inaccuracies in the translation of health information from academic papers to the popular press, school librarians have a role to play in facilitating students' ability to assess the quality of the health information they access, whatever the source. © 2012 The authors. Health Information and Libraries Journal © 2012 Health Libraries Group.

  8. Faculty research productivity in allied health settings: a TQM approach.

    Science.gov (United States)

    Paterson, M; Baker, D; Gable, C; Michael, S; Wintch, K

    1993-01-01

    Faculty research productivity in colleges of allied health has often been discussed in the literature over the last five years. Articles have focused on the problem of faculty research productivity from various viewpoints, but none have used a theoretical framework to analyze the problem. The total quality management (TQM) framework is currently being used in health care to improve quality and productivity. This article uses the TQM framework to synthesize literature concerning faculty research productivity and verifies the current relevance of synthesis findings using an allied health faculty survey. These analyses show that the TQM framework is useful in suggesting ways to increase faculty research productivity in colleges of allied health.

  9. Health care systems in Western Europe: an analytical approach.

    Science.gov (United States)

    de Gooijer, Winfried J

    2002-01-01

    Health care in the countries of Western Europe can be defined as a complex process of continuous innovation, i.e. of constantly implementing new combinations of science, technology, organisation, economics, politics, philosophy, opinions and fashion. Any element of this definition can influence the course of the health care process, whether or not combined with one or more of the other elements. This definition implies that health care systems as well as health care policy of the countries of Western Europe differ considerably. If we define a health care system as the legal and organisational framework, directed at producing, distributing, managing, regulating, supervising, co-ordinating and controlling health care activities in order to realise defined social health care values, no country can narrowly be compared to any other country. Such a comparison produces a huge basket of facts from which one can draw one conclusion only: each country acts to its own liking. The same applies for the concept of health care policy, i.e. a chosen course to achieve pre-set strategic objectives. Here too, every country acts to its own liking, where nobody is right and nobody is wrong. Consequently, the universal health care system does not exist. Consequently also, the analyst who takes a closer look at the health care systems of the countries of Western Europe, trying to map the differences, will discover a rather messy picture. All this being said, how do we deal with two burning questions? The first is: how can it be that, relatively speaking, the people of Western Europe are so healthy? Secondly: how do we clean up the mess or, in other words, how do we reform health care?

  10. An Innovative Mixed Methods Approach to Studying the Online Health Information Seeking Experiences of Adults with Chronic Health Conditions

    Science.gov (United States)

    Mayoh, Joanne; Bond, Carol S.; Todres, Les

    2012-01-01

    This article presents an innovative sequential mixed methods approach to researching the experiences of U.K. adults with chronic health conditions seeking health information online. The use of multiple methods integrated within a single study ensured that the focus of the research was emergent and relevant and ultimately provided a more complete…

  11. A Public Health Approach to Address the Mental Health Burden of Youth in Situations of Political Violence and Humanitarian Emergencies

    NARCIS (Netherlands)

    J.T.V.M. de Jong; L.H. Berckmoes; B.A. Kohrt; S.J. Song; W.A. Tol; R. Reis

    2015-01-01

    This paper describes how socio-ecological theory and a syndemic health systems and public health approach may help address the plight of youth in situations of political violence and humanitarian emergencies. We describe the treatment gap caused by discrepancies in epidemiological prevalence rates,

  12. Design health village with the approach of sustainable architecture ...

    African Journals Online (AJOL)

    Journal Home > Vol 8, No 3 (2016) >. Log in or Register to get access to full text ... parts of the country can benefit. For people to have this design can be found in different locations accomplished and the success and benefits enjoyed it. Keywords: Health; city health; smart; sustainability in architecture; architectural design ...

  13. An Informatics Approach to Establishing a Sustainable Public Health Community

    Science.gov (United States)

    Kriseman, Jeffrey Michael

    2012-01-01

    This work involved the analysis of a public health system, and the design, development and deployment of enterprise informatics architecture, and sustainable community methods to address problems with the current public health system. Specifically, assessment of the Nationally Notifiable Disease Surveillance System (NNDSS) was instrumental in…

  14. A Rational-Emotive Approach to Occupational Mental Health.

    Science.gov (United States)

    Weinrach, Stephen G.

    1980-01-01

    Occupational mental health deals with the quality of life associated with work. This article demonstrates how rational emotive therapy can be applied to occupational mental health, and suggests counselors be sensitive to stress of work as well as home. (Author/JAC)

  15. Social scientists in public health: a fuzzy approach.

    Science.gov (United States)

    do Nascimento, Juliana Luporini; Stephan, Celso; Nunes, Everardo Duarte

    2015-05-01

    This study aims to describe and analyze the presence of social scientists, anthropologists, sociologists and political scientists in the field of public health. A survey by the Lattes Curriculum and sites of Medical Colleges, Institutes of Health Research Collective, seeking professionals who work in healthcare and have done some stage of their training in the areas of social sciences. In confluence with Norbert Elias' concepts of social networks and configuration of interdependence it was used fuzzy logic, and the tool free statistical software R version 2.12.0 which enabled a graphic representation of social scientists interdependence in the field of social sciences-health-social sciences. A total of 238 professionals were ready in 6 distinct clusters according to the distance or closer of each professional in relation to public health and social sciences. The work was shown with great analytical and graphical representation possibilities for social sciences of health, in using this innovative quantitative methodology.

  16. Social scientists in public health: a fuzzy approach

    Directory of Open Access Journals (Sweden)

    Juliana Luporini do Nascimento

    2015-05-01

    Full Text Available This study aims to describe and analyze the presence of social scientists, anthropologists, sociologists and political scientists in the field of public health. A survey by the Lattes Curriculum and sites of Medical Colleges, Institutes of Health Research Collective, seeking professionals who work in healthcare and have done some stage of their training in the areas of social sciences. In confluence with Norbert Elias' concepts of social networks and configuration of interdependence it was used fuzzy logic, and the tool free statistical software R version 2.12.0 which enabled a graphic representation of social scientists interdependence in the field of social sciences-health-social sciences. A total of 238 professionals were ready in 6 distinct clusters according to the distance or closer of each professional in relation to public health and social sciences. The work was shown with great analytical and graphical representation possibilities for social sciences of health, in using this innovative quantitative methodology.

  17. Toward proof of concept of a one health approach to disease prediction and control.

    Science.gov (United States)

    Rabinowitz, Peter M; Kock, Richard; Kachani, Malika; Kunkel, Rebekah; Thomas, Jason; Gilbert, Jeffrey; Wallace, Robert; Blackmore, Carina; Wong, David; Karesh, William; Natterson, Barbara; Dugas, Raymond; Rubin, Carol

    2013-12-01

    A One Health approach considers the role of changing environments with regard to infectious and chronic disease risks affecting humans and nonhuman animals. Recent disease emergence events have lent support to a One Health approach. In 2010, the Stone Mountain Working Group on One Health Proof of Concept assembled and evaluated the evidence regarding proof of concept of the One Health approach to disease prediction and control. Aspects examined included the feasibility of integrating human, animal, and environmental health and whether such integration could improve disease prediction and control efforts. They found evidence to support each of these concepts but also identified the need for greater incorporation of environmental and ecosystem factors into disease assessments and interventions. The findings of the Working Group argue for larger controlled studies to evaluate the comparative effectiveness of the One Health approach.

  18. 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.

  19. The Mental Health Recovery Movement and Family Therapy, Part II: A Collaborative, Appreciative Approach for Supporting Mental Health Recovery

    Science.gov (United States)

    Gehart, Diane R.

    2012-01-01

    A continuation of Part I, which introduced mental health recovery concepts to family therapists, Part II of this article outlines a collaborative, appreciative approach for working in recovery-oriented contexts. This approach draws primarily upon postmodern therapies, which have numerous social justice and strength-based practices that are easily…

  20. 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…

  1. Developing a broader approach to management of infection control breaches in health care settings.

    Science.gov (United States)

    Patel, Priti R; Srinivasan, Arjun; Perz, Joseph F

    2008-12-01

    Our experiences with health departments and health care facilities suggest that questions surrounding instrument reprocessing errors and other infection control breaches are becoming increasingly common. We describe an approach to management of these incidents that focuses on risk of bloodborne pathogen transmission and the role of public health and other stakeholders to inform patient notification and testing decisions.

  2. School Social Work with Students with Mental Health Problems: Examining Different Practice Approaches

    Science.gov (United States)

    McManama O'Brien, Kimberly H.; Berzin, Stephanie C.; Kelly, Michael S.; Frey, Andy J.; Alvarez, Michelle E.; Shaffer, Gary L.

    2011-01-01

    School social workers frequently serve as the primary mental health providers to youths with mental health problems. Although school social workers play a primary role in care, many students also receive outside counseling services. Previous research has not examined whether practice approaches differ when considering mental health practice with…

  3. Health diplomacy: a new approach to the Muslim world?

    Science.gov (United States)

    Suleman, Mehrunisha; Ali, Raghib; Kerr, David J

    2014-06-13

    Three years ago, the Lancet's frontispiece stated "Health is now the most important foreign policy issue of our time" and last year, the Director-General of WHO, Margaret Chan, in her opening address, to the Executive Board at its 132nd Session said "health diplomacy works". The nascent field of health diplomacy provides a political framework which aims to deliver the dual goals of improved health in target populations and enhanced governmental relations between collaborating countries. Any government that offered tangible health improvement as a component of aid to a nation with whom they wished to develop stronger diplomatic links would have an advantage in developing a deeper relationship with its citizens.Here we suggest several different mechanisms through which such links could be developed or enhanced, including: provision of relevant health solutions, applied research, cultural alignment and the development of collaborative networks. The Islamic tradition promotes the practice of medicine as a service to humanity. Physical and spiritual wellbeing are intimately related in popular Muslim consciousness. Thoughtful Health Diplomacy therefore has the potential to bridge the perceived divides between Western and predominantly Muslim nations.

  4. Collaboration, Competencies and the Classroom: A Public Health Approach

    Directory of Open Access Journals (Sweden)

    Lauren E. Wallar

    2015-03-01

    Full Text Available The University of Guelph Master of Public Health program is a professional degree program that seeks to prepare graduates to meet complex public health needs by developing their proficiency in the 36 public health core competencies. Provision of experiential learning opportunities, such as a semester-long practicum, is part of student development. In the Fall 2013 semester, a new opportunity was introduced in which small groups of students were paired with local public health professionals to complete a capstone business plan assignment that addressed a current public health issue. However, the impact of this external collaboration on the student learning experience was unknown. To address this, quantitative and qualitative information about students’ perceived proficiency in the core competencies and their learning experiences was collected using a pre/post survey and focus groups, respectively. A post-assignment survey was also administered to participating local public health professionals in which they assessed their group’s proficiency in the core competencies, and provided additional feedback. The results of this study showed that students had unique learning experiences with enhanced proficiency in different areas including policy and program planning, implementation and evaluation, assessment and analysis, and partnerships, collaboration and advocacy. Managing and communicating expectations was important throughout the learning experience. By using realistic community-based assignments, graduate public health programs can enrich students’ learning experiences by creating an environment for students to apply their classroom knowledge and gain practical knowledge and skills.

  5. A New Approach to Health Services and Pharmacy in Cuba.

    Science.gov (United States)

    Sánchez, Alina M

    2015-12-01

    In December 17, 2014, U.S. President Barack Obama surprised the world by announcing his intention to enter into negotiations aimed at reestablishing diplomatic relations with Cuba. Since then, expectations and interest regarding the health system of that country have increased. This report focuses on the Cuban health and pharmacy systems from a practical and educational standpoint. Pharmaceutical services, strengths, opportunities, and challenges are described. Cuba's new trends toward patient-centered care are analyzed to provide insights for developing pharmaceutical care practice and implementing policies suitable for practice in all health care settings. © 2015 Pharmacotherapy Publications, Inc.

  6. Approach to Health Supporting System Using Traditional Chinese Medicine

    Science.gov (United States)

    Watsuji, Tadashi; Shinohara, Shoji; Arita, Seizaburo

    The primary prevention of disease related to the lifestyle is an essential theme in medical research. Preventing before it arises is the important concept in traditional Chinese medicine (TCM). Since TCM, which emphasizes individual physical condition in medical treatment, has recently attracted considerable attention globally, objective diagnostic methods in TCM have been investigated in this work. Firstly, the fuzzy theory was applied to develop a tongue diagnosis supporting system based on the tongue diagnosis in TCM. Secondly, the usefulness of TCM health questionnaire was examined to identify individual physical condition. Our results suggest that the TCM health questionnaire is useful in the construction of a health supporting system based on TCM.

  7. Health care: development of data for a marketing approach.

    Science.gov (United States)

    Stitt, V J

    1985-06-01

    Marketing in health care is a relatively new process. It is a business tool that can serve a very useful purpose. Health care management has become aware of the usefulness of marketing in long-range planning. Through a well-thought-out marketing plan, the provider will not be leaving the future to chance. A well-conceived, patient-oriented, competitor-aware marketing plan should place the medical practice at a strategic advantage as the health care industry joins other industries in the competitive marketplace for the consumer's dollar.The ever-increasing political and regulatory environment that the health care field is undergoing emphasizes the need for the inclusion of marketing skills, such as cost containment, in the medical curriculum. It should be the obligation of the training facilities as well as medical societies to respond to this need by providing the education that will enable black providers to survive in this competitive environment.

  8. Internal and external auditing in health systems: an integrative approach.

    Science.gov (United States)

    Mersel, Elie P; Mor-Yosef, Shlomo; Shapira, Shmuel C

    2005-01-01

    Traditionally, auditors are apprehensive when it comes to auditing clinical decisions. A novel model might lead to better integration of auditors into the core activities of health system medical care, while creating common interests among all participants in the process.

  9. A Holistic Approach to Reproductive Health Interventions: Talk 2 Me ...

    African Journals Online (AJOL)

    Erah

    the 2008 “Investing in Young People's Health and Development: Research that Improves Policies and Programs” in. Abuja ... Different methods have been proposed and used; they ... To improve youth-friendly services, traditional teaching ...

  10. Human rights and public health working together: an approach to ...

    African Journals Online (AJOL)

    African Safety Promotion: A Journal of Injury and Violence Prevention. Journal Home ... and violence against women, will be considered. In conclusion ... Keywords: human rights, public health, child injuries, violence prevention. African Safety ...

  11. Strategic approach to information security and assurance in health research

    OpenAIRE

    Akazawa, Shunichi; Igarashi, Manabu; Sawa, Hirofumi; Tamashiro, Hiko

    2005-01-01

    Information security and assurance are an increasingly critical issue in health research. Whether health research be in genetics, new drugs, disease outbreaks, biochemistry, or effects of radiation, it deals with information that is highly sensitive and which could be targeted by rogue individuals or groups, corporations, national intelligence agencies, or terrorists, looking for financial, social, or political gains. The advents of the Internet and advances in recent information technologies...

  12. Approaches to Reducing Federal Spending on Military Health Care

    Science.gov (United States)

    2014-01-01

    medical school, the Uniformed Services University of the Health Sciences (USUHS), while expanding the number of scholarships provided to students... actuaries esti- 8. Department of Defense, Evaluation of the TRICARE Program— Access, Cost and Quality: Fiscal Year 2013 Report to Congress (February...DoD’s Uniformed Services University of the Health Sciences —would be closed. 4. See Congressional Budget Office, Lessons from Medicare’s Demonstration

  13. Addressing the health workforce crisis: towards a common approach

    Directory of Open Access Journals (Sweden)

    McCaffery Jim

    2006-08-01

    Full Text Available Abstract The challenges in the health workforce are well known and clearly documented. What is not so clearly understood is how to address these issues in a comprehensive and integrated manner that will lead to solutions. This editorial presents – and invites comments on – a technical framework intended to raise awareness among donors and multisector organizations outside ministries of health and to guide planning and strategy development at the country level.

  14. Approaches to integrated monitoring for environmental health impact assessment

    Directory of Open Access Journals (Sweden)

    Liu Hai-Ying

    2012-11-01

    Full Text Available Abstract Although Integrated Environmental Health Monitoring (IEHM is considered an essential tool to better understand complex environmental health issues, there is no consensus on how to develop such a programme. We reviewed four existing frameworks and eight monitoring programmes in the area of environmental health. We identified the DPSEEA (Driving Force-Pressure-State-Exposure-Effect-Action framework as most suitable for developing an IEHM programme for environmental health impact assessment. Our review showed that most of the existing monitoring programmes have been designed for specific purposes, resulting in narrow scope and limited number of parameters. This therefore limits their relevance for studying complex environmental health topics. Other challenges include limited spatial and temporal data availability, limited development of data sharing mechanisms, heterogeneous data quality, a lack of adequate methodologies to link disparate data sources, and low level of interdisciplinary cooperation. To overcome some of these challenges, we propose a DPSEEA-based conceptual framework for an IEHM programme that would enable monitoring and measuring the impact of environmental changes on human health. We define IEHM as ‘a systemic process to measure, analyse and interpret the state and changes of natural-eco-anthropogenic systems and its related health impact over time at the same location with causative explanations across the various compartments of the cause-effect chain’. We develop a structural work process to integrate information that is based on existing environmental health monitoring programmes. Such a framework allows the development of combined monitoring systems that exhibit a large degree of compatibility between countries and regions.

  15. Reproductive rights approach to reproductive health in developing countries

    Directory of Open Access Journals (Sweden)

    Vijayan K. Pillai

    2011-12-01

    Full Text Available Research on reproductive health in developing countries focuses mostly on the role of economic development on various components of reproductive health. Cross-sectional and empirical research studies in particular on the effects of non-economic factors such as reproductive rights remain few and far between.This study investigates the influence of two components of an empowerment strategy, gender equality, and reproductive rights on women's reproductive health in developing countries. The empowerment strategy for improving reproductive health is theoretically situated on a number of background factors such as economic and social development.Cross-national socioeconomic and demographic data from a number of international organizations on 142 developing countries are used to test a model of reproductive rights and reproductive health.The findings suggest that both economic and democratic development have significant positive effects on levels of gender equality. The level of social development plays a prominent role in promoting reproductive rights. It is found that reproductive rights channel the influences of social structural factors and gender equality on reproductive health.

  16. Medication therapy disease management: Geisinger's approach to population health management.

    Science.gov (United States)

    Jones, Laney K; Greskovic, Gerard; Grassi, Dante M; Graham, Jove; Sun, Haiyan; Gionfriddo, Michael R; Murray, Michael F; Manickam, Kandamurugu; Nathanson, Douglas C; Wright, Eric A; Evans, Michael A

    2017-09-15

    Pharmacists' involvement in a population health initiative focused on chronic disease management is described. Geisinger Health System has cultivated a culture of innovation in population health management, as highlighted by its ambulatory care pharmacy program, the Medication Therapy Disease Management (MTDM) program. Initiated in 1996, the MTDM program leverages pharmacists' pharmacotherapy expertise to optimize care and improve outcomes. MTDM program pharmacists are trained and credentialed to manage over 16 conditions, including atrial fibrillation (AF) and multiple sclerosis (MS). Over a 15-year period, Geisinger Health Plan (GHP)-insured patients with AF whose warfarin therapy was managed by the MTDM program had, on average, 18% fewer emergency department (ED) visits and 18% fewer hospitalizations per year than GHP enrollees with AF who did not receive MTDM services, with 23% lower annual total care costs. Over a 2-year period, GHP-insured patients with MS whose pharmacotherapy was managed by pharmacists averaged 28% fewer annual ED visits than non-pharmacist-managed patients; however, the mean annual total care cost was 21% higher among MTDM clinic patients. The Geisinger MTDM program has evolved over 20 years from a single pharmacist-run anticoagulation clinic into a large program focused on managing the health of an ever-growing population. Initial challenges in integrating pharmacists into the Geisinger patient care framework as clinical experts were overcome by demonstrating the MTDM program's positive impact on patient outcomes. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  17. Economic benefits or drivers of a 'One Health' approach: why should anyone invest?

    Science.gov (United States)

    Rushton, Jonathan; Häsler, Barbara; De Haan, Nicoline; Rushton, Ruth

    2012-06-20

    One Health concepts and ideas are some of the oldest in the health discipline, yet they have not become main stream. Recent discussions of the need for One Health approaches require some reflection on how to present a case for greater investments. The paper approaches this problem from the perspective of the control and management of resources for health in general. It poses the following questions, (1) where do we need extra resources for One Health, (2) where can we save resources through a One Health approach and (3) who has control of the resources that do exist for One Health? In answering these questions three broad areas are explored, (1) The management and resources allocated for diseases, (2) The isolation of parts of the society that require human and animal health services and (3) The use of resources and skills that are easily transferable between human and animal health.The paper concludes that One Health approaches are applicable in many scenarios. However, the costs of getting people from different disciplines to work together in order to achieve a true One Health approach can be large. To generate tangible benefits requires careful management of specialist skills, knowledge and equipment, which can only be achieved by a greater openness of the human and animal health disciplines. Without this openness, policy makers will continue to doubt the real value of One Health. In summary the future success of One Health is about people working in the research, education and provision of health systems around the world embracing and managing change more effectively.

  18. 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.

  19. 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.

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

    Science.gov (United States)

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

    2016-06-01

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

  1. 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

    2017-01-02

    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.

  2. [Opinion of the National Federation of Education and Health Promotion on report "New approaches to public health prevention"].

    Science.gov (United States)

    Cambon, Linda; Ferron, Christine

    2011-01-01

    In 2009, the Center for Strategic Analysis initiated a study, entitled Neurosciences and Public Policies, to assess the use of neurosciences in prevention policy. Subsequently, a report highlighted the inefficiency of the "traditional" prevention programs and the potential contribution of neurosciences to defining a new prevention approach. For the French National Federation for Health Education and Promotion, health promotion cannot be limited to a "counter-manipulation" of consumers confronted with marketing strategies from the food and tobacco industries. Promoting health helps people increase control over the determinants of their health, by means of educational empowering strategies.

  3. Mental health care on the streets: An integrated approach.

    Science.gov (United States)

    Lee, Stuart; Castella, Anthony de; Freidin, Julian; Kennedy, Anthony; Kroschel, Jon; Humphrey, Cathy; Kerr, Ros; Hollows, Andrew; Wilkins, Sally; Kulkarni, Jayashri

    2010-06-01

    Mental illness can be both a cause of and a reaction to being homeless. When homelessness co-exists with mental illness, the provision of care for very vulnerable people is significantly complicated. Our initiative built on a model of assertive outreach and embedded mental health staff into the daily operations of Hanover Welfare Services and Sacred Heart Mission welfare services in inner Melbourne. The initiative's aim was to facilitate closer collaboration between mental health and welfare services and develop staff capacity to better identify and support people living homeless with a mental illness. The project involved studying the impact of our assertive outreach model on consumer and service outcomes. Demographic, clinical and service usage details for consumers engaged by the initiative were recorded. Changes to the rate of admission of people from both welfare services to The Alfred Inpatient Psychiatry Unit and requests for support from The Alfred Crisis Assessment and Treatment Service were also recorded. People engaged by this initiative had high levels of previous emergency medical or psychiatric service usage, but relatively low levels of current community mental health engagement. There were also high levels (almost 52%) of comorbid substance misuse. The initiative was, however, able to engage more people in ongoing community mental health care, which particularly when provided in collaboration between mental health and welfare staff, achieved improvements in accommodation stability. The initiative also resulted in improved identification and prevention of mental illness crises through supporting a more rapid onsite mental health response. Embedding mental health staff into the daily operations of two welfare services in inner Melbourne improved inter-service collaboration and the identification and care for people living homeless with a mental illness.

  4. 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.

  5. Evaluating Digital Health Interventions: Key Questions and Approaches.

    Science.gov (United States)

    Murray, Elizabeth; Hekler, Eric B; Andersson, Gerhard; Collins, Linda M; Doherty, Aiden; Hollis, Chris; Rivera, Daniel E; West, Robert; Wyatt, Jeremy C

    2016-11-01

    Digital health interventions have enormous potential as scalable tools to improve health and healthcare delivery by improving effectiveness, efficiency, accessibility, safety, and personalization. Achieving these improvements requires a cumulative knowledge base to inform development and deployment of digital health interventions. However, evaluations of digital health interventions present special challenges. This paper aims to examine these challenges and outline an evaluation strategy in terms of the research questions needed to appraise such interventions. As they are at the intersection of biomedical, behavioral, computing, and engineering research, methods drawn from all of these disciplines are required. Relevant research questions include defining the problem and the likely benefit of the digital health intervention, which in turn requires establishing the likely reach and uptake of the intervention, the causal model describing how the intervention will achieve its intended benefit, key components, and how they interact with one another, and estimating overall benefit in terms of effectiveness, cost effectiveness, and harms. Although RCTs are important for evaluation of effectiveness and cost effectiveness, they are best undertaken only when: (1) the intervention and its delivery package are stable; (2) these can be implemented with high fidelity; and (3) there is a reasonable likelihood that the overall benefits will be clinically meaningful (improved outcomes or equivalent outcomes at lower cost). Broadening the portfolio of research questions and evaluation methods will help with developing the necessary knowledge base to inform decisions on policy, practice, and research. Copyright © 2016 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

  6. INNOVATIVE APPROACH IN THE COMPULSORY HEALTH INSURANCE TARIFF SETTING

    Directory of Open Access Journals (Sweden)

    M. Yu. Zasypkin

    2015-02-01

    Full Text Available Development of a single channel financing in the health system of the Russian Federation based on the standards of the compulsory health insurance (CHI requires a single channel financing of the health system through the CHI as one of the main direction using payment of the medical services in the form of so-called «full» tariff [1-12].It is not a secret that for many years the medical services tariff in the CHI system contained from only five items of expenditures (salary, charges on payroll, soft goods and clothing, medicines, bandages, other medical expenses, and food. On one hand, such defective tariff was based on the parallel government financing of the medical institutions (MIs, on the other hand, because of this tariff, the manager was hoppled in the control of the financial flows.

  7. Modelling system level health information exchange: an ontological approach.

    Science.gov (United States)

    McMurray, J; Zhu, L; McKillop, I; Chen, H

    2015-01-01

    Investment of resources to purposively improve the movement of information between health system providers is currently made with imperfect information. No inventories of system-level digital information flows currently exist, nor do measures of inter-organizational electronic information. exchange (HIE). Using Protégé 4, an open-source OWL Web ontology language editor and knowledge-based framework we formalized a model that decomposes inter-organizational electronic health information flow into derivative concepts such as diversity, breadth, volume, structure, standardization and connectivity. Self-reported data from a regional health system is used to measure HIE; the ontology identifies providers with low and high HIE, useful for planners, and using a related database is used to monitor data quality.

  8. 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.

  9. Relevance of Campylobacter to public health--the need for a One Health approach.

    Science.gov (United States)

    Gölz, Greta; Rosner, Bettina; Hofreuter, Dirk; Josenhans, Christine; Kreienbrock, Lothar; Löwenstein, Anna; Schielke, Anika; Stark, Klaus; Suerbaum, Sebastian; Wieler, Lothar H; Alter, Thomas

    2014-10-01

    Campylobacter species belong to the most important foodborne bacteria which cause gastroenteritis in humans in both developed and developing countries. With increasing reporting rates, the public awareness towards Campylobacter infections is growing continuously. This strengthens the necessity to establish intervention measures for prevention and control of thermophilic Campylobacter spp. along the food chain, as in particular poultry and poultry meat represent a major source of human infections. An interdisciplinary One Health approach and a combined effort of all stakeholders are necessary to ultimately reduce the burden of campylobacteriosis cases in humans. Numerous studies point out, however, that at present a complete elimination of Campylobacter in the food chain is not feasible. The present aim should therefore be to establish control measures and intervention strategies to minimize the occurrence of Campylobacter spp. in livestock (e.g. poultry flocks) and to reduce the quantitative Campylobacter burden in animals and foods. To this end, a combination of intervention methods at different stages of the food chain appears most promising. That has to be accompanied by targeted consumer advice and education campaigns to raise the awareness towards Campylobacter infections.

  10. Community health promotion approaches within institutions for disabled

    DEFF Research Database (Denmark)

    Holm, Jesper

    from the observed institutions, and on top of three qualitative reports of the health promotion practices in their everyday culture, we are in the middle of processing future- and research workshops with the involved institutions in order to create common images of a visionary health promoting world...... culture of these institutions? We have done a number of qualitative observations, interviews and desk-top studies, and hereafter included the institutions to both verify and guide for further investigations. We have established several workshops for mutual learning of research-praxis studies and comments...

  11. Adopting public health approaches to communication disability: challenges for the education of speech-language pathologists.

    Science.gov (United States)

    Wylie, Karen; McAllister, Lindy; Davidson, Bronwyn; Marshall, Julie; Law, James

    2014-01-01

    Public health approaches to communication disability challenge the profession of speech-language pathology (SLP) to reconsider both frames of reference for practice and models of education. This paper reviews the impetus for public health approaches to communication disability and considers how public health is, and could be, incorporated into SLP education, both now and in the future. The paper describes tensions between clinical services, which have become increasingly specialized, and public health approaches that offer a broader view of communication disability and communication disability prevention. It presents a discussion of these tensions and asserts that public health approaches to communication are themselves a specialist field, requiring specific knowledge and skills. The authors suggest the use of the term 'communication disability public health' to refer to this type of work and offer a preliminary definition in order to advance discussion. Examples from three countries are provided of how some SLP degree programmes are integrating public health into the SLP curriculum. Alternative models of training for communication disability public health that may be relevant in the future in different contexts and countries are presented, prompting the SLP profession to consider whether communication disability public health is a field of practice for speech-language pathologists or whether it has broader workforce implications. The paper concludes with some suggestions for the future which may advance thinking, research and practice in communication disability public health. © 2015 S. Karger AG, Basel.

  12. What is a human-rights based approach to health and does it matter?

    Science.gov (United States)

    London, Leslie

    2008-01-01

    A human rights approach to health is critical to address growing global health inequalities. Three aspects of the nature of health as a right are relevant to shaping a human rights approach to health: (1) the indivisibility of civil and political rights, and socio-economic rights; (2) active agency by those vulnerable to human rights violations; and (3) the powerful normative role of human rights in establishing accountabiliy for protections and freedoms. Health professionals' practice, tpically governed by ethical codes, may benefit from human rights guidelines, particularly in situations of dual loyalty where clients' or communities' human rights are threatened Moreover, institutional accountability for protecting human rights is essential to avoid shifting responsibility solely onto the health professional Human rights approaches can include holding states and other parties accountable, developing policies and programs consistent with human rights, and facilitating redress for victims of violations of the right to health. However, underlying all models is the need to enable active social mobilization, without which legal approaches to rights lack sustainability and power. Evidence from South and Southern Africa has shown that different conceptions of what is meant by human rights impact substantially on state willingness and abiliy to meet constitutional obligations with regard to the right to health. New approaches to health polity development, which draw on the agency of vulnerable groups, link local struggles with their global context, and explicitly incorporate rights frameworks into public health planning are needed. Models that move away from individualizing conflict over rights between health professionals as disempowered duty bearers and patients as frustrated rights holders, toward more mutual approaches to shared rights objectives may be possible and are being actively pursued through the development of a learning network to realize the right to health

  13. Performance Ethnography as an Approach to Health-Related Education

    Science.gov (United States)

    Carless, David; Douglas, Kitrina

    2010-01-01

    This article explores the educational potential of an arts-informed performance ethnography entitled "Across the Tamar," which comprises a series of stories, songs and poems. As a classroom action research project--a "teaching experiment"--we gave three performances to undergraduate and postgraduate sport and health science,…

  14. The Public Health Approach to Campus Suicide Prevention

    Science.gov (United States)

    Jodoin, Elizabeth C.; Robertson, Jason

    2013-01-01

    The perception that college students are coming to campus with more severe psychological concerns than in the past has been empirically supported on college campuses (Benton and others, 2003). Approximately 20 percent of all adolescents have a diagnosable mental health disorder (Kessler and others, 2005), many of which then continue on to college…

  15. Health in restructuring: innovative approaches and policy recommendations

    NARCIS (Netherlands)

    Kieselbach, T.; Armgarth, E.; Bagnara, S.; Elo, A.L.; Jefferys, S.; Joling, C.; Kuhn, K.; Nielsen, K.; Popma, J.; Rogovsky, N.; Sahler, B.; Thomson, G.; Triomphe, C.E.; Widerszal-Bazyl, M.

