Motivation of health surveillance assistants in Malawi: A qualitative ...

African Journals Online (AJOL)

Background: Motivation of health workers is a critical component of performance and is shaped by multiple factors. This study explored factors that influence motivation of health surveillance assistants (HSAs) in Malawi, with the aim of identifying interventions that can be applied to enhance motivation and performance of ...

Global health development assistance remained steady in 2013 but did not align with recipients' disease burden.

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Dieleman, Joseph L; Graves, Casey M; Templin, Tara; Johnson, Elizabeth; Baral, Ranju; Leach-Kemon, Katherine; Haakenstad, Annie M; Murray, Christopher J L

2014-05-01

Tracking development assistance for health for low- and middle-income countries gives policy makers information about spending patterns and potential improvements in resource allocation. We tracked the flows of development assistance and explored the relationship between national income, disease burden, and assistance. We estimated that development assistance for health reached US$31.3 billion in 2013. Increased assistance from the Global Fund to Fight AIDS, Tuberculosis, and Malaria; the GAVI Alliance; and bilateral agencies in the United Kingdom helped raise funding to the highest level to date. The largest portion of health assistance targeted HIV/AIDS (25 percent); 20 percent targeted maternal, newborn, and child health. Disease burden and economic development were significantly associated with development assistance for health, but many countries received considerably more or less aid than these indicators predicted. Five countries received more than five times their expected amount of health aid, and seven others received less than one-fifth their expected funding. The lack of alignment between disease burden, income, and funding reveals the potential for improvement in resource allocation.

Intimate partner violence influence on deliveries assisted by skilled health personnel

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Amany Refaat

2013-10-01

Full Text Available Objective: Millennium Development Goal 5 calls for increasing proportions of deliveries assisted by skilled health personnel to reduce maternal mortality. This study aims to identifying the implication of exposure to intimate partner violence on these proportions. Methodology: This study used domestic violence modules data of Demographic and Health Surveys of six countries from 2005 to 2007. Proportions of assisted deliveries were examined by sociodemographic characteristics and exposure to intimate partner violence in the studied countries. Influence on the proportion was examined against exposure to intimate partner violence through odds ratio and 95% of logistic regression analysis after controlling for women age, residence (urban/rural, household wealth level, economic level of country, educational level and working status of women and their husbands/partners. Results: Data sets of 18,507 participants over 20 years of age showed that almost three-quarters (73% of women had deliveries assisted by skilled health personnel. One-third of the women were ever exposed to intimate partner violence (37% and 9% of them to the severe level. Exposure to intimate partner violence statistically significantly lowered this proportion to 69% (odds ratio: 0.73; 95% confidence interval: 0.67–0.78 meanwhile severe violence lowered it to 65% (odds ratio 0.64; 95% confidence interval: 0.58–0.72. When running multiple regression analysis, exposure to intimate partner violence retained its statistically significant decreasing influence on proportions and was not biased by the other stronger socioeconomic characteristics. Conclusion and recommendations: Intimate partner violence has an independent influence on reducing assisted deliveries by skilled health personnel. Programs working for increasing proportions of assisted deliveries by skilled health personnel are recommended to integrate protection women from violence.

Effectiveness of video-assisted teaching program on safety measures followed by the employees working in the silica-based industry in Puducherry, India.

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Nanthini, Thiruvengadam; Karunagari, Karaline

2016-01-01

Employees constitute a large and important sector of the world's population. The global labor force is about 2,600 million and 75% of this force is working in developing countries. Occupational health and safety (OHS) must be managed in every aspect of their work. Occupational safety and health (OSH), also commonly referred to as OHS or workplace health and safety (WHS) is an area concerned with the safety, health, and welfare of people engaged in any employment. The goal of OSH is to foster a safe and healthy work environment. The aim of this study is to evaluate the effectiveness of video-assisted teaching program on safety measures. A total of 105 employees were selected from M/s ACE Glass Containers Ltd. at Puducherry, India using the convenience sampling technique. Pretest was conducted using a self-administered questionnaire. Subsequent video-assisted teaching was conducted by the investigator after which posttest was conducted. Video-assisted teaching program was found to be effective in improving the knowledge, attitude, and practice of the subjects. Periodical reorientation on safety measures are needed for all the employees as it is essential for promoting the well-being of employees working in any industry.

Role, implementation, and effectiveness of advanced allied health assistants: a systematic review

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Stanhope J

2013-12-01

/AHA roles are being implemented in a range of settings, and appear to be effective in terms of process measures and stakeholder perceptions. Few studies have investigated these roles, indicating a need for research to be conducted in this area to enable policy-makers to consider the value of these positions and how they can best be utilized.Keywords: allied health, assistant, advanced, systematic review, effectiveness, role

Kinematic measures for upper limb robot-assisted therapy following stroke and correlations with clinical outcome measures: A review.

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Tran, Vi Do; Dario, Paolo; Mazzoleni, Stefano

2018-03-01

This review classifies the kinematic measures used to evaluate post-stroke motor impairment following upper limb robot-assisted rehabilitation and investigates their correlations with clinical outcome measures. An online literature search was carried out in PubMed, MEDLINE, Scopus and IEEE-Xplore databases. Kinematic parameters mentioned in the studies included were categorized into the International Classification of Functioning, Disability and Health (ICF) domains. The correlations between these parameters and the clinical scales were summarized. Forty-nine kinematic parameters were identified from 67 articles involving 1750 patients. The most frequently used parameters were: movement speed, movement accuracy, peak speed, number of speed peaks, and movement distance and duration. According to the ICF domains, 44 kinematic parameters were categorized into Body Functions and Structure, 5 into Activities and no parameters were categorized into Participation and Personal and Environmental Factors. Thirteen articles investigated the correlations between kinematic parameters and clinical outcome measures. Some kinematic measures showed a significant correlation coefficient with clinical scores, but most were weak or moderate. The proposed classification of kinematic measures into ICF domains and their correlations with clinical scales could contribute to identifying the most relevant ones for an integrated assessment of upper limb robot-assisted rehabilitation treatments following stroke. Increasing the assessment frequency by means of kinematic parameters could optimize clinical assessment procedures and enhance the effectiveness of rehabilitation treatments. Copyright © 2018 IPEM. Published by Elsevier Ltd. All rights reserved.

Animal-Assisted Therapy for Improving Human Health

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Sibel Cevizci

2009-06-01

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

10 CFR 455.110 - Grant application submittals for technical assistance and energy conservation measures.

Science.gov (United States)

2010-01-01

... 10 Energy 3 2010-01-01 2010-01-01 false Grant application submittals for technical assistance and... Grant application submittals for technical assistance and energy conservation measures. (a) Each... assistance for energy conservation measures, including renewable resource measures, shall include the...

Smoking behaviours and attitudes toward tobacco control among assistant environmental health officer trainees.

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Tee, G H; Gurpreet, K; Hairi, N N; Zarihah, Z; Fadzilah, K

2013-12-01

Assistant environmental health officers (AEHO) are health care providers (HCPs) who act as enforcers, educators and trusted role models for the public. This is the first study to explore smoking behaviour and attitudes toward tobacco control among future HCPs. Almost 30% of AEHO trainees did not know the role of AEHOs in counselling smokers to stop smoking, but 91% agreed they should not smoke before advising others not to do so. The majority agreed that tobacco control regulations may be used as a means of reducing the prevalence of smoking. Future AEHOs had positive attitudes toward tobacco regulations but lacked understanding of their responsibility in tobacco control measures.

School superintendents' perceptions of schools assisting students in obtaining public health insurance.

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Rickard, Megan L; Price, James H; Telljohann, Susan K; Dake, Joseph A; Fink, Brian N

2011-12-01

Superintendents' perceptions regarding the effect of health insurance status on academics, the role schools should play in the process of obtaining health insurance, and the benefits/barriers to assisting students in enrolling in health insurance were surveyed. Superintendents' basic knowledge of health insurance, the link between health and learning, and specific school system practices for assisting students were also examined. A 4-page questionnaire was sent to a national random sample of public school superintendents using a 4-wave postal mailing. Only 19% of school districts assessed the health insurance status of students. School districts' assistance in helping enroll students in health insurance was assessed using Stages of Change theory; 36% of superintendents' school districts were in the action or maintenance stages. The schools most often made health insurance materials available to parents (53%). The perceived benefits identified by more than 80% of superintendents were to keep students healthier, reduce the number of students with untreated health problems, reduce school absenteeism, and improvement of students' attention/concentration during school. The 2 most common perceived barriers identified by at least 50% of superintendents were not having enough staff or financial resources. Most superintendents believed schools should play a role in helping students obtain health insurance, but the specific role was unclear. Three fourths of superintendents indicated overwhelmingly positive beliefs regarding the effects of health insurance status on students' health and academic outcomes. School personnel and public policy makers can use the results to support collaboration in getting students enrolled in health insurance. © 2011, American School Health Association.

Should Health Care Aides Assist With Medications in Long-Term Care?

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Mubashir Arain PhD

2016-05-01

Full Text Available Objective: The objective of the study was to determine whether health care aides (HCAs could safely assist in medication administration in long-term care (LTC. Method: We obtained medication error reports from LTC facilities that involve HCAs in oral medication assistance and we analyzed Resident Assessment Instrument (RAI data from these facilities. Standard ratings of error severity were “no apparent harm,” “minimum harm,” and “moderate harm.” Results: We retrieved error reports from two LTC facilities with 220 errors reported by all health care providers including HCAs. HCAs were involved in 137 (63% errors, licensed practical nurses (LPNs/registered nurses (RNs in 77 (35%, and pharmacy in four (2%. The analysis of error severity showed that HCAs were significantly less likely to cause errors of moderate severity than other nursing staff (2% vs. 7%, chi-square = 5.1, p value = .04. Conclusion: HCAs’ assistance in oral medications in LTC facilities appears to be safe when provided under the medication assistance guidelines.

School Superintendents' Perceptions of Schools Assisting Students in Obtaining Public Health Insurance

Science.gov (United States)

Rickard, Megan L.; Price, James H.; Telljohann, Susan K.; Dake, Joseph A.; Fink, Brian N.

2011-01-01

Background: Superintendents' perceptions regarding the effect of health insurance status on academics, the role schools should play in the process of obtaining health insurance, and the benefits/barriers to assisting students in enrolling in health insurance were surveyed. Superintendents' basic knowledge of health insurance, the link between…

The relationship between weight status and the need for health care assistance in nursing home residents

DEFF Research Database (Denmark)

Beck, Anne Marie

2012-01-01

Objective: The purpose of this study was to evaluate the relationship between underweight status and weight loss events on the need for health care assistance among a sample of Danish nursing home residents over 12-months. Design: Longitudinal, repeated measures design with three data collection...... points at baseline (2004) and six and 12 months post baseline. Setting: 11 Danish nursing home facilities. Participants: 441 Danish nursing home residents over the age of 65. Measurements: Resident Assessment Instrument (RAI-NH) data were abstracted for each participant at each of three data collection...... of this study suggest that elderly nursing home residents with a low BMI or weight loss may add to the substantial and costly burden of nursing home care due to the associated need for higher levels of ADL assistance....

Measuring the Impact of the Human Rights on Health in Global Health Financing.

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Davis, Sara L M

2015-12-10

In response to new scientific developments, UNAIDS, WHO, and global health financing institutions have joined together to promote a "fast-track" global scale-up of testing and treatment programs. They have set ambitious targets toward the goal of ending the three diseases by 2030. These numerical indicators, based on infectious disease modeling, can assist in measuring countries' progressive realization of the right to health. However, they only nominally reference the catastrophic impact that human rights abuses have on access to health services; they also do not measure the positive impact provided by law reform, legal aid, and other health-related human rights programs. Drawing on experience at the Global Fund to Fight AIDS, Tuberculosis and Malaria, which has incorporated expanded stakeholder consultation and human rights programming into its grants, the article argues that addressing human rights barriers to access is often an ad hoc activity occurring on the sidelines of a health grantmaking process that has focused on the scale-up of biomedical programs to meet global health indicators. To ensure that these biomedical programs have impact, UN agencies and health financing mechanisms must begin to more systematically and proactively integrate human rights policy and practice into their modeling and measurement tools. Copyright © 2015 Davis. This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original author and source are credited.

Using data from ambient assisted living and smart homes in electronic health records.

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Knaup, P; Schöpe, L

2014-01-01

This editorial is part of the Focus Theme of Methods of Information in Medicine on "Using Data from Ambient Assisted Living and Smart Homes in Electronic Health Records". To increase efficiency in the health care of the future, data from innovative technology like it is used for ambient assisted living (AAL) or smart homes should be available for individual health decisions. Integrating and aggregating data from different medical devices and health records enables a comprehensive view on health data. The objective of this paper is to present examples of the state of the art in research on information management that leads to a sustainable use and long-term storage of health data provided by innovative assistive technologies in daily living. Current research deals with the perceived usefulness of sensor data, the participatory design of visual displays for presenting monitoring data, and communication architectures for integrating sensor data from home health care environments with health care providers either via a regional health record bank or via a telemedical center. Integrating data from AAL systems and smart homes with data from electronic patient or health records is still in an early stage. Several projects are in an advanced conceptual phase, some of them exploring feasibility with the help of prototypes. General comprehensive solutions are hardly available and should become a major issue of medical informatics research in the near future.

Preventing home health nursing assistant back and shoulder injuries.

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Leff, E W; Hagenbach, G L; Marn, K K

2000-10-01

Franklin County Home Health Agency (St Albans, Vermont) undertook a performance improvement project in 1996 to reduce employee injuries. A review of recent injuries led to the prevention of licensed nursing assistants' (LNAs') back and shoulder injuries as the first priority. Root causes of injuries were agency communication, employee training, patient home environment, nursing assistant body mechanics, and failure to use safety measures. Given that injury causality is complex and multifactorial, a variety of improvement strategies were implemented over the following two to three years. IMPLEMENTATION OF POTENTIAL SOLUTIONS: Short-term (a few months), mid-term (six months), and long-term (one year) potential solutions to the LNA back and shoulder injury problem were charted. Safety and health training was the major focus of the team's short-term plan. Risk management forms were to be used to identify and follow up on hazardous situations. Project plans that were successfully implemented included revision of LNA plans of care, standardization of the return-to-work process after injury, development of guidelines for identifying unsafe patient lifts and transfers, improved follow-up of employee reports of injury-risk situations in patient homes, improved body mechanics screening of new employees, and a stronger injury-prevention training program for current employees. A less successful initiative was aimed at collecting more data about injuries and causal factors. Employee injuries were gradually reduced from 4-10 per quarter to 0-3 per quarter. Injury prevention requires commitment, persistence, and patience--but not expensive improvements. Multiple interventions increase the chances of success when there are many root causes and lack of evidence regarding the effectiveness of various approaches.

Computer-assisted self interviewing in sexual health clinics.

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Fairley, Christopher K; Sze, Jun Kit; Vodstrcil, Lenka A; Chen, Marcus Y

2010-11-01

This review describes the published information on what constitutes the elements of a core sexual history and the use of computer-assisted self interviewing (CASI) within sexually transmitted disease clinics. We searched OVID Medline from 1990 to February 2010 using the terms "computer assisted interviewing" and "sex," and to identify published articles on a core sexual history, we used the term "core sexual history." Since 1990, 3 published articles used a combination of expert consensus, formal clinician surveys, and the Delphi technique to decide on what questions form a core sexual health history. Sexual health histories from 4 countries mostly ask about the sex of the partners, the number of partners (although the time period varies), the types of sex (oral, anal, and vaginal) and condom use, pregnancy intent, and contraceptive methods. Five published studies in the United States, Australia, and the United Kingdom compared CASI with in person interviews in sexually transmitted disease clinics. In general, CASI identified higher risk behavior more commonly than clinician interviews, although there were substantial differences between studies. CASI was found to be highly acceptable and individuals felt it allowed more honest reporting. Currently, there are insufficient data to determine whether CASI results in differences in sexually transmitted infection testing, diagnosis, or treatment or if CASI improves the quality of sexual health care or its efficiency. The potential public health advantages of the widespread use of CASI are discussed.

The effect of assisted reproduction treatment on mental health in fertile women

OpenAIRE

Zivaridelavar, Maryam; Kazemi, Ashraf; Kheirabadi, Gholam Reza

2016-01-01

Introduction: The process of assisted reproductive treatment is a stressful situation in the treatment of infertile couples and it would harm the mental health of women. Fertile women who started infertility treatment due to male factor infertility have reported to experience less stress and depression than other women before the assisted reproductive process but considering the cultural and social factors and also the etiology of the assisted reproductive process, it could affect the metal h...

An Exploratory Study of Animal-Assisted Interventions Utilized by Mental Health Professionals

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O'Callaghan, Dana M.; Chandler, Cynthia K.

2011-01-01

This study implemented an exploratory analysis to examine how a sample of mental health professionals incorporates specific animal-assisted techniques into the therapeutic process. An extensive review of literature related to animal-assisted therapy (AAT) resulted in the identification of 18 techniques and 10 intentions for the practice of AAT in…

Spanish-Language Community-Based Mental Health Treatment Programs, Policy-Required Language-Assistance Programming, and Mental Health Treatment Access Among Spanish-Speaking Clients

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McClellan, Sean R.

2013-01-01

Objectives. We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal (California’s Medicaid program) for Spanish-speaking persons with limited English proficiency, and whether it reduced language-based treatment access disparities. Methods. Using a time series nonequivalent control group design, we studied county-level penetration of language assistance programming over 10 years (1997–2006) for Spanish-speaking persons with limited English proficiency covered under Medi-Cal. We used linear regression with county fixed effects to control for ongoing trends and other influences. Results. When county mental health plans contracted with community-based organizations, those implementing language assistance programming increased penetration rates of Spanish-language mental health services under Medi-Cal more than other plans (0.28 percentage points, a 25% increase on average; P language-related disparities. Conclusions. Mental health treatment programs operated by community-based organizations may have moderately improved access after implementing required language assistance programming, but the programming did not reduce entrenched disparities in the accessibility of mental health services. PMID:23865663

Spanish-language community-based mental health treatment programs, policy-required language-assistance programming, and mental health treatment access among Spanish-speaking clients.

Science.gov (United States)

Snowden, Lonnie R; McClellan, Sean R

2013-09-01

We investigated the extent to which implementing language assistance programming through contracting with community-based organizations improved the accessibility of mental health care under Medi-Cal (California's Medicaid program) for Spanish-speaking persons with limited English proficiency, and whether it reduced language-based treatment access disparities. Using a time series nonequivalent control group design, we studied county-level penetration of language assistance programming over 10 years (1997-2006) for Spanish-speaking persons with limited English proficiency covered under Medi-Cal. We used linear regression with county fixed effects to control for ongoing trends and other influences. When county mental health plans contracted with community-based organizations, those implementing language assistance programming increased penetration rates of Spanish-language mental health services under Medi-Cal more than other plans (0.28 percentage points, a 25% increase on average; P language-related disparities. Mental health treatment programs operated by community-based organizations may have moderately improved access after implementing required language assistance programming, but the programming did not reduce entrenched disparities in the accessibility of mental health services.

Human monitoring, smart health and assisted living techniques and technologies

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Longhi, Sauro; Freddi, Alessandro

2017-01-01

This book covers the three main scientific and technological areas critical for improving people's quality of life - namely human monitoring, smart health and assisted living - from both the research and development points of view.

Pharmacoepidemiological Data from Drug Dispensing Charities as a Measure of Health Patterns in a Population not Assisted by the Italian National Health Service.

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Bini, Silvia; Cerri, Cesare; Rigamonti, Antonello E; Bertazzi, Pietro A; Fiorini, Gianfrancesco; Cella, Silvano G

2016-08-19

We analysed drug dispensation by charitable organisations in a year time. Drugs were grouped according to the Anatomic Therapeutic Chemical classification and the amount dispensed was calculated with the system of the Daily Defined Dose (DDD) and expressed as DDD/1000 subjects/day. A number of 87,550 subjects were studied (13,308 Italians; 74,242 Immigrants). Though we noticed a great sesonal variability, the drugs most frequently dispensed were those for the respiratory, cardiovascular and gastrointestinal system and antibiotics, which is different from the rest of the Italian population and the immigrant population assisted by our National Health Service (NHS). We also found that chronic diseases are increasing in these subjects. We conclude that the subjects not receiving NHS assitance have, at least in part, different health patterns and requirements. This should be considered when planning tailored interventions.