    2009-01-01

    The health dimension of enterprise restructuring is a widely neglected area of research, intervention and public concern. Restructuring is taking place in every competing organisation and is therefore affecting all European societies. With restructuring is meant an organizational change that is much

  16. Towards an integrated approach to health and medicine in Africa

    African Journals Online (AJOL)

    2016-08-18

    Aug 18, 2016 ... traditional healing prior to accessing primary health care (Kale. 1995:1182; Truter 2007:56) .... pants (both men and women) based on their willingness to share their experiences ..... factors and the prevailing societal influences' are to the process .... In 2002, I experienced serious diarrhoea, chest pains and.

  17. [Assessment and prevention of zoonoses: "one health approach"].

    Science.gov (United States)

    Bonizzi, Luigi; Guarino, Marcella; Roncada, Paola; Colosio, Claudio

    2013-01-01

    Zoonotic pathologies represent diseases that can be transmittable from animals to humans and vice versa. In most cases zoonotic agents are bacteria or viruses and represent a huge problem for health. Zoonosis could represent easily solvable diseases such as simple infections or even deathly such as prion infections. They could be directly transmittable as tuberculosis or brucellosis or indirectly transmittable through vectors as biological fluids or foods from animal production. The increasing production and the globalization of animal food production have caused the spread of zoonosis worldwide turning this topic into a global problem. It is necessary to enforce the actual scientific collaboration between all countries in order to counteract the spread of these pathologies. About this topic WHO, FAO and OIE took part to the world project "one health" highlighting as most important topics the research on Rabies virus, influenza virus and on antibiotic resistance. In particular antibiotic resistance represents one of the most important topics of the last decade due to the inappropriate use of antibiotics, from animal production to human health. This last topic represents a serious problem for health system worldwide. This paper is mainly based on zoonoses such as avian flu, BSE and brucellosis and will describe the strategies used to limit their expansion.

  18. A new axiomatic approach to the evaluation of population health

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Moreno-Ternero, Juan D.; Østerdal, Lars Peter Raahave

    2013-01-01

    represent social preferences, as a result of combinations of those axioms. Our results provide new rationale for popular theories in health economics, such as the unweighted aggregation of quality-adjusted life years (QALYs) or healthy years equivalents (HYEs) and generalizations of the two, aimed...... to capture concerns for distributive justice, without resorting to controversial assumptions on individual preferences....

  19. A new axiomatic approach to the evaluation of population health

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Moreno-Ternero, Juan D.; Østerdal, Lars Peter Raahave

    functions, which represent social preferences, as a result of combinations of those axioms. Our results provide rationale for popular theories in health economics (such as the unweighted aggregation of QALYs or HYEs, and generalizations of the two, aimed to capture concerns for distributive justice) without...

  20. Peer Approach in Adolescent Reproductive Health Education: Some Lessons Learned.

    Science.gov (United States)

    United Nations Educational, Scientific and Cultural Organization, Bangkok (Thailand). Principal Regional Office for Asia and the Pacific.

    This package is one of a series of repackaged products aimed at alerting UNESCO users to a wealth of highly valuable educational resources that exist in the field of adolescent reproductive and sexual health. This document focuses on what research says is the impact of peer education in promoting necessary changes among adolescents in attitudes…

  1. A cross-disciplinary approach to global environmental health: the case of contaminated sites.

    Science.gov (United States)

    Marsili, Daniela

    2016-01-01

    Cross-disciplinary approaches to Global Environmental Health are essential to address environmental health threats within and beyond national boundaries, taking into account the links among health, environment and socio-economic development. The aim of this study is to present a cross-disciplinary approach where knowledge and findings from environmental epidemiology and social research are integrated in studying environmental health issues, focusing on environmental health inequities, public and environmental health literacy, and international scientific cooperation. In the case of contaminated sites, environmental epidemiology can contribute investigating the multidimensionality of equity for sustainable development practices. These practices entail a better understanding of environmental contamination, health effects pathways and improved capacities of different stakeholders to identify policy options for environmental risk prevention, remediation and management that will foster informed participation in decisions influencing communities. International scientific cooperation frameworks adopting equity principles shared by scientific community, populations and decision-makers may be of valuable support to this task.

  2. Evaluating the redistributive impact of public health expenditure using an insurance value approach.

    Science.gov (United States)

    Spadaro, Amedeo; Mangiavacchi, Lucia; Moral-Arce, Ignacio; Adiego-Estella, Marta; Blanco-Moreno, Angela

    2013-10-01

    This article analyses the redistributive impact of public health expenditure in Spain using an insurance value approach to compute individual and household's value of health services non-cash benefit. We model the intensity of use of different health care services using a count data framework on a nationally representative health care survey and then predict probabilities on the 2006 Spanish EU-SILC sample. This allows us to extend disposable income with the expected monetary value of public health services and to compare it with strictly cash income. Since non-cash income due to public health services is associated with health needs, we use needs-adjusted equivalence scales to perform distributional analysis and poverty/inequality comparisons. The results show that public health expenditure in Spain acts progressively on income distribution, and that health in-kind benefits, once considered as part of disposable income, can be extremely effective in reducing poverty and inequality.

  3. Training the Next Generation of Latino Health Researchers: A Multilevel, Transdisciplinary, Community-Engaged Approach.

    Science.gov (United States)

    Kuo, Alice A; Sharif, Mienah Z; Prelip, Michael L; Glik, Deborah C; Albert, Stephanie L; Belin, Thomas; McCarthy, William J; Roberts, Christian K; Garcia, Rosa Elena; Ortega, Alexander N

    2017-07-01

    Reducing health disparities is a national public health priority. Latinos represent the largest racial/ethnic minority group in the United States and suffer disproportionately from poor health outcomes, including cardiovascular disease risk. Academic training programs are an opportunity for reducing health disparities, in part by increasing the diversity of the public health workforce and by incorporating training designed to develop a skill set to address health disparities. This article describes the Training and Career Development Program at the UCLA Center for Population Health and Health Disparities: a multilevel, transdisciplinary training program that uses a community-engaged approach to reduce cardiovascular disease risk in two urban Mexican American communities. Results suggest that this program is effective in enhancing the skill sets of traditionally underrepresented students to become health disparities researchers and practitioners.

  4. Building Interdisciplinary Research Capacity: a Key Challenge for Ecological Approaches in Public Health

    Directory of Open Access Journals (Sweden)

    Lindsay P. Galway

    2016-06-01

    Full Text Available The shortcomings of public health research informed by reductionist and fragmented biomedical approaches and the emergence of wicked problems are fueling a renewed interest in ecological approaches in public health. Despite the central role of interdisciplinarity in the context of ecological approaches in public health research, inadequate attention has been given to the specific challenge of doing interdisciplinary research in practice. As a result, important knowledge gaps exist with regards to the practice of interdisciplinary research. We argue that explicit attention towards the challenge of doing interdisciplinary research is critical in order to effectively apply ecological approaches to public health issues. This paper draws on our experiences developing and conducting an interdisciplinary research project exploring the links among climate change, water, and health to highlight five specific insights which we see as relevant to building capacity for interdisciplinary research specifically, and which have particular relevance to addressing the integrative challenges demanded by ecological approaches to address public health issues. These lessons include: (i the need for frameworks that facilitate integration; (ii emphasize learning-by-doing; (iii the benefits of examining issues at multiple scales; (iv make the implicit, explicit; and (v the need for reflective practice. By synthesizing and sharing experiences gained by engaging in interdisciplinary inquiries using an ecological approach, this paper responds to a growing need to build interdisciplinary research capacity as a means for advancing the ecological public health agenda more broadly.

  5. Tailored Educational Approaches for Consumer Health (TEACH): a model system for addressing health communication.

    Science.gov (United States)

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

    2006-01-01

    The Consumer Health Education Institute (CHEDI) has developed a model system to improve the quality and effectiveness of patient education and health communication. Through assessment of characteristics and preferences, segmentation into groups and matching with the appropriate materials, we have demonstrated that patients and health consumers have different health information needs and preferences which show promise as a basis for selecting or designing the most appropriate materials or programs.

  6. Integrated approaches to address the social determinants of health for reducing health inequity.

    NARCIS (Netherlands)

    Barten, F.J.M.H.; Mitlin, D.; Mulholland, C.; Hardoy, A.; Stern, R.

    2007-01-01

    The social and physical environments have long since been recognized as important determinants of health. People in urban settings are exposed to a variety of health hazards that are interconnected with their health effects. The Millennium Development Goals (MDGs) have underlined the

  7. Promoting Health in Early Childhood Environments: A Health-Promotion Approach

    Science.gov (United States)

    Minniss, Fiona Rowe; Wardrope, Cheryl; Johnston, Donni; Kendall, Elizabeth

    2013-01-01

    This paper investigates the mechanisms by which a health-promotion intervention might influence the health-promoting behaviours of staff members working in early childhood centres. The intervention was an ecological health-promotion initiative that was implemented within four early childhood centres in South-East Queensland, Australia. In-depth,…

  8. Medical Providers as Global Warming and Climate Change Health Educators: A Health Literacy Approach

    Science.gov (United States)

    Villagran, Melinda; Weathers, Melinda; Keefe, Brian; Sparks, Lisa

    2010-01-01

    Climate change is a threat to wildlife and the environment, but it also one of the most pervasive threats to human health. The goal of this study was to examine the relationships among dimensions of health literacy, patient education about global warming and climate change (GWCC), and health behaviors. Results reveal that patients who have higher…

  9. Integrated approaches to address the social determinants of health for reducing health inequity.

    NARCIS (Netherlands)

    Barten, F.J.M.H.; Mitlin, D.; Mulholland, C.; Hardoy, A.; Stern, R.

    2007-01-01

    The social and physical environments have long since been recognized as important determinants of health. People in urban settings are exposed to a variety of health hazards that are interconnected with their health effects. The Millennium Development Goals (MDGs) have underlined the multidimensiona

  10. Medical Providers as Global Warming and Climate Change Health Educators: A Health Literacy Approach

    Science.gov (United States)

    Villagran, Melinda; Weathers, Melinda; Keefe, Brian; Sparks, Lisa

    2010-01-01

    Climate change is a threat to wildlife and the environment, but it also one of the most pervasive threats to human health. The goal of this study was to examine the relationships among dimensions of health literacy, patient education about global warming and climate change (GWCC), and health behaviors. Results reveal that patients who have higher…

  11. Inulin, oligofructose and bone health: experimental approaches and mechanisms.

    Science.gov (United States)

    Weaver, Connie M

    2005-04-01

    Inulin-type fructans have been proposed to benefit mineral retention, thereby enhancing bone health. Many, but not all, experimental animal studies have shown increased mineral absorption by feeding non-digestible oligosaccharides. Possible reasons for inconsistencies are explored. A few studies have reported an enhanced bone mineral density or content. Bone health can be evaluated in chronic feeding studies with bone densitometry, bone breaking strength, bone mineral concentration and bone structure. Isotopic Ca tracers can be used to determine the point of metabolism affected by feeding a functional food ingredient. These methods and the effects of feeding inulin-type fructose are reviewed. Inulin-type fructans enhance Mg retention. Chicory long-chain inulin and oligofructose enhance femoral Ca content, bone mineral density and Ca retention through enhanced Ca absorption and suppressed bone turnover rates, but it is not bone-promoting under all conditions.

  12. Preventing School Shootings: A Public Health Approach to Gun Violence

    Science.gov (United States)

    2013-03-01

    requires regular self-care among mental health professionals to reduce the incidence of depression and burn-out. The best performers in music ...Available: http://www.pbs.org/wgbh/pages/frontline/shows/kinkel/kip/cron.html. 80 Dave Cullen, “The Depressive and the Psychopath,” Slate.com: 20...Semester of 2000, he was placed in an Individual Educational Program due to emotional problems and social awkwardness and continued in therapy through his

  13. STRUCTURAL HEALTH MONITORING SYSTEM – AN EMBEDDED SENSOR APPROACH

    Directory of Open Access Journals (Sweden)

    Dhivya. A

    2013-02-01

    Full Text Available Structural Health monitoring system is the implementation of improving the maintenance of any structures like buildings and bridges. It encompasses damage detection, identification and prevention of structures from natural disasters like earth quake and rain. This paper is mainly proposed for three modules. First module constitutes recognizing and alerting of abnormal vibration of the building due to an earth quake. This consists of two types of sensor to predict the abnormal vibration induced by an earth quake. Second module portrays the prediction of damage in the buildings after an earth quake or heavy rain. Damage detection includes identification of crack and the moisture content in wall bricks in real time buildings. Third module presents the smart auditorium which is used to reduce the power consumption. Depending on the number of audience inside the auditorium it can control the electric appliances like fans, lights and speakers. In any real time structural health monitoring system the main issue is the time synchronization. This paper also proposes to overcome the general issue arises in structural health monitoring system. ZigBee based reliable communication is used among the client node and server node. For the secured wireless communication between the nodes ZigBee is used.

  14. HUMAN BODY AND HEALTH IN SCHOOL CURRICULA: WHEN SOCIOCULTURAL APPROACHES INTERPELLATE BIOMEDICAL AND HYGIENIST HEGEMONY

    Directory of Open Access Journals (Sweden)

    Mariana Lima Vilela

    2016-10-01

    Full Text Available This article presents a discussion about human body and health approaches in the Brazilian science curriculum. Taking into account the hegemony of the biomedical approach, alongside a hygienist and behaviourist health vision in school Science curriculum, the article suggests that alternative approaches about human body and health – namely social and cultural approaches – have challenging that hegemony. Based on school knowledge theoretical perspective (Forquin, 1993; Lopes, 1999 and taking into consideration Ball (2001’s definition of contexts of influences within the curriculum political cycles, it has been identified evidences of dispute among those curriculum approaches in three contexts of curriculum politics production: (i teacher mediation and school constraints – analysing studies about teacher mediation and selection; (ii knowledge production both in the Science and teacher Education research – using as empirical data a literature review in Science Education journals; (iii education politics – analysing official curriculum documents which express meanings of health in the school curriculum. In other to show disputes among the curriculum approaches, the analysis of the evidences suggests that the biomedical and hygienists approaches have been progressively challenged. The analysis also shows that these approaches conflict to the social and cultural ones, bringing changes in the human body and health conceptions within the science curriculum.

  15. [Evaluating quality and effectiveness in the promotion of health: approaches and methods of public health and social sciences].

    Science.gov (United States)

    Deccache, A

    1997-06-01

    Health promotion and health education have often been limited to evaluation of the effectiveness of actions and programmes. However, since 1996 with the Third European Conference on Health Promotion and Education Effectiveness, many researchers have become interested in "quality assessment" and new ways of thinking have emerged. Quality assurance is a concept and activity developed in industry with the objective of increasing production efficiency. There are two distinct approaches: External Standard Inspection (ESI) and Continuous Quality Improvement (CQI). ESI involves establishing criteria of quality, evaluating them and improving whatever needs improvement. CQI views the activity or service as a process and includes the quality assessment as part of the process. This article attempts to answer the questions of whether these methods are sufficient and suitable for operationalising the concepts of evaluation, effectiveness and quality in health promotion and education, whether it is necessary to complement them with other methods, and whether the ESI approach is appropriate. The first section of the article explains that health promotion is based on various paradigms from epidemiology to psychology and anthropology. Many authors warn against the exclusive use of public health disciplines for understanding, implementing and evaluating health promotion. The author argues that in practice, health promotion: -integrates preventive actions with those aiming to maintain and improve health, a characteristic which widens the actions of health promotion from those of classic public health which include essentially an epidemiological or "risk" focus; -aims to replace vertical approaches to prevention with a global approach based on educational sciences; -involves a community approach which includes the individual in a "central position of power" as much in the definition of needs as in the evaluation of services; -includes the participation and socio-political actions

  16. 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.

  17. Moving Toward Paradigm-Shifting Research in Health Disparities Through Translational, Transformational, and Transdisciplinary Approaches

    Science.gov (United States)

    Rhee, Kyu B.; Stoff, David M.; Pohlhaus, Jennifer Reineke; Sy, Francisco S.; Stinson, Nathaniel; Ruffin, John

    2010-01-01

    Translational, transdisciplinary, and transformational research stands to become a paradigm-shifting mantra for research in health disparities. A windfall of research discoveries using these 3 approaches has increased our understanding of the health disparities in racial, ethnic, and low socioeconomic status groups. These distinct but related research spheres possess unique environments, which, when integrated, can lead to innovation in health disparities science. In this article, we review these approaches and propose integrating them to advance health disparities research through a change in philosophical position and an increased emphasis on community engagement. We argue that a balanced combination of these research approaches is needed to inform evidence-based practice, social action, and effective policy change to improve health in disparity communities. PMID:20147662

  18. Integrative Health Coaching and Motivational interviewing: Synergistic Approaches to Behavior Change in Healthcare.

    Science.gov (United States)

    Simmons, Leigh Ann; Wolever, Ruth Q

    2013-07-01

    As rates of preventable chronic diseases and associated costs continue to rise, there has been increasing focus on strategies to support behavior change in healthcare. Health coaching and motivational interviewing are synergistic but distinct approaches that can be effectively employed to achieve this end. However, there is some confusion in the literature about the relationship between these two approaches. The purpose of this review is to describe a specific style of health coaching-integrative health coaching-and motivational interviewing, including their origins, the processes and strategies employed, and the ways in which they are similar and different. We also provide a case example of how integrative health coaching and motivational interviewing might be employed to demonstrate how these approaches are synergistic but distinct from each other in practice. This information may be useful for both researchers and clinicians interested in investigating or using behavior change interventions to improve health and cost outcomes in chronic disease.

  19. The component alignment model: a new approach to health care information technology strategic planning.

    Science.gov (United States)

    Martin, J B; Wilkins, A S; Stawski, S K

    1998-08-01

    The evolving health care environment demands that health care organizations fully utilize information technologies (ITs). The effective deployment of IT requires the development and implementation of a comprehensive IT strategic plan. A number of approaches to health care IT strategic planning exist, but they are outdated or incomplete. The component alignment model (CAM) introduced here recognizes the complexity of today's health care environment, emphasizing continuous assessment and realignment of seven basic components: external environment, emerging ITs, organizational infrastructure, mission, IT infrastructure, business strategy, and IT strategy. The article provides a framework by which health care organizations can develop an effective IT strategic planning process.

  20. Aging and Hearing Health: The Life-course Approach.

    Science.gov (United States)

    Davis, Adrian; McMahon, Catherine M; Pichora-Fuller, Kathleen M; Russ, Shirley; Lin, Frank; Olusanya, Bolajoko O; Chadha, Shelly; Tremblay, Kelly L

    2016-04-01

    Sensory abilities decline with age. More than 5% of the world's population, approximately 360 million people, have disabling hearing loss. In adults, disabling hearing loss is defined by thresholds greater than 40 dBHL in the better hearing ear.Hearing disability is an important issue in geriatric medicine because it is associated with numerous health issues, including accelerated cognitive decline, depression, increased risk of dementia, poorer balance, falls, hospitalizations, and early mortality. There are also social implications, such as reduced communication function, social isolation, loss of autonomy, impaired driving ability, and financial decline. Furthermore, the onset of hearing loss is gradual and subtle, first affecting the detection of high-pitched sounds and with difficulty understanding speech in noisy but not in quiet environments. Consequently, delays in recognizing and seeking help for hearing difficulties are common. Age-related hearing loss has no known cure, and technologies (hearing aids, cochlear implants, and assistive devices) improve thresholds but do not restore hearing to normal. Therefore, health care for persons with hearing loss and people within their communication circles requires education and counseling (e.g., increasing knowledge, changing attitudes, and reducing stigma), behavior change (e.g., adapting communication strategies), and environmental modifications (e.g., reducing noise). In this article, we consider the causes, consequences, and magnitude of hearing loss from a life-course perspective. We examine the concept of "hearing health," how to achieve it, and implications for policy and practice. © The Author 2016. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  1. A computer science approach to managing security in health care.

    Science.gov (United States)

    Asirelli, P; Braccini, G; Caramella, D; Coco, A; Fabbrini, F

    2002-09-01

    The security of electronic medical information is very important for health care organisations, which have to ensure confidentiality, integrity and availability of the information provided. This paper will briefly outline the legal measures adopted by the European Community, Italy and the United States to regulate the use and disclosure of medical records. It will then go on to highlight how information technology can help to address these issues with special reference to the management of organisation policies. To this end, we will present a modelling example for the security policy of a radiological department.

  2. The right to health in public health: is this a new approach?

    Science.gov (United States)

    Potts, Helen

    2008-05-01

    The international human rights community has frequently reaffirmed the importance of full respect for the right to health. However, there remains a large gap between the standards set out in Art 12 of the International Covenant on Economic, Social and Cultural Rights and the situation prevailing in most countries. While there has been a substantial amount of work done to expand upon the content of the right to health, there has been little consideration of what a right to health means for public health programming generally. This article addresses this issue by considering the compatibility of the essential elements of contemporary public health programming practice with the principles contained in General Comment No 14, para 43(f) (a minimum core obligation of the right to health). The article considers that while both contemporary public health practice and para 43(f) do contain compatible elements, the right to health brings with it new elements of monitoring (through right to health indicators) and accountability, both of which will require new tools to be adopted by the public health sector.

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

    Science.gov (United States)

    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.

  4. Health, biodiversity, and natural resource use on the Amazon frontier: an ecosystem approach

    Directory of Open Access Journals (Sweden)

    Murray Tamsyn P.

    2001-01-01

    Full Text Available This study aims to improve the health of rural Amazonian communities through the development and application of a participatory ecosystem approach to human health assessment. In the study area marked seasonal fluctuations dictate food availability, water quality and disease outbreak. Determining the causal linkages between ecosystem variables, resource use and health required a variety of forms of inquiry at multiple scales with local participation. Landscape spatial mapping of resource use demonstrated the diversity of the ecological resources upon which communities depend. Household surveys detailed family and individual consumption and production patterns. Anthropometric measurements, parasite loading, water quality and anemia levels were used as indicators of health status. This was complemented with an ethnographic and participatory health assessment that provided the foundation for developing community action plans addressing health issues. Discussion is focused on three attributes of an ecosystem approach; (a methodological pluralism, (b cross-scale interactions and (c participatory action research.

  5. Health, biodiversity, and natural resource use on the Amazon frontier: an ecosystem approach

    Directory of Open Access Journals (Sweden)

    Tamsyn P. Murray

    Full Text Available This study aims to improve the health of rural Amazonian communities through the development and application of a participatory ecosystem approach to human health assessment. In the study area marked seasonal fluctuations dictate food availability, water quality and disease outbreak. Determining the causal linkages between ecosystem variables, resource use and health required a variety of forms of inquiry at multiple scales with local participation. Landscape spatial mapping of resource use demonstrated the diversity of the ecological resources upon which communities depend. Household surveys detailed family and individual consumption and production patterns. Anthropometric measurements, parasite loading, water quality and anemia levels were used as indicators of health status. This was complemented with an ethnographic and participatory health assessment that provided the foundation for developing community action plans addressing health issues. Discussion is focused on three attributes of an ecosystem approach; (a methodological pluralism, (b cross-scale interactions and (c participatory action research.

  6. Saving Lives through visual health communication: a multidisciplinary team approach.

    Science.gov (United States)

    Wressell, Adrian; Twaites, Heidi; Taylor, Stephen; Hartland, Dan; Gove-Humphries, Theo

    2014-10-01

    Saving Lives is a public health awareness charity that aims to educate the UK public about HIV and encourage testing for the virus. In May 2011 Saving Lives contacted the Medical Illustration department at Heart of England NHS Foundation Trust to discuss the idea of working together to develop a national HIV awareness campaign. A number of local sporting celebrities were invited to a studio photography session. All the sports stars and celebrities were photographed on a Mamiya 645 AFDII camera, with PhaseOne P30 + digital back, using prime 35 mm, 55 mm and 80 mm lenses. During the photography sessions, the team's film maker captured video footage of the subjects being photographed. Once the final avengers' graphical composition had been created, it was applied to the posters, billboards and public transport signs for the campaign. In the three-month period following the campaign launch, survey research was carried out, the initial data being recorded by a questionnaire which was provided to each of the 1800 patients attending the Heartlands Hospital sexual health clinic for HIV testing. Following the launch of the initial campaign, the Saving Lives team continues to produce material to assist in the promotion of the charity and its message. Its success has led to it becoming an on-going long-term project, and to date the team have photographed and filmed 33 sporting stars and visited numerous sporting institutes.

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

    Science.gov (United States)

    Figueroa, Fernando

    2009-01-01

    A sound basis to guide the community in the conception and implementation of ISHM (Integrated System Health Management) capability in operational systems was provided. The concept of "ISHM Model of a System" and a related architecture defined as a unique Data, Information, and Knowledge (DIaK) architecture were described. The ISHM architecture is independent of the typical system architecture, which is based on grouping physical elements that are assembled to make up a subsystem, and subsystems combine to form systems, etc. It was emphasized that ISHM capability needs to be implemented first at a low functional capability level (FCL), or limited ability to detect anomalies, diagnose, determine consequences, etc. As algorithms and tools to augment or improve the FCL are identified, they should be incorporated into the system. This means that the architecture, DIaK management, and software, must be modular and standards-based, in order to enable systematic augmentation of FCL (no ad-hoc modifications). A set of technologies (and tools) needed to implement ISHM were described. One essential tool is a software environment to create the ISHM Model. The software environment encapsulates DIaK, and an infrastructure to focus DIaK on determining health (detect anomalies, determine causes, determine effects, and provide integrated awareness of the system to the operator). The environment includes gateways to communicate in accordance to standards, specially the IEEE 1451.1 Standard for Smart Sensors and Actuators.

  8. Applying the Recovery Approach to the Interface between Mental Health and Child Protection Services

    Science.gov (United States)

    Duffy, Joe; Davidson, Gavin; Kavanagh, Damien

    2016-01-01

    There is a range of theoretical approaches which may inform the interface between child protection and adult mental health services. These theoretical perspectives tend to be focused on either child protection or mental health with no agreed integrating framework. The interface continues to be identified, in research, case management reviews and…

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

    Science.gov (United States)

    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…

  10. Applying the Recovery Approach to the Interface between Mental Health and Child Protection Services

    Science.gov (United States)

    Duffy, Joe; Davidson, Gavin; Kavanagh, Damien

    2016-01-01

    There is a range of theoretical approaches which may inform the interface between child protection and adult mental health services. These theoretical perspectives tend to be focused on either child protection or mental health with no agreed integrating framework. The interface continues to be identified, in research, case management reviews and…

  11. Emergency Planning Guidelines for Campus Health Services: An All-Hazards Approach

    Science.gov (United States)

    Journal of American College Health, 2011

    2011-01-01

    This document, written collaboratively by members of ACHA's Emerging Public Health Threats and Emergency Response Coalition and Campus Safety and Violence Coalition, is designed to assist members of the college health community in planning for emergencies using an all-hazards approach. Its perspective is both macro and micro, beginning with a…

  12. An integrated chronic disease management model: a diagonal approach to health system strengthening in South Africa.

    Science.gov (United States)

    Mahomed, Ozayr Haroon; Asmall, Shaidah; Freeman, Melvyn

    2014-11-01

    The integrated chronic disease management model provides a systematic framework for creating a fundamental change in the orientation of the health system. This model adopts a diagonal approach to health system strengthening by establishing a service-linked base to training, supervision, and the opportunity to try out, assess, and implement integrated interventions.

  13. A Bayesian experimental design approach to structural health monitoring

    Energy Technology Data Exchange (ETDEWEB)

    Farrar, Charles [Los Alamos National Laboratory; Flynn, Eric [UCSD; Todd, Michael [UCSD

    2010-01-01

    Optimal system design for SHM involves two primarily challenges. The first is the derivation of a proper performance function for a given system design. The second is the development of an efficient optimization algorithm for choosing a design that maximizes, or nearly maximizes the performance function. In this paper we will outline how an SHM practitioner can construct the proper performance function by casting the entire design problem into a framework of Bayesian experimental design. The approach demonstrates how the design problem necessarily ties together all steps of the SHM process.

  14. 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

  15. Combating the Triple Threat: The Need for a One Health Approach.

    Science.gov (United States)

    King, Lonnie J

    2013-10-01

    We live in a world that is rapidly changing, complex, and progressively interconnected. The convergence of people, animals, and their products embedded in an ever-changing environment has created a new dynamic. This dynamic is characterized by new threats to the health of humans, animals, and the environment. In addition, the health of each of these three domains is profoundly and inextricably linked and elaborately connected. Our interconnectedness strongly suggests that our future success in improving health will be based on a new integrative, holistic, and collaborative approach termed One Health. One Health demands that we work across professions, disciplines, and old boundaries. The challenges to our health are unique and profound, and old solutions to our new "wicked" problems are no longer as relevant or effective as in the past. The concept of One Health is not new but has reemerged as a concept to both better understand the triple threats to health and to better address these contemporary challenges using new approaches. This article discusses the health threats to each domain and calls for a new model to confront these challenges by shifting strategies and interventions upstream, closer to the origins of the threats. One Health is a new paradigm that can be used to improve the health of people, animals, and our environment as a collective rather than restricting our actions to any single domain.

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

    Science.gov (United States)

    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.

  17. 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

  18. "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

  19. "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

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

    Directory of Open Access Journals (Sweden)

    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.

  1. Integrating a primary oral health care approach in the dental curriculum: a Tanzanian experience.

    Science.gov (United States)

    Mumghamba, Elifuraha G

    2014-01-01

    This paper is based on a conference presentation made during the inauguration of the Faculty of Dentistry, Kuwait University, as a World Health Organization Collaborating Centre for Primary Oral Health Care (POHC) on November 27-28, 2012. The aim of this paper is to review how the POHC approach has been integrated into the dental curriculum, sharing the Tanzanian experience as a case presentation from a developing country. The burden of oral diseases worldwide is high, and the current oral health workforce is inadequate to meet the challenges. Curative oral health care is very costly and not accessible to the poor and minorities. To tackle the problem, the POHC approach rooted in primary health care that emphasizes equity, community involvement, prevention, appropriate technology and a multi-sectorial approach was developed and has been operating for more than 3 decades now. Execution of a comprehensive POHC requires a trained oral health workforce mix with essential competencies. For this case study, a literature search was done using the search engines subscribed to by the library of Muhimbili University of Health and Allied Sciences, including PubMed, Cochrane, ScienceDirect and Scopus, Wiley-Blackwell Interscience, Sage and the Health InterNetwork Access to Research Initiative (HINARI) that gives access to Scirus and Google Scholar. Challenges are discussed with an emphasis more on addressing the common risk factors and determinants of oral health. Integration of the POHC approach in the dental curriculum for training a competent workforce is crucial in attaining better oral health. Resources are still a major challenge, and the impact of the POHC approach in the curriculum is yet to be evaluated.

  2. Engaging Health Professionals in Health Economics: A Human Capital Informed Approach for Adults Learning Online

    Science.gov (United States)

    Lieberthal, Robert D.; Leon, Juan

    2015-01-01

    The authors describe a Wikipedia-based project designed for a graduate course introducing health economics to experienced healthcare professionals. The project allows such students to successfully write articles on niche topics in rapidly evolving health economics subspecialties. These students are given the opportunity to publish their completed…

  3. Engaging Health Professionals in Health Economics: A Human Capital Informed Approach for Adults Learning Online

    Science.gov (United States)

    Lieberthal, Robert D.; Leon, Juan

    2015-01-01

    The authors describe a Wikipedia-based project designed for a graduate course introducing health economics to experienced healthcare professionals. The project allows such students to successfully write articles on niche topics in rapidly evolving health economics subspecialties. These students are given the opportunity to publish their completed…

  4. 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.

  5. Achieving Effective Universal Health Coverage And Diagonal Approaches To Care For Chronic Illnesses.

    Science.gov (United States)

    Knaul, Felicia Marie; Bhadelia, Afsan; Atun, Rifat; Frenk, Julio

    2015-09-01

    Health systems in low- and middle-income countries were designed to provide episodic care for acute conditions. However, the burden of disease has shifted to be overwhelmingly dominated by chronic conditions and illnesses that require health systems to function in an integrated manner across a spectrum of disease stages from prevention to palliation. Low- and middle-income countries are also aiming to ensure health care access for all through universal health coverage. This article proposes a framework of effective universal health coverage intended to meet the challenge of chronic illnesses. It outlines strategies to strengthen health systems through a "diagonal approach." We argue that the core challenge to health systems is chronicity of illness that requires ongoing and long-term health care. The example of breast cancer within the broader context of health system reform in Mexico is presented to illustrate effective universal health coverage along the chronic disease continuum and across health systems functions. The article concludes with recommendations to strengthen health systems in order to achieve effective universal health coverage.