Pharmacoepidemiological data from drug dispensing charities as a measure of health patterns in a population not assisted by the Italian National Health Service

Directory of Open Access Journals (Sweden)

Silvia Bini

2016-08-01

Full Text Available We analysed drug dispensation by charitable organisations in a year time. Drugs were grouped according to the Anatomic Therapeutic Chemical classification and the amount dispensed was calculated with the system of the Daily Defined Dose (DDD and expressed as DDD/1000 subjects/day. A number of 87,550 subjects were studied (13,308 Italians; 74,242 Immigrants. Though we noticed a great sesonal variability, the drugs most frequently dispensed were those for the respiratory, cardiovascular and gastrointestinal system and antibiotics, which is different from the rest of the Italian population and the immigrant population assisted by our National Health Service (NHS. We also found that chronic diseases are increasing in these subjects. We conclude that the subjects not receiving NHS assitance have, at least in part, different health patterns and requirements. This should be considered when planning tailored interventions.

Spending on health and HIV/AIDS: domestic health spending and development assistance in 188 countries, 1995-2015.

Science.gov (United States)

2018-05-05

Comparable estimates of health spending are crucial for the assessment of health systems and to optimally deploy health resources. The methods used to track health spending continue to evolve, but little is known about the distribution of spending across diseases. We developed improved estimates of health spending by source, including development assistance for health, and, for the first time, estimated HIV/AIDS spending on prevention and treatment and by source of funding, for 188 countries. We collected published data on domestic health spending, from 1995 to 2015, from a diverse set of international agencies. We tracked development assistance for health from 1990 to 2017. We also extracted 5385 datapoints about HIV/AIDS spending, between 2000 and 2015, from online databases, country reports, and proposals submitted to multilateral organisations. We used spatiotemporal Gaussian process regression to generate complete and comparable estimates for health and HIV/AIDS spending. We report most estimates in 2017 purchasing-power parity-adjusted dollars and adjust all estimates for the effect of inflation. Between 1995 and 2015, global health spending per capita grew at an annualised rate of 3·1% (95% uncertainty interval [UI] 3·1 to 3·2), with growth being largest in upper-middle-income countries (5·4% per capita [UI 5·3-5·5]) and lower-middle-income countries (4·2% per capita [4·2-4·3]). In 2015, $9·7 trillion (9·7 trillion to 9·8 trillion) was spent on health worldwide. High-income countries spent $6·5 trillion (6·4 trillion to 6·5 trillion) or 66·3% (66·0 to 66·5) of the total in 2015, whereas low-income countries spent $70·3 billion (69·3 billion to 71·3 billion) or 0·7% (0·7 to 0·7). Between 1990 and 2017, development assistance for health increased by 394·7% ($29·9 billion), with an estimated $37·4 billion of development assistance being disbursed for health in 2017, of which $9·1 billion (24·2%) targeted HIV/AIDS. Between 2000 and

Microwave-assisted Derivatization of Fatty Acids for Its Measurement in Milk Using High-Performance Liquid Chromatography.

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Shrestha, Rojeet; Miura, Yusuke; Hirano, Ken-Ichi; Chen, Zhen; Okabe, Hiroaki; Chiba, Hitoshi; Hui, Shu-Ping

2018-01-01

Fatty acid (FA) profiling of milk has important applications in human health and nutrition. Conventional methods for the saponification and derivatization of FA are time-consuming and laborious. We aimed to develop a simple, rapid, and economical method for the determination of FA in milk. We applied a beneficial approach of microwave-assisted saponification (MAS) of milk fats and microwave-assisted derivatization (MAD) of FA to its hydrazides, integrated with HPLC-based analysis. The optimal conditions for MAS and MAD were determined. Microwave irradiation significantly reduced the sample preparation time from 80 min in the conventional method to less than 3 min. We used three internal standards for the measurement of short-, medium- and long-chain FA. The proposed method showed satisfactory analytical sensitivity, recovery and reproducibility. There was a significant correlation in the milk FA concentrations between the proposed and conventional methods. Being quick, economic, and convenient, the proposed method for the milk FA measurement can be substitute for the convention method.

Evaluation of the Use of Home Blood Pressure Measurement Using Mobile Phone-Assisted Technology: The iVitality Proof-of-Principle Study.

Science.gov (United States)

Wijsman, Liselotte W; Richard, Edo; Cachucho, Ricardo; de Craen, Anton Jm; Jongstra, Susan; Mooijaart, Simon P

2016-06-13

Mobile phone-assisted technologies provide the opportunity to optimize the feasibility of long-term blood pressure (BP) monitoring at home, with the potential of large-scale data collection. In this proof-of-principle study, we evaluated the feasibility of home BP monitoring using mobile phone-assisted technology, by investigating (1) the association between study center and home BP measurements; (2) adherence to reminders on the mobile phone to perform home BP measurements; and (3) referrals, treatment consequences and BP reduction after a raised home BP was diagnosed. We used iVitality, a research platform that comprises a Website, a mobile phone-based app, and health sensors, to measure BP and several other health characteristics during a 6-month period. BP was measured twice at baseline at the study center. Home BP was measured on 4 days during the first week, and thereafter, at semimonthly or monthly intervals, for which participants received reminders on their mobile phone. In the monthly protocol, measurements were performed during 2 consecutive days. In the semimonthly protocol, BP was measured at 1 day. We included 151 participants (mean age [standard deviation] 57.3 [5.3] years). BP measured at the study center was systematically higher when compared with home BP measurements (mean difference systolic BP [standard error] 8.72 [1.08] and diastolic BP 5.81 [0.68] mm Hg, respectively). Correlation of study center and home measurements of BP was high (R=0.72 for systolic BP and 0.72 for diastolic BP, both PMobile phone-assisted technology is a reliable and promising method with good adherence to measure BP at home during a 6-month period. This provides a possibility for implementation in large-scale studies and can potentially contribute to BP reduction.

Motivation and job satisfaction of Health Surveillance Assistants in ...

African Journals Online (AJOL)

In Malawi, hardly any research has been done on factors that motivate this cadre. This qualitative assessment was undertaken to identify factors that influence motivation and job satisfaction of health surveillance assistants (HSAs) in Mwanza district, Malawi, in order to inform development of strategies to influence staff ...

Costs of medically assisted reproduction treatment at specialized fertility clinics in the Danish public health care system

DEFF Research Database (Denmark)

Christiansen, Terkel; Erb, Karin; Rizvanovic, Amra

2014-01-01

To examine the costs to the public health care system of couples in medically assisted reproduction.......To examine the costs to the public health care system of couples in medically assisted reproduction....

Implementation of School Health Promotion: Consequences for Professional Assistance

Science.gov (United States)

Boot, N. M. W. M.; de Vries, N. K.

2012-01-01

Purpose: This case study aimed to examine the factors influencing the implementation of health promotion (HP) policies and programs in secondary schools and the consequences for professional assistance. Design/methodology/approach: Group interviews were held in two schools that represented the best and worst case of implementation of a health…

Evolution and patterns of global health financing 1995-2014: development assistance for health, and government, prepaid private, and out-of-pocket health spending in 184 countries.

Science.gov (United States)

2017-05-20

An adequate amount of prepaid resources for health is important to ensure access to health services and for the pursuit of universal health coverage. Previous studies on global health financing have described the relationship between economic development and health financing. In this study, we further explore global health financing trends and examine how the sources of funds used, types of services purchased, and development assistance for health disbursed change with economic development. We also identify countries that deviate from the trends. We estimated national health spending by type of care and by source, including development assistance for health, based on a diverse set of data including programme reports, budget data, national estimates, and 964 National Health Accounts. These data represent health spending for 184 countries from 1995 through 2014. We converted these data into a common inflation-adjusted and purchasing power-adjusted currency, and used non-linear regression methods to model the relationship between health financing, time, and economic development. Between 1995 and 2014, economic development was positively associated with total health spending and a shift away from a reliance on development assistance and out-of-pocket (OOP) towards government spending. The largest absolute increase in spending was in high-income countries, which increased to purchasing power-adjusted $5221 per capita based on an annual growth rate of 3·0%. The largest health spending growth rates were in upper-middle-income (5·9) and lower-middle-income groups (5·0), which both increased spending at more than 5% per year, and spent $914 and $267 per capita in 2014, respectively. Spending in low-income countries grew nearly as fast, at 4·6%, and health spending increased from $51 to $120 per capita. In 2014, 59·2% of all health spending was financed by the government, although in low-income and lower-middle-income countries, 29·1% and 58·0% of spending was OOP

Measuring use of electronic health record functionality using system audit information.

Science.gov (United States)

Bowes, Watson A

2010-01-01

Meaningful and efficient methods for measuring Electronic Health Record (EHR) adoption and functional usage patterns have recently become important for hospitals, clinics, and health care networks in the United State due to recent government initiatives to increase EHR use. To date, surveys have been the method of choice to measure EHR adoption. This paper describes another method for measuring EHR adoption which capitalizes on audit logs, which are often common components of modern EHRs. An Audit Data Mart is described which identified EHR functionality within 836 Departments, within 22 Hospitals and 170 clinics at Intermountain Healthcare, a large integrated delivery system. The Audit Data Mart successfully identified important and differing EHR functional usage patterns. These patterns were useful in strategic planning, tracking EHR implementations, and will likely be utilized to assist in documentation of "Meaningful Use" of EHR functionality.

Measurement of heavy metals by means of a plasma-assisted method

International Nuclear Information System (INIS)

Hernberg, R.; Haeyrinen, V.; Oikari, R.

1995-01-01

The plasma-assisted measuring device for on-line measurement of alkali metal concentrations in pressurised processes, which has been developed in the Laboratory, will be further developed to provide for simultaneous measurement of heavy metal concentrations. (author)

Achieving equity within universal health coverage: a narrative review of progress and resources for measuring success.

Science.gov (United States)

Rodney, Anna M; Hill, Peter S

2014-10-10

Equity should be implicit within universal health coverage (UHC) however, emerging evidence is showing that without adequate focus on measurement of equity, vulnerable populations may continue to receive inadequate or inferior health care. This study undertakes a narrative review which aims to: (i) elucidate how equity is contextualised and measured within UHC, and (ii) describe tools, resources and lessons which will assist decision makers to plan and implement UHC programmes which ensure equity for all. A narrative review of peer-reviewed literature published in English between 2005 and 2013, retrieved from PubMed via the search words, 'universal health coverage/care' and 'equity/inequity' was performed. Websites of key global health organizations were also searched for relevant grey literature. Papers were excluded if they failed to focus on equity (of access, financial risk protection or health outcomes) as well as focusing on one of the following: (i) the impact of UHC programmes, policies or interventions on equity (ii) indicators, measurement, monitoring and/or evaluation of equity within UHC, or (iii) tools or resources to assist with measurement. Eighteen journal articles consisting mostly of secondary analysis of country data and qualitative case studies in the form of commentaries/reviews, and 13 items of grey literature, consisting largely of reports from working groups and expert meetings focusing on defining, understanding and measuring inequity in UHC (including recent drafts of global/country monitoring frameworks) were included. The literature advocates for progressive universalism addressing monetary and non-monetary barriers to access and strengthening existing health systems. This however relies on countries being effectively able to identify and reach disadvantaged populations and estimate unmet need. Countries should assess the new WHO/WB-proposed framework for its ability to adequately track the progress of disadvantaged populations in terms

Psychiatric wards with locked doors--advantages and disadvantages according to nurses and mental health nurse assistants.

Science.gov (United States)

Haglund, K; von Knorring, L; von Essen, L

2006-04-01

To describe nurses' and mental health nurse assistants' perceptions of advantages and disadvantages about working on a psychiatric ward with a locked entrance door. Psychiatric staff sometimes needs to protect patients from harming themselves or others. To keep the entrance door locked may help staff to achieve this goal. How locked entrance doors at psychiatric wards are experienced by staff, working on these wards, has been investigated to a very limited extent. The study was explorative and descriptive. Audio taped, semi-structured interviews with open-ended questions about advantages and disadvantages about working on a psychiatric ward with a locked entrance door, were conducted with 20 nurses and 20 mental health nurse assistants. Data were analyzed with content analysis. A content analysis revealed eight categories of advantages and 18 categories of disadvantages. Most advantages mentioned by nurses and mental health nurse assistants were categorized as providing staff with control over patients, providing patients with a secure and efficient care and protecting patients and staff against 'the outside'. Most disadvantages mentioned by nurses were categorized as causing extra work for staff, making patients feel confined, making patients feel dependent and creating a non-caring environment. Most disadvantages mentioned by mental health nurse assistants were categorized as causing extra work for staff, making patients feel confined, causing emotional problems for patients, making staff's power obvious and forcing patients to adapt to other patients' needs. Nurses and mental health nurse assistants mentioned more disadvantages than advantages and nurses mentioned more disadvantages than mental health nurse assistants. Nurses and mental health nurse assistants perceive a number of advantages and disadvantages for themselves, patients and significant others with a locked door at a psychiatric ward. Most of these concern patients' experiences. It is important for

Employee assistance programs: an alternative resource for mental health service delivery.

Science.gov (United States)

Santa-Barbara, J

1984-09-01

The purpose of this article is to provide a very brief introduction to employee assistance programs (EAPs) and their role in the mental health delivery system. In addition, some consideration will be given to the opportunity these programs offer for making a significant impact on both the mental health of Canadians and the productivity of Canadian business.

Do less populous countries receive more development assistance for health per capita? Longitudinal evidence for 143 countries, 1990-2014.

Science.gov (United States)

Martinsen, Lene; Ottersen, Trygve; Dieleman, Joseph L; Hessel, Philipp; Kinge, Jonas Minet; Skirbekk, Vegard

2018-01-01

Per capita allocation of overall development assistance has been shown to be biased towards countries with lower population size, meaning funders tend to provide proportionally less development assistance to countries with large populations. Individuals that happen to be part of large populations therefore tend to receive less assistance. However, no study has investigated whether this is also true regarding development assistance for health. We examined whether this so-called 'small-country bias' exists in the health aid sector. We analysed the effect of a country's population size on the receipt of development assistance for health per capita (in 2015 US$) among 143 countries over the period 1990-2014. Explanatory variables shown to be associated with receipt of development assistance for health were included: gross domestic product per capita, burden of disease, under-5 mortality rate, maternal mortality ratio, vaccination coverage (diphtheria, tetanus and pertussis) and fertility rate. We used the within-between regression analysis, popularised by Mundluck, as well as a number of robustness tests, including ordinary least squares, random-effects and fixed-effects regressions. Our results suggest there exists significant negative effect of population size on the amount of development assistance for health per capita countries received. According to the within-between estimator, a 1% larger population size is associated with a 0.4% lower per capita development assistance for health between countries (-0.37, 95% CI -0.45 to -0.28), and 2.3% lower per capita development assistance for health within countries (-2.29, 95% CI -3.86 to -0.72). Our findings support the hypothesis that small-country bias exists within international health aid, as has been previously documented for aid in general. In a rapidly changing landscape of global health and development, the inclusion of population size in allocation decisions should be challenged on the basis of equitable

Innovation in health service delivery: integrating community health assistants into the health system at district level in Zambia.

Science.gov (United States)

Zulu, Joseph Mumba; Hurtig, Anna-Karin; Kinsman, John; Michelo, Charles

2015-01-28

To address the huge human resources for health gap in Zambia, the Ministry of Health launched the National Community Health Assistant Strategy in 2010. The strategy aims to integrate community-based health workers into the health system by creating a new group of workers, called community health assistants (CHAs). However, literature suggests that the integration process of national community-based health worker programmes into health systems has not been optimal. Conceptually informed by the diffusion of innovations theory, this paper qualitatively aimed to explore the factors that shaped the acceptability and adoption of CHAs into the health system at district level in Zambia during the pilot phase. Data gathered through review of documents, 6 focus group discussions with community leaders, and 12 key informant interviews with CHA trainers, supervisors and members of the District Health Management Team were analysed using thematic analysis. The perceived relative advantage of CHAs over existing community-based health workers in terms of their quality of training and scope of responsibilities, and the perceived compatibility of CHAs with existing groups of health workers and community healthcare expectations positively facilitated the integration process. However, limited integration of CHAs in the district health governance system hindered effective programme trialability, simplicity and observability at district level. Specific challenges at this level included a limited information flow and sense of programme ownership, and insufficient documentation of outcomes. The district also had difficulties in responding to emergent challenges such as delayed or non-payment of CHA incentives, as well as inadequate supervision and involvement of CHAs in the health posts where they are supposed to be working. Furthermore, failure of the health system to secure regular drug supplies affected health service delivery and acceptability of CHA services at community level. The

Software-assisted quantitative analysis of small bowel motility compared to manual measurements

International Nuclear Information System (INIS)

Bickelhaupt, S.; Froehlich, J.M.; Cattin, R.; Raible, S.; Bouquet, H.; Bill, U.; Patak, M.A.

2014-01-01

Aim: To validate a newly developed software prototype that automatically analyses small bowel motility by comparing it directly with manual measurement. Material and methods: Forty-five patients with clinical indication for small bowel magnetic resonance imaging (MRI) were retrospectively included in this institutional review board-approved study. MRI was performed using a 1.5 T system following a standard MR-enterography protocol. Small bowel motility parameters (contractions-per-minute, luminal diameter, amplitude) were measured three times each in identical segments using the manual and the semiautomatic software-assisted method. The methods were compared for agreement, repeatability, and time needed for each measurement. All parameters were compared between the methods. Results: A total of 91 small-bowel segments were analysed. No significant intra-individual difference (p > 0.05) was found for peristaltic frequencies between the methods (mean: 4.14/min manual; 4.22/min software-assisted). Amplitudes (5.14 mm; 5.57 mm) and mean lumen diameters (17.39 mm; 14.68) differed due to systematic differences in the definition of the bowel wall. Mean duration of single measurement was significantly (p < 0.01) shorter with the software (6.25 min; 1.30 min). The scattering of repeated measurements was significantly (p < 0.05) lower using the software. Conclusion: The software-assisted method accomplished highly reliable, fast and accurate measurement of small bowel motility. Measurement precision and duration differed significantly between the two methods in favour of the software-assisted technique

Conceptual measurement framework for help-seeking for mental health problems

Directory of Open Access Journals (Sweden)

Rickwood D

2012-12-01

Full Text Available Debra Rickwood, Kerry ThomasFaculty of Health, University of Canberra, ACT, AustraliaBackground: Despite a high level of research, policy, and practice interest in help-seeking for mental health problems and mental disorders, there is currently no agreed and commonly used definition or conceptual measurement framework for help-seeking.Methods: A systematic review of research activity in the field was undertaken to investigate how help-seeking has been conceptualized and measured. Common elements were used to develop a proposed conceptual measurement framework.Results: The database search revealed a very high level of research activity and confirmed that there is no commonly applied definition of help-seeking and no psychometrically sound measures that are routinely used. The most common element in the help-seeking research was a focus on formal help-seeking sources, rather than informal sources, although studies did not assess a consistent set of professional sources; rather, each study addressed an idiosyncratic range of sources of professional health and community care. Similarly, the studies considered help-seeking for a range of mental health problems and no consistent terminology was applied. The most common mental health problem investigated was depression, followed by use of generic terms, such as mental health problem, psychological distress, or emotional problem. Major gaps in the consistent measurement of help-seeking were identified.Conclusion: It is evident that an agreed definition that supports the comparable measurement of help-seeking is lacking. Therefore, a conceptual measurement framework is proposed to fill this gap. The framework maintains that the essential elements for measurement are: the part of the help-seeking process to be investigated and respective time frame, the source and type of assistance, and the type of mental health concern. It is argued that adopting this framework will facilitate progress in the field by

The Influence of Suicide Prevention Gatekeeper Training on Resident Assistants' Mental Health

Science.gov (United States)

Becker, Martin A. Swanbrow; Drum, David J.

2015-01-01

This study explored the mental health influence on resident assistants associated with their training in suicide prevention and their subsequent role as campus mental health gatekeepers. Despite considerable prior personal experience with their own suicidal thinking as well as with others who have thoughts of suicide, a multiple regression…

Development of the Workplace Health Savings Calculator: a practical tool to measure economic impact from reduced absenteeism and staff turnover in workplace health promotion.