  6. A discursive look at large bodies--implications for discursive approaches in nursing and health research.

    Science.gov (United States)

    Knutsen, Ingrid Ruud

    2015-01-01

    This article illuminates discursive constructions of large bodies in contemporary society and discusses what discursive approaches might add to health care. Today, the World Health Organization describes a current "epidemic of obesity" and classifies large bodies as a medical condition. Texts on the obesity epidemic often draw upon alarming perspectives that involve associations of threat and catastrophe. The concern we see for body size in contemporary discourse is not new. Understandings of body size in Western societies are highly cultural and normative and could be different. The way we approach large bodies affects health care practice as well as subjects' self-perceptions.

  7. Determinants of performance of health systems concerning maternal and child health: a global approach.

    Science.gov (United States)

    Pinzón-Flórez, Carlos Eduardo; Fernández-Niño, Julián Alfredo; Ruiz-Rodríguez, Myriam; Idrovo, Álvaro J; Arredondo López, Abel Armando

    2015-01-01

    To assess the association of social determinants on the performance of health systems around the world. A transnational ecological study was conducted with an observation level focused on the country. In order to research on the strength of the association between the annual maternal and child mortality in 154 countries and social determinants: corruption, democratization, income inequality and cultural fragmentation, we used a mixed linear regression model for repeated measures with random intercepts and a conglomerate-based geographical analysis, between 2000 and 2010. Health determinants with a significant association on child mortality(corrupt government (Q3 vs Q1 = 83,05; 95%CI: 33,10 to 133). Improving access to water and sanitation systems, decreasing corruption in the health sector must become priorities in health systems. The ethno-linguistic cultural fragmentation and the detriment of democracy turn out to be two factors related to health results.

  8. A human rights-based approach to farmworker health: an overarching framework to address the social determinants of health.

    Science.gov (United States)

    Ramos, Athena K

    2017-09-26

    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 paper 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.

  9. The benefits of anthropological approaches for health promotion research and practice.

    Science.gov (United States)

    Krumeich, A; Weijts, W; Reddy, P; Meijer-Weitz, A

    2001-04-01

    In recent years health education practitioners have been looking for ways to extend the social psychological analysis of human behavior with approaches that focus on the cultural and social context of human behavior. In this article the value of the 'thick description' approach, borrowed from anthropology, is explored by examples from the Caribbean and South Africa. It demonstrates that an anthropological approach has much to offer as a basis for sound interventions for understanding human behavior. However, although an anthropological approach offers valuable starting points for interventions, its broad scope exceeds the traditional goals of health education (changing health beliefs, health counseling). Interventions will not aim at informing individuals, but at improving cultures. They may concern the change of basic cultural and social structures such as gender roles. To limit the risk of ethnocentrism, adequate ways need to be developed to make optimal use of the information thick description offers, while avoiding ethnocentrism. The article ends with a discussion concerning the assets of a dialogical approach towards health promotion. A dialogue between health promoters and their target population may help solve the problem of ethnocentrism in broadly scoped interventions.

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

    Directory of Open Access Journals (Sweden)

    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

  11. 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.

  12. Body burdens: an integrated approach to health risk assessment

    Energy Technology Data Exchange (ETDEWEB)

    Gasper, J. R.; Dauzvardis, P. A.

    1979-01-01

    Monitoring, modeling, and laboratory data are being integrated with physiological data in order to assess the impact of the release of environmental contaminants on the human receptor. The methodology described in this paper is intended primarily for use as a screening method to identify relative health risks. Comparison of body burdens and critical organ burdens can identify the relative contribution from different sources of exposure, exposure pathways, and routes of entry. These two burdens may be used in conjunction with monitoring data and environmental modeling techniques to assess the relative risk of effluent releases from natural and industrial sources or from different effluent control technologies or waste disposal methods. The relative impact of different levels of regional economic growth or regulatory plans can also be assessed. Body burdens may also serve to indicate where effluent control efforts will be most successful in reducing impacts on humans. The example projects the relative contributions to body burdens of arsenic, cadmium, chromium, mercury and lead resulting from background air and water quality, effluent releases from a coal-fired steam electric power plant, and from diet.

  13. Prevention of Overweight and Obesity: How Effective is the Current Public Health Approach

    Directory of Open Access Journals (Sweden)

    Jean Woo

    2010-02-01

    Full Text Available Obesity is a public health problem that has become epidemic worldwide. Substantial literature has emerged to show that overweight and obesity are major causes of co-morbidities, including type II diabetes, cardiovascular diseases, various cancers and other health problems, which can lead to further morbidity and mortality. The related health care costs are also substantial. Therefore, a public health approach to develop population-based strategies for the prevention of excess weight gain is of great importance. However, public health intervention programs have had limited success in tackling the rising prevalence of obesity. This paper reviews the definition of overweight and obesity and the variations with age and ethnicity; health consequences and factors contributing to the development of obesity; and critically reviews the effectiveness of current public health strategies for risk factor reduction and obesity prevention.

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

    Science.gov (United States)

    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.

  15. News DidacticApproaches in a Health Care Graduation Class

    Directory of Open Access Journals (Sweden)

    S.B. Barreto

    2009-05-01

    Full Text Available Nowadays the educator must focus not only on acquiring cognitive knowledge, but also on other matters and competences (social, political, instrumental ones. This work took placein a private college in Recife and  was had as objectiveto verify the efficiency of the application of ne wsdidactic strategies in graduation classes.This study comprised students subscribed in Medical technology (B andPharmacy   (F/2008. Students were separated in groups regarding their college period and course (B1, B2, F1, F2. The class, divided in two stages, used different didactic strategies to explain its contents: 1st unit: besides the conventionalapproaches (explanatory class, exercises and laboratory classes, new educative activities were included (research practice in the library  and problem solving classes in the laboratory; 2nd unit: conventional approach alone. In the end of each unit, students were evaluated with a theoretical exam (with objective and subjective questions. It was shown that the arithmetic means of the gradesobtained by the 1st unit students  (B1=9,1;  B2=8,8; F1=9,7;  F2=9,5 were greater, in comparison with the 2nd unit ones (B1=7,3;   B2=7,6;  F1=7,6;  F2=8,0. The research and the problem solving classes created multiple interactions opportunities among the group subjects, which may have influenced the results. The total of subjects of each group (B1=60;  B2=34;  F1=50;  F2=35 has also been evaluated, and it was seen that there was no influence of such matter on the obtained results.   Therefore, it may be concluded t hat, the work towards the whole development of the human being demands new didactic approaches and diversification of educationalactivities.

  16. 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.

  17. Global health competencies and approaches in medical education: a literature review.

    Science.gov (United States)

    Battat, Robert; Seidman, Gillian; Chadi, Nicholas; Chanda, Mohammed Y; Nehme, Jessica; Hulme, Jennifer; Li, Annie; Faridi, Nazlie; Brewer, Timothy F

    2010-12-22

    Physicians today are increasingly faced with healthcare challenges that require an understanding of global health trends and practices, yet little is known about what constitutes appropriate global health training. A literature review was undertaken to identify competencies and educational approaches for teaching global health in medical schools. Using a pre-defined search strategy, 32 articles were identified; 11 articles describing 15 global health competencies for undergraduate medical training were found. The most frequently mentioned competencies included an understanding of: the global burden of disease, travel medicine, healthcare disparities between countries, immigrant health, primary care within diverse cultural settings and skills to better interface with different populations, cultures and healthcare systems. However, no consensus on global health competencies for medical students was apparent. Didactics and experiential learning were the most common educational methods used, mentioned in 12 and 13 articles respectively. Of the 11 articles discussing competencies, 8 linked competencies directly to educational approaches. This review highlights the imperative to document global health educational competencies and approaches used in medical schools and the need to facilitate greater consensus amongst medical educators on appropriate global health training for future physicians.

  18. Global health competencies and approaches in medical education: a literature review

    Directory of Open Access Journals (Sweden)

    Hulme Jennifer

    2010-12-01

    Full Text Available Abstract Background Physicians today are increasingly faced with healthcare challenges that require an understanding of global health trends and practices, yet little is known about what constitutes appropriate global health training. Methods A literature review was undertaken to identify competencies and educational approaches for teaching global health in medical schools. Results Using a pre-defined search strategy, 32 articles were identified; 11 articles describing 15 global health competencies for undergraduate medical training were found. The most frequently mentioned competencies included an understanding of: the global burden of disease, travel medicine, healthcare disparities between countries, immigrant health, primary care within diverse cultural settings and skills to better interface with different populations, cultures and healthcare systems. However, no consensus on global health competencies for medical students was apparent. Didactics and experiential learning were the most common educational methods used, mentioned in 12 and 13 articles respectively. Of the 11 articles discussing competencies, 8 linked competencies directly to educational approaches. Conclusions This review highlights the imperative to document global health educational competencies and approaches used in medical schools and the need to facilitate greater consensus amongst medical educators on appropriate global health training for future physicians.

  19. A domain-based approach for retrieving trustworthy health videos from YouTube.

    Science.gov (United States)

    Karlsen, Randi; Borrás Morell, Jose Enrique; Fernández Luque, Luis; Traver Salcedo, Vicente

    2013-01-01

    Health information retrieval and YouTube can be used as powerful tools to improve user's health knowledge. However, YouTube videos must be carefully analysed in order to avoid misleading, inaccurate, obsolete and incorrect health content. We present an approach for re-ranking health videos obtained from YouTube, called Domain-based ranking. Our system automatically identifies videos coming from trusted sources (channels), such as hospitals and health organizations, and re-ranks YouTube results so that such videos are presented first in the ranking list. Video and channel metadata are used to automatically determine if a video is provided by a trusted source. The approach is tested and results show that the amount of relevant and reliable videos ranked within top-10 increase when using Domain-based ranking, compared with the original YouTube ranking.

  20. Transdisciplinary approaches to understanding and eliminating ethnic health disparities: are we on the right track?

    Science.gov (United States)

    Knerr, Sarah; Fullerton, Stephanie M

    2012-01-01

    The public health community's struggle to combat domestic health disparities has occurred in a context of increasing implementation of transdisciplinary research approaches. While conceptually appealing, the focus on the multilevel framing of the causes of ethnic health disparities by large-scale transdisciplinary initiatives has, to date, resulted in few tangible products. Moreover, intervention and community engagement outcomes have received less attention than more process-oriented research outcomes, namely assessing levels of transdisciplinarity achieved during the research process. We argue that a renewed focus on the ultimate products of transdisciplinary approaches, namely effective multilevel interventions, specific health outcome improvements, and greater community involvement, will aid this promising research paradigm in carrying out its philosophical commitment to ending population health disparities.

  1. Climbing a ladder: a step-by-step approach to understanding the concept of agroecosystem health.

    Science.gov (United States)

    Alkorta, I; Albizu, I; Amezaga, I; Onaindia, M; Buchner, V; Garbisu, C

    2004-01-01

    Population and individual health is linked to agroecosystem health. To comprehend the concept of agroecosystem health, one should climb a ladder consisting of several successive steps, each rung presenting a certain degree of instability (conceptual difficulty and uncertainty) in an advisable but not inevitable order. Here we suggest a ladder consisting of the following concepts: ecosystem, agroecosystem, biodiversity, sustainability, ecosystem health, and agroecosystem health. Although these concepts are to a certain extent well understood and grasped by scientists, politicians, natural resource managers, and environmentalists, some steps are still highly debatable, unclear, and present a considerable degree of reluctance to be defined and understood. Consequently, much empirical and theoretical effort must be made to construct solid conceptual ladders made up of such steps. In this enterprise, a traditional reductionistic approach confining interpretations to narrow scientific disciplines is unadvisable. Holistic, transdisciplinary approaches are required to reach the desired goal.

  2. [Communicative approach of Situational Strategic Planning at the local level: health and equity in Venezuela].

    Science.gov (United States)

    Heredia-Martínez, Henny Luz; Artmann, Elizabeth; Porto, Silvia Marta

    2010-06-01

    The article discusses the results of operationalizing Situational Strategic Planning adapted to the local level in health, considering the communicative approach and equity in a parish in Venezuela. Two innovative criteria were used: estimated health needs and analysis of the actors' potential for participation. The problems identified were compared to the corresponding article on rights in the Venezuelan Constitution. The study measured inequalities using health indicators associated with the selected problems; equity criteria were incorporated into the action proposals and communicative elements. Priority was assigned to the problem of "low case-resolving capacity in the health services network", and five critical points were selected for the action plan, which finally consisted of 6 operations and 21 actions. The article concludes that the combination of epidemiology and planning expands the situational explanation. Incorporation of the communicative approach and the equity dimension into Situational Strategic Planning allows empowering health management and helps decrease the gaps from inequality.

  3. Complexity and dynamism from an urban health perspective: a rationale for a system dynamics approach.

    Science.gov (United States)

    Tozan, Yesim; Ompad, Danielle C

    2015-06-01

    In a variety of urban health frameworks, cities are conceptualized as complex and dynamic yet commonly used epidemiological methods have failed to address this complexity and dynamism head on due to their narrow problem definitions and linear analytical representations. Scholars from a variety of disciplines have also long conceptualized cities as systems, but few have modeled urban health issues as problems within a system. Systems thinking in general and system dynamics in particular are relatively new approaches in public health, but ones that hold immense promise as methodologies to model and analyze the complexity underlying urban processes to effectively inform policy actions in dynamic environments. This conceptual essay reviews the utility of applying the concepts, principles, and methods of systems thinking to the study of complex urban health phenomena as a complementary approach to standard epidemiological methods using specific examples and provides recommendations on how to better incorporate systems thinking methods in urban health research and practice.

  4. Probiotics: a proactive approach to health. A symposium report.

    Science.gov (United States)

    Thomas, Linda V; Suzuki, Kaori; Zhao, Jia

    2015-12-01

    This report summarises talks given at the 8th International Yakult Symposium, held on 23-24 April 2015 in Berlin. Two presentations explored different aspects of probiotic intervention: the small intestine as a probiotic target and inclusion of probiotics into integrative approaches to gastroenterology. Probiotic recommendations in gastroenterology guidelines and current data on probiotic efficacy in paediatric patients were reviewed. Updates were given on probiotic and gut microbiota research in obesity and obesity-related diseases, the gut-brain axis and development of psychobiotics, and the protective effects of equol-producing strains for prostate cancer. Recent studies were presented on probiotic benefit for antibiotic-associated diarrhoea and people with HIV, as well as protection against the adverse effects of a short-term high-fat diet. Aspects of probiotic mechanisms of activity were discussed, including immunomodulatory mechanisms and metabolite effects, the anti-inflammatory properties of Faecalibacterium prausnitzii, the relationship between periodontitis, microbial production of butyrate in the oral cavity and ageing, and the pathogenic mechanisms of Campylobacter. Finally, an insight was given on a recent expert meeting, which re-examined the probiotic definition, advised on the appropriate use and scope of the term and outlined different probiotic categories and the prevalence of different mechanisms of activity.

  5. APPROACH TO MENTAL HEALTH CARE: A SYSTEMATIC REVIEW OF LITERATURE

    Directory of Open Access Journals (Sweden)

    Virginia Faria Damasio Dutra

    2011-01-01

    Full Text Available Objetivos: Realizar um levantamento da produção científica sobre cuidado em saúde mental; mais precisamente identificar as temáticas mais frequentes; destacar a relação dos temas com a prática assistencial em saúde mental; e discutir o cuidado no campo da saúde mental. Método: Estudo bibliográfico, de natureza qualitativa, nas bases de dados SCIELO (Brasil LILACS E PsycINFO, utilizando os termos saúde mental e cuidado ou mental health e care. Resultados: Foram analisadas 249 publicações. Nas publicações latinas e brasileiras prevalecem os assuntos: estratégias de assistência, políticas para atenção em saúde mental, demanda da população para cuidados em saúde mental, ética e rede de cuidados na comunidade. Na base de dados PsycINFO, de origem norte-americana prevalecem os assuntos: neuroanatomia cerebral,  marcadores biológicos nos problemas de saúde, papel do otimismo/pessimismo/afeto  na saúde mental, saúde mental de grupos, ocorrência de transtornos mentais em determinados grupos, violência, dependência e comportamento de grupos. Conclusão: Assim fica evidente que a proposta de atenção à saúde mental brasileira está mais próxima do cuidar, enquanto a norte-america está voltada para o tratar, mesmo que as duas se preocupe de modos diferentes com o cuidar e tratar.

  6. A Service Design Thinking Approach for Stakeholder-Centred eHealth.

    Science.gov (United States)

    Lee, Eunji

    2016-01-01

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

  7. 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.

  8. WHO EMRO's approach for supporting e-health in the Eastern Mediterranean Region.

    Science.gov (United States)

    N, Al-Shorbaji

    2006-01-01

    "E-health" is a generic term covering the use of computer and communication applications and technologies in health and medical care. This paper outlines WHO's dynamic and diversified approach for supporting e-health by the Regional Office of the Eastern Mediterranean. This includes: policy-setting; human resources development; planning, monitoring and evaluation; networking and communication; infrastructure development; consulting services; electronic publishing; systems development; e-learning; telemedicine; and online library services and support to HINARI It also reviews some of the impediments towards development of e-health in the Region.

  9. THE HEALTH MEDIATORS AND THE NEED FOR AN INTERCULTURAL APPROACH TO HEALTH WITHIN ROMA COMMUNITIES

    Directory of Open Access Journals (Sweden)

    Dr. Gabriel ROMAN

    2012-11-01

    Full Text Available Romania has a network of health mediators, meant to facilitate the communication between Roma communities and the medical staff. In this qualitative study, using data collected from three focus-groups with health mediators from Iaşi and Cluj counties, we provide significant information about the problematic issues related to the Roma population. The main challenges are the barriers affecting access to healthcare and the peculiarities of this ethnic group. Access to and healthcare provision would be improved with the development of the health professionals` cultural competences. Health mediators are the key elements in this process, all the more so as they are able to render innovative, collaborative care and program building with family physicians and hospitals, committed to the comprehensive and preventive treatment of the Roma population.

  10. An approach for assessing human health vulnerability and public health interventions to adapt to climate change.

    Science.gov (United States)

    Ebi, Kristie L; Kovats, R Sari; Menne, Bettina

    2006-12-01

    Assessments of the potential human health impacts of climate change are needed to inform the development of adaptation strategies, policies, and measures to lessen projected adverse impacts. We developed methods for country-level assessments to help policy makers make evidence-based decisions to increase resilience to current and future climates, and to provide information for national communications to the United Nations Framework Convention on Climate Change. The steps in an assessment should include the following: a) determine the scope of the assessment; b) describe the current distribution and burden of climate-sensitive health determinants and outcomes; c) identify and describe current strategies, policies, and measures designed to reduce the burden of climate-sensitive health determinants and outcomes; d) review the health implications of the potential impacts of climate variability and change in other sectors; e) estimate the future potential health impacts using scenarios of future changes in climate, socioeconomic, and other factors; f) synthesize the results; and g) identify additional adaptation policies and measures to reduce potential negative health impacts. Key issues for ensuring that an assessment is informative, timely, and useful include stakeholder involvement, an adequate management structure, and a communication strategy.

  11. The effects of educational program on health volunteers’ knowledge regarding their approach to earthquake in health centers in Tehran

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    ZAHRA JOUHARI

    2015-04-01

    Full Text Available Introduction: The people’s mental, intellectual and physical nonreadiness to confront earthquake may result in disastrous outcomes. This research aimed to study of effects of a training intervention on health connector’s knowledge regarding their approach to earthquake in health-training centers in East of Tehran. Methods: This research which is a semi-experimental study was designed and executed in 2011, using a questionnaire with items based on the information of Crisis Management Org. After a pilot study and making the questionnaire valid and reliable, we determined the sample size. Then, the questionnaires were completed before and after the training program by 82 health connectors at health-treatment centers in the East of Tehran. Finally, the collected data were analyzed by SPSS 14, using paired sample t–test and Pearson’s correlation coefficient. Results: Health connectors were women with the mean age of 43.43±8.51 years. In this research, the mean score of connectors’ knowledge before and after the training was 35.15±4.3 and 43.73±2.91 out of 48, respectively. The difference was statistically significant (p=0.001. The classes were the most important source of information for the health connectors. Conclusion: The people’s knowledge to confront earthquake can be increased by holding training courses and workshops. Such training courses and workshops have an important role in data transfer and readiness of health connectors.

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

    Science.gov (United States)

    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.

  13. Music and health communication in The Gambia: A social capital approach.

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    McConnell, Bonnie B

    2016-11-01

    Drawing on ethnographic research with kanyeleng fertility society performers and health workers in The Gambia (2012-2013), this paper uses a social capital approach to analyze the relationship between musical performance and health communication. Health communication research has demonstrated the important role of social capital in mediating the impact of interventions. Music research has drawn attention to performance as a site in which social relationships and obligations are produced and negotiated. In this paper, I bring these two perspectives together in order to open up new ways of thinking about musical performance as a culturally appropriate strategy in health communication. Drawing on participant observation as well as individual and group interviews with performers and health workers (126 participants), I argue that kanyeleng performance facilitates health communication by building on existing social networks and forms of social capital. This research contributes to a paradigm shift in research on performance and health communication, moving away from individual-focused behaviour change communication, and toward a culture-centered approach that considers community participation in relation to broader social and structural issues. This research suggests that musical genres such as kanyeleng performance may help build trust between health professionals and target communities while also facilitating information dissemination and public debate on sensitive health topics. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Sexual Health and Men Who Have Sex with Men in Vietnam: An Integrated Approach to Preventive Health Care

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    Le Minh Giang

    2012-01-01

    Full Text Available Background. While HIV infection among men who have sex with men (MSM in Vietnam has received increasing attention, most studies focus on HIV knowledge and established risk factors such as injection drug use. This paper proposes to address HIV risk among MSM from an integrated approach to preventive care that takes into account syndemic conditions such as substance use, mental health, and stigma, the latter of which prevents MSM from accessing health services. Method. Current studies related to MSM in Vietnam from 2000 onwards, gathered from peer-reviewed as well as non-peer-reviewed sources, were examined. Results. HIV and STI prevalence among MSM varied significantly by location, and yet HIV prevalence has increased significantly over the past few years. Most studies have focused on sexual risk behaviors, paying little attention to the broad spectrum of sexual health, including noninjecting drug use, heavy alcohol consumption, high rates of mental health distress and anxiety, and stigma. Conclusion. Future research and interventions targeting MSM in Vietnam should address their vulnerability to HIV from an integrated approach that pays attention to both sexual health and syndemic conditions.

  15. Evaluating the Health Impact of Large-Scale Public Policy Changes: Classical and Novel Approaches.

    Science.gov (United States)

    Basu, Sanjay; Meghani, Ankita; Siddiqi, Arjumand

    2017-03-20

    Large-scale public policy changes are often recommended to improve public health. Despite varying widely-from tobacco taxes to poverty-relief programs-such policies present a common dilemma to public health researchers: how to evaluate their health effects when randomized controlled trials are not possible. Here, we review the state of knowledge and experience of public health researchers who rigorously evaluate the health consequences of large-scale public policy changes. We organize our discussion by detailing approaches to address three common challenges of conducting policy evaluations: distinguishing a policy effect from time trends in health outcomes or preexisting differences between policy-affected and -unaffected communities (using difference-in-differences approaches); constructing a comparison population when a policy affects a population for whom a well-matched comparator is not immediately available (using propensity score or synthetic control approaches); and addressing unobserved confounders by utilizing quasi-random variations in policy exposure (using regression discontinuity, instrumental variables, or near-far matching approaches).

  16. Health and economic impacts of air pollution in China: a comparison of the general equilibrium approach and human capital approach.

    Science.gov (United States)

    Wan, Yue; Yang, Hong-Wei; Masui, Toshihiko

    2005-12-01

    In China, combustion of fossil fuels and biomass has produced serious air pollution that does harm to human health. Based on dose-response relationships derived from epidemiological studies, the authors calculated the number of deaths and people with health problems which were thought to be attributable to China's air pollution in the year of 2000. In order to estimate the corresponding economic impacts from the national point of view, the general equilibrium approach was selected as an analysis tool for this study. A computable general equilibrium (CGE) model was constructed involving 39 sectors and 32 commodities. The human capital approach (HCA) was also used for comparison. The economic burden of disease for people estimated by HCA was equivalent to 1.26 per thousand (ranging from 0.44 per thousand to 1.84 per thousand) of China's gross domestic product (GDP). China's GDP loss estimated by the general equilibrium approach reached 0.38 per thousand (ranging from 0.16 per thousand to 0.51 per thousand). The difference between the two approaches and the implications of the results were discussed.

  17. Health and Economic Impacts of Air Pollution in China: A Comparison of the General Equilibrium Approach and Human Capital Approach

    Institute of Scientific and Technical Information of China (English)

    YUE WAN; HONG-WEI YANG; TOSHIHIKO MASUI

    2005-01-01

    In China, combustion of fossil fuels and biomass has produced serious air pollution that does harm to human health. Based on dose-response relationships derived from epidemiological studies, the authors calculated the number of deaths and people with health problems which were thought to be attributable to China's air pollution in the year of 2000. In order to estimate the corresponding economic impacts from the national point of view, the general equilibrium approach was selected as an analysis tool for this study. A computable general equilibrium (CGE) model was constructed involving 39 sectors and 32 commodities.The human capital approach (HCA) was also used for comparison. The economic burden of disease for people estimated by HCA was equivalent to 1.26‰ (ranging from 0.44‰ to 1.84‰) of China's gross domestic product (GDP). China's GDP loss estimated by the general equilibrium approach reached 0.38‰ (ranging from 0.16‰ to 0.51‰). The difference between the two approaches and the implications of the results were discussed.

  18. Exploring the drivers of health and healthcare access in Zambian prisons: a health systems approach.

    Science.gov (United States)

    Topp, Stephanie M; Moonga, Clement N; Luo, Nkandu; Kaingu, Michael; Chileshe, Chisela; Magwende, George; Heymann, S Jody; Henostroza, German

    2016-11-01

    Prison populations in sub-Saharan Africa (SSA) experience a high burden of disease and poor access to health care. Although it is generally understood that environmental conditions are dire and contribute to disease spread, evidence of how environmental conditions interact with facility-level social and institutional factors is lacking. This study aimed to unpack the nature of interactions and their influence on health and healthcare access in the Zambian prison setting. We conducted in-depth interviews of a clustered random sample of 79 male prisoners across four prisons, as well as 32 prison officers, policy makers and health care workers. Largely inductive thematic analysis was guided by the concepts of dynamic interaction and emergent behaviour, drawn from the theory of complex adaptive systems. A majority of inmates, as well as facility-based officers reported anxiety linked to overcrowding, sanitation, infectious disease transmission, nutrition and coercion. Due in part to differential wealth of inmates and their support networks on entering prison, and in part to the accumulation of authority and material wealth within prison, we found enormous inequity in the standard of living among prisoners at each site. In the context of such inequities, failure of the Zambian prison system to provide basic necessities (including adequate and appropriate forms of nutrition, or access to quality health care) contributed to high rates of inmate-led and officer-led coercion with direct implications for health and access to healthcare. This systems-oriented analysis provides a more comprehensive picture of the way resource shortages and human interactions within Zambian prisons interact and affect inmate and officer health. While not a panacea, our findings highlight some strategic entry-points for important upstream and downstream reforms including urgent improvement in the availability of human resources for health; strengthening of facility-based health services systems

  19. Situated health promotion: reflections on implementing situated learning approaches in health promotion.

    Science.gov (United States)

    Pieter, Andrea; Fröhlich, Michael; Emrich, Eike; Stark, Robin

    2010-07-01

    Handing down health knowledge and behavior patterns is a main objective of health promotion. Often, interventions do not bring about the intended change of behavior. This could be due, among other things, to the fact that the majority of intervention programs are not based on principles of instructional design to bridge the gap between knowledge and action. A situated design of health promotion measures is to be considered particularly suitable. That accounts for the fact that the acquisition and application of knowledge is an active construction process on the part of the individuals involved, and one that includes the possibility to improve the quality of learning processes in the area of health promotion, and thus increases the probability that acquired knowledge can be applied in real situations. In the context of the problem that most health promotion interventions frequently do not show the desired permanent behavioral changes of the participating individuals, from a pedagogical perspective, it is crucial that current didactic-methodological principles be taken into account. This, too, should be taken into account in connection with an empirical analysis of the reflections in this article. In the following paper, various suggestions for implementation are explained and discussed.

  20. Gender Approach to the Difference in the Health Status of Women and Men, Riskesdas 2013

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    Siti Isfandari

    2016-06-01

    Full Text Available chronic diseases. Differences in health and illness patterns of men and women are not primarily technical or medical innature, but also attributable to social factors such as powerlessness, access to resources, and constrained roles. Usingthe latest data of Riskesdas 2013, this analysis intends to use gender approach analyzing and interpreting health statusdifference between female and male to get inputs for the appropriate measures to reduce the gap between female and malemorbidity on NCD. Methods: Riskesdas 2013 data was analyzed using gender framework which stressed the importance ofsocio economic factors on health status defi ned as prevalence of chronic diseases. Results: With the exception of youngerage, women have higher prevalence of non communicable/chronic diseases. High education appears to benefi t only middleage women to achieve equal health status with men. Conclusion: Education, access to information is important factors toreduce the gap of female and male health status, however biological factor remains as primary factor. Recommendation:Since improving health status of women needs comprehensive approach, government policy should facilitate access toeducation and economic resources to women. Gender approach should be implemented for analysing health data.

  1. 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.

  2. The impact of the Indonesian health card program: a matching estimator approach.

    Science.gov (United States)

    Johar, Meliyanni

    2009-01-01

    This study evaluates the effectiveness of a pro-poor nation-wide health card program, which provides free basic health care at public health facilities in Indonesia. To quantify the effect of the program, it departs from the traditional regression-based approach in the literature. It employs propensity score matching to reduce the selection bias due to non-random health card distribution. The setting of the program and the richness of the data set support this strategy in providing accurate estimates of the program's effect on its recipients. The results indicate that, in general, the health card program only has limited impact on the consumption of primary health care by its recipients. This finding suggests the presence of other factors counteracting the generous demand incentive.

  3. Approaches to dog health education programs in Australian rural and remote Indigenous communities: four case studies.

    Science.gov (United States)

    Constable, S E; Dixon, R M; Dixon, R J; Toribio, J-A

    2013-09-01

    Dog health in rural and remote Australian Indigenous communities is below urban averages in numerous respects. Many Indigenous communities have called for knowledge sharing in this area. However, dog health education programs are in their infancy, and lack data on effective practices. Without this core knowledge, health promotion efforts cannot progress effectively. This paper discusses a strategy that draws from successful approaches in human health and indigenous education, such as dadirri, and culturally respectful community engagement and development. Negotiating an appropriate education program is explored in its practical application through four case studies. Though each case was unique, the comparison of the four illustrated the importance of listening (community consultation), developing and maintaining relationships, community involvement and employment. The most successful case studies were those that could fully implement all four areas. Outcomes included improved local dog health capacity, local employment and engagement with the program and significantly improved dog health.

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

    Science.gov (United States)

    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.