Science.gov (United States)

Baxter, Siyan; Campbell, Sharon; Sanderson, Kristy; Cazaly, Carl; Venn, Alison; Owen, Carole; Palmer, Andrew J

2015-09-18

Workplace health promotion is focussed on improving the health and wellbeing of workers. Although quantifiable effectiveness and economic evidence is variable, workplace health promotion is recognised by both government and business stakeholders as potentially beneficial for worker health and economic advantage. Despite the current debate on whether conclusive positive outcomes exist, governments are investing, and business engagement is necessary for value to be realised. Practical tools are needed to assist decision makers in developing the business case for workplace health promotion programs. Our primary objective was to develop an evidence-based, simple and easy-to-use resource (calculator) for Australian employers interested in workplace health investment figures. Three phases were undertaken to develop the calculator. First, evidence from a literature review located appropriate effectiveness measures. Second, a review of employer-facilitated programs aimed at improving the health and wellbeing of employees was utilised to identify change estimates surrounding these measures, and third, currently available online evaluation tools and models were investigated. We present a simple web-based calculator for use by employers who wish to estimate potential annual savings associated with implementing a successful workplace health promotion program. The calculator uses effectiveness measures (absenteeism and staff turnover rates) and change estimates sourced from 55 case studies to generate the annual savings an employer may potentially gain. Australian wage statistics were used to calculate replacement costs due to staff turnover. The calculator was named the Workplace Health Savings Calculator and adapted and reproduced on the Healthy Workers web portal by the Australian Commonwealth Government Department of Health and Ageing. The Workplace Health Savings Calculator is a simple online business tool that aims to engage employers and to assist participation

Plasma assisted measurements of alkali metal concentrations in pressurized combustion processes

Energy Technology Data Exchange (ETDEWEB)

Hernberg, R.; Haeyrinen, V. [Tampere Univ. of Technology (Finland). Dept. of Physics

1996-12-01

The plasma assisted method for continuous measurement of alkali concentrations in product gas flows of pressurized energy processes will be tested and applied at the 1.6 MW PFBC/G facility at Delft University of Technology in the Netherlands. During the reporting period the alkali measuring device has been tested under pressurized conditions at VTT Energy, DMT, Foster-Wheeler Energia and ABB Carbon. Measurements in Delft will be performed during 1996 after installation of the hot gas filter. The original plan for measurements in Delft has been postponed due to schedule delays in Delft. The results are expected to give information about the influence of different process conditions on the generation of alkali vapours, the comparison of different methods for alkali measurement and the specific performance of our system. This will be the first test of the plasma assisted measurement method in a gasification process. The project belongs to the Joule II extension program under contract JOU2-CT93-0431. (author)

Work-Family Conflict, Sleep, and Mental Health of Nursing Assistants Working in Nursing Homes.

Science.gov (United States)

Zhang, Yuan; Punnett, Laura; Nannini, Angela

2017-07-01

Work-family conflict is challenging for workers and may lead to depression, anxiety, and overall poor health. Sleep plays an important role in the maintenance of mental health; however, the role of sleep in the association between work-family conflict and mental health is not well-studied. Questionnaires were collected from 650 nursing assistants in 15 nursing homes. Multivariate linear regression modeling demonstrated that increased work-family conflict was associated with lower mental health scores (β = -2.56, p work-family conflict was correlated with more job demands, less job control, less social support, and longer work hours. Poor sleep quality, but not short sleep duration, mediated the association between work-family conflict and mental health. Workplace interventions to improve nursing assistants' mental health should increase their control over work schedules and responsibilities, provide support to meet their work and family needs, and address healthy sleep practices.

Communication and Information Barriers to Health Assistance for Deaf Patients

Science.gov (United States)

Pereira, Patricia Cristina Andrade; Fortes, Paulo Antonio de Carvalho

2010-01-01

In Brazil, recent regulations require changes in private and public health systems to make special services available to deaf patients. In the present article, the researchers analyze the perceptions of 25 sign language-using patients regarding this assistance. The researchers found communication difficulties between these patients and health…

Allocation of development assistance for health: is the predominance of national income justified?

Science.gov (United States)

Sterck, Olivier; Roser, Max; Ncube, Mthuli; Thewissen, Stefan

2018-02-01

Gross national income (GNI) per capita is widely regarded as a key determinant of health outcomes. Major donors heavily rely on GNI per capita to allocate development assistance for health (DAH). This article questions this paradigm by analysing the determinants of health outcomes using cross-sectional data from 99 countries in 2012. We use disability-adjusted life years (Group I) per capita as our main indicator for health outcomes. We consider four primary variables: GNI per capita, institutional capacity, individual poverty and the epidemiological surroundings. Our empirical strategy has two innovations. First, we construct a health poverty line of 10.89 international-$ per day, which measures the minimum level of income an individual needs to have access to basic healthcare. Second, we take the contagious nature of communicable diseases into account, by estimating the extent to which the population health in neighbouring countries (the epidemiological surroundings) affects health outcomes. We apply a spatial two-stage least-squares model to mitigate the risks of reverse causality. Our model captures 92% of the variation in health outcomes. We emphasize four findings. First, GNI per capita is not a significant predictor of health outcomes once other factors are controlled for. Second, the poverty gap below the 10.89 health poverty line is a good measure of universal access to healthcare, as it explains 19% of deviation in health outcomes. Third, the epidemiological surroundings in which countries are embedded capture as much as 47% of deviation in health outcomes. Finally, institutional capacity explains 10% of deviation in health outcomes. Our empirical findings suggest that allocation frameworks for DAH should not only take into account national income, which remains an important indicator of countries' financial capacity, but also individual poverty, governance and epidemiological surroundings to increase impact on health outcomes. The Author(s) 2017

Precision of lumbar intervertebral measurements: does a computer-assisted technique improve reliability?

Science.gov (United States)

Pearson, Adam M; Spratt, Kevin F; Genuario, James; McGough, William; Kosman, Katherine; Lurie, Jon; Sengupta, Dilip K

2011-04-01

Comparison of intra- and interobserver reliability of digitized manual and computer-assisted intervertebral motion measurements and classification of "instability." To determine if computer-assisted measurement of lumbar intervertebral motion on flexion-extension radiographs improves reliability compared with digitized manual measurements. Many studies have questioned the reliability of manual intervertebral measurements, although few have compared the reliability of computer-assisted and manual measurements on lumbar flexion-extension radiographs. Intervertebral rotation, anterior-posterior (AP) translation, and change in anterior and posterior disc height were measured with a digitized manual technique by three physicians and by three other observers using computer-assisted quantitative motion analysis (QMA) software. Each observer measured 30 sets of digital flexion-extension radiographs (L1-S1) twice. Shrout-Fleiss intraclass correlation coefficients for intra- and interobserver reliabilities were computed. The stability of each level was also classified (instability defined as >4 mm AP translation or 10° rotation), and the intra- and interobserver reliabilities of the two methods were compared using adjusted percent agreement (APA). Intraobserver reliability intraclass correlation coefficients were substantially higher for the QMA technique THAN the digitized manual technique across all measurements: rotation 0.997 versus 0.870, AP translation 0.959 versus 0.557, change in anterior disc height 0.962 versus 0.770, and change in posterior disc height 0.951 versus 0.283. The same pattern was observed for interobserver reliability (rotation 0.962 vs. 0.693, AP translation 0.862 vs. 0.151, change in anterior disc height 0.862 vs. 0.373, and change in posterior disc height 0.730 vs. 0.300). The QMA technique was also more reliable for the classification of "instability." Intraobserver APAs ranged from 87 to 97% for QMA versus 60% to 73% for digitized manual

Indicators of human health in ecosystems: what do we measure?

International Nuclear Information System (INIS)

Cole, D.C.; Eyles, J.; Gibson, B.L.

1998-01-01

Increasingly, scientists are being called upon to assist in the development of indicators for monitoring ecosystem health. For human health indicators, they may draw on environmental exposure, human morbidity/mortality or well-being and sustainability approaches. To improve the rigour of indicators, we propose six scientific criteria for indicator selection: (1) data availability, suitability and representativeness (of populations), (2) indicator validity (face, construct, predictive and convergent) and reliability; (3) indicator responsiveness to change; (4) indicator desegregation capability (across personal and community characteristics); (5) indicator comparability (across populations and jurisdictions); and (6) indicator representativeness (across important dimensions of concern). We comment on our current capacity to adhere to such criteria with examples of measures of environmental exposure, human health and sustainability. We recognize the considerable work still required on documenting environment-human health relationships and on monitoring potential indicators in similar ways over time. Yet we argue that such work is essential in order for science to inform policy decisions which affect the health of ecosystems and human health. (Copyright (c) 1998 Elsevier Science B.V., Amsterdam. All rights reserved.)

Trends in perinatal health after assisted reproduction

DEFF Research Database (Denmark)

Henningsen, Anna-Karina Aaris; Gissler, M.; Skjaerven, R.

2015-01-01

STUDY QUESTIONS Has the perinatal outcome of children conceived after assisted reproductive technology (ART) improved over time? SUMMARY ANSWER The perinatal outcomes in children born after ART have improved over the last 20 years, mainly due to the reduction of multiple births. WHAT IS KNOWN...... with ART outcome and health data from Denmark, Finland, Norway and Sweden. PARTICIPANTS, SETTING AND METHODS We analysed the perinatal outcome of 62 379 ART singletons and 29 758 ART twins, born from 1988 to 2007 in four Nordic countries. The ART singletons were compared with a control group of 362 215...

Computer-aided-design-model-assisted absolute three-dimensional shape measurement.

Science.gov (United States)

Li, Beiwen; Bell, Tyler; Zhang, Song

2017-08-20

Conventional three-dimensional (3D) shape measurement methods are typically generic to all types of objects. Yet, for many measurement conditions, such a level of generality is inessential when having the preknowledge of the object geometry. This paper introduces a novel adaptive algorithm for absolute 3D shape measurement with the assistance of the object computer-aided-design (CAD) model. The proposed algorithm includes the following major steps: (1) export the 3D point cloud data from the CAD model; (2) transform the CAD model into the camera perspective; (3) obtain a wrapped phase map from three phase-shifted fringe images; and (4) retrieve absolute phase and 3D geometry assisted by the CAD model. We demonstrate that if object CAD models are available, such an algorithm is efficient in recovering absolute 3D geometries of both simple and complex objects with only three phase-shifted fringe images.

A review of low income energy assistance measures adopted in other jurisdictions

International Nuclear Information System (INIS)

2008-01-01

Low-income energy assistance programs (LIEPs) have been established and implemented in many jurisdictions to help make electricity and natural gas more affordable. Low-income programs also serve many other public interest goals, such as safeguarding and protecting the public health and welfare of the citizens; augmenting incomes or standards of living for the lowest income energy customers; encouraging conservation and more efficient use of energy resources; reducing customer care costs for utilities; reducing uncollectible accounts and bad debt expense for utilities; and reducing carbon emissions and greenhouse gas levels. This report contained a summary of the policies, programs, and measures that have been implemented, mandated, or allowed by regulators in other jurisdictions to assist low-income energy consumers with electricity and natural gas costs. The report categorized the differing low income policies and programs that have been implemented and examined the effectiveness of those policies and programs as measured by the costs and benefits, as well the level of customer participation. These categories included rate discounts or waivers; modified rate designs; alternative billing methods; customer rebates; conservation and demand side management programs; budget or equal billing; payment plans for past due accounts; waivers of late payment charges; waivers or reductions of customer security deposits; limits on disconnections; and reduced or waived fees for reconnections. The report covered regulatory jurisdictions, including those in Canada, the United States, the United Kingdom, Australia, New Zealand, France, Spain, and Finland. The report also discussed the role of regulators, utilities, charitable organizations, and other interested parties in developing and implementing low-income energy assistance programs that were cost-effective and efficient. It was concluded that, in addition to rate discounts or waivers of the fixed monthly service charge, many

The Personal Norm of Reciprocity among mental health service users: conceptual development and measurement.

Science.gov (United States)

Matejkowski, Jason; McCarthy, Kevin S; Draine, Jeffrey

2011-01-01

A measure of an individual's level of internalization of the norm of reciprocity may signal exchange preferences and indicate whether "active" or "passive" mental health services are preferable to consumers. We evaluated the psychometric properties of one such measure, the Personal Norm of Reciprocity (PNR) scale. We recruited 70 persons receiving mental health services and 65 comparison participants to complete questionnaires assessing reciprocity tendencies and correlates of mental illness. Two of three subscales of a shortened PNR showed evidence of reliability and validity. Consumers endorsed higher levels of the reciprocity norm than persons not seeking services. Persons in "active" service settings displayed greater rigidity in application of the reciprocity norm than individuals in "passive" service settings or comparison participants. The shortened PNR can be a useful measure of individual reciprocity preferences. Measurement of the internalization of the norm of reciprocity may assist practitioners in identifying what types of services are more likely to retain and benefit mental health service consumers.

An integrated model to measure service management and physical constraints' effect on food consumption in assisted-living facilities.

Science.gov (United States)

Huang, Hui-Chun; Shanklin, Carol W

2008-05-01

The United States is experiencing remarkable growth in the elderly population, which provides both opportunities and challenges for assisted-living facilities. The objective of this study was to explore how service management influences residents' actual food consumption in assisted-living facilities. Physical factors influencing residents' service evaluation and food consumption also were investigated. A total of 394 questionnaires were distributed to assisted-living residents in seven randomly selected facilities. The questionnaire was developed based on an in-depth literature review and pilot study. Residents' perceived quality evaluations, satisfaction, and physical constraints were measured. Residents' actual food consumption was measured using a plate waste technique. A total of 118 residents in five facilities completed both questionnaires and food consumption assessments. Descriptive, multivariate analyses and structural equation modeling techniques were employed. Service management, including food and service quality and customer satisfaction, was found to significantly influence residents' food consumption. Physical constraints associated with aging, including a decline in health status, chewing problems, sensory loss, and functional disability, also significantly influenced residents' food consumption. A significant relationship was found between physical constraints and customer satisfaction. Foodservice that provides good food and service quality increases customer satisfaction and affects residents' actual food consumption. Physical constraints also influence residents' food consumption directly, or indirectly through satisfaction. The findings suggest that food and nutrition professionals in assisted-living should consider the physical profiles of their residents to enhance residents' satisfaction and nutrient intake. Recommendations for exploring residents' perspectives are discussed.

Recognising Health Care Assistants' Prior Learning through a Caring Ideology

Science.gov (United States)

Sandberg, Fredrik

2010-01-01

This article critically appraises a process of recognising prior learning (RPL) using analytical tools from Habermas' theory of communicative action. The RPL process is part of an in-service training program for health care assistants where the goal is to become a licensed practical nurse. Data about the RPL process were collected using interviews…

Concept of Educational Assistance to Health Protection of the Individual

Science.gov (United States)

Levanova, Elena Aleksandrovna; Kokorina, Olga Rafailovna; Nikitin, Yuriy Vladimirovich; Perepelkina, Tatiyna Vladislavovna; Segodina, Polina Anatolievna

2016-01-01

The article describes the theoretical and practical need for the development of the concept of assistance to health protection of the individual in order to address the problem of health protection of students and teachers in the conditions of a higher pedagogical education. The problem of studying human health, its entirety, systemacity and connection with the environment attracts particular attention in recent years. This was one of the reasons to study the problem of “healthy lifestyle” as the qualitative characteristic of a human life aimed at health, due to the fact that a healthy lifestyle is one of the determinants of health. This is made possible with the use of specific health-protecting technologies aimed at searching for ways and means of protection and conservation of health of students and teachers in the conditions of the educational process and using educational tools, which is currently included into the priorities of education. PMID:26493439

Technical assistance from state health departments for communities engaged in policy, systems, and environmental change: the ACHIEVE Program.

Science.gov (United States)

Hefelfinger, Jenny; Patty, Alice; Ussery, Ann; Young, Walter

2013-10-24

This study assessed the value of technical assistance provided by state health department expert advisors and by the staff of the National Association of Chronic Disease Directors (NACDD) to community groups that participated in the Action Communities for Health, Innovation, and Environmental Change (ACHIEVE) Program, a CDC-funded health promotion program. We analyzed quantitative and qualitative data reported by community project coordinators to assess the nature and value of technical assistance provided by expert advisors and NACDD staff and the usefulness of ACHIEVE resources in the development and implementation of community action plans. A grounded theory approach was used to analyze and categorize phrases in text data provided by community coordinators. Open coding placed conceptual labels on text phrases. Frequency distributions of the quantitative data are described and discussed. The most valuable technical assistance and program support resources were those determined to be in the interpersonal domain (ie, interactions with state expert advisors, NACDD staff, and peer-to-peer support). The most valuable technical assistance events were action institutes, coaches' meetings, webinars, and technical assistance conference calls. This analysis suggests that ACHIEVE communities valued the management and training assistance provided by expert advisors and NACDD staff. State health department expert advisors provided technical guidance and support, including such skills or knowledge-based services as best-practice strategies, review and discussion of community assessment data, sustainability planning, and identification of possible funding opportunities. NACDD staff led development and implementation of technical assistance events.

Tracking development assistance for health to fragile states: 2005-2011.

Science.gov (United States)

Graves, Casey M; Haakenstad, Annie; Dieleman, Joseph L

2015-03-19

Development assistance for health (DAH) has grown substantially, totaling more than $31.3 billion in 2013. However, the degree that countries with high concentrations of armed conflict, ethnic violence, inequality, debt, and corruption have received this health aid and how that assistance might be different from the funding provided to other countries has not been assessed. We combine DAH estimates and a multidimensional fragile states index for 2005 through 2011. We disaggregate and compare total DAH disbursed for fragile states versus stable states. Between 2005 and 2011, DAH per person in fragile countries increased at an annualized rate of 5.4%. In 2011 DAH to fragile countries totaled $6.2 billion, which is $5.05 per person. This is 43% of total DAH that is traced to a country. Comparing low-income countries, funding channeled to fragile countries was $7.22 per person while stable countries received $11.15 per person. Relative to stable countries, donors preferred to provide more funding to low-income fragile countries that have refugees or ongoing external intervention but tended to avoid providing funding to countries with political gridlock, flawed elections, or economic decline. In 2011, Ethiopia received the most health aid of all fragile countries, while the United States provided the most funds to fragile countries. In 2011, 1.2 billion people lived in fragile countries. DAH can bolster health systems and might be especially valuable in providing long-term stability in fragile environments. While external health funding to these countries has increased since 2005, it is, in per person terms, almost half as much as the DAH provided to stable countries of comparable income levels.

Health coaching by medical assistants to improve control of diabetes, hypertension, and hyperlipidemia in low-income patients: a randomized controlled trial.

Science.gov (United States)

Willard-Grace, Rachel; Chen, Ellen H; Hessler, Danielle; DeVore, Denise; Prado, Camille; Bodenheimer, Thomas; Thom, David H

2015-03-01

Health coaching by medical assistants could be a financially viable model for providing self-management support in primary care if its effectiveness were demonstrated. We investigated whether in-clinic health coaching by medical assistants improves control of cardiovascular and metabolic risk factors when compared with usual care. We conducted a 12-month randomized controlled trial of 441 patients at 2 safety net primary care clinics in San Francisco, California. The primary outcome was a composite measure of being at or below goal at 12 months for at least 1 of 3 uncontrolled conditions at baseline as defined by hemoglobin A1c, systolic blood pressure, and low-density lipoprotein (LDL) cholesterol. Secondary outcomes were meeting all 3 goals and meeting individual goals. Data were analyzed using χ(2) tests and linear regression models. Participants in the coaching arm were more likely to achieve both the primary composite measure of 1 of the clinical goals (46.4% vs 34.3%, P = .02) and the secondary composite measure of reaching all clinical goals (34.0% vs 24.7%, P = .05). Almost twice as many coached patients achieved the hemoglobin A1c goal (48.6% vs 27.6%, P = .01). At the larger study site, coached patients were more likely to achieve the LDL cholesterol goal (41.8% vs 25.4%, P = .04). The proportion of patients meeting the systolic blood pressure goal did not differ significantly. Medical assistants serving as in-clinic health coaches improved control of hemoglobin A1c and LDL levels, but not blood pressure, compared with usual care. Our results highlight the need to understand the relationship between patients' clinical conditions, interventions, and the contextual features of implementation. © 2015 Annals of Family Medicine, Inc.

Electronic health records and technical assistance to improve quality of primary care: Lessons for regional extension centers.

Science.gov (United States)

Boas, Samuel J; Bishop, Tara F; Ryan, Andrew M; Shih, Sarah C; Casalino, Lawrence P

2014-07-01

In 2009, the American Recovery and Reinvestment Act apportioned $643 million for a Health Information Technology Extension Program, which established Regional Extension Centers (RECs) to support the implementation and use of electronic health records (EHRs). Little is known, however, about how RECs should assist in EHR implementation and how they should structure ongoing support. The purpose of this paper is to describe physicians' experiences with the Primary Care Information Project (PCIP), an REC run by the New York City Department of Health and Mental Hygiene. We interviewed 17 physicians enrolled in PCIP to understand the role of the EHRon quality of care and their experience with technical assistance from PCIP. All physicians stated that they felt that the EHR improved the quality of care they delivered to their patients particularly because it helped them track patients. All the physicians found technical assistance helpful but most wanted ongoing assistance months or years after they adopted the EHR. © 2013 Published by Elsevier Inc.

Health physics assistant. A special training in health physics in the Federal Republic of Germany

International Nuclear Information System (INIS)

Kiefer, H.; Koelzer, W.

1977-01-01

In the Federal Republic of Germany knowledge in health physics is imparted mainly as a supplement training in courses of some days up to a few weeks duration. This may be adequate for strictly defined sectors, although it is not sufficient as to the education of a true health physicist. Already in the early sixties the necessity of such special training was recognized at the Karlsruhe Nuclear Research Center and training was started of 'health physics assistants' as this profession is called. Significant details are given about training, the contributions of the individual training institutions (Karlsruhe Nuclear Research Center, nuclear medical hospital, Euratom institute, S.C.P.R.I.) examinations and subjects examined, experience regarding future employments and activities

Assisted Living

Science.gov (United States)

... it, too. Back to top What is the Cost for Assisted Living? Although assisted living costs less than nursing home ... Primarily, older persons or their families pay the cost of assisted living. Some health and long-term care insurance policies ...

Assistive technologies along supply chains in health care and in the social services sector.

Science.gov (United States)

Mayer, Peter; Hauer, Katharina; Schloffer, Evelyn; Leyrer, Barbara

2015-01-01

Health care systems in Austria and Slovenia are currently facing challenges due to scarce resources and demographic change which can be seen especially along the supply chains. The main objective of this paper is to present an option to improve the use of assistive technologies. An extensive literature research for the theoretic part as well as a qualitative survey for the empiric part focusing on short-term care were carried out. Results show that there is a lack of information and training on assistive technologies. As a consequence, their full potential cannot be exploited. Therefore a guideline for nursing consultations was developed. To conclude, both the literature research and the qualitative survey show that assistive technologies have high potentials to improve the supply chains in the health care and social services sector, but there is a lot of information and training on them needed.

Sexual health education in U.S. physician assistant programs.

Science.gov (United States)

Seaborne, Lori A; Prince, Ronald J; Kushner, David M

2015-05-01

Since the 1950s, sexual health education in medical schools has been evaluated and reported upon, but there has never been an assessment published about sexual health curricula in U.S. physician assistant (PA) programs. The aim of this study was to gain better understanding of how PA programs cover sexual health topics. Between January and March 2014, 181 accredited PA programs received a mailed survey inquiring about their sexual health curriculum. The survey assessed general sexual health topics; lesbian, gay, bisexual, transgender (LGBT) topics; teaching methods; and the amount of time spent on sexual health education. A total of 106 programs responded (59%). Ten programs offered a required, discrete course on human sexuality. The majority incorporated training into other coursework, which is consistent with most medical schools. LGBT topics were covered less thoroughly than the general sexual health topics. Total amount of time spent on sexual health topics varied widely among programs, from a minimum of 2-4 hours to a maximum of 60 hours, with a median of 12 hours. PA programs in the United States appear to compare favorably with the training offered to medical students in regard to time spent on sexual health education. Transgender issues were least well-covered of all the topics queried. © 2015 International Society for Sexual Medicine.

Role of Health Educators in Assisting Youth and Adolescents with Diabetes

Science.gov (United States)

Spiegel, Gail A.; Evert, Alison; Shea, Laura

2009-01-01

Management of diabetes in children requires balancing nutrition, physical activity and medication on a daily basis in order to achieve blood glucose targets. The health educator can assist children and their families in meeting their diabetes management goals by better understanding the current recommendations and tasks involved to achieve them.…

Towards an artificial therapy assistant: Measuring excessive stress from speech

NARCIS (Netherlands)

van der Sluis, Frans; van den Broek, Egon; Dijkstra, Ton; Traver, V.; Fred, A.; Filipe, J.; Gamboa, H.

2011-01-01

The measurement of (excessive) stress is still a challenging endeavor. Most tools rely on either introspection or expert opinion and are, therefore, often less reliable or a burden on the patient. An objective method could relieve these problems and, consequently, assist diagnostics. Speech was

Usability of an adaptive computer assistant that improves self-care and health literacy of older adults

NARCIS (Netherlands)

Blanson Henkemans, O.A.; Rogers, W.A.; Fisk, A.D.; Neerincx, M.A.; Lindenberg, J.; Mast, C.A.P.G. van der

2008-01-01

Objectives: We developed an adaptive computer assistant for the supervision of diabetics' self-care, to support limiting illness and need for acute treatment, and improve health literacy. This assistant monitors self-care activities logged in the patient's electronic diary. Accordingly, it provides

Health promotion through employee assistance programs: a role for occupational therapists.

Science.gov (United States)

Maynard, M

1986-11-01

Health promotion is predicted to have a major impact on occupational therapy practice. Keeping people well and promoting a healthy life-style will be the focus for the future. Many companies and agencies are taking the lead by instituting employee assistance programs (EAPs). With the de-emphasis on long-term hospital care, many occupational therapists will be seeking employment with community health programs. This paper advocates a role for occupational therapists in health promotion and disease prevention in an EAP. A description of EAPs and the contributions that occupational therapists can make to these programs is offered. Practice and education considerations for occupational therapists' roles in EAPs are provided.

Validation of a laser-assisted wound measurement device in a wound healing model.

Science.gov (United States)

Constantine, Ryan S; Bills, Jessica D; Lavery, Lawrence A; Davis, Kathryn E

2016-10-01

In the treatment and monitoring of a diabetic or chronic wound, accurate and repeatable measurement of the wound provides indispensable data for the patient's medical record. This study aims to measure the accuracy of the laser-assisted wound measurement (LAWM) device against traditional methods in the measurement of area, depth and volume. We measured four 'healing' wounds in a Play-Doh(®) -based model over five subsequent states of wound healing progression in which the model was irregularly filled in to replicate the healing process. We evaluated the LAWM device against traditional methods including digital photograph assessment with National Institutes of Health ImageJ software, measurements of depth with a ruler and weight-to-volume assessment with dental paste. Statistical analyses included analysis of variance (ANOVA) and paired t-tests. We demonstrate that there are significantly different and nearly statistically significant differences between traditional ruler depth measurement and LAWM device measurement, but there are no statistically significant differences in area measurement. Volume measurements were found to be significantly different in two of the wounds. Rate of percentage change was analysed for volume and depth in the wound healing model, and the LAWM device was not significantly different than the traditional measurement technique. While occasionally inaccurate in its absolute measurement, the LAWM device is a useful tool in the clinician's arsenal as it reliably measures rate of percentage change in depth and volume and offers a potentially aseptic alternative to traditional measurement techniques. © 2014 The Authors. International Wound Journal © 2014 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Measurement of blood flow from an assist ventricle by computation of pneumatic driving parameters.

Science.gov (United States)

Qian, K X

1992-03-01

The measurement of blood flow from an assist ventricle is important but sometimes difficult in artificial heart experiments. Along with the development of a pneumatic cylinder-piston driver coupled with a ventricular assist device, a simplified method for measuring pump flow was established. From driving parameters such as the piston (or cylinder) displacement and air pressure, the pump flow could be calculated by the use of the equation of state for an ideal gas. The results of this method are broadly in agreement with electromagnetic and Doppler measurements.

Critical Cases Faced by Mental Health Nurses and Assistant Nurses in Psychiatric Hospitals in Greece

Directory of Open Access Journals (Sweden)

Evmorfia Koukia

2013-01-01

Full Text Available Background: Psychiatric Nurses and nurses’ assistants working in an inpatient unit experience a significant number of critical cases. A small number of studies have explored which patients’ problems nurses perceive as ‘critical case or incident’ and particularly which interventions they choose. Aim: The aim of the research was 1. To identify the clinical problems that mental health nurses and assistant nurses characterize as critical 2. To report the main nursing interventions 3. To investigate the main person involved in the critical incident. Material-Method: Critical incident technique was used as a method of data collection. Content analysis was carried out in order nurses’ information to be categorized into subcategories. The sample consisted of 35 mental health nurses and nurses’ assistants who work in psychiatric acute inpatient wards.Results: Nurses identified ten types of critical incidents. They noted violence (verbal, physical by patients and psychotic symptoms to be the most critical situations. Nurses were the main person involved in these incidents. The study also described eight nursing interventions used by nurses when faced with critical events. Conclusions: The findings indicated that mental health nurses and assistant nurses working in acute inpatient wards are called to confront a variety of critical incidents in their every day practice. Further research is necessary to identify in-depth nursing interventions and decision-making used in these situations.

Employee assistance programs: a prevention and treatment prescription for problems in health care organizations.

Science.gov (United States)

Rotarius, T; Liberman, A; Liberman, J S

2000-09-01

Employee assistance programs (EAPs) are a by-product of community-based mental health services--making behavioral care available in an outpatient ambulatory setting. This manuscript outlines an application of EAPs to health care workers and the multiplicity of challenges they must confront and describes the importance of timely intervention and support.

Making environmental health interesting for medical students-internet assisted facilitated collaborative learning approach.

Science.gov (United States)

Sudharsanam, Manni Balasubramaniam

2014-01-01

Topics on environmental health are usually neglected by students and it is necessary for them to learn this area with a public health perspective as environment plays a vital role in multi-factorial causation of diseases. Hence there is a need for alternative teaching/learning methods to facilitate students in acquiring the required knowledge. To increase the student interest and enhance their participation in acquiring knowledge in public health perspective of environmental health. Teaching Objectives/Learning Were: At the end of the session students should know the importance of air as an environmental factor in disease causation in special reference to public health hazards, the major sources of air pollution, major pollutants causing the health hazards, the way to measure pollutants and control them. The whole class of students was divided into two batches and one session was planned for each batch. Each batch was divided into six small groups. The groups were given task of exploring the internet on the different topics mentioned in the learning objectives. All the students were asked to explore, compile information and collectively prepare a presentation and present their findings based on their reviews. Students' feedback was collected at the end of each session. Eighty five percent of them were clear about the learning objectives and interested about internet learning. Most of them gave a positive opinion about the newer teaching learning method. Internet assisted group study served as a valuable alternative, innovative, and interesting tool to teach and learn the environmental health as revealed by students' feedback.

77 FR 11001 - Small Business Size Standards: Health Care and Social Assistance

Science.gov (United States)

2012-02-24

..., and (3) within a specific small business definition or size standard established by the SBA... SMALL BUSINESS ADMINISTRATION 13 CFR Part 121 RIN 3245-AG30 Small Business Size Standards: Health Care and Social Assistance AGENCY: U.S. Small Business Administration. ACTION: Proposed rule. SUMMARY...

The Benefit of Pets and Animal-Assisted Therapy to the Health of Older Individuals

Science.gov (United States)

Cherniack, E. Paul; Cherniack, Ariella R.

2014-01-01

Many studies utilizing dogs, cats, birds, fish, and robotic simulations of animals have tried to ascertain the health benefits of pet ownership or animal-assisted therapy in the elderly. Several small unblinded investigations outlined improvements in behavior in demented persons given treatment in the presence of animals. Studies piloting the use of animals in the treatment of depression and schizophrenia have yielded mixed results. Animals may provide intangible benefits to the mental health of older persons, such as relief social isolation and boredom, but these have not been formally studied. Several investigations of the effect of pets on physical health suggest animals can lower blood pressure, and dog walkers partake in more physical activity. Dog walking, in epidemiological studies and few preliminary trials, is associated with lower complication risk among patients with cardiovascular disease. Pets may also have harms: they may be expensive to care for, and their owners are more likely to fall. Theoretically, zoonotic infections and bites can occur, but how often this occurs in the context of pet ownership or animal-assisted therapy is unknown. Despite the poor methodological quality of pet research after decades of study, pet ownership and animal-assisted therapy are likely to continue due to positive subjective feelings many people have toward animals. PMID:25477957

The benefit of pets and animal-assisted therapy to the health of older individuals.

Science.gov (United States)

Cherniack, E Paul; Cherniack, Ariella R

2014-01-01

Many studies utilizing dogs, cats, birds, fish, and robotic simulations of animals have tried to ascertain the health benefits of pet ownership or animal-assisted therapy in the elderly. Several small unblinded investigations outlined improvements in behavior in demented persons given treatment in the presence of animals. Studies piloting the use of animals in the treatment of depression and schizophrenia have yielded mixed results. Animals may provide intangible benefits to the mental health of older persons, such as relief social isolation and boredom, but these have not been formally studied. Several investigations of the effect of pets on physical health suggest animals can lower blood pressure, and dog walkers partake in more physical activity. Dog walking, in epidemiological studies and few preliminary trials, is associated with lower complication risk among patients with cardiovascular disease. Pets may also have harms: they may be expensive to care for, and their owners are more likely to fall. Theoretically, zoonotic infections and bites can occur, but how often this occurs in the context of pet ownership or animal-assisted therapy is unknown. Despite the poor methodological quality of pet research after decades of study, pet ownership and animal-assisted therapy are likely to continue due to positive subjective feelings many people have toward animals.

The Benefit of Pets and Animal-Assisted Therapy to the Health of Older Individuals

Directory of Open Access Journals (Sweden)

E. Paul Cherniack

2014-01-01

Full Text Available Many studies utilizing dogs, cats, birds, fish, and robotic simulations of animals have tried to ascertain the health benefits of pet ownership or animal-assisted therapy in the elderly. Several small unblinded investigations outlined improvements in behavior in demented persons given treatment in the presence of animals. Studies piloting the use of animals in the treatment of depression and schizophrenia have yielded mixed results. Animals may provide intangible benefits to the mental health of older persons, such as relief social isolation and boredom, but these have not been formally studied. Several investigations of the effect of pets on physical health suggest animals can lower blood pressure, and dog walkers partake in more physical activity. Dog walking, in epidemiological studies and few preliminary trials, is associated with lower complication risk among patients with cardiovascular disease. Pets may also have harms: they may be expensive to care for, and their owners are more likely to fall. Theoretically, zoonotic infections and bites can occur, but how often this occurs in the context of pet ownership or animal-assisted therapy is unknown. Despite the poor methodological quality of pet research after decades of study, pet ownership and animal-assisted therapy are likely to continue due to positive subjective feelings many people have toward animals.

Assistência farmacêutica no sistema público de saúde no Brasil Pharmaceutical assistance in the Brazilian public health care system

Directory of Open Access Journals (Sweden)

Fabiola Sulpino Vieira

2010-02-01

Full Text Available This article deals with the organization of pharmaceutical assistance within the Brazilian Public Unified Health System (Sistema Único de Saúde, SUS by analyzing the progress made so far and the challenges that still must be faced to ensure the right to universal therapeutic and pharmaceutical coverage in Brazil. Among the improvements, the article discusses the National List of Essential Drugs and its role to guide the supply, prescription, and dispensing of drugs within SUS. The structure of federal funding and the existing pharmaceutical programs are described, as well as the responsibilities of the Federal Government, states, and municipalities concerning allocation of financial resources. Despite the progress made, the model of access to SUS drugs has not been successful in securing universal therapeutic assistance. It is essential to consider a type of funding and organization of pharmaceutical assistance that is driven by a notion of regionalization, with financing based on health care flows rather than on the population circumscribed to a given territory. It is also essential to qualify pharmaceutical management by hiring pharmacists and support personnel, professionalizing workers, and setting up facilities with appropriate information systems and equipment.

International obligations through collective rights: Moving from foreign health assistance to global health governance.

Science.gov (United States)

Meier, Benjamin Mason; Fox, Ashley M

2010-06-15

This article analyzes the growing chasm between international power and state responsibility in health rights, proposing an international legal framework for collective rights - rights that can reform international institutions and empower developing states to realize the determinants of health structured by global forces. With longstanding recognition that many developing state governments cannot realize the health of their peoples without international cooperation, scholars have increasingly sought to codify international obligations under the purview of an evolving human right to health, applying this rights-based approach as a foundational framework for reducing global health inequalities through foreign assistance. Yet the inherent limitations of the individual human rights framework stymie the right to health in impacting the global institutions that are most crucial for realizing underlying determinants of health through the strengthening of primary health care systems. Whereas the right to health has been advanced as an individual right to be realized by a state duty-bearer, the authors find that this limited, atomized right has proven insufficient to create accountability for international obligations in global health policy, enabling the deterioration of primary health care systems that lack the ability to address an expanding set of public health claims. For rights scholars to advance disease protection and health promotion through national primary health care systems - creating the international legal obligations necessary to spur development supportive of the public's health - the authors conclude that scholars must look beyond the individual right to health to create collective international legal obligations commensurate with a public health-centered approach to primary health care. Through the development and implementation of these collective health rights, states can address interconnected determinants of health within and across countries

Health System Measurement Project

Data.gov (United States)

U.S. Department of Health & Human Services — The Health System Measurement Project tracks government data on critical U.S. health system indicators. The website presents national trend data as well as detailed...

[Mental Health: Concepts, Measures, Determinants].

Science.gov (United States)

Doré, Isabelle; Caron, Jean

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

Physics measurements and health education

OpenAIRE

HAJDUCH, Petr

2016-01-01

The thesis "Physical measurements and health education" looks at physical quantities that are related to human health and can be measured in a elementary school environment. It focuses especially on the cross-curricular relationship between physics and health education and also on the use of relevant online measurement systems. As part of this thesis, we suggest a number of activities that exploit this relationship.

Client satisfaction with reproductive health-care quality: integrating business approaches to modeling and measurement.

Science.gov (United States)

Alden, Dana L; Do, Mai Hoa; Bhawuk, Dharm

2004-12-01

Health-care managers are increasingly interested in client perceptions of clinic service quality and satisfaction. While tremendous progress has occurred, additional perspectives on the conceptualization, modeling and measurement of these constructs may further assist health-care managers seeking to provide high-quality care. To that end, this study draws on theories from business and health to develop an integrated model featuring antecedents to and consequences of reproductive health-care client satisfaction. In addition to developing a new model, this study contributes by testing how well Western-based theories of client satisfaction hold in a developing, Asian country. Applied to urban, reproductive health clinic users in Hanoi, Vietnam, test results suggest that hypothesized antecedents such as pre-visit expectations, perceived clinic performance and how much performance exceeds expectations impact client satisfaction. However, the relative importance of these predictors appears to vary depending on a client's level of service-related experience. Finally, higher levels of client satisfaction are positively related to future clinic use intentions. This study demonstrates the value of: (1) incorporating theoretical perspectives from multiple disciplines to model processes underlying health-care satisfaction and (2) field testing those models before implementation. It also furthers research designed to provide health-care managers with actionable measures of the complex processes related to their clients' satisfaction.

Utilization of internet technology by low-income adults: the role of health literacy, health numeracy, and computer assistance.

Science.gov (United States)

Jensen, Jakob D; King, Andy J; Davis, LaShara A; Guntzviller, Lisa M

2010-09-01

To examine whether low-income adults' utilization of Internet technology is predicted or mediated by health literacy, health numeracy, and computer assistance. Low-income adults (N = 131) from the midwestern United States were surveyed about their technology access and use. Individuals with low health literacy skills were less likely to use Internet technology (e.g., email, search engines, and online health information seeking), and those with low health numeracy skills were less likely to have access to Internet technology (e.g., computers and cell phones). Consistent with past research, males, older participants, and those with less education were less likely to search for health information online. The relationship between age and online health information seeking was mediated by participant literacy. The present study suggests that significant advances in technology access and use could be sparked by developing technology interfaces that are accessible to individuals with limited literacy skills.