  5. Developing a curriculum framework for global health in family medicine: emerging principles, competencies, and educational approaches

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    Wilson Briana

    2011-07-01

    Full Text Available Abstract Background Recognizing the growing demand from medical students and residents for more comprehensive global health training, and the paucity of explicit curricula on such issues, global health and curriculum experts from the six Ontario Family Medicine Residency Programs worked together to design a framework for global health curricula in family medicine training programs. Methods A working group comprised of global health educators from Ontario's six medical schools conducted a scoping review of global health curricula, competencies, and pedagogical approaches. The working group then hosted a full day meeting, inviting experts in education, clinical care, family medicine and public health, and developed a consensus process and draft framework to design global health curricula. Through a series of weekly teleconferences over the next six months, the framework was revised and used to guide the identification of enabling global health competencies (behaviours, skills and attitudes for Canadian Family Medicine training. Results The main outcome was an evidence-informed interactive framework http://globalhealth.ennovativesolution.com/ to provide a shared foundation to guide the design, delivery and evaluation of global health education programs for Ontario's family medicine residency programs. The curriculum framework blended a definition and mission for global health training, core values and principles, global health competencies aligning with the Canadian Medical Education Directives for Specialists (CanMEDS competencies, and key learning approaches. The framework guided the development of subsequent enabling competencies. Conclusions The shared curriculum framework can support the design, delivery and evaluation of global health curriculum in Canada and around the world, lay the foundation for research and development, provide consistency across programmes, and support the creation of learning and evaluation tools to align with the

  6. Developing a curriculum framework for global health in family medicine: emerging principles, competencies, and educational approaches

    Science.gov (United States)

    2011-01-01

    Background Recognizing the growing demand from medical students and residents for more comprehensive global health training, and the paucity of explicit curricula on such issues, global health and curriculum experts from the six Ontario Family Medicine Residency Programs worked together to design a framework for global health curricula in family medicine training programs. Methods A working group comprised of global health educators from Ontario's six medical schools conducted a scoping review of global health curricula, competencies, and pedagogical approaches. The working group then hosted a full day meeting, inviting experts in education, clinical care, family medicine and public health, and developed a consensus process and draft framework to design global health curricula. Through a series of weekly teleconferences over the next six months, the framework was revised and used to guide the identification of enabling global health competencies (behaviours, skills and attitudes) for Canadian Family Medicine training. Results The main outcome was an evidence-informed interactive framework http://globalhealth.ennovativesolution.com/ to provide a shared foundation to guide the design, delivery and evaluation of global health education programs for Ontario's family medicine residency programs. The curriculum framework blended a definition and mission for global health training, core values and principles, global health competencies aligning with the Canadian Medical Education Directives for Specialists (CanMEDS) competencies, and key learning approaches. The framework guided the development of subsequent enabling competencies. Conclusions The shared curriculum framework can support the design, delivery and evaluation of global health curriculum in Canada and around the world, lay the foundation for research and development, provide consistency across programmes, and support the creation of learning and evaluation tools to align with the framework. The process used to

  7. Developing a curriculum framework for global health in family medicine: emerging principles, competencies, and educational approaches.

    Science.gov (United States)

    Redwood-Campbell, Lynda; Pakes, Barry; Rouleau, Katherine; MacDonald, Colla J; Arya, Neil; Purkey, Eva; Schultz, Karen; Dhatt, Reena; Wilson, Briana; Hadi, Abdullahel; Pottie, Kevin

    2011-07-22

    Recognizing the growing demand from medical students and residents for more comprehensive global health training, and the paucity of explicit curricula on such issues, global health and curriculum experts from the six Ontario Family Medicine Residency Programs worked together to design a framework for global health curricula in family medicine training programs. A working group comprised of global health educators from Ontario's six medical schools conducted a scoping review of global health curricula, competencies, and pedagogical approaches. The working group then hosted a full day meeting, inviting experts in education, clinical care, family medicine and public health, and developed a consensus process and draft framework to design global health curricula. Through a series of weekly teleconferences over the next six months, the framework was revised and used to guide the identification of enabling global health competencies (behaviours, skills and attitudes) for Canadian Family Medicine training. The main outcome was an evidence-informed interactive framework http://globalhealth.ennovativesolution.com/ to provide a shared foundation to guide the design, delivery and evaluation of global health education programs for Ontario's family medicine residency programs. The curriculum framework blended a definition and mission for global health training, core values and principles, global health competencies aligning with the Canadian Medical Education Directives for Specialists (CanMEDS) competencies, and key learning approaches. The framework guided the development of subsequent enabling competencies. The shared curriculum framework can support the design, delivery and evaluation of global health curriculum in Canada and around the world, lay the foundation for research and development, provide consistency across programmes, and support the creation of learning and evaluation tools to align with the framework. The process used to develop this framework can be applied

  8. One Health approach: A platform for intervention in emerging public health challenges of Kerala state

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    A. Sukumaran

    2015-05-01

    Full Text Available The authors, key functionaries in the Kerala state public health system, review the communicable disease scenario of the state for the past 4 years, and in the background of the One Health concept, opines that the re-emerged discipline is perfectly in tune with the current challenges of the state. The unique model of Kerala state is witnessing newer challenges in its public health arena: The rapidly increasing migrant workforce from relatively poorer states of India, rapid urbanization and its consequent stress on public health, unsolved issues of urban waste disposal, reemergence of many communicable diseases like malaria, more so, the falciparum type, emergence of many zoonotic diseases like Lyme disease, scrub typhus, and Kyasanur forest disease etc. Conventional zoonotic infections such as anthrax and brucellosis remain potential threat for human health as well. Rabies continued to cause major concern from mortality point of view, as well as major drainer of state’s budget every year. Leptospirosis has remained major burden among the communicable disease for the past 10 years, and the annual incidence ranged from 2 to 7 per 100,000 population. Having a large section of its people working in various agriculture and animal rearing occupations, the state has all risk factors for propagation of Leptospirosis, but lacks interdisciplinary collaboration in its control and prevention area, the author highlights major avenues for collaboration. Japanese encephalitis appeared as an epidemic in 2011 in two of the southern districts in Kerala, one of the districts being famous tourist spot for both humans, as well as migrant birds. There is ample scope for collaborative research on the source of the virus, and in the subsequent years, the disease had been detected in more districts. Lyme disease was reported for the first time in India, from one of the districts in Kerala, promptly investigated by a joint team from Human Public Health and Veterinary

  9. Discussion of "Representation of People's Decisions in Health Information Systems: A Complementary Approach for Understanding Health Care Systems and Population Health".

    Science.gov (United States)

    Al-Shorbaji, Najeeb; Borycki, Elizabeth M; Kimura, Michio; Lehmann, Christoph U; Lorenzi, Nancy M; Moura, Lincoln A; Winter, Alfred

    2017-02-01

    This article is part of a For-Discussion-Section of Methods of Information in Medicine about the paper "Representation of People's Decisions in Health Information Systems: A Complementary Approach for Understanding Health Care Systems and Population Health" written by Fernan Gonzalez Bernaldo de Quiros, Adriana Ruth Dawidowski, and Silvana Figar. It is introduced by an editorial. This article contains the combined commentaries invited to independently comment on the paper of de Quiros, Dawidowski, and Figar. In subsequent issues the discussion can continue through letters to the editor.

  10. 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.

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

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    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.

  12. Latent or Manifest Observers: Two Dichotomous Approaches of Surveillance in Mental Health Nursing

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    Martin Salzmann-Erikson

    2011-01-01

    Full Text Available Background. Surveillance is a central activity among mental health nursing, but it is also questioned for its therapeutic value and considered to be custodial. Aim. The aim of this study was to describe how mental health nurses use different approaches to observe patients in relation to the practice of surveillance in psychiatric nursing care. Methods. In this study, Spradley's twelve-step ethnographic method was used. Results. Mental health nurses use their cultural knowing to observe patients in psychiatric care in various ways. Two dichotomous approaches were identified: the latent and the manifest approach. Discussion. Different strategies and techniques for observing patients are structured along two dichotomies. The underlying relationships between these two different dichotomous positions transform the act of observing into surveillance. This is further developed in a theoretical model called the powerful scheme of observation and surveillance (PSOS.

  13. Reframing the Interpretation of Sex Worker Health: A Behavioral–Structural Approach

    Science.gov (United States)

    Tuminez, Astrid S.

    2011-01-01

    Expanding sexually transmitted infection (STI) epidemics in many parts of Asia increase the importance of effective human immunodeficiency virus (HIV)/STI prevention programs for female sex workers. Designing sex worker health research and programs demands a well-stated conceptual approach, especially when one is interpreting the relationship between local policy environments and sex worker health. However, the core principles of the 2 most common conceptual approaches used in sex worker health programs—abolitionism and empowerment—have frequently divergent assumptions and implications. The abolitionist approach sees major aspects of the sex industry as fundamentally coercive and exploitative of women and supports dismantling all or parts of the sex sector. The empowerment approach strengthens sex workers’ agency and rights in order to build collective self-efficacy and have women invested in implementing their own HIV/STI prevention programs. This review compares these approaches using implication analysis and empirical cases from Asia. The misperception of an unresolvable gap between the 2 approaches ignores common ground that forms the basis of a new behavioral–structural conceptual framework. Explicitly accounting for the interaction between female sex worker behaviors and larger structures and policies, a behavioral–structural approach may provide a solid foundation for sex work research and programs. PMID:22043033

  14. A socio-economic approach to One Health policy research in southern Africa

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    Kim A. Kayunze

    2012-06-01

    Full Text Available One-health approaches have started being applied to health systems in some countries in controlling infectious diseases in order to reduce the burden of disease in humans, livestock and wild animals collaboratively. However, one wonders whether the problem of lingering and emerging zoonoses is more affected by health policies, low application of one-health approaches, or other factors. As part of efforts to answer this question, the Southern African Centre for Infectious Disease Surveillance (SACIDS smart partnership of human health, animal health and socio-economic experts published, in April 2011, a conceptual framework to support One Health research for policy on emerging zoonoses. The main objective of this paper was to identify which factors really affect the burden of disease and how the burden could affect socio-economic well-being. Amongst other issues, the review of literature shows that the occurrence of infectious diseases in humans and animals is driven by many factors, the most important ones being the causative agents (viruses, bacteria, parasites, etc. and the mediator conditions (social, cultural, economic or climatic which facilitate the infection to occur and hold. Literature also shows that in many countries there is little collaboration between medical and veterinary services despite the shared underlying science and the increasing infectious disease threat. In view of these findings, a research to inform health policy must walk on two legs: a natural sciences leg and a social sciences one.

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

    Science.gov (United States)

    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.

  16. 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.

  17. Family Centered Approach in Primary Health Care: Experience from an Urban Area of Mangalore, India

    Directory of Open Access Journals (Sweden)

    Siddharudha Shivalli

    2015-01-01

    Full Text Available Introduction. “Health for All” still eludes public health experts despite many approaches to prevent disease and promote health among urban poor. Several key illness factors lie beyond the conventional healthcare boundaries. Objective. To examine the effectiveness of family centered approach (FCA in addressing health and related issues in an urban area of Mangalore, India. Method. A longitudinal study was conducted in Bengre, an outreach centre of Mangalore from June 2011 to November 2013. Family folders were created with pertinent details. Demand generation and health education activities were conducted through two female community health link workers. An FCA package was implemented by medical and nursing interns, under supervision, to address the priority issues. Effect was assessed by comparing their practices and service utilization before and after the study. Results. About 809 families participated in this study. Social, cultural, and religious factors were responsible for viciousness of malaria and maternal and child health issues. FCA improved their perceptions and practices towards health and related issues. Significant (P<0.05 and sustained hike in service utilization was evident. Conclusion. FCA exposes key illness factors beyond the conventional care, eases need based healthcare implementation, and provides feasible and enduring solutions. Community involvement makes it more practicable.

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

    Directory of Open Access Journals (Sweden)

    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.

  19. Knowledge translation in health research: a novel approach to health sciences education.

    Science.gov (United States)

    Reitmanova, Sylvia

    2009-08-18

    The salient role of knowledge translation process, by which knowledge is put into practice, is increasingly recognized by various research stakeholders. However, medical schools are slow in providing medical students and health professionals engaged in research with the sufficient opportunities to examine more closely the facilitators and barriers to utilization of research evidence in policymaking and implementation, or the effectiveness of their research communication strategies. Memorial University of Newfoundland now offers a knowledge translation course that equips students of community health and applied health research with the knowledge and skills necessary for conducting research, that responds more closely to the needs of their communities, and for improving the utilization of their research by a variety of research consumers. This case study illustrates how the positive research outcomes resulted from implementing the knowledge translation strategies learned in the course. Knowledge translation can be useful also in attracting more funding and support from research agencies, industry, government agencies and the public. These reasons offer a compelling rationale for the standard inclusion of knowledge translation courses in health sciences education.

  20. Person-centred health care: a critical assessment of current and emerging research approaches.

    Science.gov (United States)

    Martin, Carmel M; Félix-Bortolotti, Margot

    2014-12-01

    Person-centred health care is prominent in international health care reforms. A shift to understanding and improving personal care at the point of delivery has generated debates about the nature of the person-centred research agenda. This paper purviews research paradigms that influence current person-centred research approaches and traditions that influence knowledge foundations in the field. It presents a synthesis of the emergent approaches and methodologies and highlights gaps between static academic research and the increasing accessibility of evaluation, informatics and big data from health information systems. Paradigms in health services research range from theoretical to atheoretical, including positivist, interpretive, postmodern and pragmatic. Interpretivist (subjective) and positivist (objectivist) paradigms have been historically polarized. Yet, integrative and pragmatic approaches have emerged. Nevertheless, there is a tendency to reductionism, and to reduce personal experiences to metrics in the positivist paradigm. Integrating personalized information into clinical systems is increasingly driven by the pervasive health information technology, which raises many issues about the asymmetry and uncertainty in the flow of information to support personal health journeys. The flux and uncertainty of knowledge between and within paradigmatic or pragmatic approaches highlights the uncertainty and the 'unorder and disorder' in what is known and what it means. Transdisciplinary, complex adaptive systems theory with multi-ontology sense making provides an overarching framework for making sense of the complex dynamics in research progress. A major challenge to current research paradigms is focus on the individualizing of care and enhancing experiences of persons in health settings. There is an urgent need for person-centred research to address this complex process. A transdisciplinary and complex systems approach provides a sense-making framework. © 2014 John

  1. Health care privatization in Latin America: comparing divergent privatization approaches in Chile, Colombia, and Mexico.

    Science.gov (United States)

    Bustamante, Arturo Vargas; Méndez, Claudio A

    2014-08-01

    The public-private mix in Chile, Colombia, and Mexico was very similar until the early 1980s when Chile undertook health care privatization as part of comprehensive health care reform. Since then, health care privatization policies have diverged in these countries. In this study we characterize health care privatization in Latin America and identify the main factors that promoted and hindered privatization by comparing the experiences of these countries. We argue that policy elites took advantage of specific policy environments and the diffusion of privatization policies to promote health care privatization while political mobilization against privatization, competing policy priorities, weak market and government institutions, and efforts to reach universal health insurance hindered privatization. The privatization approaches of Chile and Colombia were classified as "big-bang," since these countries implemented health care privatization more rapidly and with a wider scope compared with the case of Mexico, which was classified as gradualist, since the privatization path followed by this country adopted a slower pace and became more limited and focalized over time. We conclude that the emphasis on policy-driven privatization diminished in the 1990s and 2000s because of increased public health care financing and a shift in health care reform priorities. Health care privatization in the region, however, continued as a consequence of demand-driven privatization.

  2. A semantic approach for digital long-term preservation of electronic health documents.

    Science.gov (United States)

    Kiefer, Stephan; Schäfer, Michael; Rauch, Jochen

    2012-01-01

    Long-term preservation of electronic patient health information is a key issue for life-long electronic health records, however, it is poorly implemented in healthcare institutions and little attention is given to problems like obsolescence of formats and EHR applications or changing regulations, which jeopardize reusability of information after decades of preservation. We present in this paper an ontology driven approach to digital preservation and related metadata management which seems to be superior to conventional concepts of the digital library world.

  3. Human factors multi-technique approach to teenage engagement in digital technologies health research

    OpenAIRE

    Lang, Alexandra R; Craven, Michael P; Atkinson, Sarah; Simons, Lucy; Cobb, Sue; Mazzola, Marco

    2016-01-01

    This chapter explores the use of multi-techniques for teenage HCI health research. Through four case studies we present information about adolescents as users of healthcare services and technologies, adolescent personal development and the human factors approaches through which teenagers have been involved in healthcare research projects. In each case study; comprising of the design or evaluation of a new digital technology for supporting health or well-being, the techniques used by researche...

  4. 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.

  5. Pilot-testing an applied competency-based approach to health human resources planning.

    Science.gov (United States)

    Tomblin Murphy, Gail; MacKenzie, Adrian; Alder, Rob; Langley, Joanne; Hickey, Marjorie; Cook, Amanda

    2013-10-01

    A competency-based approach to health human resources (HHR) planning is one that explicitly considers the spectrum of knowledge, skills and judgement (competencies) required for the health workforce based on the health needs of the relevant population in some specific circumstances. Such an approach is of particular benefit to planners challenged to make optimal use of limited HHR as it allows them to move beyond simply estimating numbers of certain professionals required and plan instead according to the unique mix of competencies available from the existing health workforce. This kind of flexibility is particularly valuable in contexts where healthcare providers are in short supply generally (e.g. in many developing countries) or temporarily due to a surge in need (e.g. a pandemic or other disease outbreak). A pilot application of this approach using the context of an influenza pandemic in one health district of Nova Scotia, Canada, is described, and key competency gaps identified. The approach is also being applied using other conditions in other Canadian jurisdictions and in Zambia.

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

    DEFF Research Database (Denmark)

    Jæger, Kirsten

    2012-01-01

    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...... 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...... paradigms and advocates the adoption of a critical intercultural communication approach in relation to ethnicity-based health inequality....

  7. Determinants of Performance of Health Systems Concerning Maternal and Child Health: A Global Approach

    Science.gov (United States)

    Pinzón-Flórez, Carlos Eduardo; Fernández-Niño, Julián Alfredo; Ruiz-Rodríguez, Myriam; Idrovo, Álvaro J.; Arredondo López, Abel Armando

    2015-01-01

    Aims To assess the association of social determinants on the performance of health systems around the world. Methods A transnational ecological study was conducted with an observation level focused on the country. In order to research on the strength of the association between the annual maternal and child mortality in 154 countries and social determinants: corruption, democratization, income inequality and cultural fragmentation, we used a mixed linear regression model for repeated measures with random intercepts and a conglomerate-based geographical analysis, between 2000 and 2010. Results Health determinants with a significant association on child mortality(<1year): higher access to water (βa Quartile 4(Q4) vs Quartile 1(Q1) = -6,14; 95%CI: -11,63 to -0,73), sanitation systems, (Q4 vs Q1 = -25,58; 95%CI: -31,91 to -19,25), % measles vaccination coverage (Q4 vs Q1 = -7.35; 95%CI: -10,18 to -4,52), % of births attended by a healthcare professional (Q4 vs Q1 = -7,91; 95%CI: -11,36 to -4,52) and a % of the total health expenditure (Q3 vs Q1 = -2,85; 95%CI: -4,93 to -0,7). Ethnic fragmentation (Q4 vs Q1 = 9,93; 95%CI: -0.03 to 19.89) had a marginal effect. For child mortality<5 years, an association was found for these variables and democratization (not free vs free = 11,23; 95%CI: -0,82 to 23,29), out-of-pocket expenditure (Q1 vs Q4 = 17,71; 95%CI: 5,86 to 29,56). For MMR (Maternal mortality ratio), % of access to water for all the quartiles, % of access to sanitation systems, (Q3 vs Q1 = -171,15; 95%CI: -281,29 to -61), birth attention by a healthcare professional (Q4 vs Q1 = -231,23; 95%CI: -349,32 to -113,15), and having corrupt government (Q3 vs Q1 = 83,05; 95%CI: 33,10 to 133). Conclusions Improving access to water and sanitation systems, decreasing corruption in the health sector must become priorities in health systems. The ethno-linguistic cultural fragmentation and the detriment of democracy turn out to be two factors related to health results. PMID

  8. Determinants of performance of health systems concerning maternal and child health: a global approach.

    Directory of Open Access Journals (Sweden)

    Carlos Eduardo Pinzón-Flórez

    Full Text Available To assess the association of social determinants on the performance of health systems around the world.A transnational ecological study was conducted with an observation level focused on the country. In order to research on the strength of the association between the annual maternal and child mortality in 154 countries and social determinants: corruption, democratization, income inequality and cultural fragmentation, we used a mixed linear regression model for repeated measures with random intercepts and a conglomerate-based geographical analysis, between 2000 and 2010.Health determinants with a significant association on child mortality(<1year: higher access to water (βa Quartile 4(Q4 vs Quartile 1(Q1 = -6,14; 95%CI: -11,63 to -0,73, sanitation systems, (Q4 vs Q1 = -25,58; 95%CI: -31,91 to -19,25, % measles vaccination coverage (Q4 vs Q1 = -7.35; 95%CI: -10,18 to -4,52, % of births attended by a healthcare professional (Q4 vs Q1 = -7,91; 95%CI: -11,36 to -4,52 and a % of the total health expenditure (Q3 vs Q1 = -2,85; 95%CI: -4,93 to -0,7. Ethnic fragmentation (Q4 vs Q1 = 9,93; 95%CI: -0.03 to 19.89 had a marginal effect. For child mortality<5 years, an association was found for these variables and democratization (not free vs free = 11,23; 95%CI: -0,82 to 23,29, out-of-pocket expenditure (Q1 vs Q4 = 17,71; 95%CI: 5,86 to 29,56. For MMR (Maternal mortality ratio, % of access to water for all the quartiles, % of access to sanitation systems, (Q3 vs Q1 = -171,15; 95%CI: -281,29 to -61, birth attention by a healthcare professional (Q4 vs Q1 = -231,23; 95%CI: -349,32 to -113,15, and having corrupt government (Q3 vs Q1 = 83,05; 95%CI: 33,10 to 133.Improving access to water and sanitation systems, decreasing corruption in the health sector must become priorities in health systems. The ethno-linguistic cultural fragmentation and the detriment of democracy turn out to be two factors related to health results.

  9. A systems biology approach to studying the role of microbes in human health.

    Science.gov (United States)

    Thiele, Ines; Heinken, Almut; Fleming, Ronan M T

    2013-02-01

    Host-microbe interactions play a crucial role in human health and disease. Of the various systems biology approaches, reconstruction of genome-scale metabolic networks combined with constraint-based modeling has been particularly successful at in silico predicting the phenotypic characteristics of single organisms. Here, we summarize recent studies, which have applied this approach to investigate microbe-microbe and host-microbe metabolic interactions. This approach can be also expanded to investigate the properties of an entire microbial community, as well as single organisms within the community. We illustrate that the constraint-based modeling approach is suitable to model host-microbe interactions at molecular resolution and will enable systematic investigation of metabolic links between the human host and its microbes. Such host-microbe models, combined with experimental data, will ultimately further our understanding of how microbes influence human health.

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

    Science.gov (United States)

    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.

  11. 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.

  12. Exploring the feasibility and synergistic value of the One Health approach in clinical research

    DEFF Research Database (Denmark)

    Cordoba Currea, Gloria Cristina; Sørensen, Tina Møller; Holm, Anne

    2015-01-01

    Background: The One Health approach is emerging in response to the development of bacterial resistance. To thebest of our knowledge, the possibility to use this approach in a clinical context has not yet been explored. Thus, inthis paper, we report the procedures to implement a prospective...... interventions aimed at influencing the diagnostic process in human and caninepatients in order to decrease inappropriate use of antibiotics. Trial registration: The study in humans has been registered in ClinicalTrials.gov NCT02249273....

  13. Stennis Space Center's approach to liquid rocket engine health monitoring using exhaust plume diagnostics

    Science.gov (United States)

    Gardner, D. G.; Tejwani, G. D.; Bircher, F. E.; Loboda, J. A.; Van Dyke, D. B.; Chenevert, D. J.

    1991-01-01

    Details are presented of the approach used in a comprehensive program to utilize exhaust plume diagnostics for rocket engine health-and-condition monitoring and assessing SSME component wear and degradation. This approach incorporates both spectral and video monitoring of the exhaust plume. Video monitoring provides qualitative data for certain types of component wear while spectral monitoring allows both quantitative and qualitative information. Consideration is given to spectral identification of SSME materials and baseline plume emissions.

  14. An Asset Based Approach to Health Care and Wider Public Sector Reform in the Wigan Borough

    OpenAIRE

    Wilson, Robert Lee; Blandamer, Will

    2016-01-01

    Introduction: The Wigan Borough’s system wide approach is based on the fastest and greatest improvement in the health of the population of the Borough. The way services are delivered to citizens are being reformed to include improved access, standardisation to best practice, technology deployment, integrated approaches to care, shifts to community and primary care orientated service delivery.Description: Wigan Borough has developed integrated care based on populations’ assets and is actively ...

  15. Determinants of Performance of Health Systems Concerning Maternal and Child Health: A Global Approach

    OpenAIRE

    2015-01-01

    Aims To assess the association of social determinants on the performance of health systems around the world. Methods A transnational ecological study was conducted with an observation level focused on the country. In order to research on the strength of the association between the annual maternal and child mortality in 154 countries and social determinants: corruption, democratization, income inequality and cultural fragmentation, we used a mixed linear regression model for repeated measures ...

  16. Transformational leadership in primary care: Clinicians' patterned approaches to care predict patient satisfaction and health expectations.

    Science.gov (United States)

    Huynh, Ho Phi; Sweeny, Kate; Miller, Tricia

    2016-11-01

    Clinicians face the complex challenge of motivating their patients to achieve optimal health while also ensuring their satisfaction. Inspired by transformational leadership theory, we proposed that clinicians' motivational behaviors can be organized into three patient care styles (transformational, transactional, and passive-avoidant) and that these styles differentially predict patient health outcomes. In two studies using patient-reported data and observer ratings, we found that transformational patient care style positively predicted patients' satisfaction and health expectations above and beyond transactional and passive-avoidant patient care style. These findings provide initial support for the patient care style approach and suggest novel directions for the study of clinicians' motivational behaviors.

  17. First tooth, first visit, zero cavities: a practical approach to the infant oral health visit

    LENUS (Irish Health Repository)

    Fitzgerald, Kirsten

    2017-04-01

    The IDA adopted a formal policy on children’s oral health in 2011. There is increasing evidence to support early dental visits for children. The background to the infant oral health visit is discussed and a systematic approach to the practicalities of the visit is offered. General dental practitioners are encouraged to offer the first oral health visit before the first birthday, and this paper aims to give them practical advice concerning this visit. The feature is accompanied by a companion paper that reviews the literature pertaining to the topic, and serves to complement the recent clinical feature published in the Journal of the Irish Dental Association.

  18. Smart Telecare Technology in Health and Social Primary Care Management for Personalized Approach in Greece.

    Science.gov (United States)

    Alexandri, Danae; Tsirintani, Maria

    2017-01-01

    The paper studies the smart telecare utility in health & social care fields for the satisfactory increase of external and internal user through personalized approach and the capability proof of continuing management improvement through quality indicators. Primary survey studies of aged people's satisfaction through smart telecare in Greece - maybe in good health or patients or socially isolated - interviewing four types involved - aged, caregivers, health or social care providers and smart technology providers or producers. The sample seems positive to smart telecare for prevention, protection, safety and security. To sum up, they believe there are organizational problems in Greece due to lack of information.

  19. Evaluation models and Brazilian health reform: a qualitative-participatory approach.

    Science.gov (United States)

    Bosi, Maria Lúcia Magalhães; Mercado-Martinez, Francisco Javier

    2010-06-01

    Throughout the last years, there has been a growing interest in ongoing assessment proposals in Latin America, which are more far-reaching and not traditional. The aim of this study was to analyze the potential of qualitative-participatory evaluation in view of the challenge of strengthening health reforms in the region, particularly those considered progressive, such as the Brazilian case. There is the need to assess health reforms in a rigorous and permanent way, especially the incongruity when using normative models to evaluate health systems based on principles of universality, comprehensiveness, humanization and democratic management. In addition to the demand for assessment instruments and strategies, the Brazilian health reform requires the adoption of evaluation proposals and practices that are founded on other paradigms, distinct from the hegemonic one, in the sphere of health assessment. It is recommended that emerging evaluative models be used, such as those with a qualitative-participatory approach.

  20. A case study: planning a statewide information resource for health professionals: an evidence-based approach.

    Science.gov (United States)

    Aspinall, Erinn E; Chew, Katherine; Watson, Linda; Parker, Mary

    2009-10-01

    What is the best approach for implementing a statewide electronic health library (eHL) to serve all health professionals in Minnesota? The research took place at the University of Minnesota Health Sciences Libraries. In January 2008, the authors began planning a statewide eHL for health professionals following the five-step process for evidence-based librarianship: formulating the question, finding the best evidence, appraising the evidence, assessing costs and benefits, and evaluating the effectiveness of resulting actions. The authors identified best practices for developing a statewide eHL for health professionals relating to audience or population served, information resources, technology and access, funding model, and implementation and sustainability. They were compared to the mission of the eHL project to drive strategic directions by developing recommendations. EBL can guide the planning process for a statewide eHL, but findings must be tailored to the local environment to address information needs and ensure long-term sustainability.

  1. A survey of pedagogical approaches and quality mechanisms used in education programs for mental health professionals.

    Science.gov (United States)

    McCann, Edward; Higgins, Agnes; Maguire, Gerry; Alexander, Jane; Watts, Mike; Creaner, Mary; Rani, Shobha

    2012-09-01

    The provision of high-quality education and training that is responsive, relevant, accessible and evidence based is critical if the vision for quality mental health services presented in recent policy initiatives in Ireland is to be fulfilled. This paper reports the findings related to pedagogical approaches and quality assurance mechanisms utilized within mental health education. The study involved canvassing all Higher Education Institutions in Ireland. A total of 227 courses in 31 educational institutes were identified and 149 questionnaires were returned from 129 Course Coordinators. Various quality processes were identified in existing programs; however, formal feedback from service providers, service users and carers was seldom reported. Ongoing evaluation and quality assurance strategies are a key element of governance and there is a need to develop strategies that explore the impact of education programs on mental health education and health outcomes. Recommendations are made in terms of future interprofessional mental health education and practice.

  2. An ecological approach to health promotion in remote Australian Aboriginal communities.

    Science.gov (United States)

    McDonald, Elizabeth; Bailie, Ross; Grace, Jocelyn; Brewster, David

    2010-03-01

    Poor environmental conditions and poor child health in remote Australian Aboriginal communities are a symptom of a disjuncture in the cultures of a disadvantaged (and only relatively recently enfranchised) minority population and a proportionally large, wealthy dominant immigrant population, problematic social policies and the legacy of colonialism. Developing effective health promotion interventions in this environment is a challenge. Taking an ecological approach, the objective of this study was to identify the key social, economic, cultural and environmental factors that contribute to poor hygiene in remote Aboriginal communities, and to determine approaches that will improve hygiene and reduce the burden of infection among children. The methods included a mix of quantitative and qualitative community-based studies and literature reviews. Study findings showed that a combination of crowding, non-functioning health hardware and poor standards of personal and domestic hygiene underlie the high burden of infection experienced by children. Also, models of health promotion drawn from developed and developing countries can be adapted for use in remote Australian Aboriginal community contexts. High levels of disadvantage in relation to social determinants of health underlie the problem of poor environmental conditions and poor child health in remote Australian Aboriginal communities. Measures need to be taken to address the immediate problems that impact on children's health-for example, by ensuring the availability of functional and adequate water and sanitation facilities-but these interventions are unlikely to have a major effect unless the underlying issues are also addressed.

  3. 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.

  4. [Migrant workers: evolution of the Israel health system approach to the new social issue].

    Science.gov (United States)

    Leventhal, Alex; Berlowitz, Yitzhak; Chemtob, Daniel

    2003-09-01

    The immigration of workers from poor countries to Israel began in earnest in 1993, and by 2003 their number had reached 250,000, the majority without work permits. In this article we describe the evolution of the Israeli approach to providing health services to migrant workers, noting particularly the swings between exclusion and inclusion, ranging from providing only the most minimal services to providing a complete health services package. The National Insurance Institute was the first to provide benefits to documented migrant workers, mandating compensation benefits for those injured at work or in terrorist incidents. The health care sector provided an ever-increasing package of health benefits for documented migrant workers, culminating in the Foreign Workers Law of 2000 obligating employers to insure workers with a health package similar to that of Israeli citizens. The provision of health services to undocumented migrant workers and their families arose more gradually, but ultimately included the full range of mother and child preventive health services, school health services, provision of ambulatory medical care by volunteer physicians members of human rights organization, the possibility of enrolling their children at a reduced premium in Meuchedet Health Fund, free diagnostic and treatment services for tuberculosis and sexually transmitted diseases, free antiretroviral treatment of HIV-positive pregnant women, and, finally, the ability to obtain gas masks for a token deposit prior to the Iraq War of 2003

  5. Estimating the Relationship between Economic Growth and Health Expenditures in ECO Countries Using Panel Cointegration Approach

    Directory of Open Access Journals (Sweden)

    Nahid Hatam

    2016-03-01

    Full Text Available Increasing knowledge of people about health leads to raising the share of health expenditures in government budget continuously; although governors do not like this rise because of budget limitations. This study aimed to find the association between health expenditures and economic growth in ECO countries. We added health capital in Solow model and used the panel cointegration approach to show the importance of health expenditures in economic growth. For estimating the model, first we used Pesaran cross-sectional dependency test, after that we used Pesaran CADF unit root test, and then we used Westerlund panel cointegration test to show if there is a long-term association between variables or not. After that, we used chaw test, Breusch-Pagan test and Hausman test to find the form of the model. Finally, we used OLS estimator for panel data. Findings showed that there is a positive, strong association between health expenditures and economic growth in ECO countries. If governments increase investing in health, the total production of the country will be increased, so health expenditures are considered as an investing good. The effects of health expenditures in developing countries must be higher than those in developed countries. Such studies can help policy makers to make long-term decisions.

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

    Science.gov (United States)

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

    2017-08-28

    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.

  7. Bed bugs and public health: new approaches for an old scourge.

    Science.gov (United States)

    Shum, Mona; Comack, Elizabeth; Stuart, Taz; Ayre, Reg; Perron, Stéphane; Beaudet, Shelley A; Kosatsky, Tom

    2012-11-07

    To share four Canadian cities' experiences with bed bug infestations and to explore public health roles in managing them. We summarize presentations from a workshop at the 2010 Canadian Public Health Association Conference which examined the re-emergence of bed bugs in Canada and compared management approaches of municipal and public health authorities in four large Canadian cities. We include updates on their activities since the workshop. Cities across Canada have observed an increase in complaints of bed bug infestations over recent years. Toronto Public Health considers bed bugs to be a threat to health and has been heavily involved in the front-line response to bed bug complaints. In Winnipeg, Montreal and Vancouver, city inspectors are responsible for investigating complaints, and public health plays a supporting or secondary role. We identified factors that may contribute to successful management of bed bugs: sufficient funding, partnerships among many stakeholders, training and education, and surveillance and evaluation. Various public health agencies in Canadian cities have played key roles in the fight against bed bugs through new initiatives, education, and encouragement and support for others. By working with the public, owners, tenants, the health sector and other stakeholders, public health practitioners can begin to curb the resurgence of bed bugs and the social strains associated with them.

  8. Estimating the Relationship between Economic Growth and Health Expenditures in ECO Countries Using Panel Cointegration Approach.

    Science.gov (United States)

    Hatam, Nahid; Tourani, Sogand; Homaie Rad, Enayatollah; Bastani, Peivand

    2016-02-01

    Increasing knowledge of people about health leads to raising the share of health expenditures in government budget continuously; although governors do not like this rise because of budget limitations. This study aimed to find the association between health expenditures and economic growth in ECO countries. We added health capital in Solow model and used the panel cointegration approach to show the importance of health expenditures in economic growth. For estimating the model, first we used Pesaran cross-sectional dependency test, after that we used Pesaran CADF unit root test, and then we used Westerlund panel cointegration test to show if there is a long-term association between variables or not. After that, we used chaw test, Breusch-Pagan test and Hausman test to find the form of the model. Finally, we used OLS estimator for panel data. Findings showed that there is a positive, strong association between health expenditures and economic growth in ECO countries. If governments increase investing in health, the total production of the country will be increased, so health expenditures are considered as an investing good. The effects of health expenditures in developing countries must be higher than those in developed countries. Such studies can help policy makers to make long-term decisions.

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

    Directory of Open Access Journals (Sweden)

    Béland François

    2009-02-01

    Full Text Available Abstract Background 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. Methods 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. Results 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. Conclusion 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

  10. 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.

  11. Vouchers for health: A demand side output-based aid approach to reproductive health services in Kenya.

    Science.gov (United States)

    Janisch, C P; Albrecht, M; Wolfschuetz, A; Kundu, F; Klein, S

    2010-01-01

    Reaching the United Nation's Millennium Development Goals has been a focus for many countries and development partners. In Kenya, as in many other countries with low levels of development, access to and equity of basic quality health services is limited, especially for the very poor. Among poor populations, maternal mortality is high as access to medical care and financial means are lacking. In 2005, the Governments of Kenya and Germany in cooperation with KfW Banking Group made funds available for the Reproductive Health OBA Voucher Programme offering vouchers for Safe Motherhood, Family Planning and Gender Violence Recovery Services. This programme, herein referred to as Vouchers for Health, was launched in June of 2006 in five Kenyan districts with the aim of providing health services for safe deliveries, long-term family planning methods and victims of gender violence. The way that the programme is being implemented in Kenya demonstrates that the voucher-based approach comprises a variety of key structural elements of a national health insurance scheme: accreditation; quality assurance; reimbursement system; claims processing; integrating the private sector; client choice; provider competition; and access to and equity of services provided.

  12. What does the public know about environmental health? A qualitative approach to refining an environmental health awareness instrument.

    Science.gov (United States)

    Ratnapradipa, Dhitinut; Middleton, Wendi K; Wodika, Alicia B; Brown, Stephen L; Preihs, Kristin

    2015-04-01

    Despite an increased level of interest in environmental health concerns among the American public, awareness of the risks associated with environmental hazards is generally lacking. Assessing population awareness is typically performed through surveys, yet a comprehensive national environmental health questionnaire is currently unavailable. In 2009, a Delphi study using environmental health experts from federal, state, and local government and academia identified 11 core areas of environmental health (air, water, radiation, food safety, emergency preparedness, healthy housing, infectious disease and vector control, toxicology, injury prevention, waste and sanitation, and weather and climate change) and provided content validity for 443 questions covering 25 specific topics for possible inclusion on a national instrument. The authors' study described in this article used the qualitative approach of focus groups to refine the questions. Questions were divided into four sections and randomly assigned to a focus group location; 32 individuals participated. Results indicated that many perceptions are based on misinformation (or lack of information), which may lead to poor environmental health decision making.

  13. Primary health care nurses implement and evaluate a community outreach approach to health care in the South African agricultural sector.

    Science.gov (United States)

    Dick, J; Clarke, M; van Zyl, H; Daniels, K

    2007-12-01

    Early detection and effective case management of tuberculosis (TB) among a high-risk group of materially poor farm workers in an area of the Cape Winelands, South Africa, presents special challenges to the health community, where resource constraints lead to service reduction. In order to address this problem, local nurses established a collaborative partnership between permanent farm workers and their families, their employers, selected non-governmental organizations and the public health sector. In consultation with stakeholders, they developed an intervention primarily focusing on having peer selected trained lay health workers (LHWs) on farms, mentored and managed by nurses. To describe the complex process of implementation and evaluation of the LHW project, and provide a summary of a number of discrete studies evaluating the effectiveness, cost implications, and the perceptions and experiences of key stakeholders of the intervention. Quantitative and qualitative research methods conducted within the context of a pragmatic unblinded community cluster randomized control trial were used. Emphasis was placed on an iterative participatory interaction between the researchers and key stakeholders. The intervention contributed to significantly better successful treatment completion rates among adult new smear-positive TB cases. The process implemented proved cost-effective and was pivotal in initiating a community-based social development programme. The use of peer-selected LHWs within a wider programme of integrated care designed to merge technical biomedical approaches to disease management with more holistic social development activities, appears essential to meet the complex health needs in conjunction with public health of the rural poor.

  14. 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.

  15. 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

  16. THE CHANGING APPROACH TO THE HEALTH POLICY AND GOVERNANCE: INSIGHTS FROM LITHUANIA

    Directory of Open Access Journals (Sweden)

    Vaida Pukinaite

    2013-06-01

    Full Text Available Purpose – The aim of this review is to present the changing approach to the health policy and governance and to provide an overview of the appropriate public governance model which would allow the practical realization of contemporary health policy and governance in Lithuania. Design/methodology/approach – A literature search was carried out in order to describe the context of contemporary health policy and governance. The analysis of the draft Lithuanian Health Programme 2020, as well as the EU legislation, has also been made. The review analyses the logic of the main public governance models, defines the features of traditional public administration, the New Public Management and the New Public Governance in a summarised way, by emphasising their nature in the current Lithuanian health policy and governance. Findings – Health policy both on a global scale and in Lithuania tends to apply the integrated “bottom-to-top” models, which are based on networking, partnership and cooperation. The attitudes prevailing in Lithuania on the improvement of health policy and governance reflect the logics of the New Public Governance (NPG. The NPG could be the theoretical framework which might allow the practical realization of prevailing ideas in Lithuania on health policy and governance improvement. Research limitations/implications – The small scope of this review and the necessity for a more detailed empirical data analysis cannot lead to overall generalizations. The Lithuanian Health Programme 2020 has not been approved by the Seimas yet. Practical implications – The review provides the practical features that would be essential in order to achieve the objectives of contemporary health policy and governance. Originality/Value – Prevailing ideas on the improvement of health policy and governance are changing, and previously applied theoretical models of public governance no longer meet the realia of these days. Assurance of effective

  17. 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.

  18. 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

  19. 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.

  20. Acute effects of ozone on mortality from the "Air pollution and health : A European approach" project

    NARCIS (Netherlands)

    Gryparis, A; Forsberg, B; Katsouyanni, K; Analitis, A; Touloumi, G; Schwartz, J; Samoli, E; Medina, S; Anderson, HR; Niciu, EM; Wichmann, HE; Kriz, B; Kosnik, M; Skorkovsky, J; Vonk, JM; Dortbudak, Z

    2004-01-01

    In the Air Pollution and Health: A European Approach (APHEA2) project, the effects of ambient ozone concentrations on mortality were investigated. Data were collected on daily ozone concentrations, the daily number of deaths, confounders, and potential effect modifiers from 23 cities/areas for at le

  1. Addressing Health Disparities in the Undergraduate Curriculum: An Approach to Develop a Knowledgeable Biomedical Workforce

    Science.gov (United States)

    Benabentos, Rocio; Ray, Payal; Kumar, Deepak

    2014-01-01

    Disparities in health and healthcare are a major concern in the United States and worldwide. Approaches to alleviate these disparities must be multifaceted and should include initiatives that touch upon the diverse areas that influence the healthcare system. Developing a strong biomedical workforce with an awareness of the issues concerning health…

  2. 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 develo

  3. 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

    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...

  4. 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

  5. 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 develo

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

    NARCIS (Netherlands)

    Seeleman, C.; Essink-Bot, M.-L.; Stronks, K.; Ingleby, D.

    2015-01-01

    Background 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

  7. Addressing Health Disparities in the Undergraduate Curriculum: An Approach to Develop a Knowledgeable Biomedical Workforce

    Science.gov (United States)

    Benabentos, Rocio; Ray, Payal; Kumar, Deepak

    2014-01-01

    Disparities in health and healthcare are a major concern in the United States and worldwide. Approaches to alleviate these disparities must be multifaceted and should include initiatives that touch upon the diverse areas that influence the healthcare system. Developing a strong biomedical workforce with an awareness of the issues concerning health…

  8. 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

  9. The Effectiveness of Healthy Community Approaches on Positive Health Outcomes in Canada and the United States

    Directory of Open Access Journals (Sweden)

    Hazel Williams-Roberts

    2015-12-01

    Full Text Available Healthy community approaches encompass a diverse group of population based strategies and interventions that create supportive environments, foster community behavior change and improve health. This systematic review examined the effectiveness of ten most common healthy community approaches (Healthy Cities/Communities, Smart Growth, Child Friendly Cities, Safe Routes to Schools, Safe Communities, Active Living Communities, Livable Communities, Social Cities, Age-Friendly Cities, and Dementia Friendly Cities on positive health outcomes. Empirical studies were identified through a search of the academic and grey literature for the period 2000–2014. Of the 231 articles retrieved, 26 met the inclusion criteria with four receiving moderate quality ratings and 22 poor ratings using the Effective Public Health Practice Project Quality Assessment Tool. The majority of studies evaluated Safe Routes to School Programs and reported positive associations with students’ active commute patterns. Fewer studies assessed benefits of Smart Growth, Safe Communities, Active Living Communities and Age-Friendly Cities. The remaining approaches were relatively unexplored in terms of their health benefits however focused on conceptual frameworks and collaborative processes. More robust studies with longer follow-up duration are needed. Priority should be given to evaluation of healthy community projects to show their effectiveness within the population health context.

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

    Directory of Open Access Journals (Sweden)

    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.

  11. A Simple, Flexible and Scalable Approach for Generating Tailored Questionnaires and Health Education Messages

    Science.gov (United States)

    MACRI, JENNIFER M.; DOWNS, STEPHEN M.; DEMARK-WAHNEFRIED, WENDY; SNYDER, DENISE C.; LOBACH, DAVID F.

    2006-01-01

    Tailored health information is important for generating patient-specific recommendations in clinical decision support systems and for crafting health education materials that are specifically customized to a patient. Many previous attempts to generate tailored information require complex representations, lack general applicability, and are inflexible to content alterations. In this article, we describe a simple, yet flexible approach for tailoring health communication. This generalized and scalable approach relies on a flexible state representation of each individual and an expandable rule drafting and processing engine. It utilizes a relational database schema and a simple table structure to maintain each individual's past and current health information. Content for tailored communication is represented in a single table which stores predefined logic describing the rules for selecting content applicable to specific individuals. The flexibility, scalability, and simplicity of this approach are demonstrated by describing two diverse projects. One project has provided patient-tailored decision support for physicians for over 82,000 patient encounters and the other generates tailored health questions and messages for patients through a tool developed in less than 4 months. PMID:16292046

  12. Utilizing Electronic Health Record Information to Optimize Medication Infusion Devices: A Manual Data Integration Approach.

    Science.gov (United States)

    Chuk, Amanda; Maloney, Robert; Gawron, Joyce; Skinner, Colin

    Health information technology is increasingly utilized within healthcare delivery systems today. Two examples of this type of technology include the capture of patient-specific information within an electronic health record and intravenous medication infusion devices equipped with dose error reduction software known as drug libraries. Automatic integration of these systems, termed intravenous (IV) interoperability, should serve as the goal toward which all healthcare systems work to maximize patient safety. For institutions lacking IV interoperability, we describe a manual approach of querying the electronic health record to incorporate medication administration information with data from infusion device software to optimize drug library settings. This approach serves to maximize utilization of available information to optimize medication safety provided by drug library software.

  13. [Ecosystemic and communicative approaches in the implementation of territorial agendas for sustainable development and health promotion].

    Science.gov (United States)

    Gallo, Edmundo; Setti, Andréia Faraoni Freitas

    2012-06-01

    This paper analyzes the sustainability of ecosystemic and communicative approaches in terms of strategic planning for the implementation of territorial agendas that seek to integrate the principles of Sustainable Development and Health Promotion. It takes the Sustainable Development and Health Promotion project: Implementation of the Healthy Cities Agenda integrated with Agenda 21 in Traditional Communities of Protected Areas of the Bocaina Region" as a point of reference. It involves action-research that strives to contribute to the promotion of quality of life by means of the implementation of a participative strategic agenda and the promotion of mutual economic sustainability. The work seeks to build theoretical/practical bridges between the approaches and the methodologies and technologies used, assessing their consistency and effectiveness in relation to the principles of sustainable development and health promotion, especially in the empowerment of the local population and the broadening of the autonomy of the community.

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

    Directory of Open Access Journals (Sweden)

    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.

  15. From polarisation to practice: puzzles and insights on integrated approaches from public health professionals.

    Science.gov (United States)

    Buffardi, Anne L

    2014-01-01

    Much of the debate in the global health literature about vertical and horizontal programmatic approaches, between narrowly targeted interventions and those providing broader system-wide support, has taken place at the global level. Based on a comparative case study of international donors in the health sector in Peru that varied in their vertical-horizontal orientation, this article examines the extent to which health care practitioners and national policy-makers perceive and attempt to reconcile the tension between these approaches. Informants readily identified advantages and disadvantages of both approaches, but did not perceive a marked vertical-horizontal division, suggesting that tensions appear to be less pronounced in practice than academic debates suggest. A clear consensus did not emerge, and although more people spoke of a mixed approached, they too puzzled over how best to balance trade-offs. In practice, there were examples of more integrated approaches, targeted aspects of horizontal programmes and system-strengthening elements of vertical programmes; however, they were not explicitly identified as such. Practitioner perspectives reinforced the diverse and dynamic nature of disease, both epidemics and country profiles, and suggest that focusing on periods of transition and points of integration may be a fruitful path forward.

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

    Science.gov (United States)

    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.

  17. Using Data Envelopment Analysis approach to estimate the health production efficiencies in China

    Institute of Scientific and Technical Information of China (English)

    ZHANG Ning; HU Angang; ZHENG Jinghai

    2007-01-01

    By using Data Envelopment Analysis approach,we treat the health production system in a certain province as a Decision Making Unit (DMU),identify its inputs and outputs,evaluate its technical efficiency in 1982,1990 and 2000 respectively,and further analyze the relationship between efficiency scores and social-environmental variables.This paper has found several interesting findings.Firstly,provinces on frontier in different year are different,but provinces far from the frontier keep unchanged.The average efficiency of health production has made a significant progress from 1982 to 2000.Secondly,all provinces in China can be divided into six categories in terms of health production outcome and efficiency,and each category has specific approach of improving health production efficiency.Thirdly,significant differences in health production efficiencies have been found among the eastern,middle and western regions in China,and among the eastern and middle regions.At last,there is significant positive relationship between population density and health production efficiency but negative relationship (not very significant) between the proportions of public health expenditure in total expense and efficiency.Maybe it is the result of inappropriate tendency of public expenditure.The relationship between abilities to pay for health care services and efficiency in urban areas is opposite to that in rural areas.One possible reason is the totally different income and public services treatments between rural and urban residents.Therefore,it is necessary to adjust health policies and service provisions which are specifically designed to different population groups.

  18. Coordinating medical education and health care systems: the power of the social accountability approach.

    Science.gov (United States)

    Boelen, Charles

    2017-09-07

    As the purpose of medical education is to produce graduates able to most effectively address people's health concerns, there is general agreement that coordination with the health care system is essential. For too long, coordination has been dealt with in a subjective manner with only few landmarks to ensure objective and measurable achievements. Over the last 30 years, since the Edinburgh Declaration on medical education, progress has been made, namely with the concept of social accountability. The social accountability approach provides a way to plan, deliver and assess medical education with the explicit aim to contribute to effective, equitable and sustainable health system development. It is based on a system-wide scope exploring issues from identification of people's and society's health needs to verification of the effects of medical education in meeting those needs. A wide international consultation among medical education leaders led to the adoption of the Global Consensus on Social Accountability of Medical Schools. Benchmarks of social accountability are in the process of being conceived and tested, enabling medical schools to steer medical education in a more purposeful way in relation to determinants of health. A sample of schools using the social accountability approach claims to have had a positive influence on health care system performance and people's health status. Improved coordination of medical education and other key stakeholders in the health system is an important challenge for medical schools as well as for countries confronted with an urgent need for optimal use of their health workforce. There is growing interest worldwide in defining policies and strategies and supporting experiences in this regard. © 2017 John Wiley & Sons Ltd and The Association for the Study of Medical Education.

  19. Modern approaches to preservation of health at students in the course of physical education.

    Directory of Open Access Journals (Sweden)

    Kashuba V.A.

    2012-09-01

    Full Text Available The analysis of the special scientific literature is conducted on issue health of economy for students, approaches and features of forming for the students of requirement in the healthy physically active way of life in the process of physical education. It is set that creation of environment, cooperant the physical and moral making healthy of students must become the strategic purpose of higher education. Also - to maintenance of health level, strengthening of health, forming of skills of healthy way of life. It is marked that education of culture of health is reduced negative action of external and internal средовых factors. The theoretical going is generalized near research of problem health of economy for the participants of educational process. Possible directions activity are rotined on realization health of saving technologies in the institute of higher. Essence, components, criteria and directions of development, is certain health of saving technologies in the process of teaching in the system of trade education. It is well-proven that development and realization of ideology and policy of economy of health of students, overcoming of crisis demographic situation, must be fixed in basis of activity of all of public organs of power. Main strategies of decision of problems of national development and safety of Ukraine are rotined, further effective socio-economic development of country.

  20. New approaches to addressing information needs in local public health agencies.

    Science.gov (United States)

    Chambers, L W; Haynes, R B; Pickering, R; McKibbon, A; Walker-Dilks, C J; Panton, L; Goldblatt, E

    1991-01-01

    For local Public Health agencies to be fully responsive to community needs, staff must have ready access to up-to-date and accurate information. During the last several years, the Hamilton-Wentworth Department of Public Health Services (DPHS), a Teaching Health Unit affiliated with McMaster University, has been developing new information services including establishment of a specialized library on site; education sessions on the use of information stored in this library and in the Hamilton-Wentworth Health Library Network; innovative approaches to tailoring information services to staff needs including on-site access to on-line literature databases; and establishment of a group to retrieve and report community health data. In the initial three years of operation, surveys of Hamilton-Wentworth staff and a comparison health unit (Niagara) revealed that staff most frequently sought information from managers and support staff, as well as from personal books, articles and journals. Over half (57%) of the Hamilton-Wentworth staff reported use of the DPHS library, whereas 28% of Niagara Regional Health Unit staff reported use of their library. Other information services, for example, bibliographic indexes on population health, were less frequently used. Plans to increase their use are discussed.

  1. Using human rights-based approaches to conceptualise lesbian and bisexual women's health inequalities.

    Science.gov (United States)

    Fish, Julie; Bewley, Susan

    2010-07-01

    This article makes a contribution to current debates in human rights-based approaches to lesbian and bisexual (LB) women's health. With reference to concepts embodied in the Yogyakarta Principles, it is proposed that the right to health includes access to health information, participation, equity, equality and non-discrimination. Specifically, the article examines how LB women's health can be considered as a health inequality and discusses international developments to reduce disparities. Drawing on qualitative data collected in an online survey, the article reports on sexual minority women's experiences of health-care. Participants were recruited via a purposive sampling strategy; questionnaires were completed by 6490 respondents of whom 5909 met the study criteria of residence in the UK, sexual orientation and completing the survey once. Analysis revealed four broad themes: heteronormativity in health-care; improving attitudes among healthcare professionals; equality in access; raising awareness and informed communities. The accounts highlight the centrality of human rights principles: fairness, respect, equality, dignity and autonomy. The implications for healthcare policy and practice are discussed including ways to empower staff and service users with knowledge and skills and ensuring non-discrimination in health service delivery.

  2. Applications of the Capability Approach in the Health Field: A Literature Review.

    Science.gov (United States)

    Mitchell, Paul Mark; Roberts, Tracy E; Barton, Pelham M; Coast, Joanna

    2017-01-01

    The primary aims of this review are to document capability applications in the health field and to explore the objectives and decision-rules of studies measuring capability more broadly. Relevant studies are identified using a literature search strategy known as "comprehensive pearl growing". All studies with a primary focus on health are assessed individually, whilst a summary narrative analysis of the full review examines the objectives of capability studies. Four distinct groups in the health field are identified in the review: (1) physical activity and diet; (2) patient empowerment; (3) multidimensional poverty and (4) assessments of health and social care interventions. Different approaches to applying mixed methods, selecting capability dimensions and weighting capabilities are found across studies. There is a noticeable non-reliance on health status as a sole indicator of capability in health. In terms of objectives of studies measuring capability, although there is a lack of consistency, an objective related to sufficiency of capabilities appeared most often in the studies found in this review. Even though one of the appeals of the capability perspective is its underspecified nature, this review highlights the challenge of finding a coherent alternative to more established approaches of evaluation.

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

    Science.gov (United States)

    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

  4. Child nutrition: a primary health care approach towards health for all by 2000 AD.

    Science.gov (United States)

    David, U

    1989-05-01

    Children 14 years old (40% of the population; 21% 6 years old) comprise the most neglected population group in India in terms of nutritional status. Poor nutritional status, infections, and large fertility rates, all of which are interrelated, contribute greatly to the excess mortality of infants 5 years old. Presence or lack of health facilities and literacy of mothers and fathers are strong determinants of nutritional status. The Indian National Nutrition Monitoring Bureau's diet and nutrition surveys reveal that prevalence of nutritional deficiencies is higher among children living in slums and those of industrial laborers than professionals, paraprofessionals, office workers, and drivers. Further, other studies show that the larger the family the higher the prevalence of nutritional deficiencies. For example, 70% of all malnutrition cases are at least a birth order of 4. The leading nutritional problems include kwashiorkor, anemia, deficiency of B complex, and hypovitaminosis A. Indian rural preschool children's heights and weights stand between 15-20% and 40-50% below US standards respectively. On average, mothers wean their infants between 9-12 months. The older women in the community dictate what weaning foods to use based on their beliefs and practices which often contribute to poor nutritional status. Many nurses are not entirely informed of the nutritional problems and do not make time to learn about them thus making it difficult to combat theses problems. They need to familiarize themselves with child rearing and food practices in their communities and work with village health workers and dais to teach mothers about good nutrition.

  5. A cloud-based approach for interoperable electronic health records (EHRs).

    Science.gov (United States)

    Bahga, Arshdeep; Madisetti, Vijay K

    2013-09-01

    We present a cloud-based approach for the design of interoperable electronic health record (EHR) systems. Cloud computing environments provide several benefits to all the stakeholders in the healthcare ecosystem (patients, providers, payers, etc.). Lack of data interoperability standards and solutions has been a major obstacle in the exchange of healthcare data between different stakeholders. We propose an EHR system - cloud health information systems technology architecture (CHISTAR) that achieves semantic interoperability through the use of a generic design methodology which uses a reference model that defines a general purpose set of data structures and an archetype model that defines the clinical data attributes. CHISTAR application components are designed using the cloud component model approach that comprises of loosely coupled components that communicate asynchronously. In this paper, we describe the high-level design of CHISTAR and the approaches for semantic interoperability, data integration, and security.

  6. Evaluating the process of online health information searching: a qualitative approach to exploring consumer perspectives.

    Science.gov (United States)

    Fiksdal, Alexander S; Kumbamu, Ashok; Jadhav, Ashutosh S; Cocos, Cristian; Nelsen, Laurie A; Pathak, Jyotishman; McCormick, Jennifer B

    2014-10-07

    The Internet is a common resource that patients and consumers use to access health-related information. Multiple practical, cultural, and socioeconomic factors influence why, when, and how people utilize this tool. Improving the delivery of health-related information necessitates a thorough understanding of users' searching-related needs, preferences, and experiences. Although a wide body of quantitative research examining search behavior exists, qualitative approaches have been under-utilized and provide unique perspectives that may prove useful in improving the delivery of health information over the Internet. We conducted this study to gain a deeper understanding of online health-searching behavior in order to inform future developments of personalizing information searching and content delivery. We completed three focus groups with adult residents of Olmsted County, Minnesota, which explored perceptions of online health information searching. Participants were recruited through flyers and classifieds advertisements posted throughout the community. We audio-recorded and transcribed all focus groups, and analyzed data using standard qualitative methods. Almost all participants reported using the Internet to gather health information. They described a common experience of searching, filtering, and comparing results in order to obtain information relevant to their intended search target. Information saturation and fatigue were cited as main reasons for terminating searching. This information was often used as a resource to enhance their interactions with health care providers. Many participants viewed the Internet as a valuable tool for finding health information in order to support their existing health care resources. Although the Internet is a preferred source of health information, challenges persist in streamlining the search process. Content providers should continue to develop new strategies and technologies aimed at accommodating diverse populations

  7. Comparing health system performance assessment and management approaches in the Netherlands and Ontario, Canada

    Directory of Open Access Journals (Sweden)

    Klazinga Niek S

    2007-02-01

    Full Text Available Abstract Background Given the proliferation and the growing complexity of performance measurement initiatives in many health systems, the Netherlands and Ontario, Canada expressed interests in cross-national comparisons in an effort to promote knowledge transfer and best practise. To support this cross-national learning, a study was undertaken to compare health system performance approaches in The Netherlands with Ontario, Canada. Methods We explored the performance assessment framework and system of each constituency, the embeddedness of performance data in management and policy processes, and the interrelationships between the frameworks. Methods used included analysing governmental strategic planning and policy documents, literature and internet searches, comparative descriptive tables, and schematics. Data collection and analysis took place in Ontario and The Netherlands. A workshop to validate and discuss the findings was conducted in Toronto, adding important insights to the study. Results Both Ontario and The Netherlands conceive health system performance within supportive frameworks. However they differ in their assessment approaches. Ontario's Scorecard links performance measurement with strategy, aimed at health system integration. The Dutch Health Care Performance Report (Zorgbalans does not explicitly link performance with strategy, and focuses on the technical quality of healthcare by measuring dimensions of quality, access, and cost against healthcare needs. A backbone 'five diamond' framework maps both frameworks and articulates the interrelations and overlap between their goals, themes, dimensions and indicators. The workshop yielded more contextual insights and further validated the comparative values of each constituency's performance assessment system. Conclusion To compare the health system performance approaches between The Netherlands and Ontario, Canada, several important conceptual and contextual issues must be addressed

  8. A participatory approach to designing and enhancing integrated health information technology systems for veterans: protocol.

    Science.gov (United States)

    Haun, Jolie N; Nazi, Kim M; Chavez, Margeaux; Lind, Jason D; Antinori, Nicole; Gosline, Robert M; Martin, Tracey L

    2015-02-27

    The Department of Veterans Affairs (VA) has developed health information technologies (HIT) and resources to improve veteran access to health care programs and services, and to support a patient-centered approach to health care delivery. To improve VA HIT access and meaningful use by veterans, it is necessary to understand their preferences for interacting with various HIT resources to accomplish health management related tasks and to exchange information. The objective of this paper was to describe a novel protocol for: (1) developing a HIT Digital Health Matrix Model; (2) conducting an Analytic Hierarchy Process called pairwise comparison to understand how and why veterans want to use electronic health resources to complete tasks related to health management; and (3) developing visual modeling simulations that depict veterans' preferences for using VA HIT to manage their health conditions and exchange health information. The study uses participatory research methods to understand how veterans prefer to use VA HIT to accomplish health management tasks within a given context, and how they would like to interact with HIT interfaces (eg, look, feel, and function) in the future. This study includes two rounds of veteran focus groups with self-administered surveys and visual modeling simulation techniques. This study will also convene an expert panel to assist in the development of a VA HIT Digital Health Matrix Model, so that both expert panel members and veteran participants can complete an Analytic Hierarchy Process, pairwise comparisons to evaluate and rank the applicability of electronic health resources for a series of health management tasks. This protocol describes the iterative, participatory, and patient-centered process for: (1) developing a VA HIT Digital Health Matrix Model that outlines current VA patient-facing platforms available to veterans, describing their features and relevant contexts for use; and (2) developing visual model simulations based on

  9. 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

    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...

  10. 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

    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 rese...

  11. A Public Health Approach to Eating Disorders Prevention: It’s Time for Public Health Professionals to Take a Seat at the Table

    OpenAIRE

    Austin, Sydney Bryn

    2012-01-01

    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 re...

  12. Sentinel Animals in a One Health Approach to Harmful Cyanobacterial and Algal Blooms

    Directory of Open Access Journals (Sweden)

    Lorraine C. Backer

    2016-04-01

    Full Text Available People, domestic animals, and wildlife are all exposed to numerous environmental threats, including harmful algal blooms (HABs. However, because animals exhibit wide variations in diet, land use and biology, they are often more frequently or heavily exposed to HAB toxins than are people occupying the same habitat, making them sentinels for human exposures. Historically, we have taken advantage of unique physiological characteristics of animals, such as the sensitivity of canaries to carbon monoxide, to more quickly recognize threats and help protect human health. As HAB events become more severe and widespread worldwide, exposure and health outcome data for animals can be extremely helpful to predict, prevent, and evaluate human exposures and health outcomes. Applying a One Health approach to investigation of HABs means that lessons learned from animal sentinels can be applied to protect people, animals and our shared environment.