Measuring self-rated health status among resettled adult refugee populations to inform practice and policy - a scoping review.

Science.gov (United States)

Dowling, Alison; Enticott, Joanne; Russell, Grant

2017-12-08

The health status of refugees is a significant factor in determining their success in resettlement and relies heavily on self-rated measures of refugee health. The selection of robust and appropriate self-rated health measurement tools is challenging due to the number and methodological variation in the use of assessment tools across refugee health studies. This study describes the existing self-report health measures which have been used in studies of adult refugees living in the community to allow us to address the challenges of selecting appropriate assessments to measure health within refugee groups. Electronic databases of Ovid Medline, CINAHL, SCOPUS, Embase and Scopus. This review identified 45 different self-rated health measurements in 183 studies. Most of the studies were cross sectional explorations of the mental health status of refugees living in community settings within Western nations. A third of the tools were designed specifically for use within refugee populations. More than half of the identified measurement tools have been evaluated for reliability and/or validity within refugee populations. Much variation was found in the selection, development and testing of measurement tools across the reviewed studies. This review shows that there are currently a number of reliable and valid tools available for use in refugee health research; however, further work is required to achieve consistency in the quality and in the use of these tools. Methodological guidelines are required to assist researchers and clinicians in the development and testing of self-rated health measurement tools for use in refugee research.

Measuring population health in Moldova: health expectancies

Directory of Open Access Journals (Sweden)

Cristina Avram

2018-05-01

Full Text Available Health measures are decisive for the development and implementation of population health policies. Monitoring health indicators can lead to improvements in health and decrease in the inequalities among subpopulations. The life expectancy at birth for the Moldovan population did not increase considerably during the last decades, due to the social and economic crisis which led to high mortality and poor health. In Moldova, no aggregated health indicators are utilized for health monitoring. Therefore, the authors calculated health indicators to assess the population health and argue their importance. Mortality and subjective data on self-perceived health and self-rated morbidity from the Household Budget Survey was used for constructing period morbidity-mortality tables. Thus, the authors applied Sullivan’s method to calculate the life expectancy in very good/good/fair health and the life expectancy without chronic morbidity for the period 2006 - 2015. The life expectancies in very good/good/fair health showed a compression of morbidity in the older ages for both sexes, and for rural and urban types of residence. The life expectancies without chronic morbidity for males and for urban dwellers demonstrated an expansion of morbidity. Although the life expectancy is slowly increasing, the trends in population health are contradictory, depending on the applied measures. The health expectancy indicators, based on self-perceived health, depict the actual situation in the population health. These indicators are becoming more essential with the ageing process and can be used for the tailoring of social and health policies and services to the real needs of the population.

Decoherence assisting a measurement-driven quantum evolution process

International Nuclear Information System (INIS)

Roa, Luis; Olivares-Renteria, G. A.

2006-01-01

We study the problem of driving an unknown initial mixed quantum state onto a known pure state without using unitary transformations. This can be achieved, in an efficient manner, with the help of sequential measurements on at least two unbiased bases. However here we found that, when the system is affected by a decoherence mechanism, only one observable is required in order to achieve the same goal. In this way the decoherence can assist the process. We show that, depending on the sort of decoherence, the process can converge faster or slower than the method implemented by means of two complementary observables

[Wide-spectrum clinical interventions in mental health: 'care' and 'subject supposed to know' in therapeutic assistance].

Science.gov (United States)

Estellita-Lins, Carlos; Oliveira, Verônica Miranda; Coutinho, Maria Fernanda

2009-01-01

This paper discusses the theme therapeutic assistance (TA), understood as homecare-based mental health intervention. We emphasize the importance of community interventions for dealing with psychic suffering, either through reading the symptoms based on visibility, or through a psychoanalytic approach mainly concerned with listening. Lacking an independent theoretical background to support this practice, therapeutic assistance makes use of theories coming from other related fields of knowledge. Therefore, we discuss the influence of psychoanalysis and its role among broad spectrum mental health practice through clinical interventions belonging to the field of TA, focusing on two long-range operative concepts: Lacan's subject supposed to know and Winnicott's care (or caring process). Both concepts guide the clinical action and provide answers to theoretical problems within the TA field. We conclude that TA meets some requirements of the classical management of transference by means of a complex care process developed in the daily life and environment of the patient, in which desire and subjectivity are necessarily recognized although no psychotherapic setting is intentionally settled. Therapeutic assistance performs the role of an advanced clinical sentinel in the field of community psychiatry and public health.

Health-physics Measurements: Services

International Nuclear Information System (INIS)

Hardeman, F.; Hurtgen, C.; Vanhavere, F.; Vanmarcke, H.

1998-01-01

SCK-CEN's programme on health-physics (1) offers complete services in health-physics measurements according to international quality standards; (2) contributes to improve continuously these measurement techniques and follows up international recommendations and legislation concerning the surveillance of workers; (3) provides support and advise to nuclear and non-nuclear industry on issues of radioactive contamination. Progress and achievements in 1997 are summarised

Animal-assisted therapy: evaluation and implementation of a complementary therapy to improve the psychological and physiological health of critically ill patients.

Science.gov (United States)

DeCourcey, Mary; Russell, Anne C; Keister, Kathy J

2010-01-01

Animal-assisted therapy has gained widespread support in a variety of health care settings, including critical care units. This article seeks to review some of the current animal-assisted therapy, define a structured program, and evaluate the potential ability of the therapy to enhance the progress and health of our patients.

Performance measures, hours of caregiving assistance, and risk of adverse care outcomes among older adult users of Medicaid home and community-based services

Directory of Open Access Journals (Sweden)

Margaret K Danilovich

2015-11-01

Full Text Available Objectives: This study used validated physical performance measures to examine function, risk of adverse health outcomes, and the relationship with allocated hours of weekly caregiving assistance among older adults receiving home and community-based services through a Medicaid waiver program. Methods: Older adults (n = 42 completed physical performance measures including grip strength, 30-s chair rise, Timed Up and Go, and gait speed. Demographic information including age, gender, and allocated hours of weekly caregiving assistance were also collected. Results: A majority, 72% of females and 86% of males, had weak grip strength, 57% met criteria for fall risk based on their Timed Up and Go score, 83% had lower extremity strength impairments, and 98% were unable to ambulate more than 1.0 m/s. Frailty was prevalent in the sample with 72% of clients meeting Fried’s frailty criteria. The most significant predictors of allocated hours of weekly caregiving assistance approved for clients were race and gait speed. Conclusion: Based on scores on physical performance measures, clients are at risk of falls, hospitalization, and mortality, and scores indicate an urgent need to assess performance in addition to self-reported activities of daily living limitations for this population. Performance measures associated with quantifiable risk of adverse outcomes can be critical indicators for referrals and services needed to enhance the safety and improve care outcomes for homebound older adults.

Multiple births associated with assisted human reproduction in Canada.

Science.gov (United States)

Cook, Jocelynn L; Geran, Leslie; Rotermann, Michelle

2011-06-01

Assisted human reproduction has been associated with increased rates of multiple births. Data suggest that twins and higher order multiple pregnancies are at risk for pre- and postnatal health complications that contribute to stress on both the family and the Canadian health care system. No published Canadian data estimate the contribution of assisted human reproduction to multiple birth rates. This study was designed to determine the contributions of age and assisted human reproduction to multiple birth rates in Canada. We performed analyses of existing Canadian databases, using a mathematical model from the Centers for Disease Control and Prevention. More specifically, data from the Canadian Vital Statistics: Births and Stillbirths database were combined with data from the Canadian Assisted Reproductive Technologies Register collected by the Canadian Fertility and Andrology Society. Datasets were standardized to age distributions of mothers in 1978. RESULTS suggest that in vitro fertilization, ovulation induction, and age each contribute more to the rates of triplets than to twins. As expected, the contribution of natural factors was higher to twins than to triplets. These are the first Canadian data analyzed to separate and measure the contributions of age and assisted reproductive technologies to multiple birth rates. Our findings are important for guiding physician and patient education and informing the development of treatment protocols that will result in lower-risk pregnancies and improved long-term health for women and their offspring.

The Benefit of Pets and Animal-Assisted Therapy to the Health of Older Individuals

OpenAIRE

E. Paul Cherniack; Ariella R. Cherniack

2014-01-01

Many studies utilizing dogs, cats, birds, fish, and robotic simulations of animals have tried to ascertain the health benefits of pet ownership or animal-assisted therapy in the elderly. Several small unblinded investigations outlined improvements in behavior in demented persons given treatment in the presence of animals. Studies piloting the use of animals in the treatment of depression and schizophrenia have yielded mixed results. Animals may provide intangible benefits to the mental health...

Applying the balanced scorecard to local public health performance measurement: deliberations and decisions

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Kurji Karim

2009-05-01

Full Text Available Abstract Background All aspects of the heath care sector are being asked to account for their performance. This poses unique challenges for local public health units with their traditional focus on population health and their emphasis on disease prevention, health promotion and protection. Reliance on measures of health status provides an imprecise and partial picture of the performance of a health unit. In 2004 the provincial Institute for Clinical Evaluative Sciences based in Ontario, Canada introduced a public-health specific balanced scorecard framework. We present the conceptual deliberations and decisions undertaken by a health unit while adopting the framework. Discussion Posing, pondering and answering key questions assisted in applying the framework and developing indicators. Questions such as: Who should be involved in developing performance indicators? What level of performance should be measured? Who is the primary intended audience? Where and how do we begin? What types of indicators should populate the health status and determinants quadrant? What types of indicators should populate the resources and services quadrant? What type of indicators should populate the community engagement quadrant? What types of indicators should populate the integration and responsiveness quadrants? Should we try to link the quadrants? What comparators do we use? How do we move from a baseline report card to a continuous quality improvement management tool? Summary An inclusive, participatory process was chosen for defining and creating indicators to populate the four quadrants. Examples of indicators that populate the four quadrants of the scorecard are presented and key decisions are highlighted that facilitated the process.

Applying the balanced scorecard to local public health performance measurement: deliberations and decisions.

Science.gov (United States)

Weir, Erica; d'Entremont, Nadine; Stalker, Shelley; Kurji, Karim; Robinson, Victoria

2009-05-08

All aspects of the heath care sector are being asked to account for their performance. This poses unique challenges for local public health units with their traditional focus on population health and their emphasis on disease prevention, health promotion and protection. Reliance on measures of health status provides an imprecise and partial picture of the performance of a health unit. In 2004 the provincial Institute for Clinical Evaluative Sciences based in Ontario, Canada introduced a public-health specific balanced scorecard framework. We present the conceptual deliberations and decisions undertaken by a health unit while adopting the framework. Posing, pondering and answering key questions assisted in applying the framework and developing indicators. Questions such as: Who should be involved in developing performance indicators? What level of performance should be measured? Who is the primary intended audience? Where and how do we begin? What types of indicators should populate the health status and determinants quadrant? What types of indicators should populate the resources and services quadrant? What type of indicators should populate the community engagement quadrant? What types of indicators should populate the integration and responsiveness quadrants? Should we try to link the quadrants? What comparators do we use? How do we move from a baseline report card to a continuous quality improvement management tool? An inclusive, participatory process was chosen for defining and creating indicators to populate the four quadrants. Examples of indicators that populate the four quadrants of the scorecard are presented and key decisions are highlighted that facilitated the process.

End-point impedance measurements across dominant and nondominant hands and robotic assistance with directional damping.

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Erden, Mustafa Suphi; Billard, Aude

2015-06-01

The goal of this paper is to perform end-point impedance measurements across dominant and nondominant hands while doing airbrush painting and to use the results for developing a robotic assistance scheme. We study airbrush painting because it resembles in many ways manual welding, a standard industrial task. The experiments are performed with the 7 degrees of freedom KUKA lightweight robot arm. The robot is controlled in admittance using a force sensor attached at the end-point, so as to act as a free-mass and be passively guided by the human. For impedance measurements, a set of nine subjects perform 12 repetitions of airbrush painting, drawing a straight-line on a cartoon horizontally placed on a table, while passively moving the airbrush mounted on the robot's end-point. We measure hand impedance during the painting task by generating sudden and brief external forces with the robot. The results show that on average the dominant hand displays larger impedance than the nondominant in the directions perpendicular to the painting line. We find the most significant difference in the damping values in these directions. Based on this observation, we develop a "directional damping" scheme for robotic assistance and conduct a pilot study with 12 subjects to contrast airbrush painting with and without robotic assistance. Results show significant improvement in precision with both dominant and nondominant hands when using robotic assistance.

Predicting physical health: implicit mental health measures versus self-report scales.

Science.gov (United States)

Cousineau, Tara McKee; Shedler, Jonathan

2006-06-01

Researchers have traditionally relied on self-report questionnaires to assess psychological well-being, but such measures may be unable to differentiate individuals who are genuinely psychologically healthy from those who maintain a facade or illusion of mental health based on denial and self-deception. Prior research suggests that clinically derived assessment procedures that assess implicit psychological processes may have advantages over self-report mental health measures. This prospective study compared the Early Memory Index, an implicit measure of mental health/distress, with a range of familiar self-report scales as predictors of physical health. The Early Memory Index showed significant prospective associations with health service utilization and clinically verified illness. In contrast, self-report measures of mental health, perceived stress, life events stress, and mood states did not predict health outcomes. The findings highlight the limitations of self-report questionnaires and suggest that implicit measures have an important role to play in mental health research.

Measuring health inequalities over time

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Gustavo Bergonzoli

2007-11-01

Full Text Available Background: several methodologies have been used to measure health inequalities. Most of them do so in a cross- sectional fashion, causing significant loss of information. None of them measure health inequalities in social territories over time. Methods: this article presents two approaches measure health inequalities: one approach consists of a refinement of cross-sectional study, by using the analysis of ANOVA variance (ANOVA procedure to explore whether the gap between social territories is real or due to chance. Several adjustments were made to limit errors inevitably found in multiple comparisons. Polynomial procedures were then applied to identify and evaluate any trends. The second sociales se utilizó approach measures the health gap between social territories or strata (as defined in this study over time using the Poisson regression. These approaches were applied using life expectancy and maternal mortality data from Venezuela. Results: a positive relationship between tendenterritories and life expectancy was found, with a significant cia linal trend. The relation between maternal mortality and materna y territorios sociales fue cuadrática. La medición desocial territories was quadratic. The measurement of the la brecha, gap between least developed social territory and the most, a developed territory showed a gap reduction from the first to the second decade, mainly because of an increase of territorio social maternal mortality in the more developed area, rather than a real improvement in the least developed. Conclusions: study helps to clarify the impact that public policies and interventions have in reducing the health gap. Knowledge that a health gap between social territories can decrease without showing improvement in the least developed sector , is an important finding for monitoring and evaluating health interventions for improving living and health conditions in the population.

Plasma assisted measurements of alkali metal concentrations in pressurized combustion processes

International Nuclear Information System (INIS)

Hernberg, R.; Haeyrinen, V.

1995-01-01

The plasma assisted method for continuous measurement of alkali metal concentrations in product gas flows of pressurized energy processes will be tested and applied at the 1.6 MW PFBC/G facility at Delft University of Technology in the Netherlands. Measurements will be performed during 1995 and 1996 at different stages of the research programme. The results are expected to give information about the influence of different process conditions on the generation of alkali metal vapours, the comparison of different methods for alkali measurement and the specific performance of our system. The project belongs to the Joule II extension program under contract JOU2-CT93-0431. (author)

The health outcomes of human offspring conceived by assisted reproductive technologies (ART).

Science.gov (United States)

Chen, M; Heilbronn, L K

2017-08-01

Concerns have been raised about the health and development of children conceived by assisted reproductive technologies (ART) since 1978. Controversially, ART has been linked with adverse obstetric and perinatal outcomes, an increased risk of birth defects, cancers, and growth and development disorders. Emerging evidence suggests that ART treatment may also predispose individuals to an increased risk of chronic ageing related diseases such as obesity, type 2 diabetes and cardiovascular disease. This review will summarize the available evidence on the short-term and long-term health outcomes of ART singletons, as multiple pregnancies after multiple embryos transfer, are associated with low birth weight and preterm delivery, which can separately increase risk of adverse postnatal outcomes, and impact long-term health. We will also examine the potential factors that may contribute to these health risks, and discuss underlying mechanisms, including epigenetic changes that may occur during the preimplantation period and reprogram development in utero, and adult health, later in life. Lastly, this review will consider the future directions with the view to optimize the long-term health of ART children.

The relationship between employer health insurance characteristics and the provision of employee assistance programs.

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Zarkin, G A; Garfinkel, S A

1994-01-01

Workplace drug and alcohol abuse imposes substantial costs on employers. In response, employers have implemented a variety of programs to decrease substance abuse in the workplace, including drug testing, health and wellness programs, and employee assistance programs (EAPs). This paper focuses on the relationship between enterprises' organizational and health insurance characteristics and the firms' decisions to provide EAPs. Using data from the 1989 Survey of Health Insurance Plans (SHIP), sponsored by the Health Care Financing Administration (HCFA), we estimated the prevalence of EAPs by selected organizational and health insurance characteristics for those firms that offer health insurance to their workers. In addition, we estimated logistic models of the enterprises' decisions to provide EAPs as functions of the extent of state substance abuse and mental health insurance mandates, state-level demographic variables, and organizational and health insurance characteristics. Our results suggest that state mandates and demographic variables, as well as organizational and health insurance characteristics, are important explanatory variables of enterprises' decisions to provide EAPs.

Validating a measure to assess factors that affect assistive technology use by students with disabilities in elementary and secondary education.

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Zapf, Susan A; Scherer, Marcia J; Baxter, Mary F; H Rintala, Diana

2016-01-01

The purpose of this study was to measure the predictive validity, internal consistency and clinical utility of the Matching Assistive Technology to Child & Augmentative Communication Evaluation Simplified (MATCH-ACES) assessment. Twenty-three assistive technology team evaluators assessed 35 children using the MATCH-ACES assessment. This quasi-experimental study examined the internal consistency, predictive validity and clinical utility of the MATCH-ACES assessment. The MATCH-ACES assessment predisposition scales had good internal consistency across all three scales. A significant relationship was found between (a) high student perseverance and need for assistive technology and (b) high teacher comfort and interest in technology use (p = (0).002). Study results indicate that the MATCH-ACES assessment has good internal consistency and validity. Predisposition characteristics of student and teacher combined can influence the level of assistive technology use; therefore, assistive technology teams should assess predisposition factors of the user when recommending assistive technology. Implications for Rehabilitation Educational and medical professionals should be educated on evidence-based assistive technology assessments. Personal experience and psychosocial factors can influence the outcome use of assistive technology. Assistive technology assessments must include an intervention plan for assistive technology service delivery to measure effective outcome use.

Factors associated with the use of social workers for assistance with lifetime and 12-month behavioral health disorders.

Science.gov (United States)

Woodward, Amanda Toler; Taylor, Robert Joseph

2018-04-01

This study examined the use of social workers for assistance with a behavioral health disorder. Data were from the Collaborative Psychiatric Epidemiology Surveys. The analytic sample included respondents who reported using professional services for assistance with a behavioral health disorder during their lifetime (n = 5,585). Logistic regression was used to examine the use of a social worker during the respondent's lifetime or 12 months prior to the interview. Ten percent of respondents visited a social worker for help with a behavioral health disorder during their lifetime and 3% did so in the 12 months prior to the interview. Women were less likely than men to report using a social worker. Those who visited a social worker tended to also use other professionals for a behavioral health disorder although overall respondents reported visiting social workers less frequently for this reason than other types of professionals.

Estimating the development assistance for health provided to faith-based organizations, 1990-2013.