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

    Science.gov (United States)

    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

  14. Japanese and American public health approaches to preventing population weight gain: A role for paternalism?

    Science.gov (United States)

    Borovoy, Amy; Roberto, Christina A

    2015-10-01

    Controlling population weight gain is a major concern for industrialized nations because of associated health risks. Although Japan is experiencing rising prevalence of obesity and overweight, historically they have had and continue to maintain a low prevalence relative to other developed countries. Therefore, Japan provides an interesting case study of strategies to curb population weight gain. In this paper we explore Japanese approaches to obesity and diet through observational and ethnographic interviews conducted between June 2009 and September 2013. Nineteen interviews were conducted at four companies and three schools in Tokyo, as well as at a central Tokyo community health care center and school lunch distribution center. Interviewees included physicians, a Ministry of Health bureaucrat, human resources managers, welfare nurses employed by health insurance organizations, school nurses (also government employees), school nutritionists, and a school counselor. We highlight the role of culture and social norms in encouraging healthful behavior in Japan, focusing on the Ministry of Health, Labor, and Welfare's metabolic syndrome screening program (implemented in 2005) and the Japanese national school lunch program. The Japanese government prescribes optimal body metrics for all Japanese citizens and relies on institutions such as schools and health insurance organizations that are in some instances closely affiliated with the workplace to carry out education. Japan's socio-cultural approach leads us reflect on the cultural and social conditions that make different policy prescriptions more politically feasible and potentially effective. It also provokes us to question whether limited behavioral modifications and "nudging" can lead to broader change in an environment like the United States where there are fewer broadly shared socio-cultural norms regarding acceptable health behavior. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Rapid Assessment of Health Services in Punjab using a Mixed Method Approach

    Directory of Open Access Journals (Sweden)

    Rajesh Kumar

    2015-06-01

    Full Text Available Introduction: The out-of-pocket expenditure is quite high in Punjab. Hence, a rapid review of health facilities was undertaken to suggest remedial measures. Methods: Mixed method research approach was used to identify strengths and weaknesses of the health services in Punjab. All health institutions were included in the assessment from the three purposively sampled districts – one from each of the three regions of Punjab. Tools were developed to collect data from record review, observations, and in-depth interviews. Six building blocks framework proposed by the World Health Organization was used for data collection and analyses. Results: In general physical infrastructure, especially the buildings were found to be reasonably constructed at most of the healthcare facilities. However, the maintenance was not regular. The vacancies for general doctors, specialist doctors, nurses, and paramedics were 26%, 38%, 31% and 12% respectively. Supply of drugs was irregular and inadequate. A large proportion (45% of ‘user charges’ were spent on purchase of drugs and other consumables. Most registers were found to be updated, and reports were transmitted to higher levels usually on time. However, institutionalized system of monitoring and supervision was lacking. Govt. hospitals were providing in-patient care to about 35.5% of those who were estimated to need hospitalization. State had allocated about Rs. 1200 crores to health (0.46% of GDP, thus, spending only Rs. 433 per capita per year. Conclusions: Despite constraints, the government health service is catering to the needs of a large section of the population. Rapid health system assessment at periodic intervals using a mixed method approach can supplement routine monitoring of the health system.

  16. An approach to classifying human resources constraints to attaining health-related Millennium Development Goals.

    Science.gov (United States)

    Wyss, Kaspar

    2004-07-06

    interventions, poverty reduction strategies, and training approaches. Multisectoral collaboration and the sociopolitical and economic context of a country determine health sector workforce development and potential emigration. CONCLUSIONS: Key determinants of success for achieving international development goals are closely related to human-resource development.

  17. An approach to classifying human resources constraints to attaining health-related Millennium Development Goals

    Directory of Open Access Journals (Sweden)

    Wyss Kaspar

    2004-07-01

    -up of priority interventions, poverty reduction strategies, and training approaches. Multisectoral collaboration and the sociopolitical and economic context of a country determine health sector workforce development and potential emigration. Conclusions Key determinants of success for achieving international development goals are closely related to human-resource development.

  18. Public health nutrition in the civil service (England): approaches to tackling obesity.

    Science.gov (United States)

    Blackshaw, J R

    2016-08-01

    The seriousness and scale of the physical, psychological, economic and societal consequences relating to poor diets, inactivity and obesity is unprecedented. Consequently, the contextual factors underpinning the work of a nutritionist in the civil service are complex and significant; however, there are real opportunities to make a difference and help improve the health of the nation. The present paper describes the delivery of public health nutrition through two work programmes, namely action to support young people develop healthier lifestyle choices and more recently the investigation and deployment of local insights to develop action to tackle obesity. Combining the application of nutrition expertise along with broader skills and approaches has enabled the translation of research and evidence into programmes of work to better the public's health. It is evident that the appropriate evaluation of such approaches has helped to deliver engaging and practical learning opportunities for young people. Furthermore, efforts to build on local intelligence and seek collaborative development can help inform the evidence base and seek to deliver public health approaches, which resonate with how people live their lives.

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

    Directory of Open Access Journals (Sweden)

    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.

  20. Who's users? Participation and empowerment in socio-technical approaches to health IT developments.

    Science.gov (United States)

    Kushniruk, Andre W; Turner, Paul

    2011-01-01

    Health informatics researchers advocating socio-technical approaches to the design, implementation and evaluation of health information technology (HIT) consistently promote the important role of users. Aside from conventional ethical and legal considerations around their involvement, there are a number of philosophical and methodological issues that have received less attention because of the tendency for researchers to assume the term 'user' is well defined and understood. It is however, evident that there are significant differences amongst users, and differences in how researchers engage, involve and interact with them during health IT developments. Failure to acknowledge these differences and their impact on Health IT developments makes comparisons across different studies problematic and raises fundamental questions about participation and empowerment of end-users in our developments. This paper re-examines the term user in the context of socio-technical approaches to HIT and presents a preliminary approach to differentiating between types of users and our changing expectations of their roles in enhancing different HIT projects across design, implementation and evaluation.

  1. Understanding wealth-based inequalities in child health in India: a decomposition approach.

    Science.gov (United States)

    Chalasani, Satvika

    2012-12-01

    India experienced tremendous economic growth since the mid-1980s but this growth was paralleled by sharp rises in economic inequality. Urban areas experienced greater economic growth as well as greater increases in economic inequality than rural areas. During the same period, child health improved on average but socioeconomic differentials in child health persisted. This paper attempts to explain wealth-based inequalities in child mortality and malnutrition using a regression-based decomposition approach. Data for the analysis come from the 1992/93, 1998/99, and 2005/06 Indian National Family Health Surveys. Inequalities in child health are measured using the concentration index. The concentration index for each outcome is then decomposed into the contributions of wealth-based inequality in the observed determinants of child health. Results indicate that mortality inequality declined in urban areas but remained unchanged or increased in rural areas. Malnutrition inequality increased dramatically both in urban and rural areas. The two largest individual/household-level sources of disparities in child health are (i) inequality in the distribution of wealth itself, and (ii) inequality in maternal education. The contributions of observed determinants (i) to neonatal mortality inequality remained unchanged, (ii) to child mortality inequality increased, and (ii) to malnutrition inequality increased. It is possible that the increases in child health inequality reflect urban biases in economic growth, and the mixed performance of public programs that could have otherwise offset the impacts of unequal growth.

  2. A new approach to teaching veterinary public health at the Ohio State University.

    Science.gov (United States)

    Hoet, Armando E; Caswell, Robert J; DeGraves, Fred J; Rajala-Schultz, Paivi J; Gebreyes, Wondwossen A; Saville, William J A; Wittum, Thomas E

    2008-01-01

    Public-health practitioners with expertise in the area of veterinary public health are expected to understand the prevention and control of zoonotic infectious diseases in both human and animal populations. This focus on multiple species is what makes the veterinary public health (VPH) official unique. The development of a new VPH specialization within the existing Master of Public Health (MPH) degree program at the Ohio State University represents a significant new collaboration between the College of Veterinary Medicine and the College of Public Health. The main objective of the VPH specialization is to educate and train professionals to provide them with the skills, knowledge, and resources necessary to protect and improve human health using a One Medicine approach. The program targets a population of students who will likely enter the professional veterinary medicine curriculum but have one year available to enhance their preparatory training in health sciences before beginning the program. A core series of VPH courses was initiated to complement the existing MPH course requirements. The program has been successful in attracting students from the primary target population, but it has also attracted students wanting the MPH as a terminal degree and veterinarians returning to school to expand their career options.

  3. Suffering and powerlessness: the significance of promoting participation in rights-based approaches to health.

    Science.gov (United States)

    Yamin, Alicia Ely

    2009-01-01

    In a rights framework, participation is inextricably related to power. Through effective participation, we can challenge political and other forms of exclusion that prevent people from having power over the decisions and processes that affect their lives and health. Yet concepts of power are as contested as notions of participation. Thus, I argue here that, far from there being a formula for what participation means in a rights-based approach to health, the way in which we conceptualize the role of participation is closely linked to how we understand power and, in turn, the purpose and meaning of human rights themselves. I outline three ways of thinking about domination and participation-as-empowerment. In a liberal understanding of how power operates, there is an overarching concern for ensuring processes of participation that enable competing groups to express their voices on the proverbial level playing field, so that no one group may impose its will on the others. Critics of this approach assert that it ignores the power relations in which participatory processes are embedded, which determine which of the issues that affect health get decided--and which issues are never brought to the table because they are systematically blocked. If a second dimension of power entails deciding what gets decided, participatory approaches need to challenge the definition of what is "up for contention," or they risk merely legitimating social control. A third dimension of power entails securing compliance from oppressed groups by shaping their perceptions of their own interests. A human rights-based approach concerned with the effects of this form of domination on people's health calls for developing critical consciousness before there can be any truly "empowering" participation. I conclude by arguing that much is at stake in defining participation in a human rights framework to health, because in defining what we are calling for, we will determine how relevant human rights are

  4. 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.

  5. Designing a model for trauma system management using public health approach: the case of Iran.

    Science.gov (United States)

    Tarighi, Payam; Tabibi, Seyed Jamaledin; Motevalian, Seyed Abbas; Tofighi, Shahram; Maleki, Mohammad Reza; Delgoshaei, Bahram; Panahi, Farzad; Masoomi, Gholam Reza

    2012-01-01

    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.

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

    Directory of Open Access Journals (Sweden)

    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.

  7. Qualitative evaluation: a critical and interpretative complementary approach to improve health programs and services.

    Science.gov (United States)

    Tayabas, Luz María Tejada; León, Teresita Castillo; Espino, Joel Monarrez

    2014-01-01

    This short essay aims at commenting on the origin, development, rationale, and main characteristics of qualitative evaluation (QE), emphasizing the value of this methodological tool to evaluate health programs and services. During the past decades, different approaches have come to light proposing complementary alternatives to appraise the performance of public health programs, mainly focusing on the implementation process involved rather than on measuring the impact of such actions. QE is an alternative tool that can be used to illustrate and understand the process faced when executing health programs. It can also lead to useful suggestions to modify its implementation from the stakeholders' perspectives, as it uses a qualitative approach that considers participants as reflective subjects, generators of meanings. This implies that beneficiaries become involved in an active manner in the evaluated phenomena with the aim of improving the health programs or services that they receive. With this work we want to encourage evaluators in the field of public health to consider the use of QE as a complementary tool for program evaluation to be able to identify areas of opportunity to improve programs' implementation processes from the perspective of intended beneficiaries.

  8. Use of a systems approach and evidence-based One Health for zoonoses research.

    Science.gov (United States)

    Asokan, G V; Asokan, Vanitha; Fedorowicz, Zbys; Tharyan, Prathap

    2011-05-01

    The World Health Organization estimates that 25% of the 57 million annual deaths that occur globally are caused by microbes. A study reported 1415 species of infectious organisms are known to be pathogenic to humans. Zoonoses constitute 61% of all known infectious diseases, with humans serving as the primary reservoir for only 3% of them. Of the 175 infectious species considered to be emerging, 75% are zoonotic. Zoonotic diseases and their impact on human and animal health are not monitored, prevented, and treated in an integrated way, despite the fact that etiologies and treatments are similar across species. The efficacy and resistance of a drug in one species has a bearing on others, in the context of zoonoses. Further, an RCT involving many species is effective in a natural setting, is robust, and may require fewer human volunteers. One Health is based on a systems approach and a collaborative effort of multiple disciplines - working locally, nationally, and globally - to attain optimal health for people, animals, and the environment. Systematic reviews and meta-analyses have so far been independent and discipline oriented. Pooling of results for diagnostic test accuracies and treatment effects of drugs for zoonoses across species has to be done, since the results of preclinical trials emanate from laboratory animals. The Cochrane Collaboration is the platform of choice to initiate a new group on zoonoses to carry out systematic meta-analyses of diagnostic tests and drug efficacies without bias, thus underpinning the systems approach and One Health.

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

    Science.gov (United States)

    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.

  10. Qualitative evaluation: A critical and interpretative complementary approach to improve health programs and services

    Science.gov (United States)

    Tayabas, Luz María Tejada; León, Teresita Castillo; ESPINO, JOEL MONARREZ

    2014-01-01

    This short essay aims at commenting on the origin, development, rationale, and main characteristics of qualitative evaluation (QE), emphasizing the value of this methodological tool to evaluate health programs and services. During the past decades, different approaches have come to light proposing complementary alternatives to appraise the performance of public health programs, mainly focusing on the implementation process involved rather than on measuring the impact of such actions. QE is an alternative tool that can be used to illustrate and understand the process faced when executing health programs. It can also lead to useful suggestions to modify its implementation from the stakeholders’ perspectives, as it uses a qualitative approach that considers participants as reflective subjects, generators of meanings. This implies that beneficiaries become involved in an active manner in the evaluated phenomena with the aim of improving the health programs or services that they receive. With this work we want to encourage evaluators in the field of public health to consider the use of QE as a complementary tool for program evaluation to be able to identify areas of opportunity to improve programs’ implementation processes from the perspective of intended beneficiaries. PMID:25152220

  11. Qualitative evaluation: A critical and interpretative complementary approach to improve health programs and services

    Directory of Open Access Journals (Sweden)

    Luz MarÍa Tejada Tayabas

    2014-08-01

    Full Text Available This short essay aims at commenting on the origin, development, rationale, and main characteristics of qualitative evaluation (QE, emphasizing the value of this methodological tool to evaluate health programs and services. During the past decades, different approaches have come to light proposing complementary alternatives to appraise the performance of public health programs, mainly focusing on the implementation process involved rather than on measuring the impact of such actions. QE is an alternative tool that can be used to illustrate and understand the process faced when executing health programs. It can also lead to useful suggestions to modify its implementation from the stakeholders’ perspectives, as it uses a qualitative approach that considers participants as reflective subjects, generators of meanings. This implies that beneficiaries become involved in an active manner in the evaluated phenomena with the aim of improving the health programs or services that they receive. With this work we want to encourage evaluators in the field of public health to consider the use of QE as a complementary tool for program evaluation to be able to identify areas of opportunity to improve programs’ implementation processes from the perspective of intended beneficiaries.

  12. Approaching usability: a study of an academic health sciences library web site.

    Science.gov (United States)

    Ascher, Marie T; Lougee-Heimer, Haldor; Cunningham, Diana J

    2007-01-01

    A usability study was conducted at a medium-sized academic health sciences library with the goal of providing data to inform the future redesign of the library's Web page. A two-stage approach was used: (1) A preliminary survey designed to identify common tasks and issues on which to focus, and (2) usability testing. Responses to the survey indicated general satisfaction with the site and suggested areas for testing. Usability testing participants were asked to perform scripted tasks. The results indicate that users do have considerable difficulty navigating the site and recommendations are presented. This method of testing is recommended for health sciences libraries.

  13. The accountability for reasonableness approach to guide priority setting in health systems within limited resources

    DEFF Research Database (Denmark)

    Byskov, Jens; Marchal, Bruno; Maluka, Stephen;

    2014-01-01

    BACKGROUND: Priority-setting decisions are based on an important, but not sufficient set of values and thus lead to disagreement on priorities. Accountability for Reasonableness (AFR) is an ethics-based approach to a legitimate and fair priority-setting process that builds upon four conditions...... of the potential of AFR in supporting priority-setting and other decision-making processes in health systems to achieve better agreed and more sustainable health improvements linked to a mutual democratic learning with potential wider implications....

  14. Determinants of Health Spending Efficiency: a Tobit Panel Data Approach Based on DEA Efficiency Scores

    Directory of Open Access Journals (Sweden)

    Douanla Tayo Lionel

    2015-08-01

    Full Text Available This study aims at identifying the determinants of health expenditure efficiency over the period 2005-2011 using a Tobit Panel Data Approach based on DEA Efficiency Scores. The study was made on 150 countries, where we had 45 high income countries, 40 upper middle income countries, 36 lower middle income countries and 29 low income countries. The estimated results show that Carbon dioxide emission, gross domestic product per capita, improvement in corruption, the age composition of the population, population density and government effectiveness are significant determinants of health expenditure efficiency. Thus, low income countries should promote green growth and all the income groups should intensively fight against poverty.

  15. Utilization of Ayurveda in health care: an approach for prevention, health promotion, and treatment of disease. Part 2--Ayurveda in primary health care.

    Science.gov (United States)

    Sharma, Hari; Chandola, H M; Singh, Gurdip; Basisht, Gopal

    2007-12-01

    Ayurveda is a comprehensive natural health care system that originated in India more than 5000 years ago. It is still widely used in India as a system of primary health care, and interest in it is growing worldwide as well. Ayurveda has unique concepts and methodologies to address health care throughout the course of life, from pregnancy and infant care to geriatric disorders. Common spices are utilized, as well as herbs, herbal mixtures, and special preparations known as Rasayanas. Purification procedures known as Panchakarma remove toxins from the physiology. Research has been conducted worldwide on Ayurveda. There are encouraging results for its effectiveness in treating various ailments, including chronic disorders associated with the aging process. Pilot studies presented in this paper were conducted on depression, anxiety, sleep disorders, hypertension, diabetes mellitus, Parkinson's disease, and Alzheimer's disease. These preliminary studies yielded positive results and provide a basis for conducting larger, more rigorous clinical trials. Conducting research that compares Ayurveda's comprehensive treatment approach, Western allopathic treatment, and an integrated approach combining the Ayurvedic and allopathic treatments would shed light on which treatment approach is the most effective for the benefit of the patient.

  16. 75 FR 1770 - An Approach to Using Toxicogenomic Data in U.S. EPA Human Health Risk Assessments: A Dibutyl...

    Science.gov (United States)

    2010-01-13

    ... AGENCY An Approach to Using Toxicogenomic Data in U.S. EPA Human Health Risk Assessments: A Dibutyl... in U.S. EPA Human Health Risk Assessments: A Dibutyl Phthalate Case Study'' (EPA/600/R-09/028F... assessment. This report describes an approach to evaluate toxicogenomic data for use in risk assessment and a...

  17. 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.

  18. An interactive integrative approach to translating knowledge and building a "learning organization" in health services management.

    Science.gov (United States)

    Chunharas, Somsak

    2006-08-01

    This paper proposes a basic approach to ensuring that knowledge from research studies is translated for use in health services management with a view towards building a "learning organization". (A learning organization is one in which the environment is structured in such a way as to facilitate learning as well as the sharing of knowledge among members or employees.) This paper highlights various dimensions that determine the complexity of knowledge translation, using the problem-solving cycle as the backbone for gaining a better understanding of how different types of knowledge interact in health services management. It is essential to use an integrated and interactive approach to ensure that knowledge from research is translated in a way that allows a learning organization to be built and that knowledge is not used merely to influence a single decision in isolation from the overall services and management of an organization.

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

    Science.gov (United States)

    Vezzetti, Vittorio Carlo

    2016-01-01

    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. PMID:28070408

  20. Exploring the feasibility and synergistic value of the One Health approach in clinical research

    DEFF Research Database (Denmark)

    Cordoba Currea, Gloria Cristina; Sørensen, Tina Møller; Holm, Anne;

    2015-01-01

    diagnostic pathways (i.e., 16 possiblecombinations of diagnostic tools) to gold standard in human and veterinary primary care practice in Denmark.Fifty primary care practices and 100 veterinary clinics will each consecutively include 20 human patients or 8–10dogs, respectively. Data will be collected......Background: The One Health approach is emerging in response to the development of bacterial resistance. To thebest of our knowledge, the possibility to use this approach in a clinical context has not yet been explored. Thus, inthis paper, we report the procedures to implement a prospective...... observational study of diagnostic pathways in humanand canine patients with suspected urinary tract infection as a means to assess the feasibility and synergistic value ofsetting up One Health clinical research projects and interventions. Methods/design: A prospective observational study will compare different...

  1. Urban governance and the systems approaches to health-environment co-benefits in cities.

    Science.gov (United States)

    Oliveira, Jose A Puppim de; Doll, Christopher N H; Siri, José; Dreyfus, Magali; Farzaneh, Hooman; Capon, Anthony

    2015-11-01

    The term "co-benefits" refers to positive outcomes accruing from a policy beyond the intended outcome, often or usually in other sectors. In the urban context, policies implemented in particular sectors (such as transport, energy or waste) often generate multiple co-benefits in other areas. Such benefits may be related to the reduction of local or global environmental impacts and also extend into the area of public health. A key to identifying and realising co-benefits is the adoption of systems approaches to understand inter-sectoral linkages and, in particular, the translation of this understanding to improved sector-specific and city governance. This paper reviews a range of policies which can yield health and climate co-benefits across different urban sectors and illustrates, through a series of cases, how taking a systems approach can lead to innovations in urban governance which aid the development of healthy and sustainable cities.

  2. Concept mapping as an approach for expert-guided model building: The example of health literacy.

    Science.gov (United States)

    Soellner, Renate; Lenartz, Norbert; Rudinger, Georg

    2017-02-01

    Concept mapping served as the starting point for the aim of capturing the comprehensive structure of the construct of 'health literacy.' Ideas about health literacy were generated by 99 experts and resulted in 105 statements that were subsequently organized by 27 experts in an unstructured card sorting. Multidimensional scaling was applied to the sorting data and a two and three-dimensional solution was computed. The three dimensional solution was used in subsequent cluster analysis and resulted in a concept map of nine "clusters": (1) self-regulation, (2) self-perception, (3) proactive approach to health, (4) basic literacy and numeracy skills, (5) information appraisal, (6) information search, (7) health care system knowledge and acting, (8) communication and cooperation, and (9) beneficial personality traits. Subsequently, this concept map served as a starting point for developing a "qualitative" structural model of health literacy and a questionnaire for the measurement of health literacy. On the basis of questionnaire data, a "quantitative" structural model was created by first applying exploratory factor analyses (EFA) and then cross-validating the model with confirmatory factor analyses (CFA). Concept mapping proved to be a highly valuable tool for the process of model building up to translational research in the "real world".

  3. Public health impact of zoonoses and international approaches for their detection and containment

    Directory of Open Access Journals (Sweden)

    François-Xavier Meslin

    2008-12-01

    Full Text Available Many new, emerging and re-emerging diseases of humans are caused by pathogens that originate from animals or products of animal origin. A wide variety of both domestic and wild animal species act as reservoirs for these pathogens, which may be viruses, bacteria or parasites. Given the extensive distribution of the animal species affected, the effective surveillance, prevention and control of zoonotic diseases pose a significant challenge. There are direct and indirect implications for public health of emerging zoonoses. Direct implications are defined as the consequences for human health in terms of morbidity and mortality. Indirect implications are defined as the effect of the influence of emerging zoonotic disease on health professionals and the general public. The tremendous indirect impact of emerging zoonotic diseases on public health policy and structures and on public perception of health risks is acknowledged. A biphasic approach for handling emerging zoonoses is proposed, i.e. a short- to intermediate-term response to an outbreak or emergency and a long-term comprehensive study of the ecology of the zoonotic pathogen. Resource-rich countries should invest in the establishment and strengthening of surveillance systems in resource-limited countries considering the international significance of emerging zoonoses. Based on the new international health regulations, emphasis should be placed on building the appropriate preparedness and response capacity in countries and on promoting intersectoral collaboration and coordination.

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

    Directory of Open Access Journals (Sweden)

    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.

  5. A Whole School Approach: Collaborative Development of School Health Policies, Processes, and Practices

    Science.gov (United States)

    Hunt, Pete; Barrios, Lisa; Telljohann, Susan K; Mazyck, Donna

    2015-01-01

    BACKGROUND The Whole School, Whole Community, Whole Child (WSCC) model shows the interrelationship between health and learning and the potential for improving educational outcomes by improving health outcomes. However, current descriptions do not explain how to implement the model. METHODS The existing literature, including scientific articles, programmatic guidance, and publications by national agencies and organizations, was reviewed and synthesized to describe an overview of interrelatedness of learning and health and the 10 components of the WSCC model. RESULTS The literature suggests potential benefits of applying the WSCC model at the district and school level. But, the model lacks specific guidance as to how this might be made actionable. A collaborative approach to health and learning is suggested, including a 10-step systematic process to help schools and districts develop an action plan for improving health and education outcomes. Essential preliminary actions are suggested to minimize the impact of the challenges that commonly derail systematic planning processes and program implementation, such as lack of readiness, personnel shortages, insufficient resources, and competing priorities. CONCLUSIONS All new models require testing and evidence to confirm their value. District and schools will need to test this model and put plans into action to show that significant, substantial, and sustainable health and academic outcomes can be achieved. PMID:26440822

  6. Communicable disease control programmes and health systems: an analytical approach to sustainability.

    Science.gov (United States)

    Shigayeva, Altynay; Coker, Richard J

    2015-04-01

    There is renewed concern over the sustainability of disease control programmes, and re-emergence of policy recommendations to integrate programmes with general health systems. However, the conceptualization of this issue has remarkably received little critical attention. Additionally, the study of programmatic sustainability presents methodological challenges. In this article, we propose a conceptual framework to support analyses of sustainability of communicable disease programmes. Through this work, we also aim to clarify a link between notions of integration and sustainability. As a part of development of the conceptual framework, we conducted a systematic literature review of peer-reviewed literature on concepts, definitions, analytical approaches and empirical studies on sustainability in health systems. Identified conceptual proposals for analysis of sustainability in health systems lack an explicit conceptualization of what a health system is. Drawing upon theoretical concepts originating in sustainability sciences and our review here, we conceptualize a communicable disease programme as a component of a health system which is viewed as a complex adaptive system. We propose five programmatic characteristics that may explain a potential for sustainability: leadership, capacity, interactions (notions of integration), flexibility/adaptability and performance. Though integration of elements of a programme with other system components is important, its role in sustainability is context specific and difficult to predict. The proposed framework might serve as a basis for further empirical evaluations in understanding complex interplay between programmes and broader health systems in the development of sustainable responses to communicable diseases.

  7. Using a social justice approach to prevent the mental health consequences of heterosexism.

    Science.gov (United States)

    Matthews, Connie R; Adams, Eve M

    2009-01-01

    Albee's social justice approach to prevention offers a framework for understanding the detrimental effect of heterosexism on lesbian, gay, and bisexual (LGB) people. Minority stress models likewise address the role of discrimination and other social injustices in contributing to psychological distress in minority populations. This article describes Albee's framework in the context of minority stress theory as it applies to LGB people and suggests activities mental health professionals can engage in to help prevent the psychological consequences of heterosexism.

  8. Environmental health risk assessment of ambient lead levels in Lisbon, Portugal: A full chain study approach

    DEFF Research Database (Denmark)

    Casimiro, E.; Philippe Ciffroy, P.; Serpa, P.;

    2011-01-01

    The multi-causality interactions between environment and health are complex and call for an integrated multidisciplinary study approach. Emerging computational toxicology tools that link toxicology, chemistry, environmental sciences, biostatistics, and computer sciences are proving to be very...... useful for integrated full-chain human health risk assessments. In this study we use a newly developed computational tool – the 2FUN player to conduct a full-chain assessment combining measured ambient air lead concentrations with multi-media modelling and PBPK simulations to estimate the health risks...... from ambient air levels of lead in air-borne particulates (PM10) in Lisbon, Portugal. Ambient air Pb concentrations were used together with local climate variables in the 2FUN atmospheric model to calculate the amount of Pb deposited (wet and dry) onto soil. The 2FUN environmental and PBPK models were...

  9. Continuous quality improvement in acute health care: creating a holistic and integrated approach.

    Science.gov (United States)

    Sewell, N

    1997-01-01

    Reviews the range of quality activity in a National Health Service hospital trust, using a staff questionnaire survey, self-assessment against the Baldrige Quality Award criteria, and the application of the SERVQUAL approach to service quality assessment. Reviews the acute health care quality programme literature. Finds that there are needs for greater integration of quality effort, to engage with patients in a more meaningful manner, and to achieve greater commitment and involvement from clinicians and managers. Identifies lack of time and resources as a major barrier to greater application of quality programmes. Explores ways of developing a more holistic and integrated programme of quality improvement. Describes the creation and implementation of a model for continuous improvement in health care quality.

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

    DEFF Research Database (Denmark)

    Jæger, Kirsten

    2012-01-01

    Even in the Scandinavian countries, where welfare resources such as education and healthcare are offered wholly or partly free of charge, health disparities between the majority populations and ethnic minority groups challenge the national healthcare systems. The knowledge levels of health...... 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...

  11. Electronic health records approaches and challenges: a comparison between Malaysia and four East Asian countries.

    Science.gov (United States)

    Abd Ghani, Mohd Khanapi; Bali, Rajeev K; Naguib, Raouf N G; Marshall, Ian M

    2008-01-01

    An integrated Lifetime Health Record (LHR) is fundamental for achieving seamless and continuous access to patient medical information and for the continuum of care. However, the aim has not yet been fully realised. The efforts are actively progressing around the globe. Every stage of the development of the LHR initiatives had presented peculiar challenges. The best lessons in life are those of someone else's experiences. This paper presents an overview of the development approaches undertaken by four East Asian countries in implementing a national Electronic Health Record (EHR) in the public health system. The major challenges elicited from the review including integration efforts, process reengineering, funding, people, and law and regulation will be presented, compared, discussed and used as lessons learned for the further development of the Malaysian integrated LHR.

  12. 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.

  13. 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.

  14. Health-related quality of life research and the capability approach of Amartya Sen.

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    Verkerk, M A; Busschbach, J J; Karssing, E D

    2001-01-01

    Standardised health-related quality of life questionnaires play an increasing role as measures of outcome in the evaluation of health care interventions. However, problems can arise when the selected functions or dimensions of such standardised measures are not in line with the intervention that is the focus of the research. Furthermore, the subjective element of quality of life makes standardised questionnaires vulnerable to the coping mechanism, thereby decreasing their sensitivity. The capability approach of the economist and philosopher Amartya Sen offers a descriptive concept that contributes to a better understanding of these problems. This article provides an introduction to the ideas of Sen for researchers who wish to go beyond the traditional framework of measuring health-related quality of life.

  15. Health outcomes for older Hispanics with HIV in New York City using the Oaxaca Decomposition Approach.

    Science.gov (United States)

    Dela Cruz, Juan J; Karpiak, Stephen E; Brennan-Ing, Mark

    2014-08-22

    Although HIV and aging are two well-established medical and economic domains, their intersection represents an emerging area of study. Older adults with HIV, who sill comprise 50% of the US HIV-infected population by 2015, are disadvantaged as evidenced by disproportionately poorer health outcomes. The Oaxaca Decomposition Approach (ODA) was used to analyze data from the Research on Older Adults with HIV (ROAH) Study of 1,000 older adults with HIV in New York City (NYC). This paper establishes the sources of health disparities for Hispanics with HIV compared to a match group of Non-Hispanics with HIV. The ODA analyses shows that Hispanics on average have higher levels of declining health and increased depression attributable to the discrimination factor.

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

    Science.gov (United States)

    Fissler, Patrick; Kolassa, Iris-Tatjana; Schrader, Claudia

    2015-01-01

    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.

  17. [Association between approach-avoidance commitment to romantic relationships, emotional experiences in romantic relationships, and personal mental health].

    Science.gov (United States)

    Komura, Kentaro

    2016-02-01

    The present study examined the association between approach-avoidance commitment, emotional experiences in romantic relationships, and mental health. It was hypothesized that the association between avoidance commitment and emotional experiences was moderated by approach commitment. Two hundred and three undergraduates who were involved in romantic relationships participated in a questionnaire survey. Results revealed that approach commitment was associated with greater positive emotion and less negative emotion, and these emotional experiences were associated with higher mental health. On the other hand, the association between avoidance commitment and emotional experiences was moderated by approach commitment. That is, only when approach commitment was weak, avoidance commitment was associated with fewer positive emotions and greater negative emotions, and that these emotional experiences were associated with lower mental health. These results reveal that approach-avoidance commitment was associated with mental health via emotional experiences in romantic relationships, and verified Johnson's (1999) and Levinger's (1999) theoretical argument.

  18. A quantile regression approach for modelling a Health-Related Quality of Life Measure

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    Giulia Cavrini

    2013-05-01

    Full Text Available Objective. The aim of this study is to propose a new approach for modeling the EQ-5D index and EQ-5D VAS in order to explain the lifestyle determinants effect using the quantile regression analysis. Methods. Data was collected within a cross-sectional study that involved a probabilistic sample of 1,622 adults randomly selected from the population register of two Health Authorities of Bologna in northern Italy. The perceived health status of people was measured using the EQ-5D questionnaire. The Visual Analogue Scale included in the EQ-5D Questionnaire, the EQ-VAS, and the EQ-5D index were used to obtain the synthetic measures of quality of life. To model EQ-VAS Score and EQ-5D index, a quantile regression analysis was employed. Quantile Regression is a way to estimate the conditional quantiles of the VAS Score distribution in a linear model, in order to have a more complete view of possible associations between a measure of Health Related Quality of Life (dependent variable and socio-demographic and determinants data. This methodological approach was preferred to an OLS regression because of the EQ-VAS Score and EQ-5D index typical distribution. Main Results. The analysis suggested that age, gender, and comorbidity can explain variability in perceived health status measured by the EQ-5D index and the VAS.

  19. A participatory approach to health promotion for informal sector workers in Thailand

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    Jittra Rukijkanpanich

    2010-07-01

    Full Text Available BACKGROUND: This study aims to promote occupational health in the informal sector in Thailand by using a participatory approach. The success of the intervention is based on an evaluation of the informal sector workers' a knowledge, attitudes, and behaviors in occupational health and safety, b work practice improvement, and c working condition improvement. METHODS: This study applies the Participatory Action Research (PAR method. The participants of the study consisted of four local occupations in different regions of Thailand, including a ceramic making group in the North, a plastic weaving group in the Central region, a blanket making group in the Northeast, and a pandanus weaving group in the South. Data was collected using both qualitative and quantitative methods through questionnaires, industrial hygiene instruments, and group discussions. RESULTS: The results showed that the working conditions of the informal sector were improved to meet necessary standards after completing the participatory process. Also, the post-test average scores on 1 the occupational health and safety knowledge, attitudes and behaviors measures and 2 the work practice improvement measures were significantly higher than the pre-test average scores (p=sig. CONCLUSIONS: The results demonstrate that the participatory approach is an effective tool to use when promoting the health safety of the informal sector and when encouraging the workers to voluntarily improve the quality of their own lives.

  20. Universal coverage challenges require health system approaches; the case of India.

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    Duran, Antonio; Kutzin, Joseph; Menabde, Nata

    2014-02-01

    This paper uses the case of India to demonstrate that Universal Health Coverage (UHC) is about not only health financing; personal and population services production issues, stewardship of the health system and generation of the necessary resources and inputs need to accompany the health financing proposals. In order to help policy makers address UHC in India and sort out implementation issues, the framework developed by the World Health Organization (WHO) in the World Health Report 2000 and its subsequent extensions are advocated. The framework includes final goals, generic intermediate objectives and four inter-dependent functions which interact as a system; it can be useful by diagnosing current shortcomings and facilitating the filling up of gaps between functions and goals. Different positions are being defended in India re the preconditions for UHC to succeed. This paper argues that more (public) money will be important, but not enough; it needs to be supplemented with broad interventions at various health system levels. The paper analyzes some of the most important issues in relation to the functions of service production, generation of inputs and the necessary stewardship. It also pays attention to reform implementation, as different from its design, and suggests critical aspects emanating from a review of recent health system reforms. Precisely because of the lack of comparative reference for India, emphasis is made on the need to accompany implementation with analysis, so that the "solutions" ("what to do?", "how to do it?") are found through policy analysis and research embedded into flexible implementation. Strengthening "evidence-to-policy" links and the intelligence dimension of stewardship/leadership as well as accountability during implementation are considered paramount. Countries facing similar challenges to those faced by India can also benefit from the above approaches.

  1. Networked remote area dental services: a viable, sustainable approach to oral health care in challenging environments.

    Science.gov (United States)

    Dyson, Kate; Kruger, Estie; Tennant, Marc

    2012-12-01

    This study examines the cost effectiveness of a model of remote area oral health service. Retrospective financial analysis. Rural and remote primary health services. Clinical activity data and associated cost data relating to the provision of a networked visiting oral health service by the Centre for Rural and Remote Oral Health formed the basis of the study data frameset. The cost-effectiveness of the Centre's model of service provision at five rural and remote sites in Western Australia during the calendar years 2006, 2008 and 2010 was examined in the study. Calculations of the service provision costs and value of care provided were made using data records and the Fee Schedule of Dental Services for Dentists. The ratio of service provision costs to the value of care provided was determined for each site and was benchmarked against the equivalent ratios applicable to large scale government sector models of service provision. The use of networked models have been effective in other disciplines but this study is the first to show a networked hub and spoke approach of five spokes to one hub is cost efficient in remote oral health care. By excluding special cost-saving initiatives introduced by the Centre, the study examines easily translatable direct service provision costs against direct clinical care outcomes in some of Australia's most challenging locations. This study finds that networked hub and spoke models of care can be financially efficient arrangements in remote oral health care. © 2012 The Authors. Australian Journal of Rural Health © National Rural Health Alliance Inc.

  2. Reusable design: A proposed approach to Public Health Informatics system design

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    Revere Debra

    2011-02-01

    Full Text Available Abstract Background Since it was first defined in 1995, Public Health Informatics (PHI has become a recognized discipline, with a research agenda, defined domain-specific competencies and a specialized corpus of technical knowledge. Information systems form a cornerstone of PHI research and implementation, representing significant progress for the nascent field. However, PHI does not advocate or incorporate standard, domain-appropriate design methods for implementing public health information systems. Reusable design is generalized design advice that can be reused in a range of similar contexts. We propose that PHI create and reuse information design knowledge by taking a systems approach that incorporates design methods from the disciplines of Human-Computer Interaction, Interaction Design and other related disciplines. Discussion Although PHI operates in a domain with unique characteristics, many design problems in public health correspond to classic design problems, suggesting that existing design methods and solution approaches are applicable to the design of public health information systems. Among the numerous methodological frameworks used in other disciplines, we identify scenario-based design and participatory design as two widely-employed methodologies that are appropriate for adoption as PHI standards. We make the case that these methods show promise to create reusable design knowledge in PHI. Summary We propose the formalization of a set of standard design methods within PHI that can be used to pursue a strategy of design knowledge creation and reuse for cost-effective, interoperable public health information systems. We suggest that all public health informaticians should be able to use these design methods and the methods should be incorporated into PHI training.

  3. Put the Family Back in Family Health History: A Multiple-Informant Approach.

    Science.gov (United States)

    Lin, Jielu; Marcum, Christopher S; Myers, Melanie F; Koehly, Laura M

    2017-05-01

    An accurate family health history is essential for individual risk assessment. This study uses a multiple-informant approach to examine whether family members have consistent perceptions of shared familial risk for four common chronic conditions (heart disease, Type 2 diabetes, high cholesterol, and hypertension) and whether accounting for inconsistency in family health history reports leads to more accurate risk assessment. In 2012-2013, individual and family health histories were collected from 127 adult informants of 45 families in the Greater Cincinnati Area. Pedigrees were linked within each family to assess inter-informant (in)consistency regarding common biological family member's health history. An adjusted risk assessment based on pooled pedigrees of multiple informants was evaluated to determine whether it could more accurately identify individuals affected by common chronic conditions, using self-reported disease diagnoses as a validation criterion. Analysis was completed in 2015-2016. Inter-informant consistency in family health history reports was 54% for heart disease, 61% for Type 2 diabetes, 43% for high cholesterol, and 41% for hypertension. Compared with the unadjusted risk assessment, the adjusted risk assessment correctly identified an additional 7%-13% of the individuals who had been diagnosed, with a ≤2% increase in cases that were predicted to be at risk but had not been diagnosed. Considerable inconsistency exists in individual knowledge of their family health history. Accounting for such inconsistency can, nevertheless, lead to a more accurate genetic risk assessment tool. A multiple-informant approach is potentially powerful when coupled with technology to support clinical decisions. Published by Elsevier Inc.

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

    Science.gov (United States)

    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.

  5. A decolonizing approach to health promotion in Canada: the case of the Urban Aboriginal Community Kitchen Garden Project.

    Science.gov (United States)

    Mundel, Erika; Chapman, Gwen E

    2010-06-01

    Aboriginal people in Canada suffer ill-health at much higher rates compared with the rest of the population. A key challenge is the disjuncture between the dominant biomedical approach to health in Canada and the holistic and integrative understandings of and approaches to health in many Aboriginal cultures. More fundamentally, colonization is at the root of the health challenges faced by this population. Thus, effective approaches to health promotion with Aboriginal people will require decolonizing practices. In this paper, we look at one case study of a health promotion project, the Urban Aboriginal Community Kitchen Garden Project in Vancouver, Canada, which, guided by the teachings of the Medicine Wheel, aims to provide culturally appropriate health promotion. By drawing on Aboriginal approaches to healing, acknowledging the legacy of colonization and providing a context for cultural celebration, we suggest that the project can be seen as an example of what decolonizing health promotion could look like. Further, we suggest that a decolonizing approach to health promotion has the potential to address immediate needs while simultaneously beginning to address underlying causes of Aboriginal health inequities.

  6. Approaches to health-care provider education and professional development in perinatal depression: a systematic review.

    Science.gov (United States)

    Legere, Laura E; Wallace, Katherine; Bowen, Angela; McQueen, Karen; Montgomery, Phyllis; Evans, Marilyn

    2017-07-24

    lack of strong research in multi-disciplinary, sector, site, and modal approaches to education and professional development for providers to identify and care for women at risk for, or experiencing, depression. To ensure optimal health outcomes, further research comparing diverse educational and professional development approaches is needed to identify the most effective strategies and consistently meet the needs of health-care providers. A protocol for this systematic review was registered on PROSPERO (Protocol number: CRD42015023701 ), June 21, 2015.

  7. Approaches to the Development of Human Health Toxicity Values for Active Pharmaceutical Ingredients in the Environment.

    Science.gov (United States)

    Sorell, Tamara L

    2016-01-01

    Management of active pharmaceutical ingredients (API) in the environment is challenging because these substances represent a large and diverse group of compounds. Advanced wastewater treatment technologies that can remove API tend to be costly. Because of the potential resources required to address API in the environment, there is a need to establish environmental benchmarks that can serve as targets for treatment and release. To date, there are several different approaches that have been taken to derive human health toxicity values for API. These methods include traditional risk assessment approaches that calculate "safe" doses using experimental data and uncertainty (safety) factors; point of departure (POD), which starts from a therapeutic human dose and applies uncertainty factors; and threshold of toxicological concern (TTC), a generic approach that establishes threshold values across broad classes of chemicals based on chemical structure. To evaluate the use of these approaches, each of these methods was applied to three API commonly encountered in the environment: acetaminophen, caffeine, and chlorpromazine. The results indicate that the various methods of estimating toxicity values produce highly varying doses. Associated doses are well below typical intakes, or toxicity thresholds cannot be derived due to a lack of information. No uniform approach can be applied to establishing thresholds for multiple substances. Rather, an individualized approach will need to be applied to each target API.

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

    Science.gov (United States)

    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.

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

    Science.gov (United States)

    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.

  10. Using a human resource management approach to support community health workers: experiences from five African countries.

    Science.gov (United States)

    Raven, Joanna; Akweongo, Patricia; Baba, Amuda; Baine, Sebastian Olikira; Sall, Mohamadou Guelaye; Buzuzi, Stephen; Martineau, Tim

    2015-09-01

    Like any other health worker, community health workers (CHWs) need to be supported to ensure that they are able to contribute effectively to health programmes. Management challenges, similar to those of managing any other health worker, relate to improving attraction, retention and performance. Exploratory case studies of CHW programmes in the Democratic Republic of Congo, Ghana, Senegal, Uganda and Zimbabwe were conducted to provide an understanding of the practices for supporting and managing CHWs from a multi-actor perspective. Document reviews (n = 43), in-depth interviews with programme managers, supervisors and community members involved in managing CHWs (n = 31) and focus group discussions with CHWs (n = 13) were conducted across the five countries. Data were transcribed, translated and analysed using the framework approach. CHWs had many expectations of their role in healthcare, including serving the community, enhancing skills, receiving financial benefits and their role as a CHW fitting in with their other responsibilities. Many human resource management (HRM) practices are employed, but how well they are implemented, the degree to which they meet the expectations of the CHWs and their effects on human resource (HR) outcomes vary across contexts. Front-line supervisors, such as health centre nurses and senior CHWs, play a major role in the management of CHWs and are central to the implementation of HRM practices. On the other hand, community members and programme managers have little involvement with managing the CHWs. This study highlighted that CHW expectations are not always met through HRM practices. This paper calls for a coordinated HRM approach to support CHWs, whereby HRM practices are designed to not only address expectations but also ensure that the CHW programme meets its goals. There is a need to work with all three groups of management actors (front-line supervisors, programme managers and community members) to ensure the use of an effective

  11. 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.

  12. Assessing socioeconomic health care utilization inequity in Israel: impact of alternative approaches to morbidity adjustment

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    Balicer Ran D

    2011-08-01

    Full Text Available Background The ability to accurately detect differential resource use between persons of different socioeconomic status relies on the accuracy of health-needs adjustment measures. This study tests different approaches to morbidity adjustment in explanation of health care utilization inequity. Methods A representative sample was selected of 10 percent (~270,000 adult enrolees of Clalit Health Services, Israel's largest health care organization. The Johns-Hopkins University Adjusted Clinical Groups® were used to assess each person's overall morbidity burden based on one year's (2009 diagnostic information. The odds of above average health care resource use (primary care visits, specialty visits, diagnostic tests, or hospitalizations were tested using multivariate logistic regression models, separately adjusting for levels of health-need using data on age and gender, comorbidity (using the Charlson Comorbidity Index, or morbidity burden (using the Adjusted Clinical Groups. Model fit was assessed using tests of the Area Under the Receiver Operating Characteristics Curve and the Akaike Information Criteria. Results Low socioeconomic status was associated with higher morbidity burden (1.5-fold difference. Adjusting for health needs using age and gender or the Charlson index, persons of low socioeconomic status had greater odds of above average resource use for all types of services examined (primary care and specialist visits, diagnostic tests, or hospitalizations. In contrast, after adjustment for overall morbidity burden (using Adjusted Clinical Groups, low socioeconomic status was no longer associated with greater odds of specialty care or diagnostic tests (OR: 0.95, CI: 0.94-0.99; and OR: 0.91, CI: 0.86-0.96, for specialty visits and diagnostic respectively. Tests of model fit showed that adjustment using the comprehensive morbidity burden measure provided a better fit than age and gender or the Charlson Index. Conclusions Identification of

  13. Operationalising the capability approach for outcome measurement in mental health research.

    Science.gov (United States)

    Simon, Judit; Anand, Paul; Gray, Alastair; Rugkåsa, Jorun; Yeeles, Ksenija; Burns, Tom

    2013-12-01

    Amartya Sen's multidimensional capability approach focuses on the importance of freedoms to be or do things people have reason to value. It is an alternative to standard utilitarian welfarism, the theoretical approach to quality-adjusted life years (QALYs) and cost-utility analyses. Despite the limitations of the utility approach in capturing non-health benefits and broader welfare inequalities, there have been very limited applications of the capability approach in the mental health context where these issues are imperative. We report the development and application of a multidimensional instrument, the OxCAP-MH, which aims to operationalise the capability approach for outcome measurement in mental health research. The study was carried out as part of an ongoing programme on community coercion experienced by service users with severe and enduring mental illness being treated using Community Treatment Orders. Capabilities data were collected at baseline in the OCTET RCT for 333 'revolving door' mental health service users who were in involuntary hospital treatment at the time of recruitment in England (2008-2011). The research focused on the identification of capabilities domains most affected by mental illness and their association with socio-demographic and clinical factors and other measures of well-being such as the EQ-5D and Global Assessment of Functioning (GAF) scales. The OxCAP-MH item response rate was 90%-68%. There were significant correlations between service users' overall capability scores and the GAF, EQ-5D VAS and EQ-5D-3L utilities (corr = 0.249, 0.514, 0.415, respectively). The most affected capability domains were: 'Daily activities', 'Influencing local decisions', 'Enjoying recreation', 'Planning one's life' and 'Discrimination'. Age had a mixed effect, while female service users and those with a primary diagnosis of schizophrenia or longer illness duration reported significantly lower capability scores. The results support the feasibility and

  14. Exploring the relationship between childhood adversity and oral health: An anecdotal approach and integrative view.

    Science.gov (United States)

    Kirkengen, Anna Luise; Lygre, Henning

    2015-08-01

    During the past two decades, increasing recognition has been given to a relationship between oral health and systemic diseases. Associated systemic conditions include cardiovascular disease, diabetes, low birth weight and preterm births, respiratory diseases, rheumatoid arthritis, obesity, osteoporosis, and, in particular among oral conditions, periodontal disease. Low-grade inflammation is a common denominator linking these disorders. Applying an anecdotal approach and an integrative view, the medical and dental histories of two women document increasing ill health subsequent to incidences of maltreatment and sexual abuse, including oral penetration, at an early age. Comprehensive oral rehabilitation was required in both cases. These cases open for medical insight with regard to their implicit patho-physiology, when integrated with current evidence from neuroscience, endocrinology, and immunology, converging in the concepts of allostasis and allostatic load. In cases such as those presented in this paper, primary care physicians (family doctors, General Practitioners) and dentists may be the first to identify an etiological pattern. This report underlines the importance of increased and enhanced multidisciplinary research cooperation among health professionals. Our hypothesis is that childhood adversity may affect all aspects of human health, including adult oral health.

  15. The health promoting sports club in Finland--a challenge for the settings-based approach.

    Science.gov (United States)

    Kokko, Sami; Kannas, Lasse; Villberg, Jari

    2006-09-01

    The purpose of this article is, first, to compile a frame of reference for the health promoting sports club and, second, to develop standards for the concept. This concept is based on the settings-based health promotion approach. Sports clubs are a new setting for health promotion, which until now has been little examined from a settings point of view. Nevertheless, this concept has much potential. For example, sports clubs attract a large number of children and adolescents and their educational nature can be considered to be informal. The present standards were developed using the Delphi method. The researcher, in cooperation with a panel of experts (experts in health promotion, n = 11, and experts in sports clubs, n = 16), sought to create a consensus statement on the standards. At the preliminary stage of the study 64 original standards were created on the basis of existing literature and the principles of the Ottawa Charter. During the three rounds of the Delphi process 15 standards were evaluated as the most important. After the Delphi process, the researcher modified the standards by eliminating overlap, interpolating seven standards to involve all strategic areas of the Ottawa Charter and creating a preliminary typology of the standards. At the subsequent stages of the study, indicators for these standards will be drafted and tested in practice. Therefore, this study would provide tools for determining and evaluating how health promoting a particular sports club is.

  16. Ten approaches for enhancing empathy in health and human services cultures.

    Science.gov (United States)

    Hojat, Mohammadreza

    2009-01-01

    Empathy is defined as a predominantly cognitive attribute that involves an understanding of experiences, concerns and perspectives of another person, combined with a capacity to communicate this understanding. Empathy in the context of clinical care can lead to positive patient outcomes including greater patient satisfaction and compliance, lower rates of malpractice litigation, lower cost of medical care, and lower rate of medical errors. Also, health professionals' wellbeing is associated with higher empathy. Enhancing empathic engagement in patient care is one of the important tasks of medical education. In this article, I briefly describe 10 approaches for enhancing empathy in the health care environment: improving interpersonal skills, audio- or video-taping of encounters with patients, exposure to role models, role playing (aging game), shadowing a patient (patient navigator), hospitalization experiences, studying literature and the arts, improving narrative skills, theatrical performances, and the Balint method. I conclude that empathic engagement in the health care and human services is beneficial not only to the patients, but also to physicians, other health care providers, administrators, managers, health care institutions, and the public at large.

  17. HACCP-based quality risk management approach to udder health problems on dairy farms

    Directory of Open Access Journals (Sweden)

    Noordhuizen JPTM

    2009-04-01

    Full Text Available Abstract Against the background of prevailing udder health problems on dairy farms, this paper discusses a new approach to mastitis control. Current udder health control programmes, such as the 'five-point plan', are highlighted and their drawbacks indicated. The concept and principles of hazard analysis critical control points (HACCP are introduced. The eight core elements of this concept are dealt with by using the example of a dairy herd with a mastitis problem due to Staphylococcus aureus. The various steps to be taken in the development of a HACCP-based quality risk management programme are illustrated through the application of core elements. Finally, it is shown that the HACCP key words, structure, organisation, planning, communication and formalisation; which do not frequently appear in conventional herd health and production management programmes can contribute to better udder health. The role of the veterinarian can be paramount and of added value, if he/she is willing to invest in new knowledge and skills, such as the HACCP concept, farm economics, animal nutrition, and particularly the role of coach to the dairy farmer in the implementation of preventative measures in relation to udder health.

  18. NDE using sensor based approach to propulsion health monitoring of a turbine engine disk

    Science.gov (United States)

    Abdul-Aziz, Ali; Woike, Mark R.; Abumeri, G.; Lekki, John D.; Baaklini, George Y.

    2009-03-01

    Rotor health monitoring and on-line damage detection have been increasingly gaining interest to manufacturers of aircraft engines, primarily to increase safety of operation and lower the high maintenance costs. But health monitoring in the presence of scatter in the loading conditions, crack size, disk geometry, and material property is rather challenging. However, detection factors that cause fractures and hidden internal cracks can be implemented via noninvasive types of health monitoring and or nondestructive evaluation techniques. These evaluations go further to inspect materials discontinuities and other anomalies that have grown to become critical defects that can lead to failure. To address the bulk of these concerning issues and understand the technical aspects leading to these outcomes, a combined analytical and experimental study is being thought. Results produced from the experiments such as blade tip displacement and other data collected from tests conducted at the NASA Glenn Research Center's Rotordynamics Laboratory, a high precision spin rig, are evaluated, discussed and compared with data predicted from finite element analysis simulating the engine rotor disk spinning at various rotational speeds. Further computations using the progressive failure analysis (PFA) approach with GENOA code [6] to additionally assess the structural response, damage initiation, propagation, and failure criterion are also performed. This study presents an inclusive evaluation of an on-line health monitoring of a rotating disk and an examination for the capability of the in-house spin system in support of ongoing research under the NASA Integrated Vehicle Health Management (IVHM) program.

  19. [Regular bike use in Nantes: a combined health and mobility approach].

    Science.gov (United States)

    Gassiot, Marion; Guyard, Fabrice; Bedok, Hadrien; Héritage, Zoë; Hemery, Céline; Saraux-Salaün, Patricia

    2016-06-08

    The health benefits of regular physical activity have now been clearly established. Two initiatives developed in Nantes allowed estimation of the benefits as perceived by local authorities as well as the motivations of cyclists and the general population. The City Council and the metropolitan area of Greater Nantes used the HEAT tool, which identifies the economic health benefit of increasing active forms of transport at the population level. The number of deaths avoided and the economic benefits were calculated by using both current and 2030-projected cycling rates and mortality rates. HEAT shows that, at current cycling rates, the health benefits result in 120 deaths avoided over 10 years for the city of Nantes (260 for the metropolitan area) with an economic benefit of €461,000,000 (€1,005,000,000 for the metropolitan area). A study of bike usage carried out in Greater Nantes based on interviews of cyclists and the general population showed that health and well-being were the leading reasons cited for cycling. The study showed an overrepresentation of academically-qualified men amongst cyclists. This inter-sectorial approach reinforced the exchanges between politicians and staff in both the transport and health sectors. It also allowed sharing of objectives and joint actions notably in the form of the 2015-2020 Cycling Plan, which is designed to promote cycling among people not currently using this modality. .

  20. Utility of syndromic approach in management of sexually transmitted infections:public health perspective

    Institute of Scientific and Technical Information of China (English)

    Prateek Saurabh Shrivastava; Jegadeesh Ramasamy

    2014-01-01

    Sexually transmitted infections (STIs) are infections that are mainly transmitted from person-to-person through sexual contact. Untreated or inadequately treated STIs can have significant impact on the maternal and newborn health. An extensive search of all materials related to the topic was made using library sources including PubMed, Medline and World Health Organization website for a period of one month. Relevant documents, technical publication series, systematic reviews, research articles focusing on the practice of syndromic management in treatment of STIs published in the period 1995-2013 were included in the review. The identified articles were then re-grouped into different sections for better understanding. Keywords used in the search include syndromic management, sexually transmitted infections, women, reproductive age-group and pregnancy. There is an immense need for implementation of prevention and control of STIs because of the associated morbidity/mortality, association with HIV and adverse outcomes of pregnancy and burdening of the health system. Multiple socio-demographic determinants have been identified, which usually precipitates STIs. In addition, some of the barriers have been recognized which is hampering with the expected utilization of the health care services. To counter the high prevalence of reproductive tract infection/STI, especially in countries with limited resources, syndromic diagnostic approach has been adopted by countries for the standardized management of sexually transmitted disease cases. The aim of syndromic management is to identify a syndrome and treat it accordingly with combination therapy which will cover the main pathogens that cause it. Strategies have been suggested to overcome the limitations of the syndromic approach and bring the problem under control. To conclude, syndromic management is a rapid and cost-effective approach in reducing the transmission of STIs.

  1. Stabilizing Dog Populations and Improving Animal and Public Health Through a Participatory Approach in Indigenous Communities.

    Science.gov (United States)

    Schurer, J M; Phipps, K; Okemow, C; Beatch, H; Jenkins, E

    2015-09-01

    Free-roaming dog populations are a global concern for animal and human health including transmission of infectious disease (e.g. rabies, distemper and parasites), dog bite injuries/mortalities, animal welfare and adverse effects on wildlife. In Saskatchewan (SK), Canada, veterinary care is difficult to access in the remote and sparsely inhabited northern half of the province, where the population is predominately Indigenous. Even where veterinary clinics are readily available, there are important barriers such as cost, lack of transportation, unique cultural perspectives on dog husbandry and perceived need for veterinary care. We report the effects of introducing a community action plan designed to improve animal and human health, increase animal health literacy and benefit community well-being in two Indigenous communities where a dog-related child fatality recently occurred. Initial door-to-door dog demographic surveys indicated that most dogs were sexually intact (92% of 382 dogs), and few had ever been vaccinated (6%) or dewormed (6%). Approximately three animal-related injuries requiring medical care were reported in the communities per 1000 persons per year (95% CL: 1.6-6.6), and approximately 86% of 145 environmentally collected dog faecal samples contained parasites, far above levels reported in other urban or rural settings in SK. Following two subsidized spay/neuter clinics and active rehoming of dogs, parasite levels in dog faeces decreased significantly (P < 0.001), and important changes were observed in the dog demographic profile. This project demonstrates the importance of engaging people using familiar, local resources and taking a community specific approach. As well, it highlights the value of integrated, cross-jurisdictional cooperation, utilizing the resources of university researchers, veterinary personnel, public health, environmental health and community-based advocates to work together to solve complex issues in One Health. On

  2. Awareness in nine countries: a public health approach to suicide prevention.

    Science.gov (United States)

    Hoven, Christina W; Wasserman, Danuta; Wasserman, Camilla; Mandell, Donald J

    2009-04-01

    Suicide is an important public health problem, increasing worldwide, and on a yearly basis accounting for the death of more than one million people, with estimates as high as 10-20 times that many attempting to take their own life. Because successful suicide prevention depends upon recognition of symptoms of mental ill-health, awareness of these signs is a necessary precondition. The ability and responsibility for recognizing signs and symptoms of suicide, until most recently, however, was the exclusive purview of mental health professionals. Lately, there have been efforts to screen high risk populations and to train others to effectively respond to suicidal behavior, including classic first responders, primary care providers, hot line operators, teachers, etc. But what about everyone else who may have an opportunity to prevent a suicide simply by knowing when to ask questions, what to listen for, and understanding when additional assistance is warranted? What about the suicidal person who wants to tell someone about their distress but "knows" that such a conversation will not help nor be well-received? Where does a person living where mental health services are lacking or are beyond one's financial means turn to for relief and assistance? Does not Public Health have something to offer in response to these pressing questions? In 2002-2005, a study was carried out in nine countries, distributed over five continents, under the auspices and support of the Presidential Commission of the World Psychiatric Association (WPA), the World Health Organization (WHO), and the International Association of Child and Adolescent Psychiatry and Allied Professions (IACAPAP), to test the feasibility and effectiveness of raising awareness and increasing knowledge about child mental health, including suicidality, among students, teachers and parents. Implications for this approach as a model for suicide prevention are presented.

  3. Neighborhoods and adolescent health-risk behavior: an ecological network approach.

    Science.gov (United States)

    Browning, Christopher R; Soller, Brian; Jackson, Aubrey L

    2015-01-01

    This study integrates insights from social network analysis, activity space perspectives, and theories of urban and spatial processes to present an novel approach to neighborhood effects on health-risk behavior among youth. We suggest spatial patterns of neighborhood residents' non-home routines may be conceptualized as ecological, or "eco"-networks, which are two-mode networks that indirectly link residents through socio-spatial overlap in routine activities. We further argue structural configurations of eco-networks are consequential for youth's behavioral health. In this study we focus on a key structural feature of eco-networks--the neighborhood-level extent to which household dyads share two or more activity locations, or eco-network reinforcement--and its association with two dimensions of health-risk behavior, substance use and delinquency/sexual activity. Using geographic data on non-home routine activity locations among respondents from the Los Angeles Family and Neighborhood Survey (L.A.FANS), we constructed neighborhood-specific eco-networks by connecting sampled households to "activity clusters," which are sets of spatially-proximate activity locations. We then measured eco-network reinforcement and examined its association with dimensions of adolescent health risk behavior employing a sample of 830 youth ages 12-17 nested in 65 census tracts. We also examined whether neighborhood-level social processes (collective efficacy and intergenerational closure) mediate the association between eco-network reinforcement and the outcomes considered. Results indicated eco-network reinforcement exhibits robust negative associations with both substance use and delinquency/sexual activity scales. Eco-network reinforcement effects were not explained by potential mediating variables. In addition to introducing a novel theoretical and empirical approach to neighborhood effects on youth, our findings highlight the importance of intersecting conventional routines for

  4. The Voice of Chinese Health Consumers: A Text Mining Approach to Web-Based Physician Reviews.

    Science.gov (United States)

    Hao, Haijing; Zhang, Kunpeng

    2016-05-10

    skills and bedside manner, general appreciation from patients, and description of various symptoms. To the best of our knowledge, our work is the first study using an automated text-mining approach to analyze a large amount of unstructured textual data of Web-based physician reviews in China. Based on our analysis, we found that Chinese reviewers mainly concentrate on a few popular topics. This is consistent with the goal of Chinese online health platforms and demonstrates the health care focus in China's health care system. Our text-mining approach reveals a new research area on how to use big data to help health care providers, health care administrators, and policy makers hear patient voices, target patient concerns, and improve the quality of care in this age of patient-centered care. Also, on the health care consumer side, our text mining technique helps patients make more informed decisions about which specialists to see without reading thousands of reviews, which is simply not feasible. In addition, our comparison analysis of Web-based physician reviews in China and the United States also indicates some cultural differences.

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

    Science.gov (United States)

    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.…

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

    Science.gov (United States)

    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…

  7. 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.

  8. Disseminating perinatal depression screening as a public health initiative: a train-the-trainer approach.

    Science.gov (United States)

    Segre, Lisa S; Brock, Rebecca L; O'Hara, Michael W; Gorman, Laura L; Engeldinger, Jane

    2011-08-01

    This case report describes the development and implementation of the Train-the-Trainer: Maternal Depression Screening Program (TTT), a novel approach to disseminating perinatal depression screening. We trained screeners according to a standard pyramid scheme of train-the-trainer programs: three experts trained representatives from health care agencies (the TTT trainers), who in turn trained their staff and implemented depression screening at their home agencies. The TTT trainers had little or no prior mental health experience so "enhanced" components were added to ensure thorough instruction. Although TTT was implemented primarily as a services project, we evaluated both the statewide dissemination and the screening rates achieved by TTT programs. Thirty-two social service or health agencies implemented maternal depression screening in 20 counties throughout Iowa; this reached 58.2% of the Iowa population. For the 16 agencies that provided screening data, the average screening rate (number of women screened/number eligible to be screened) for the first 3 months of screening was 73.2%, 80.5% and 79.0%. We compared screening rates of our TTT programs with those of Healthy Start, a program in which screening was established via an intensive consultation model. We found the screening rates in 62.5% of TTT agencies were comparable to those in Healthy Start. Our "enhanced" train-the-trainer method is a promising approach for broadly implementing depression-screening programs in agencies serving pregnant and postpartum women.