Science.gov (United States)

Haakenstad, Annie; Johnson, Elizabeth; Graves, Casey; Olivier, Jill; Duff, Jean; Dieleman, Joseph L

2015-01-01

Faith-based organizations (FBOs) have been active in the health sector for decades. Recently, the role of FBOs in global health has been of increased interest. However, little is known about the magnitude and trends in development assistance for health (DAH) channeled through these organizations. Data were collected from the 21 most recent editions of the Report of Voluntary Agencies. These reports provide information on the revenue and expenditure of organizations. Project-level data were also collected and reviewed from the Bill & Melinda Gates Foundation and the Global Fund to Fight AIDS, Tuberculosis and Malaria. More than 1,900 non-governmental organizations received funds from at least one of these three organizations. Background information on these organizations was examined by two independent reviewers to identify the amount of funding channeled through FBOs. In 2013, total spending by the FBOs identified in the VolAg amounted to US$1.53 billion. In 1990, FB0s spent 34.1% of total DAH provided by private voluntary organizations reported in the VolAg. In 2013, FBOs expended 31.0%. Funds provided by the Global Fund to FBOs have grown since 2002, amounting to $80.9 million in 2011, or 16.7% of the Global Fund's contributions to NGOs. In 2011, the Gates Foundation's contributions to FBOs amounted to $7.1 million, or 1.1% of the total provided to NGOs. Development assistance partners exhibit a range of preferences with respect to the amount of funds provided to FBOs. Overall, estimates show that FBOS have maintained a substantial and consistent share over time, in line with overall spending in global health on NGOs. These estimates provide the foundation for further research on the spending trends and effectiveness of FBOs in global health.

Estimating the development assistance for health provided to faith-based organizations, 1990-2013.

Directory of Open Access Journals (Sweden)

Annie Haakenstad

Full Text Available Faith-based organizations (FBOs have been active in the health sector for decades. Recently, the role of FBOs in global health has been of increased interest. However, little is known about the magnitude and trends in development assistance for health (DAH channeled through these organizations.Data were collected from the 21 most recent editions of the Report of Voluntary Agencies. These reports provide information on the revenue and expenditure of organizations. Project-level data were also collected and reviewed from the Bill & Melinda Gates Foundation and the Global Fund to Fight AIDS, Tuberculosis and Malaria. More than 1,900 non-governmental organizations received funds from at least one of these three organizations. Background information on these organizations was examined by two independent reviewers to identify the amount of funding channeled through FBOs.In 2013, total spending by the FBOs identified in the VolAg amounted to US$1.53 billion. In 1990, FB0s spent 34.1% of total DAH provided by private voluntary organizations reported in the VolAg. In 2013, FBOs expended 31.0%. Funds provided by the Global Fund to FBOs have grown since 2002, amounting to $80.9 million in 2011, or 16.7% of the Global Fund's contributions to NGOs. In 2011, the Gates Foundation's contributions to FBOs amounted to $7.1 million, or 1.1% of the total provided to NGOs.Development assistance partners exhibit a range of preferences with respect to the amount of funds provided to FBOs. Overall, estimates show that FBOS have maintained a substantial and consistent share over time, in line with overall spending in global health on NGOs. These estimates provide the foundation for further research on the spending trends and effectiveness of FBOs in global health.

Measuring financial well-being in cancer prevention research: Results from the Money-Health Connection Study

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Dr. Reginald Tucker-Seeley joined the faculty at the University of Southern California (USC) Leonard Davis School of Gerontology in June 2017. Prior to joining USC, Dr. Tucker-Seeley was an Assistant Professor at the Dana-Farber Cancer Institute (DFCI) and the Harvard T.H. Chan School of Public Health (HSPH). He completed master and doctoral degrees at HSPH and a postdoctoral fellowship in cancer prevention and control at HSPH and DFCI. Dr. Tucker-Seeley’s research focuses primarily on social determinants of health, such as the association between the neighborhood environment and health behavior; and on individual-level socioeconomic determinants of multi-morbidity, mortality, self-rated health, and health self-efficacy. His current work focuses on financial well-being across the cancer continuum, from prevention to end-of-life care. He has received R21 and K01 grants from the National Cancer Institute (NCI) to develop measures of financial well-being at two points along the cancer continuum: prevention and following diagnosis. He was also funded by the Academy Health/Aetna Foundation Scholars in Residence Fellowship Program to develop measures of neighborhood economic well-being. Dr. Tucker-Seeley’s research has been published in journals such as the American Journal of Public Health, Preventive Medicine, Journal of National Cancer Institute, Cancer Causes and Control, and the American Journal of Preventive Medicine. Dr. Tucker-Seeley is also committed to community service that targets the elimination of health disparities. He served for three years on the Rhode Island Commission for Health Advocacy and Equity. Based on his experience on this Commission, Dr. Tucker-Seeley developed a new course at HSPH called “Measuring and Reporting Health Disparities;” and in 2016, he received the HSPH teaching award for this course.

HEALTH EDUCATION TO PROMOTE HEALTHY AGING WITH ELDERLY PATIENTS AT A REFERRAL CENTER FOR SOCIAL ASSISTANCE (CRAS IN SINOP-MT

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J. O. Iori

2017-02-01

Full Text Available Nursing care for the elderly should aim to promote elderly health and reduction of foreseeable risk factors, as well as value and institute measures to the greatest possible degree of autonomy and independence in the elderly in relation to his life and especially about his Cheers. With this view, we carried out a study with 16 members aged from Linkages Strengthening Group of a Social Assistance Reference Center (CRAS, the municipality of Sinop - MT, to enhance understanding of the elderly as the promotion of health through education about risk and protective factors of the most common diseases and health problems among the elderly. We used the action research as a methodological reasons, because this means turning the subject both at the level of thought and in action. The results of this research showed a female predominance in the participation of older age groups, increased participation of older widows with education of 01 years to 04 years. The perception of the elderly as the educational activity performed was satisfactory, reporting that the dynamics of the talks were good, important and promoted new information. It was also found through most of the elderly respondents reported the need for health education activities for this audience. It is concluded that the elderly incorporated into their daily health promotion measures learned in the educational activity, with improvements in quality of life. As well, the need to implement more health education programs for the elderly aimed at promoting healthy aging.

Capturing the True Value of Assistive Technologies to Consumers in Routine Outcome Measurement

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Desleigh de Jonge

2016-10-01

Full Text Available (1 Background: Recent reforms in Australia, providing people with disability and older people with choice and control over allocated funding, have altered consumer expectations and transformed the landscape of assistive technology (AT service provision. The purpose of this study is to report on the routine AT outcomes of people who accessed an AT consultation service and examine how well these capture the impact of AT on their lives; (2 Methods: This study, which uses mixed methods for concurrent triangulation of the data, reports on the outcomes for 127 people who acquired a range of assistive technology in 2015 and examines the adequacy of an existing service outcome framework in capturing the true value of these technologies to AT users. Outcome data was routinely collected by a community service 2–4 months following an AT consultation. A telephone or face-to-face interview gathered demographic information as well as AT outcomes, using two standardized tools, the Individualized Prioritised Problem Assessment (IPPA and the EATS 6D. Qualitative comments relating to the impact of the AT on the person’s life were also documented; (3 Results: The acquired AT generally met or exceeded expectations of the person using the AT and the attending health professional. Overall, people experienced decreased difficulty and increased feelings of autonomy, with most of the reported improvements identified in mobility and usual activities; (4 Conclusion: Routine outcome data provide some evidence of the value of AT in addressing concerns as identified by clients. Qualitative data, which captured the impact of AT on people’s lives, suggest that the empowering and transformative aspects of AT are not currently being captured by existing measures.

Tracking official development assistance for reproductive health in conflict-affected countries.

Science.gov (United States)

Patel, Preeti; Roberts, Bayard; Guy, Samantha; Lee-Jones, Louise; Conteh, Lesong

2009-06-09

Reproductive health needs are particularly acute in countries affected by armed conflict. Reliable information on aid investment for reproductive health in these countries is essential for improving the efficiency and effectiveness of aid. The purpose of this study was to analyse official development assistance (ODA) for reproductive health activities in conflict-affected countries from 2003 to 2006. The Creditor Reporting System and the Financial Tracking System databases were the chosen data sources for the study. ODA disbursement for reproductive health activities to 18 conflict-affected countries was analysed for 2003, 2004, 2005, and 2006. An average of US $20.8 billion in total ODA was disbursed annually to the 18 conflict-affected countries between 2003 and 2006, of which US $509.3 million (2.4%) was allocated to reproductive health. This represents an annual average of US $1.30 disbursed per capita in the 18 sampled countries for reproductive health activities. Non-conflict-affected least-developed countries received 53.3% more ODA for reproductive health activities than conflict-affected least-developed countries, despite the latter generally having greater reproductive health needs. ODA disbursed for HIV/AIDS prevention and treatment increased by 119.4% from 2003 to 2006. The ODA disbursed for other direct reproductive health activities declined by 35.9% over the same period. This study provides evidence of inequity in disbursement of reproductive health ODA between conflict-affected countries and non-conflict-affected countries, and between different reproductive health activities. These findings and the study's recommendations seek to support initiatives to make aid financing more responsive to need in the context of armed conflict.

Tracking official development assistance for reproductive health in conflict-affected countries.

Directory of Open Access Journals (Sweden)

Preeti Patel

2009-06-01

Full Text Available BACKGROUND: Reproductive health needs are particularly acute in countries affected by armed conflict. Reliable information on aid investment for reproductive health in these countries is essential for improving the efficiency and effectiveness of aid. The purpose of this study was to analyse official development assistance (ODA for reproductive health activities in conflict-affected countries from 2003 to 2006. METHODS AND FINDINGS: The Creditor Reporting System and the Financial Tracking System databases were the chosen data sources for the study. ODA disbursement for reproductive health activities to 18 conflict-affected countries was analysed for 2003, 2004, 2005, and 2006. An average of US $20.8 billion in total ODA was disbursed annually to the 18 conflict-affected countries between 2003 and 2006, of which US $509.3 million (2.4% was allocated to reproductive health. This represents an annual average of US $1.30 disbursed per capita in the 18 sampled countries for reproductive health activities. Non-conflict-affected least-developed countries received 53.3% more ODA for reproductive health activities than conflict-affected least-developed countries, despite the latter generally having greater reproductive health needs. ODA disbursed for HIV/AIDS prevention and treatment increased by 119.4% from 2003 to 2006. The ODA disbursed for other direct reproductive health activities declined by 35.9% over the same period. CONCLUSIONS: This study provides evidence of inequity in disbursement of reproductive health ODA between conflict-affected countries and non-conflict-affected countries, and between different reproductive health activities. These findings and the study's recommendations seek to support initiatives to make aid financing more responsive to need in the context of armed conflict.

Impact of an alcohol misuse intervention for health care workers --2: Employee assistance programme utilization, on-the-job injuries, job loss and health services utilization.

Science.gov (United States)

Lapham, Sandra C; McMillan, Garnett; Gregory, Cindy

2003-01-01

We evaluated the effects of an enhanced substance misuse (SM) prevention/early intervention programme on referrals to an employee assistance programme, health care utilization rates, on-the-job injury rates and job termination rates among health care professionals employed in a managed care organization. The intervention was implemented at one site, with the remaining sites serving as the comparison group. Existing data from hospital databases were used to compare events occurring in the periods before and after initiation of the intervention. To account for baseline differences in age, gender and job class, logistic regression models produced adjusted means for events per employee month-at-risk. We found that employee assistance referrals and non-SM-related in-patient hospitalizations increased significantly post-intervention, while rates of total out-patient SM-related visits decreased at both the intervention and comparison sites post-intervention. There was a small, statistically significant decrease in the monthly rate (OR = 0.92) of non-SM out-patient utilization at the intervention site, once the intervention was in place. No differences potentially attributable to the intervention were detected in job turnover or injury rates. We conclude that, while the intervention did not appear to affect health care utilization for SM-related problems, it was associated with increased referrals for employee assistance.

Development of the Health Insurance Literacy Measure (HILM): Conceptualizing and Measuring Consumer Ability to Choose and Use Private Health Insurance

OpenAIRE

Paez, Kathryn A.; Mallery, Coretta J.; Noel, HarmoniJoie; Pugliese, Christopher; McSorley, Veronica E.; Lucado, Jennifer L.; Ganachari, Deepa

2014-01-01

Understanding health insurance is central to affording and accessing health care in the United States. Efforts to support consumers in making wise purchasing decisions and using health insurance to their advantage would benefit from the development of a valid and reliable measure to assess health insurance literacy. This article reports on the development of the Health Insurance Literacy Measure (HILM), a self-assessment measure of consumers' ability to select and use private health insurance...

Automatic mental heath assistant : monitoring and measuring nonverbal behavior of the crew during long-term missions

NARCIS (Netherlands)

Voynarovskaya, N.; Gorbunov, R.D.; Barakova, E.I.; Rauterberg, G.W.M.; Barakova, E.I.; Ruyter, B.; Spink, A.

2010-01-01

This paper presents a method for monitoring the mental state of small isolated crews during long-term missions (such as space mission, polar expeditions, submarine crews, meteorological stations, and etc.) The research is done as a part of Automatic Mental Health Assistant (AMHA) project which aims

Tracking development assistance and government health expenditures for 35 malaria-eliminating countries: 1990-2017.

Science.gov (United States)

Shretta, Rima; Zelman, Brittany; Birger, Maxwell L; Haakenstad, Annie; Singh, Lavanya; Liu, Yingying; Dieleman, Joseph

2017-07-14

Donor financing for malaria has declined since 2010 and this trend is projected to continue for the foreseeable future. These reductions have a significant impact on lower burden countries actively pursuing elimination, which are usually a lesser priority for donors. While domestic spending on malaria has been growing, it varies substantially in speed and magnitude across countries. A clear understanding of spending patterns and trends in donor and domestic financing is needed to uncover critical investment gaps and opportunities. Building on the Institute for Health Metrics and Evaluation's annual Financing Global Health research, data were collected from organizations that channel development assistance for health to the 35 countries actively pursuing malaria elimination. Where possible, development assistance for health (DAH) was categorized by spend on malaria intervention. A diverse set of data points were used to estimate government health budgets expenditure on malaria, including World Malaria Reports and government reports when available. Projections were done using regression analyses taking recipient country averages and earmarked funding into account. Since 2010, DAH for malaria has been declining for the 35 countries actively pursuing malaria elimination (from $176 million in 2010 to $62 million in 2013). The Global Fund is the largest external financier for malaria, providing 96% of the total external funding for malaria in 2013, with vector control interventions being the highest cost driver in all regions. Government expenditure on malaria, while increasing, has not kept pace with diminishing DAH or rising national GDP rates, leading to a potential gap in service delivery needed to attain elimination. Despite past gains, total financing available for malaria in elimination settings is declining. Health financing trends suggest that substantive policy interventions will be needed to ensure that malaria elimination is adequately financed and that

Development of the Health Insurance Literacy Measure (HILM): Conceptualizing and Measuring Consumer Ability to Choose and Use Private Health Insurance

Science.gov (United States)

Paez, Kathryn A.; Mallery, Coretta J.; Noel, HarmoniJoie; Pugliese, Christopher; McSorley, Veronica E.; Lucado, Jennifer L.; Ganachari, Deepa

2014-01-01

Understanding health insurance is central to affording and accessing health care in the United States. Efforts to support consumers in making wise purchasing decisions and using health insurance to their advantage would benefit from the development of a valid and reliable measure to assess health insurance literacy. This article reports on the development of the Health Insurance Literacy Measure (HILM), a self-assessment measure of consumers' ability to select and use private health insurance. The authors developed a conceptual model of health insurance literacy based on formative research and stakeholder guidance. Survey items were drafted using the conceptual model as a guide then tested in two rounds of cognitive interviews. After a field test with 828 respondents, exploratory factor analysis revealed two HILM scales, choosing health insurance and using health insurance, each of which is divided into a confidence subscale and likelihood of behavior subscale. Correlations between the HILM scales and an objective measure of health insurance knowledge and skills were positive and statistically significant which supports the validity of the measure. PMID:25315595

COMPARATIVE STUDY ON THE RIGHT TO HEALTH CARE SYSTEM PRISON LAW INTENDED TO ROMANIAN NATIONAL HEALTH LAW

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Florentina Laurenţia GĂIŞTEANU

2017-05-01

Full Text Available Health protection represents a protection measure for persons being a guaranteed right in Romania provided by the 34 Article of Romanian Constitution. The state is liable for taking measures of protecting physical and mental health, both for free persons and for those persons serving custodial measures. Starting from the Recommendation of the Committee of Ministers of the Member States relating to the European Prison Rules Rec (2006 2, which provides in paragraph 2 of subparagraph 40 – “The organization of health care in prisons”- that health policy from prison will be integrated in national health policy, being compatible with that. That comparative study aims at the implementation of European’s recommendations in different medical specialty areas. During this presentation are highlighted identical or different provisions stipulated in the relevant legislation of both two health systems, concluding that in certain areas of prison system, the state provides extra healthcare legislation. Comparative study between the right of medical assistance provided by Romanian Prison Legislation and the right of medical assistance provided by Romanian National Health Care System.

[Development and reliability evaluation of an instrument to measure health-related quality of life in independent elderly].

Science.gov (United States)

Lima, Maria José Barbosa de; Portela, Margareth Crisóstomo

2010-08-01

This study presents an instrument, the health-related quality of life (HRQOL) profile for independent elderly, to measure the health-related quality of life of the functionally independent elderly assisted in the outpatient setting, based on the adaptation of four validated scales: Short-Form Health Survey (SF-36), Duke-UNC Health Profile (DUHP), Sickness Impact Profile (SIP), and Nottingham Health Profile (NHP). The study also evaluates the instrument's reliability based on its use by two different observers with a 15-day interval. The instrument includes five dimensions (health perception, symptoms, physical function, psychological function, and social function) and 45 items. Reliability evaluation of the QUASI instrument was based on interviews with 142 elderly outpatients in the city of Rio de Janeiro, Brazil. Prevalence-adjusted kappa statistic was used to assess all 45 items. Correlation was also calculated between overall scores and scores on individual dimensions. In the reliability evaluation, 39 of the 45 items showed prevalence-adjusted kappa greater than 0.60.

Children With Special Health Care Needs: Child Health and Functioning Outcomes and Health Care Service Use.

Science.gov (United States)

Caicedo, Carmen

This study describes health, functioning, and health care service use by medically complex technology-dependent children according to condition severity (moderately disabled, severely disabled, and vegetative state). Data were collected monthly for 5 months using the Pediatric Quality of Life Generic Core Module 4.0 Parent-Proxy Report. Health care service use measured the number of routine and acute care office visits (including primary and specialty physicians), emergency department visits, hospitalizations, nursing health care services, special therapies, medications, medical technology devices (MTDs), and assistive devices. Child physical health was different across the condition severity groups. The average age of the children was 10.1 years (SD, 6.2); the average number of medications used was 5.5 (SD, 3.7); the average number of MTDs used was 4.2 (SD, 2.9); and the average number of assistive devices used was 4.3 (SD, 2.7). Severely disabled and vegetative children were similar in age (older) and had a similar number of medications, MTDs, and assistive devices (greater) than moderately disabled children. The advanced practice nurse care coordinator role is necessary for the health and functioning of medically complex, technology-dependent children. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

The effect of Employee Assistance Programs use on healthcare utilization.

OpenAIRE

Zarkin, G A; Bray, J W; Qi, J

2000-01-01

OBJECTIVE: To estimate the effect of Employee Assistance Program (EAP) use on healthcare utilization as measured by health claims. DATA SOURCES: A unique data set that combines individual-level information on EAP utilization, demographic information, and health insurance claims from 1991 to 1995 for all employees of a large midwestern employer. STUDY DESIGN: Using "fixed-effect" econometric models that control for unobserved differences between individuals' propensities to use healthcare reso...

Randomized trial of the effects of housing assistance on the health and risk behaviors of homeless and unstably housed people living with HIV.

Science.gov (United States)

Wolitski, Richard J; Kidder, Daniel P; Pals, Sherri L; Royal, Scott; Aidala, Angela; Stall, Ron; Holtgrave, David R; Harre, David; Courtenay-Quirk, Cari

2010-06-01

Homelessness affects HIV risk and health, but little is known about the longitudinal effects of rental assistance on the housing status and health of homeless and unstably housed people living with HIV/AIDS. Homeless/unstably housed people living with HIV/AIDS (N = 630) were randomly assigned to immediate Housing Opportunities for People with AIDS (HOPWA) rental assistance or customary care. Self-reported data, CD4, and HIV viral load were collected at baseline, 6, 12, and 18 months. Results showed that housing status improved in both groups, with greater improvement occurring in the treatment group. At 18 months, 51% of the comparison group had their own housing, limiting statistical power. Intent-to-treat analyses demonstrated significant reductions in medical care utilization and improvements in self-reported physical and mental health; significant differential change benefiting the treatment group was observed for depression and perceived stress. Significant differences between homeless and stably housed participants were found in as-treated analyses for health care utilization, mental health, and physical health. HOPWA rental assistance improves housing status and, in some cases, health outcomes of homeless and unstably housed people living with HIV/AIDS.