  9. Key components and potential benefits of a comprehensive approach to women's musculoskeletal health.

    Science.gov (United States)

    Goldring, Anne E; Ashok, Annie P; Casey, Ellen K; Mulcahey, Mary K

    2016-11-01

    Over the last 40 years there has been a significant increase in the number of female athletes, as well as a rise in musculoskeletal injuries observed in women. There is sufficient evidence from past medical research identifying various musculoskeletal injuries and conditions that more commonly affect women, such as osteoarthritis, osteoporosis, stress fractures, and anterior cruciate ligament tears. Several women's sports medicine and musculoskeletal health programs have been developed throughout the United States in an attempt to provide more tailored care to the female athlete. The goal of a comprehensive approach to women's musculoskeletal health is to create an interdisciplinary team to facilitate treatment for a variety of injuries and related conditions. This manuscript outlines the musculoskeletal conditions that commonly affect women and highlights the various etiologies of these sex disparities. We discuss the role of interdisciplinary women's musculoskeletal health and sports medicine programs, and define the potential benefits of such an approach. Future studies should focus on assessing the outcomes of multidisciplinary women's sports medicine programs as current literature in this area is lacking.

  10. Triple P-Positive Parenting Program as a public health approach to strengthening parenting.

    Science.gov (United States)

    Sanders, Matthew R

    2008-08-01

    Parenting programs have considerable potential to improve the mental health and well-being of children, improve family relationships, and benefit the community at large. However, traditional clinical models of service delivery reach relatively few parents. A public health approach is needed to ensure that more parents benefit and that a societal-level impact is achieved. The Triple P-Positive Parenting Program is a comprehensive, multilevel system of parenting intervention that combines within a single intervention universal and more targeted interventions for high-risk children and their parents. With Triple P, the overarching goal is to enhance the knowledge, skills, and confidence of parents at a whole-of-population level and, in turn, to reduce the prevalence rates of behavioral and emotional problems in children and adolescents. The distinguishing features of the intervention and variables that influence its effective implementation are discussed. Self-regulation is a unifying concept that is applied throughout the entire system (e.g., to interactions between children, parents, service providers, and agencies involved in delivering the intervention). Challenges and future directions for the development of public health approaches to parenting are discussed.

  11. Towards One Health disease surveillance: The Southern African Centre for Infectious Disease Surveillance approach

    Directory of Open Access Journals (Sweden)

    Esron D. Karimuribo

    2012-06-01

    Full Text Available Africa has the highest burden of infectious diseases in the world and yet the least capacity for its risk management. It has therefore become increasingly important to search for ‘fit-for- purpose’ approaches to infectious disease surveillance and thereby targeted disease control. The fact that the majority of human infectious diseases are originally of animal origin means we have to consider One Health (OH approaches which require inter-sectoral collaboration for custom-made infectious disease surveillance in the endemic settings of Africa. A baseline survey was conducted to assess the current status and performance of human and animal health surveillance systems and subsequently a strategy towards OH surveillance system was developed. The strategy focused on assessing the combination of participatory epidemiological approaches and the deployment of mobile technologies to enhance the effectiveness of disease alerts and surveillance at the point of occurrence, which often lies in remote areas. We selected three study sites, namely the Ngorongoro, Kagera River basin and Zambezi River basin ecosystems. We have piloted and introduced the next-generation Android mobile phones running the EpiCollect application developed by Imperial College to aid geo-spatial and clinical data capture and transmission of this data from the field to the remote Information Technology (IT servers at the research hubs for storage, analysis, feedback and reporting. We expect that the combination of participatory epidemiology and technology will significantly improve OH disease surveillance in southern Africa.

  12. Improving health in cities through systems approaches for urban water management.

    Science.gov (United States)

    Rietveld, L C; Siri, J G; Chakravarty, I; Arsénio, A M; Biswas, R; Chatterjee, A

    2016-03-08

    As human populations become more and more urban, decision-makers at all levels face new challenges related to both the scale of service provision and the increasing complexity of cities and the networks that connect them. These challenges may take on unique aspects in cities with different cultures, political and institutional frameworks, and at different levels of development, but they frequently have in common an origin in the interaction of human and environmental systems and the feedback relationships that govern their dynamic evolution. Accordingly, systems approaches are becoming recognized as critical to understanding and addressing such complex problems, including those related to human health and wellbeing. Management of water resources in and for cities is one area where such approaches hold real promise. This paper seeks to summarize links between water and health in cities and outline four main elements of systems approaches: analytic methods to deal with complexity, interdisciplinarity, transdisciplinarity, and multi-scale thinking. Using case studies from a range of urban socioeconomic and regional contexts (Maputo, Mozambique; Surat and Kolkata, India; and Vienna, Austria). We show how the inclusion of these elements can lead to better research design, more effective policy and better outcomes.

  13. Two approaches to improving mental health care: positivist/quantitative versus skill-based/qualitative.

    Science.gov (United States)

    Luchins, Daniel

    2012-01-01

    The quality improvement model currently used in medicine and mental health was adopted from industry, where it developed out of early 20th-century efforts to apply a positivist/quantitative agenda to improving manufacturing. This article questions the application of this model to mental health care. It argues that (1) developing "operational definitions" for something as value-laden as "quality" risks conflating two realms, what we measure with what we value; (2) when measurements that are tied to individuals are aggregated to establish benchmarks and goals, unwarranted mathematical assumptions are made; (3) choosing clinical outcomes is problematic; (4) there is little relationship between process measures and clinical outcomes; and (5) since changes in quality indices do not relate to improved clinical care, management's reliance on such indices provides an illusory sense of control. An alternative model is the older, skill-based/qualitative approach to knowing, which relies on "implicit/ expert" knowledge. These two approaches offer a series of contrasts: quality versus excellence, competence versus expertise, management versus leadership, extrinsic versus intrinsic rewards. The article concludes that we need not totally dispense with the current quality improvement model, but rather should balance quantitative efforts with the older qualitative approach in a mixed methods model.

  14. 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.

    2016-01-01

    Background: 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. Objectives: 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). Discussion: 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. Conclusions: 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 PMID:27352407

  15. The 'diagonal' approach to Global Fund financing: a cure for the broader malaise of health systems?

    Directory of Open Access Journals (Sweden)

    Baker Brook K

    2008-03-01

    Full Text Available Abstract Background The potentially destructive polarisation between 'vertical' financing (aiming for disease-specific results and 'horizontal' financing (aiming for improved health systems of health services in developing countries has found its way to the pages of Foreign Affairs and the Financial Times. The opportunity offered by 'diagonal' financing (aiming for disease-specific results through improved health systems seems to be obscured in this polarisation. In April 2007, the board of the Global Fund to fight AIDS, Tuberculosis and Malaria agreed to consider comprehensive country health programmes for financing. The new International Health Partnership Plus, launched in September 2007, will help low-income countries to develop such programmes. The combination could lead the Global Fund to fight AIDS, Tuberculosis and Malaria to a much broader financing scope. Discussion This evolution might be critical for the future of AIDS treatment in low-income countries, yet it is proposed at a time when the Global Fund to fight AIDS, Tuberculosis and Malaria is starved for resources. It might be unable to meet the needs of much broader and more expensive proposals. Furthermore, it might lose some of its exceptional features in the process: its aim for international sustainability, rather than in-country sustainability, and its capacity to circumvent spending restrictions imposed by the International Monetary Fund. Summary The authors believe that a transformation of the Global Fund to fight AIDS, Tuberculosis and Malaria into a Global Health Fund is feasible, but only if accompanied by a substantial increase of donor commitments to the Global Fund. The transformation of the Global Fund into a 'diagonal' and ultimately perhaps 'horizontal' financing approach should happen gradually and carefully, and be accompanied by measures to safeguard its exceptional features.

  16. Women Health and Psychological Functioning in Different Periods of Life: Evaluation of Nursing Approach

    Directory of Open Access Journals (Sweden)

    Fusun Terzioglu

    2011-03-01

    Full Text Available World Health Organization describes health as the state of being completely fine corporally, socially and psychologically. The state of being completely fine which is indicated in this description of health has been criticised by many scientists and with the idea that noone shall ever realise tha state of being completely fine corporally and psychologically, it was emphasized that individuals could be evaluated to be “healthy” as long as they are productive. Starting from the intrauterine period, woman passes through different periods such as childhood, adolescence, adulthood, elderliness and she experiences some physical, psychological and social differences in each of these periods within the frame of life cycle. While these differences influence productivities and life qualities of women negatively, they also make them more inclined to psychiatric illnesses. Therefore, psychological problems are more common among women and they last longer. Considering the fact that among the medical personnel, it is the nurses who spend time with patients during the phases of diagnosis, treatment and rehabilitation the most, it could be said that nurses have a significant role in intervening in problems that affect the psychological health of woman. The nurse has responsibilities such as determining the problem the woman goes through, providing protective care, getting an early diagnosis, making the convenient remedial intervention and consigning, when necessary. In this article, significant woman health problems that could be experienced starting from the intrauterine life until the end of life by woman, the effects of this problem to the psychological health of the woman and nursing approaches in view of these problems are discussed.

  17. Re-orienting a remote acute care model towards a primary health care approach: key enablers.

    Science.gov (United States)

    Carroll, Vicki; Reeve, Carole A; Humphreys, John S; Wakerman, John; Carter, Maureen

    2015-01-01

    The objective of this study was to identify the key enablers of change in re-orienting a remote acute care model to comprehensive primary healthcare delivery. The setting of the study was a 12-bed hospital in Fitzroy Crossing, Western Australia. Individual key informant, in-depth interviews were completed with five of six identified senior leaders involved in the development of the Fitzroy Valley Health Partnership. Interviews were recorded and transcripts were thematically analysed by two investigators for shared views about the enabling factors strengthening primary healthcare delivery in a remote region of Australia. Participants described theestablishment of a culturally relevant primary healthcare service, using a community-driven, 'bottom up' approach characterised by extensive community participation. The formal partnership across the government and community controlled health services was essential, both to enable change to occur and to provide sustainability in the longer term. A hierarchy of major themes emerged. These included community participation, community readiness and desire for self-determination; linkages in the form of a government community controlled health service partnership; leadership; adequate infrastructure; enhanced workforce supply; supportive policy; and primary healthcare funding. The strong united leadership shown by the community and the health service enabled barriers to be overcome and it maximised the opportunities provided by government policy changes. The concurrent alignment around a common vision enabled implementation of change. The key principle learnt from this study is the importance of community and health service relationships and local leadership around a shared vision for the re-orientation of community health services.

  18. A risk-adjusted approach to comparing the return on investment in health care programs.

    Science.gov (United States)

    Sendi, Pedram; Al, Maiwenn J; Zimmermann, Heinz

    2004-09-01

    The league table approach to rank ordering health care programs according to the incremental cost-effectiveness ratio is a common method to guide policy makers in setting priorities for resource allocation. In the presence of uncertainty, however, ranking programs is complicated by the degree of variability associated with each program. Confidence intervals for cost-effectiveness ratios may be overlapping. Moreover, confidence intervals may include negative ratios and the interpretation of negative cost-effectiveness ratios is ambiguous. We suggest to rank mutually exclusive health care programs according to their rate of return which is defined as the net monetary benefit over the costs of the program. However, how does a program with a higher expected return but higher uncertainty compare to a program with a lower expected return but lower risk? In the present paper we propose a risk-adjusted measure to compare the return on investment in health care programs. Financing a health care program is treated as an investment in a risky asset. The risky asset is combined with a risk-free asset in order to construct a combined portfolio. The weights attributed to the risk-free and risky assets are chosen in such a manner that all programs under consideration exhibit the same degree of uncertainty. We can then compare the performance of the individual programs by constructing a risk-adjusted league table of expected returns.

  19. Adolescent Maternal Lifecourse Outcomes: Implications from an Integrated Mental Health Services Approach

    Directory of Open Access Journals (Sweden)

    Beth S. Russell

    2014-06-01

    Full Text Available Family intervention literature on adolescent parenting describes the pathways between outcomes for adolescent mothers and their children and the contexts of the pregnancy itself (e.g., poverty, low or no prenatal care, lower educational attainment. The aim of these descriptions is often to inform intervention designs that promote adaptive functioning for the child, the mother, and the dyad. Mental health services are an important component of many of these interventions; these services may be delivered by a clinician within the organization providing the intervention, or the organization may connect mothers with external mental health services in their communities. Using in-house clinicians rather than external providers may be beneficial by decreasing the high attrition rates common to this population. Although this service delivery approach is theoretically appealing, it has not been subject to rigorous empirical evaluation. In the current randomized study, we examine outcomes for teenage mothers based on two service delivery methods: Integrated Mental Health Services (IMHS and the Standard of Care (SoC which outsources clients’ mental health needs through community referrals. Information about the effectiveness of service delivery strategies can help program providers make decisions about how best to allocate limited funds to provide effective services.

  20. Health locus of control theory in diabetes: a worthwhile approach in managing diabetic foot ulcers?

    Science.gov (United States)

    Przybylski, M

    2010-06-01

    The current global epidemic of type two diabetes mellitus has led to an accompanying increase in both foot ulceration and amputations, which pose significant health problems to populations worldwide. If improved treatment options are to be offered, then we clearly need a better understanding of all aspects of this disease. To date the major focus of diabetes research has been on physical factors, which are undeniably important, but there has been little acknowledgement of the significant psychological effects that can influence health and delay wound healing. The 'health locus of control' (HLC) theory, a psychological theory concerning patients' perceptions of how much control they have over life events (both positive and negative) may well be of use in this patient group. It has been suggested that concordance with treatment is improved when patients have a high 'internal' HLC (as measured by a questionnaire), which aligns with the belief that they have greater control over their health. It has further been suggested that through the implementation of 'group-care' education programmes, patients' attitudes can change, with a shift towards higher 'internal' HLC values. Thus a new approach in patient management might be to implement such education programmes, in the hope of improving adherence to treatment regimens and, hence, patient outcomes. To date there has been little conclusive evidence of the application of this theory, and although various studies have been performed in diabetic populations, only one study has been conducted specifically regarding diabetic foot ulcers. Clearly more research is needed.

  1. Biodiesel exhaust: the need for a systematic approach to health effects research.

    Science.gov (United States)

    Larcombe, Alexander N; Kicic, Anthony; Mullins, Benjamin J; Knothe, Gerhard

    2015-10-01

    Biodiesel is a generic term for fuel that can be made from virtually any plant or animal oil via transesterification of triglycerides with an alcohol (and usually a catalyst). Biodiesel has received considerable scientific attention in recent years, as it is a renewable resource that is directly able to replace mineral diesel in many engines. Additionally, some countries have mandated a minimum biodiesel content in all diesel fuel sold on environmental grounds. When combusted, biodiesel produces exhaust emissions containing particulate matter, adsorbed chemicals and a range of gases. In many cases, absolute amounts of these pollutants are lower in biodiesel exhaust compared with mineral diesel exhaust, leading to speculation that biodiesel exhaust may be less harmful to health. Additionally, engine performance studies show that the concentrations of these pollutants vary significantly depending on the renewable oil used to make the biodiesel and the ratio of biodiesel to mineral diesel in the fuel mix. Given the strategic and legislative push towards the use of biodiesel in many countries, a concerning possibility is that certain biodiesels may produce exhaust emissions that are more harmful to health than others. This variation suggests that a comprehensive, systematic and comparative approach to assessing the potential for a range of different biodiesel exhausts to affect health is urgently required. Such an assessment could inform biodiesel production priorities, drive research and development into new exhaust treatment technologies, and ultimately minimize the health impacts of biodiesel exhaust exposure.

  2. Approaches and challenges to optimising primary care teams’ electronic health record usage

    Directory of Open Access Journals (Sweden)

    Nancy Pandhi

    2014-07-01

    Full Text Available Background Although the presence of an electronic health record (EHR alone does not ensure high quality, efficient care, few studies have focused on the work of those charged with optimising use of existing EHR functionality.Objective To examine the approaches used and challenges perceived by analysts supporting the optimisation of primary care teams’ EHR use at a large U.S. academic health care system.Methods A qualitative study was conducted. Optimisation analysts and their supervisor were interviewed and data were analysed for themes.Results Analysts needed to reconcile the tension created by organisational mandates focused on the standardisation of EHR processes with the primary care teams’ demand for EHR customisation. They gained an understanding of health information technology (HIT leadership’s and primary care team’s goals through attending meetings, reading meeting minutes and visiting with clinical teams. Within what was organisationally possible, EHR education could then be tailored to fit team needs. Major challenges were related to organisational attempts to standardise EHR use despite varied clinic contexts, personnel readiness and technical issues with the EHR platform. Forcing standardisation upon clinical needs that current EHR functionality could not satisfy was difficult.Conclusions Dedicated optimisation analysts can add value to health systems through playing a mediating role between HIT leadership and care teams. Our findings imply that EHR optimisation should be performed with an in-depth understanding of the workflow, cognitive and interactional activities in primary care.

  3. Exploring differential health effects of work stress: a latent class cluster approach

    Directory of Open Access Journals (Sweden)

    Hannes Mayerl

    2017-03-01

    Full Text Available Background While evidence highlights the detrimental health consequences of adverse working conditions, effect sizes vary by the stressor examined. In this study, we aimed to explore the differential effects various constellations of job demands have on prevalent symptom clusters. Methods We analysed self-reported data from a nationwide Austrian survey (N = 16,466, based on a cross-sectional design. By means of latent class analysis, a set of items was used to assess the burden from several job demands as well as the frequency of occurrence of mental and physical symptoms in order to identify stress profiles and symptom clusters, respectively. Results Analysis revealed four subgroups that each demonstrated a typological response pattern regarding job demands and health symptoms, respectively. The revealed stress profiles were found to be strongly related to the symptom clusters, while the effects differed considerably depending on the types of demands experienced. Conclusion The current study presents an alternative method of examining the stress-health link by using a combined person- and variable-centred approach. The findings suggest a hierarchy in stress exposure with the most pronounced health consequences found for a synchronous burden from physical, psychosocial and organizational demands.

  4. Allocation of basic health units based on the multicriteria approach: a proposition for a mediumsized city

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    Raquel Ferreira de Negreiros

    2015-03-01

    Full Text Available The Basic Health Units (UBSs are responsible for the treatment of diseases in their initial phase. It is possible to observe that there is an investment by the Brazilian government into this kind of strategy in health policies. These kinds of actions aim to reduce the number of patients being sent to hospitals, because the low and medium priority problems can be treated at a UBS. The UBSs are related to the Family Health Program (PSF with the objective of serving the poorest population. The government must allocate these units efficiently, to improve the services and serve more people. However, this kind of decision is made by the empirical knowledge of municipal managers. This paper proposes a model to rationalize this decision process using the multiple criteria decision aid approach to allocate these units in a city in the west region of Rio Grande do Norte State, in Brazil. We can conclude that the model developed prioritizes the neighborhoods with the greatest need for healthcare, using the value system of the city’s health department.

  5. 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.

  6. Mental health in a context of urban poverty: a qualitative approach

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    Carolina Martínez S

    2009-05-01

    Full Text Available Objective: With the premise that there is a strong relationship between mental health problems and the characteristics of the world in which people live, this article analyzes the findings of a qualitative inquiry about the situation of a small group of low-income urban families in Mexico at the end of the 20th century. It proposes also a reflection about the contributions of this kind of approach to achieve a better understanding of the complex constellations that give rise to mental health disturbances in each context. Methodology:The interpretation offered in this paper is oriented by a postkleinian psychoanalytic model developed for the study of the influence of the family and community contexts on the person’s psychic structure. The data analyzed was collected several years ago by means of direct observation and in-depth personal interviews to each member of twenty low-income urban families living in the south of Mexico City. Results:The analysis oriented by this model showed different types of family emotional dynamics and its influence on the psychic structure and function of their members. It was found a low coverage of public health services for this group of population, and specially a lack of preventive and curative mental health services.

  7. Exploring differential health effects of work stress: a latent class cluster approach.

    Science.gov (United States)

    Mayerl, Hannes; Stolz, Erwin; Waxenegger, Anja; Freidl, Wolfgang

    2017-01-01

    While evidence highlights the detrimental health consequences of adverse working conditions, effect sizes vary by the stressor examined. In this study, we aimed to explore the differential effects various constellations of job demands have on prevalent symptom clusters. We analysed self-reported data from a nationwide Austrian survey (N = 16,466), based on a cross-sectional design. By means of latent class analysis, a set of items was used to assess the burden from several job demands as well as the frequency of occurrence of mental and physical symptoms in order to identify stress profiles and symptom clusters, respectively. Analysis revealed four subgroups that each demonstrated a typological response pattern regarding job demands and health symptoms, respectively. The revealed stress profiles were found to be strongly related to the symptom clusters, while the effects differed considerably depending on the types of demands experienced. The current study presents an alternative method of examining the stress-health link by using a combined person- and variable-centred approach. The findings suggest a hierarchy in stress exposure with the most pronounced health consequences found for a synchronous burden from physical, psychosocial and organizational demands.

  8. Sleepwalking Into Infertility: The Need for a Public Health Approach Toward Advanced Maternal Age.

    Science.gov (United States)

    Lemoine, Marie-Eve; Ravitsky, Vardit

    2015-01-01

    In Western countries today, a growing number of women delay motherhood until their late 30s and even 40s, as they invest time in pursuing education and career goals before starting a family. This social trend results from greater gender equality and expanded opportunities for women and is influenced by the availability of contraception and assisted reproductive technologies (ART). However, advanced maternal age is associated with increased health risks, including infertility. While individual medical solutions such as ART and elective egg freezing can promote reproductive autonomy, they entail significant risks and limitations. We thus argue that women should be better informed regarding the risks of advanced maternal age and ART, and that these individual solutions need to be supplemented by a public health approach, including policy measures that provide women with the opportunity to start a family earlier in life without sacrificing personal career goals.

  9. Information security governance: a risk assessment approach to health information systems protection.

    Science.gov (United States)

    Williams, Patricia A H

    2013-01-01

    It is no small task to manage the protection of healthcare data and healthcare information systems. In an environment that is demanding adaptation to change for all information collection, storage and retrieval systems, including those for of e-health and information systems, it is imperative that good information security governance is in place. This includes understanding and meeting legislative and regulatory requirements. This chapter provides three models to educate and guide organisations in this complex area, and to simplify the process of information security governance and ensure appropriate and effective measures are put in place. The approach is risk based, adapted and contextualized for healthcare. In addition, specific considerations of the impact of cloud services, secondary use of data, big data and mobile health are discussed.

  10. Taijiao:a traditional Chinese approach to enhancing fetal growth through maternal physical and mental health

    Institute of Scientific and Technical Information of China (English)

    Fung-Kei Cheng

    2016-01-01

    abstract Despite the fact that Taijiao (traditional Chinese eugenics) has been part of the Chinese obstetrical culture over the years, there is insufficient scientific evidence for its effectiveness. This literature review analyzes the discourse on Taijiao associated with physical and psychological maternalefetal symbiosis, together with relevant peripheral research outcomes. Taijiao combines maternal health and external environment for benefits in fetal growth through preventive, indirect, and direct measures. Discussing practical im-plications and future research directions, this review reveals a modernized Taijiao to be a holistic, non-invasive pregnancy management system using a multi-disciplinary approach that enhances infantile life quality, reduces negative consequences of pregnancy deficits and child development, and saves public health expenditure.

  11. Identifying best-fitting inputs in health-economic model calibration: a Pareto frontier approach.

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    Enns, Eva A; Cipriano, Lauren E; Simons, Cyrena T; Kong, Chung Yin

    2015-02-01

    To identify best-fitting input sets using model calibration, individual calibration target fits are often combined into a single goodness-of-fit (GOF) measure using a set of weights. Decisions in the calibration process, such as which weights to use, influence which sets of model inputs are identified as best-fitting, potentially leading to different health economic conclusions. We present an alternative approach to identifying best-fitting input sets based on the concept of Pareto-optimality. A set of model inputs is on the Pareto frontier if no other input set simultaneously fits all calibration targets as well or better. We demonstrate the Pareto frontier approach in the calibration of 2 models: a simple, illustrative Markov model and a previously published cost-effectiveness model of transcatheter aortic valve replacement (TAVR). For each model, we compare the input sets on the Pareto frontier to an equal number of best-fitting input sets according to 2 possible weighted-sum GOF scoring systems, and we compare the health economic conclusions arising from these different definitions of best-fitting. For the simple model, outcomes evaluated over the best-fitting input sets according to the 2 weighted-sum GOF schemes were virtually nonoverlapping on the cost-effectiveness plane and resulted in very different incremental cost-effectiveness ratios ($79,300 [95% CI 72,500-87,600] v. $139,700 [95% CI 79,900-182,800] per quality-adjusted life-year [QALY] gained). Input sets on the Pareto frontier spanned both regions ($79,000 [95% CI 64,900-156,200] per QALY gained). The TAVR model yielded similar results. Choices in generating a summary GOF score may result in different health economic conclusions. The Pareto frontier approach eliminates the need to make these choices by using an intuitive and transparent notion of optimality as the basis for identifying best-fitting input sets. © The Author(s) 2014.

  12. [A holistic approach and typology for the health promotion of women with breast cancer].

    Science.gov (United States)

    Duboc, Annie

    2012-09-01

    The aim of this research is to better understand how women with breast cancer protect themselves against their disease in a holistic approach taking into account cognitive, subjective, biologic and social factors. This approach leads to the development of a typology of feminine protection, typology today absent of the French health system. The protection concept refers to the salutogenesis theory. It brings together factors which help explain the way women think while going through their cancer and how they try to maintain themselves in good health in such an extreme situation. The research is based on a mix method. This article discusses the results of the quantitative data analysis with some insights from the qualitative data. Our findings identify three distinctive types of women with regard to the types of protection they put in place (cluster analysis). The typology demonstrates three types of protection: (1) an ineffective protection characterised by weak SOC and stress, an internal control over the cause of cancer, a medium self-efficacy and the recourse to the protection's instinct; (2) a mixed protection marked by a weak SOC and a strong stress, an internal control over the cause of cancer, a low self-efficacy and a strong difficulty to confront authority; and (3) an effective protection expressed by a strong SOC and a weak stress, an internal control over the course of cancer, a high self-efficacy and the capacity to act in face of danger. In short, in our sample, one woman in two encounter difficulties to protect herself against breast cancer and one woman in four does not manage to do it. The typology offers a clinical framework to help women to maintain their health in face of cancer, allowing health professionals to identify those who have difficulties to protect themselves efficiently.

  13. An innovative approach to diabetes education for a Hispanic population utilizing community health workers.

    Science.gov (United States)

    Valen, Mieca S; Narayan, Suzanne; Wedeking, Lorene

    2012-01-01

    Type 2 diabetes disproportionately affects the Hispanic population. New approaches are needed to provide effective education to this population. This evidence-based project utilized community health workers (CHWs) to deliver a culturally relevant diabetes education program to a Hispanic population at a migrant clinic. The program emphasized culturally relevant interventions to improve self-efficacy. Formative evaluation was used to develop and improve the program. Participants showed improvement in diabetes knowledge and diabetes related self-efficacy scores. Outcomes also included improvement in CHWs' diabetes knowledge and development of an educational program that could be utilized in other settings serving Hispanic populations with type 2 diabetes.

  14. A team approach to recruitment in hospice research: engaging patients, close people and health professionals.

    Science.gov (United States)

    L Campbell, Cathy; Bailey, Cara; Armour, Kathy; Perry, Rachel; Orlando, Rosanna; Kinghorn, Philip; Jones, Louise; Coast, Joanna

    2016-07-02

    Research is vital to the future development of hospice care. However, research in hospice settings is very challenging. This paper describes a case study of a successful multidisciplinary research team approach (MDRT) to the recruitment of participants (hospice patients, family members and health professionals) for a study in a hospice setting on the economic evaluation of end-of-life care. A successful recruitment plan includes three key strategies: identifying key members of the MDRT early in the research process; having a clear and constant communication stream; and creating an environment where all team members have a shared commitment to the research, all voices are heard and valued, and everyone contributes to the research aims. An MDRT approach will be helpful to guide the development of successful recruitment plans for academic-community research partnerships in the hospice setting.

  15. A One-Health integrated approach to control fascioliasis in the Cajamarca valley of Peru.

    Science.gov (United States)

    Rinaldi, Laura; Gonzalez, Sergio; Guerrero, Jorge; Aguilera, Luisa Carol; Musella, Vincenzo; Genchi, Claudio; Cringoli, Giuseppe

    2012-09-01

    Fasciola hepatica infection is reported from many Latin American countries, with very high prevalence rates in both humans and livestock in the Andean countries. Due to its environmental characteristics, particularly suitable for liver fluke infection, the Cajamarca valley of Peru has often been chosen as a model to study the epidemiology of liver fluke infection in the Andes. In this paper we describe the profile of a project aimed at a multidisciplinary and integrated approach for the control of fascioliasis in animals and humans in this valley. The One-Health integrated approach applied here is based on accurate and sensitive diagnostics, namely the FLOTAC, and the use of geospatial tools for epidemiological scrutiny.

  16. A One-Health integrated approach to control fascioliasis in the Cajamarca valley of Peru

    Directory of Open Access Journals (Sweden)

    Laura Rinaldi

    2012-09-01

    Full Text Available Fasciola hepatica infection is reported from many Latin American countries, with very high prevalence rates in both humans and livestock in the Andean countries. Due to its environmental characteristics, particularly suitable for liver fluke infection, the Cajamarca valley of Peru has often been chosen as a model to study the epidemiology of liver fluke infection in the Andes. In this paper we describe the profile of a project aimed at a multidisciplinary and integrated approach for the control of fascioliasis in animals and humans in this valley. The One-Health integrated approach applied here is based on accurate and sensitive diagnostics, namely the FLOTAC, and the use of geospatial tools for epidemiological scrutiny.

  17. Flexible approaches for teaching computational genomics in a health information management program.

    Science.gov (United States)

    Zhou, Leming; Watzlaf, Valerie; Abdelhak, Mervat

    2013-01-01

    The astonishing improvement of high-throughput biotechnologies in recent years makes it possible to access a huge amount of genomic data. The association between genomic data and genetic disease has already been and will continue to be applied to personalized healthcare. Health information management (HIM) professionals are the ones who will handle personal genetic information and provide solid evidence to support physicians' diagnoses and personalized treatment strategies, and therefore they will need to have the knowledge and skills to process genomic data. In this paper, we describe flexible approaches for teaching a computational genomics course in the HIM program at the University of Pittsburgh. HIM programs at other universities may choose an appropriate approach to fit into their own curriculum.

  18. Researching children's health experiences: The place for participatory, child-centered, arts-based approaches.

    Science.gov (United States)

    Carter, Bernie; Ford, Karen

    2013-02-01

    A central concern when conducting qualitative health research with children is eliciting data that genuinely reflect their perspectives. Invariably, this involves being child-centered and participatory. Drawing and photography increasingly accompany dialogic methods to facilitate children's communication through arts-based and verbal modes of expression. However, little literature is available on how arts-based tools shape data. We suggest that researchers need to be attentive to how such tools can liberate, constrain and frame data generated by children, drawing attention to the promises of such approaches as well as the conundrums that can arise from their use. We explore the place for participatory, child-centered, arts-based approaches using examples of the use of drawing and photography in our own studies.

  19. The Large Marine Ecosystem Approach for 21st Century Ocean Health and International Sustainable Development

    Science.gov (United States)

    Honey, K. T.

    2014-12-01

    The global coastal ocean and watersheds are divided into 66 Large Marine Ecosystems (LMEs), which encompass regions from river basins, estuaries, and coasts to the seaward boundaries of continental shelves and margins of major currents. Approximately 80% of global fisheries catch comes from LME waters. Ecosystem goods and services from LMEs contribute an estimated US 18-25 trillion dollars annually to the global economy in market and non-market value. The critical importance of these large-scale systems, however, is threatened by human populations and pressures, including climate change. Fortunately, there is pragmatic reason for optimism. Interdisciplinary frameworks exist, such as the Large Marine Ecosystem (LME) approach for adaptive management that can integrate both nature-centric and human-centric views into ecosystem monitoring, assessment, and adaptive management practices for long-term sustainability. Originally proposed almost 30 years ago, the LME approach rests on five modules are: (i) productivity, (ii) fish and fisheries, (iii) pollution and ecosystem health, (iv) socioeconomics, and (v) governance for iterative adaptive management at a large, international scale of 200,000 km2 or greater. The Global Environment Facility (GEF), World Bank, and United Nations agencies recognize and support the LME approach—as evidenced by over 3.15 billion in