Accurate measurement of surface areas of anatomical structures by computer-assisted triangulation of computed tomography images

Energy Technology Data Exchange (ETDEWEB)

Allardice, J.T.; Jacomb-Hood, J.; Abulafi, A.M.; Williams, N.S. (Royal London Hospital (United Kingdom)); Cookson, J.; Dykes, E.; Holman, J. (London Hospital Medical College (United Kingdom))

1993-05-01

There is a need for accurate surface area measurement of internal anatomical structures in order to define light dosimetry in adjunctive intraoperative photodynamic therapy (AIOPDT). The authors investigated whether computer-assisted triangulation of serial sections generated by computed tomography (CT) scanning can give an accurate assessment of the surface area of the walls of the true pelvis after anterior resection and before colorectal anastomosis. They show that the technique of paper density tessellation is an acceptable method of measuring the surface areas of phantom objects, with a maximum error of 0.5%, and is used as the gold standard. Computer-assisted triangulation of CT images of standard geometric objects and accurately-constructed pelvic phantoms gives a surface area assessment with a maximum error of 2.5% compared with the gold standard. The CT images of 20 patients' pelves have been analysed by computer-assisted triangulation and this shows the surface area of the walls varies from 143 cm[sup 2] to 392 cm[sup 2]. (Author).

Measuring sustainability as a programming tool for health sector investments: report from a pilot sustainability assessment in five Nepalese health districts.

Science.gov (United States)

Sarriot, Eric; Ricca, Jim; Ryan, Leo; Basnet, Jagat; Arscott-Mills, Sharon

2009-01-01

Sustainability is a critical determinant of scale and impact of health sector development assistance programs. Working with USAID/Nepal implementing partners, we adapted a sustainability assessment framework to help USAID test how an evaluation tool could inform its health portfolio management. The essential first process step was to define the boundaries of the local system being examined. This local system-the unit of analysis of the study-was defined as the health district.We developed a standardized set of assessment tools to measure 53 indicators. Data collection was carried out over 4 weeks by a Nepalese agency. Scaling and combining indicators into six component indices provided a map of progress toward sustainable maternal, child, health, and family planning results for the five districts included in this pilot study, ranked from "no sustainability" to "beginning of sustainability."We conclude that systematic application of the Sustainability Framework could improve the health sector investment decisions of development agencies. It could also give districts an information base on which to build autonomy and accountability. The ability to form and test hypotheses about the sustainability of outcomes under various funding strategies-made possible by this approach-will be a prerequisite for more efficiently meeting the global health agenda.

Straylight measurements in laser in situ keratomileusis and laser-assisted subepithelial keratectomy for myopia

NARCIS (Netherlands)

Lapid-Gortzak, Ruth; van der Linden, Jan Willem; van der Meulen, Ivanka; Nieuwendaal, Carla; van den Berg, Tom

2010-01-01

PURPOSE: To compare straylight values before and 3 months after laser in situ keratomileusis (LASIK) and laser-assisted subepithelial keratectomy (LASEK) and to analyze the causes of any change. SETTING: Private refractive surgery clinic, Driebergen, The Netherlands. METHODS: Straylight was measured

Physician-assisted suicide-a clean bill of health?

Science.gov (United States)

Preston, Robert

2017-09-01

Physician-assisted suicide (PAS) laws have been enacted in five US States and, along with physician-administered euthanasia, in Canada and the Netherlands. Annual reports of the Oregon Health Authority and published research papers. Not all recipients of lethal drugs use them to end their lives. Improvements in palliative care provision. Rising numbers of deaths from PAS. Emergence of 'doctor shopping' and multiple-prescribing. Absence of qualitative scrutiny of assessment process. No re-assessment or oversight when prescribed drugs are ingested. Recent pressures to extend Oregon's PAS law. Reasons given for seeking PAS indicate this is a societal rather than a clinical issue and raise the question whether adjudicating on requests for legalized PAS is an appropriate role for doctors. Research into quality of decision-making in requests for PAS and into potential role of doctors as expert witnesses rather than judges in requests for PAS. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

Lies, Damned Lies, and Health Inequality Measurements

Science.gov (United States)

Gerdtham, Ulf-G; Petrie, Dennis

2015-01-01

Measuring and monitoring socioeconomic health inequalities are critical for understanding the impact of policy decisions. However, the measurement of health inequality is far from value neutral, and one can easily present the measure that best supports one’s chosen conclusion or selectively exclude measures. Improving people’s understanding of the often implicit value judgments is therefore important to reduce the risk that researchers mislead or policymakers are misled. While the choice between relative and absolute inequality is already value laden, further complexities arise when, as is often the case, health variables have both a lower and upper bound, and thus can be expressed in terms of either attainments or shortfalls, such as for mortality/survival. We bring together the recent parallel discussions from epidemiology and health economics regarding health inequality measurement and provide a deeper understanding of the different value judgments within absolute and relative measures expressed both in attainments and shortfalls, by graphically illustrating both hypothetical and real examples. We show that relative measures in terms of attainments and shortfalls have distinct value judgments, highlighting that for health variables with two bounds the choice is no longer only between an absolute and a relative measure but between an absolute, an attainment- relative and a shortfall-relative one. We illustrate how these three value judgments can be combined onto a single graph which shows the rankings according to all three measures, and illustrates how the three measures provide ethical benchmarks against which to judge the difference in inequality between populations. PMID:26133019

Measuring health care process quality with software quality measures.

Science.gov (United States)

Yildiz, Ozkan; Demirörs, Onur

2012-01-01

Existing quality models focus on some specific diseases, clinics or clinical areas. Although they contain structure, process, or output type measures, there is no model which measures quality of health care processes comprehensively. In addition, due to the not measured overall process quality, hospitals cannot compare quality of processes internally and externally. To bring a solution to above problems, a new model is developed from software quality measures. We have adopted the ISO/IEC 9126 software quality standard for health care processes. Then, JCIAS (Joint Commission International Accreditation Standards for Hospitals) measurable elements were added to model scope for unifying functional requirements. Assessment (diagnosing) process measurement results are provided in this paper. After the application, it was concluded that the model determines weak and strong aspects of the processes, gives a more detailed picture for the process quality, and provides quantifiable information to hospitals to compare their processes with multiple organizations.

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

Science.gov (United States)

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

2016-06-18

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

New developments in employee assistance programs.

Science.gov (United States)

White, R K; McDuff, D R; Schwartz, R P; Tiegel, S A; Judge, C P

1996-04-01

Employee assistance programs have developed from alcoholism assessment and referral centers to specialized behavioral health programs. Comprehensive employee assistance programs are defined by six major components: identification of problems based on job performance, consultation with supervisors, constructive confrontation, evaluation and referral, liaison with treatment providers, and substance abuse expertise. Other services have been added as enhancements to the basic model and include managed behavioral health activities and professional assistance committees, which provide services for impaired professionals and executives. Recent developments in the field are illustrated through examples from the experience of the employee assistance program at the University of Maryland Medical System in Baltimore.

Frailty and geriatric syndromes in elderly assisted in primary health care

Directory of Open Access Journals (Sweden)

Vera Elizabeth Closs

2016-06-01

Full Text Available The aim of this study was to describe the association between frailty and geriatric syndromes (GS [cognitive impairment (CI; postural instability (PI; urinary/fecal incontinence (UFI; polypharmacy (PP; and immobility (IM] and the frequency of these conditions in elderly people assisted in primary health care. Five hundred twenty-one elderly participants of The Multidimensional Study of the Elderly in the Family Health Strategy (EMI-SUS were evaluated. Sociodemographic data, identification of frailty (Fried phenotype and GS were collected. Multinomial logistic regression analysis was performed. The frequency of frailty was 21.5%, prefrailty 51.1% and robustness 27.4%. The frequency of CI was 54.7%, PP 41.2%, PI 36.5%, UFI 14% and IM 5.8%. The odds of frailty when compared to robustness and adjusted for gender, age, depression, self-perception of health, nutritional status, falls, vision and hearing, was significantly higher in elderly with CI, PI and PP. The adjusted odds of prefrail when compared to robustness was significantly higher only in elderly with CI. The most frequently presented number of GS (0-5 was two geriatric syndromes (26.87%. The frequency of frailty was high among elderly in primary health care and was associated with three of five GS (CI - PI - PP.

Animal-Assisted Activity: Effects of a Complementary Intervention Program on Psychological and Physiological Variables.

Science.gov (United States)

Nepps, Peggy; Stewart, Charles N; Bruckno, Stephen R

2014-07-01

Animal-assisted activity is the use of trained animals for the therapeutic, motivational, or educational benefit of patients. Subjects of this study were 218 patients hospitalized on the mental health unit of a community hospital with an existing, complementary animal-assisted activity program. Half of the patients participated in a 1-hour session of animal-assisted activity. The other half, who served as a comparison group, participated in a 1-hour stress management program. It was hypothesized that an animal-assisted activity program would improve ratings of depression, anxiety, and pain and the associated physiological measures of stress and discomfort. Self-report ratings of depression, anxiety, and pain were collected before and after treatment sessions, and blood pressure, pulse, and salivary cortisol were measured. There were significant decreases in depression (P animal-assisted activity program, comparable to those in the more traditional stress management group. © The Author(s) 2014.

Advancing Health Literacy Measurement: A Pathway to Better Health and Health System Performance

Science.gov (United States)

Pleasant, Andrew

2014-01-01

The concept of health literacy initially emerged and continues to gain strength as an approach to improving health status and the performance of health systems. Numerous studies clearly link low levels of education, literacy, and health literacy with poor health, poor health care utilization, increased barriers to care, and early death. However, theoretical understandings and methods of measuring the complex social construct of health literacy have experienced a continual evolution that remains incomplete. As a result, the seemingly most-cited definition of health literacy proposed in the now-decade-old Institute of Medicine report on health literacy is long overdue for updating. Such an effort should engage a broad and diverse set of health literacy researchers, practitioners, and members of the public in creating a definition that can earn broad consensus through validation testing in a rigorous scientific approach. That effort also could produce the basis for a new universally applicable measure of health literacy. Funders, health systems, and policymakers should reconsider their timid approach to health literacy. Although the field and corresponding evidence base are not perfect, health literacy—especially when combined with a focus on prevention and integrative health—is one of the most promising approaches to advancing public health. PMID:25491583

Measuring the Effects of an Animal-Assisted Intervention for Pediatric Oncology Patients and Their Parents: A Multisite Randomized Controlled Trial [Formula: see text].

Science.gov (United States)

McCullough, Amy; Ruehrdanz, Ashleigh; Jenkins, Molly A; Gilmer, Mary Jo; Olson, Janice; Pawar, Anjali; Holley, Leslie; Sierra-Rivera, Shirley; Linder, Deborah E; Pichette, Danielle; Grossman, Neil J; Hellman, Cynthia; Guérin, Noémi A; O'Haire, Marguerite E

2018-05-01

This multicenter, parallel-group, randomized trial examined the effects of an animal-assisted intervention on the stress, anxiety, and health-related quality of life for children diagnosed with cancer and their parents. Newly diagnosed patients, aged 3 to 17 years (n = 106), were randomized to receive either standard care plus regular visits from a therapy dog (intervention group), or standard care only (control group). Data were collected at set points over 4 months of the child's treatment. Measures included the State-Trait Anxiety Inventory™, Pediatric Quality of Life Inventory, Pediatric Inventory for Parents, and child blood pressure and heart rate. All instruments were completed by the child and/or his/her parent(s). Children in both groups experienced a significant reduction in state anxiety ( P Animal-assisted interventions may provide certain benefits for parents and families during the initial stages of pediatric cancer treatment.

Inequality in access to health care in Cambodia: socioeconomically disadvantaged women giving birth at home assisted by unskilled birth attendants.

Science.gov (United States)

Hong, Rathavuth; Them, Rathnita

2015-03-01

Cambodia faces major challenges in its effort to provide access to health care for all. Although there is a sharp improvement in health and health care in Cambodia, 6 in 10 women still deliver at home assisted by unskilled birth attendants. This practice is associated with higher maternal and infant deaths. This article analyzes the 2005 Cambodia Demographic and Health Survey data to examine the relationship between socioeconomic inequality and deliveries at home assisted by unskilled birth attendants. It is evident that babies in poorer households are significantly more likely to be delivered at home by an unskilled birth attendant than those in wealthier households. Moreover, delivery at home by an unskilled attendant is associated with mothers who have no education, live in a rural residence, and are farmers, and with higher birth order children. Results from this analysis demonstrate that socioeconomic inequality is still a major factor contributing to ill health in Cambodia. © 2011 APJPH.

Assisting the Blind and Visually Impaired: Guidelines for Eye Health Workers and Other Helpers

Directory of Open Access Journals (Sweden)

Sue Stevens

2003-01-01

Full Text Available As eye health workers, we give much attention to learning and teaching the importance of health education and the prevention and treatment of eye disease. Despite our gained knowledge, sadly, our efforts are not always successful and we are presented with the responsibility and challenge of caring for people who have to cope with visual impairment, perhaps for the rest of their lives. We have to understand their difficulties, recognise their abilities and learn how to cooperate and communicate with them in a social as well as hospital environment. It is often within the eye hospital itself that the lack in education of health workers and their understanding of the assistance needs of blind and visually impaired patients is all too evident.

Estimating the Development Assistance for Health Provided to Faith-Based Organizations, 1990–2013

Science.gov (United States)

Haakenstad, Annie; Johnson, Elizabeth; Graves, Casey; Olivier, Jill; Duff, Jean; Dieleman, Joseph L.

2015-01-01

Background Faith-based organizations (FBOs) have been active in the health sector for decades. Recently, the role of FBOs in global health has been of increased interest. However, little is known about the magnitude and trends in development assistance for health (DAH) channeled through these organizations. Material and Methods Data were collected from the 21 most recent editions of the Report of Voluntary Agencies. These reports provide information on the revenue and expenditure of organizations. Project-level data were also collected and reviewed from the Bill & Melinda Gates Foundation and the Global Fund to Fight AIDS, Tuberculosis and Malaria. More than 1,900 non-governmental organizations received funds from at least one of these three organizations. Background information on these organizations was examined by two independent reviewers to identify the amount of funding channeled through FBOs. Results In 2013, total spending by the FBOs identified in the VolAg amounted to US$1.53 billion. In 1990, FB0s spent 34.1% of total DAH provided by private voluntary organizations reported in the VolAg. In 2013, FBOs expended 31.0%. Funds provided by the Global Fund to FBOs have grown since 2002, amounting to $80.9 million in 2011, or 16.7% of the Global Fund’s contributions to NGOs. In 2011, the Gates Foundation’s contributions to FBOs amounted to $7.1 million, or 1.1% of the total provided to NGOs. Conclusion Development assistance partners exhibit a range of preferences with respect to the amount of funds provided to FBOs. Overall, estimates show that FBOS have maintained a substantial and consistent share over time, in line with overall spending in global health on NGOs. These estimates provide the foundation for further research on the spending trends and effectiveness of FBOs in global health. PMID:26042731

Study on ultra-fine w-EDM with on-machine measurement-assisted

International Nuclear Information System (INIS)

Chen Shuntong; Yang Hongye

2011-01-01

The purpose of this study was to develop the on-machine measurement techniques so as to precisely fabricate micro intricate part using ultra-fine w-EDM. The measurement-assisted approach which employs an automatic optical inspection (AOI) is incorporated to ultra-fine w-EDM process to on-machine detect the machining error for next re-machining. The AOI acquires the image through a high resolution CCD device from the contour of the workpiece after roughing in order to further process and recognize the image for determining the residual. This facilitates the on-machine error detection and compensation re-machining. The micro workpiece and electrode are not repositioned during machining. A fabrication for a micro probe of 30-μm diameter is rapidly machined and verified successfully. Based on the proposed technique, on-machine measurement with AOI has been realized satisfactorily.

Hope and despair: community health assistants' experiences of working in a rural district in Zambia.

Science.gov (United States)

Zulu, Joseph Mumba; Kinsman, John; Michelo, Charles; Hurtig, Anna-Karin

2014-05-25

In order to address the challenges facing the community-based health workforce in Zambia, the Ministry of Health implemented the national community health assistant strategy in 2010. The strategy aims to address the challenges by creating a new group of workers called community health assistants (CHAs) and integrating them into the health system. The first group started working in August 2012. The objective of this paper is to document their motivation to become a CHA, their experiences of working in a rural district, and how these experiences affected their motivation to work. A phenomenological approach was used to examine CHAs' experiences. Data collected through in-depth interviews with 12 CHAs in Kapiri Mposhi district and observations were analysed using a thematic analysis approach. Personal characteristics such as previous experience and knowledge, passion to serve the community and a desire to improve skills motivated people to become CHAs. Health systems characteristics such as an inclusive work culture in some health posts motivated CHAs to work. Conversely, a non-inclusive work culture created a social structure which constrained CHAs' ability to learn, to be innovative and to effectively conduct their duties. Further, limited supervision, misconceptions about CHA roles, poor prioritisation of CHA tasks by some supervisors, as well as non- and irregular payment of incentives also adversely affected CHAs' ability to work effectively. In addition, negative feedback from some colleagues at the health posts affected CHA's self-confidence and professional outlook. In the community, respect and support provided to CHAs by community members instilled a sense of recognition, appreciation and belonging in CHAs which inspired them to work. On the other hand, limited drug supplies and support from other community-based health workers due to their exclusion from the government payroll inhibited CHAs' ability to deliver services. Programmes aimed at integrating

Assessing the Acceptability and Usability of an Internet-Based Intelligent Health Assistant Developed for Use among Turkish Migrants: Results of a Study Conducted in Bremen, Germany

Directory of Open Access Journals (Sweden)

Florence Samkange-Zeeb

2015-12-01

Full Text Available The Internet offers a new chance for health professionals to reach population groups not usually reached through traditional information channels, for example, migrants. Criticism has, however, been raised that most health information on the Internet is not easy to read and lacks cultural sensitivity. We developed an Internet-based bilingual health assistant especially for Turkish migrants in Germany, tested its acceptance, and evaluated its usability in a participatory research design with families with and without Turkish migrant background. The interactive health assistant covered the following: nutrition, physical activity, overweight, diabetes, as well as pregnancy and pregnancy support. The idea of an Internet-based health assistant was generally accepted by all participants of the evaluation study, as long as it would be incorporated in existing appliances, such as smartphones. The bilingual nature of the assistant was welcomed especially by first generation migrants, but migrant participants also indicated that not all health information needed to be made available in a culture-specific way. The participants were least satisfied with the nutrition component, which they felt should include recipes and ingredients from the culture of origin, as well as specific aspects of food preparation.

Assessing the Acceptability and Usability of an Internet-Based Intelligent Health Assistant Developed for Use among Turkish Migrants: Results of a Study Conducted in Bremen, Germany.

Science.gov (United States)

Samkange-Zeeb, Florence; Ernst, Sinja Alexandra; Klein-Ellinghaus, Funda; Brand, Tilman; Reeske-Behrens, Anna; Plumbaum, Till; Zeeb, Hajo

2015-12-03

The Internet offers a new chance for health professionals to reach population groups not usually reached through traditional information channels, for example, migrants. Criticism has, however, been raised that most health information on the Internet is not easy to read and lacks cultural sensitivity. We developed an Internet-based bilingual health assistant especially for Turkish migrants in Germany, tested its acceptance, and evaluated its usability in a participatory research design with families with and without Turkish migrant background. The interactive health assistant covered the following: nutrition, physical activity, overweight, diabetes, as well as pregnancy and pregnancy support. The idea of an Internet-based health assistant was generally accepted by all participants of the evaluation study, as long as it would be incorporated in existing appliances, such as smartphones. The bilingual nature of the assistant was welcomed especially by first generation migrants, but migrant participants also indicated that not all health information needed to be made available in a culture-specific way. The participants were least satisfied with the nutrition component, which they felt should include recipes and ingredients from the culture of origin, as well as specific aspects of food preparation.

Assessing the Acceptability and Usability of an Internet-Based Intelligent Health Assistant Developed for Use among Turkish Migrants: Results of a Study Conducted in Bremen, Germany

Science.gov (United States)

Samkange-Zeeb, Florence; Ernst, Sinja Alexandra; Klein-Ellinghaus, Funda; Brand, Tilman; Reeske-Behrens, Anna; Plumbaum, Till; Zeeb, Hajo

2015-01-01

The Internet offers a new chance for health professionals to reach population groups not usually reached through traditional information channels, for example, migrants. Criticism has, however, been raised that most health information on the Internet is not easy to read and lacks cultural sensitivity. We developed an Internet-based bilingual health assistant especially for Turkish migrants in Germany, tested its acceptance, and evaluated its usability in a participatory research design with families with and without Turkish migrant background. The interactive health assistant covered the following: nutrition, physical activity, overweight, diabetes, as well as pregnancy and pregnancy support. The idea of an Internet-based health assistant was generally accepted by all participants of the evaluation study, as long as it would be incorporated in existing appliances, such as smartphones. The bilingual nature of the assistant was welcomed especially by first generation migrants, but migrant participants also indicated that not all health information needed to be made available in a culture-specific way. The participants were least satisfied with the nutrition component, which they felt should include recipes and ingredients from the culture of origin, as well as specific aspects of food preparation. PMID:26633455

A new measure for infant mental health screening

DEFF Research Database (Denmark)

Ammitzbøll, Janni; Holstein, Bjorn E.; Wilms, Lisbeth

2016-01-01

by community health nurses (CHN) in existing service settings in Denmark. This study was conducted to describe the development of a service setting based measure to screen for infant mental health problems, to investigate problems identified by the measure and assess the validity and feasibility in existing......Background: Mental health problems are a major public health challenges, and strategies of early prevention are needed. Effective prevention depends on feasible and validated measures of screening and intervention. Previous research has demonstrated potentials for infant mental health screening...... and feasibility was demonstrated, and the participation was 91%. Conclusions:The new measure shows potentials for infant mental health screening. However, further exploration of construct validity and reliability is needed....

Mental health and coping strategies among social assistance receivers

DEFF Research Database (Denmark)

Andersen, John; Larsen, Jørgen Elm; Muller, Maja

.g. in terms of participation in job training schemes and a requirement? of a certain minimum amount ( app 3 months ) of employment in the open labour market has increased. The arguments in the policy discource has been that lower benefits increases motivation and realistic, rational jobseeking behavior....... In short: lower benefit levels increases motivation which in turn increases labour market inclusion. This paper presents empirical results from an ongoing research project ( Consequences of living on the lowest social benefits financed by the Danish Social Council (Rådet for Socialt Udsatte) ,2008......-2011) about living conditions and how Danish citizens on the lowest benefits coped with their life situation. The longitudinal data followed the long term receivers of social assistance respondents over 1 year in order to observe changes in (selvreported) health, living conditions and coping strategies...

Persuasive robotic assistant for health self-management of older adults: Design and evaluation of social behaviors

NARCIS (Netherlands)

Looije, R.; Neerincx, M.A.; Cnossen, F.

2010-01-01

Daily health self-management, such as the harmonization of food, exercise and medication, is a major problem for a large group of older adults with obesity or diabetics. Computer-based personal assistance can help to behave healthy by persuading and guiding older adults. For effective persuasion,

Persuasive robotic assistant for health self-management of older adults : Design and evaluation of social behaviors

NARCIS (Netherlands)

Looije, Rosemarijn; Neerincx, Mark A.; Cnossen, Fokie

Daily health self-management, such as the harmonization of food, exercise and medication, is a major problem for a large group of older adults with obesity or diabetics Computer-based personal assistance can help to behave healthy by persuading and guiding older adults For effective persuasion, the

Maternal and neonatal health outcomes following assisted reproduction.

Science.gov (United States)

Farhi, A; Reichman, B; Boyko, V; Hourvitz, A; Ron-El, R; Lerner-Geva, L

2013-05-01

This study assessed the risk for maternal complications in women and neonatal outcomes in children conceived following assisted reproductive treatment as compared with spontaneously conception and also separately evaluated conventional IVF and intracytoplasmic sperm injection (ICSI). The prospective cohort included 1161 women with singleton pregnancies: 561 who conceived following assisted reproduction (223 following IVF and 338 following ICSI) and 600 who conceived spontaneously. No differences were observed in pregnancy complications (including spontaneous abortion, pregnancy-induced hypertension, gestational diabetes and Caesarean delivery) except for significantly increased risk for excess vaginal bleeding in assisted reproduction pregnancies (21.4% versus 12.9%; OR 1.67, 95% CI 1.18-2.37), which was prominent in women who reported polycystic ovary syndrome. Neonates born following assisted reproduction had increased risk for prematurity (10.6% versus 5.3%; OR 1.72, 95% CI 1.04-2.87), and IVF, but not ICSI, was associated with significantly increased risk for prematurity (OR 2.36, 95% CI 1.28-4.37) and low birthweight (OR 1.89, 95% CI 1.03-3.46). In conclusion, this study observed only an increased risk for excess vaginal bleeding as a pregnancy-associated complication in singleton pregnancies following assisted compared with spontaneous conception. However, singleton neonates born following IVF, but not ICSI, were at increased risk for prematurity. Copyright © 2013 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

Assessing alternative measures of wealth in health research.

Science.gov (United States)

Cubbin, Catherine; Pollack, Craig; Flaherty, Brian; Hayward, Mark; Sania, Ayesha; Vallone, Donna; Braveman, Paula

2011-05-01

We assessed whether it would be feasible to replace the standard measure of net worth with simpler measures of wealth in population-based studies examining associations between wealth and health. We used data from the 2004 Survey of Consumer Finances (respondents aged 25-64 years) and the 2004 Health and Retirement Survey (respondents aged 50 years or older) to construct logistic regression models relating wealth to health status and smoking. For our wealth measure, we used the standard measure of net worth as well as 9 simpler measures of wealth, and we compared results among the 10 models. In both data sets and for both health indicators, models using simpler wealth measures generated conclusions about the association between wealth and health that were similar to the conclusions generated by models using net worth. The magnitude and significance of the odds ratios were similar for the covariates in multivariate models, and the model-fit statistics for models using these simpler measures were similar to those for models using net worth. Our findings suggest that simpler measures of wealth may be acceptable in population-based studies of health.

Health-related quality of life measurement in pediatric clinical practice: An appraisal and precept for future research and application

Directory of Open Access Journals (Sweden)

Lane Mariella M

2005-05-01

Full Text Available Abstract Health-related quality of life (HRQOL measurement has emerged as an important health outcome in clinical trials, clinical practice improvement strategies, and healthcare services research and evaluation. HRQOL measures are also increasingly proposed for use in clinical practice settings to inform treatment decisions. In settings where HRQOL measures have been utilized with adults, physicians report such measures as useful, some physicians alter their treatment based on patient reports on such instruments, and patients themselves generally feel the instruments to be helpful. However, there is a dearth of studies evaluating the clinical utility of HRQOL measurement in pediatric clinical practice. This paper provides an updated review of the literature and proposes a precept governing the application of pediatric HRQOL measurement in pediatric clinical practice. Utilizing HRQOL measurement in pediatric healthcare settings can facilitate patient-physician communication, improve patient/parent satisfaction, identify hidden morbidities, and assist in clinical decision-making. Demonstrating the utility of pediatric HRQOL measurement in identifying children with the greatest needs, while simultaneously demonstrating the cost advantages of providing timely, targeted interventions to address those needs, may ultimately provide the driving force for incorporating HRQOL measurement in pediatric clinical practice.

A Habermasian Analysis of a Process of Recognition of Prior Learning for Health Care Assistants

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Sandberg, Fredrik

2012-01-01

This article discusses a process of recognition of prior learning for accreditation of prior experiential learning to qualify for course credits used in an adult in-service education program for health care assistants at the upper-secondary level in Sweden. The data are based on interviews and observations drawn from a field study, and Habermas's…

Measuring health systems strength and its impact: experiences from the African Health Initiative.

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Sherr, Kenneth; Fernandes, Quinhas; Kanté, Almamy M; Bawah, Ayaga; Condo, Jeanine; Mutale, Wilbroad

2017-12-21

Health systems are essential platforms for accessible, quality health services, and population health improvements. Global health initiatives have dramatically increased health resources; however, funding to strengthen health systems has not increased commensurately, partially due to concerns about health system complexity and evidence gaps demonstrating health outcome improvements. In 2009, the African Health Initiative of the Doris Duke Charitable Foundation began supporting Population Health Implementation and Training Partnership projects in five sub-Saharan African countries (Ghana, Mozambique, Rwanda, Tanzania, and Zambia) to catalyze significant advances in strengthening health systems. This manuscript reflects on the experience of establishing an evaluation framework to measure health systems strength, and associate measures with health outcomes, as part of this Initiative. Using the World Health Organization's health systems building block framework, the Partnerships present novel approaches to measure health systems building blocks and summarize data across and within building blocks to facilitate analytic procedures. Three Partnerships developed summary measures spanning the building blocks using principal component analysis (Ghana and Tanzania) or the balanced scorecard (Zambia). Other Partnerships developed summary measures to simplify multiple indicators within individual building blocks, including health information systems (Mozambique), and service delivery (Rwanda). At the end of the project intervention period, one to two key informants from each Partnership's leadership team were asked to list - in rank order - the importance of the six building blocks in relation to their intervention. Though there were differences across Partnerships, service delivery and information systems were reported to be the most common focus of interventions, followed by health workforce and leadership and governance. Medical products, vaccines and technologies, and

Animal-Assisted Therapies for Youth with or at Risk for Mental Health Problems: A Systematic Review

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Hoagwood, Kimberly Eaton; Acri, Mary; Morrissey, Meghan; Peth-Pierce, Robin

2017-01-01

To systematically review experimental evidence regarding animal-assisted therapies (AAT) for children or adolescents with or at risk for mental health conditions, we reviewed all experimental AAT studies published between 2000-2015, and compared studies by animal type, intervention, and outcomes. Studies were included if used therapeutically for…

Access to surgical assistance: challenges and perspectives

Directory of Open Access Journals (Sweden)

Maria Fernanda do Prado Tostes

2016-01-01

Full Text Available Objective to characterize the access to surgical assistance in Brazil. Method documentary study, with a quantitative approach, developed from information of the Caixa Preta da Saúde [Health Black Box] database, of the Brazilian Medical Association. Results in the one-year period 3773 cases related to health care in Brazil were recorded. There were 458 (12.3% records on surgical assistance. Of these, most, 339 (74.1%, involved the lack of access in all regions of Brazil. The main access constraint was the prolonged waiting time for surgery. Other constraints were the excessive waiting for medical appointment with experts, doing examinations and cancellation of surgeries. Conclusion the access to surgical assistance, by users of the Brazilian health system, is not widely guaranteed, reinforcing the need for integrated governmental actions, organization of the health care network, management of health care and human resources to overcome the challenges imposed to achieve the Universal Access to Health and Universal Health Coverage.

Improving symptom communication through personal digital assistants: the CHAT (Communicating Health Assisted by Technology) project.

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Post, Douglas M; Shapiro, Charles L; Cegala, Donald J; David, Prabu; Katz, Mira L; Krok, Jessica L; Phillips, Gary S; McAlearney, Ann Sheck; Lehman, Jennifer S; Hicks, William; Paskett, Electra D

2013-12-01

Communication problems impede effective symptom management during chemotherapy. The primary aim of this pilot randomized controlled trial was to test the effects of a personal digital assistant-delivered communication intervention on pain, depression, and fatigue symptoms among breast cancer patients undergoing chemotherapy. Secondary aims included assessment of 1) study feasibility, 2) patient and clinician responses to study participation, and 3) intervention effects on health-related quality of life (HRQoL) and communication self-efficacy. Intervention group participants (n = 27) completed symptom inventories at baseline, once per week during treatment, and at posttreatment. Depending on symptom severity, they viewed race-concordant videos on how to communicate about pain, depression and/or fatigue, using the personal digital assistant. Symptom records were tracked and shared with clinicians. Control group participants (n = 23) received usual care. Longitudinal random effects modeling assessed the changes in average symptom scores over time. Descriptive statistics assessed study feasibility and intervention effects on HRQoL and communication self-efficacy. Postintervention focus groups, interviews, and surveys assessed responses to study participation. Mean age of the participants was 51.0 years; 42 participants (84%) were white. In comparison with control, intervention group participants reported lower average pain severity over time (P = .015). Mean pain interference scores over time were marginally different between groups (P = .07); mean depression and fatigue scores over time were statistically nonsignificant. Feasibility outcomes and perspectives about study participation were positive. Mean pre-post decreases in HRQoL were generally higher among intervention group participants; pre-post changes in communication self-efficacy were equivalent. Mixed findings of the study indicate the need for future research.

9th Ambient Assisted Living Congress

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Mand, Beate

2017-01-01

In this book, leading authors in the field discuss the habitats of tomorrow. These habitats will be connected through autonomous and assistive systems, turning habitats into health resorts. This book discusses how assistance technologies enable a smooth transition from comfortable health support to medical or nursing care. The contributions have been chosen and invited at the 9th AAL congress, Frankfurt. .

Incidence of acquisition of methicillin-resistant Staphylococcus aureus, Clostridium difficile, and other health-care-associated pathogens by dogs that participate in animal-assisted interventions.

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Lefebvre, Sandra L; Reid-Smith, Richard J; Waltner-Toews, David; Weese, J Scott

2009-06-01

To determine whether dogs that visited human health-care facilities were at greater risk of acquiring certain health-care-associated pathogens, compared with dogs performing animal-assisted interventions in other settings, and to identify specific behaviors of dogs associated with an increased risk of acquiring these pathogens. Prospective cohort and nested case-control studies. 96 dogs that visited human health-care facilities and 98 dogs involved in other animal-assisted interventions. Fecal samples and nasal swab specimens were collected from dogs at the time of recruitment and every 2 months for 1 year and were tested for methicillin-resistant Staphylococcus aureus (MRSA), Clostridium difficile, and other selected bacteria. Information was also obtained on facilities visited during animal-assisted interventions, dog diet, dog illnesses, and antimicrobial use within the home. At the end of the study, dog handlers were asked about the behavior of their dogs during visits to health-care facilities. Rates of acquisition of MRSA and C difficile were 4.7 and 2.4 times as high, respectively, among dogs that visited human health-care facilities, compared with rates among dogs involved in other animal-assisted interventions. Among dogs that visited human health-care facilities, those that licked patients or accepted treats during visits were more likely to be positive for MRSA and C difficile than were dogs that did not lick patients or accept treats. Results suggested that dogs that visited human health-care facilities were at risk of acquiring MRSA and C difficile, particularly when they licked patients or accepted treats during visits.

Assistance provided by physical therapists from primary health care to patients after stroke

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Christina Danielli Coelho de Morais Faria

Full Text Available Abstract Introduction: Motor impairments, which are prevalent in stroke subjects, require physical therapy (PT rehabilitation. In primary care in the Brazilian Public Health System, PT are part of the Núcleo de Apoio à Saúde da Família (NASF. Objective: To describe the PT assistance provided to stroke patients in a primary healthcare center. Methods: The records of all stroke patients (n = 44; 69.23 ± 13.12 years identified by the health professionals were analyzed. Using keyword recognition, frequency analysis of the services offered by the PT was performed. Subjects were classified according to the Modified Rankin Scale. Results: In the 44 records, 45.5% had a description of the assistance provided by any professional of the NASF and 36.4% of the PT care. PT care was provided at the subject’s home (94.2% and at the healthcare center (5.8%. The PT practices were identified as: orientation (93.8%, evaluation (87.5%, exercises (50%, follow-up (37.5%, referral to another service or to undergrad PT students (18.8%, and referral to other NASF professionals (12.5%. Most of the subjects were classified as having mild/moderate disability. Conclusion: The minority of records had registration of attendance by the NASF PT. The majority of the sessions occurred at the subject’s home, which reveals a practice focused on individual care. The orientation was common, which illustrates that in primary care there is a focus on empowerment for health self-improvement. Follow-up was not common, despite clinical guidelines state that stroke subjects should be monitored at least once a year by the rehabilitation team.

PSYCHIC HEALTH PROTECTION IN NATIVE CHILDREN OF TYVA REPUBLIC

Directory of Open Access Journals (Sweden)

I.P. Artyukhov

2009-01-01

Full Text Available The article represents organizational - functional pattern of optimization of social psychic and medical pedagogical assistance for native children and adolescents in Tyva Republic. The pattern is aimed at psychic health improvement and prophylaxis against non-adaptable forms of conduct. It is based on complex approach to providing assistance to children and adolescents, preventive measures and the increase in the quality of medical assistance.Key words: Children, psychic health, non-adaptable conduct, prophylaxis(Voprosy sovremennoi pediatrii — Current Pediatrics. 2009;8(2:12-15

A Critique of Health System Performance Measurement.

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Lynch, Thomas

2015-01-01

Health system performance measurement is a ubiquitous phenomenon. Many authors have identified multiple methodological and substantive problems with performance measurement practices. Despite the validity of these criticisms and their cross-national character, the practice of health system performance measurement persists. Theodore Marmor suggests that performance measurement invokes an "incantatory response" wrapped within "linguistic muddle." In this article, I expand upon Marmor's insights using Pierre Bourdieu's theoretical framework to suggest that, far from an aberration, the "linguistic muddle" identified by Marmor is an indicator of a broad struggle about the representation and classification of public health services as a public good. I present a case study of performance measurement from Alberta, Canada, examining how this representational struggle occurs and what the stakes are. © The Author(s) 2015.

Pacific Northwest Laboratory annual report for 1987 to the Assistant Secretary for Environment, Safety, and Health: Part 5: Environment, safety, health, and quality assurance

International Nuclear Information System (INIS)

Faust, L.G.; Steelman, B.L.; Selby, J.M.

1988-02-01

Part 5 of the 1987 Annual Report to the US Department of Energy's Assistant Secretary for Environment, Safety, and Health presents Pacific Northwest Laboratory's progress on work performed for the Office of Nuclear Safety, the Office of Environmental Guidance and Compliance, the Office of Environmental Audit, and the Office of National Environmental Policy Act Project Assistance. For each project, as identified by the Field Work Proposal, articles describe progress made during fiscal year 1987. Authors of these articles represent a broad spectrum of capabilities derived from five of the seven technical centers of the Laboratory, reflecting the interdisciplinary nature of the work

Animal-assisted interventions as innovative tools for mental health

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Francesca Cirulli

2011-12-01

Full Text Available There is a growing interest for the potential health benefits of human-animal interactions. Although scientific evidence on the effects is far from being consistent, companion animals are used with a large number of human subjects, ranging from children to elderly people, who benefit most from emotional support. Based on a comprehensive review of the literature, this paper examines the potential for domesticated animals, such as dogs, for providing emotional and physical opportunities to enrich the lives of many frail subjects. In particular, we focus on innovative interventions, including the potential use of dogs to improve the life of emotionally-impaired children, such as those affected by autism spectrum disorders. Overall an ever increasing research effort is needed to search for the mechanism that lie behind the human-animal bond as well as to provide standardized methodologies for a cautious and effective use of animal-assisted interventions.

Resident assistant training program for increasing alcohol, other drug, and mental health first-aid efforts.

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Thombs, Dennis L; Gonzalez, Jennifer M Reingle; Osborn, Cynthia J; Rossheim, Matthew E; Suzuki, Sumihiro

2015-05-01

In college and university residence halls, resident assistants (RAs) are expected to serve as first-aid providers to students who may have alcohol, other drug, mental health, and academic problems. Despite this responsibility, evidence-based, first-aid programs have not been developed and tested for the RA workforce. The current study examined effects of an investigational first-aid program designed specifically for RAs. The online Peer Hero Training program is a novel approach to RA training in its use of interactive video dramatizations of incidents involving substance-using or distressed residents. A 9-month randomized trial conducted on eight US campuses compared RAs who participated in the Peer Hero Training program to RAs who received training-as-usual. Participation in the Peer Hero Training program significantly increased RA first-aid efforts for residential students who may have had alcohol, other drug, mental health, or academic problems 6 months after baseline. Compared with those in the training-as-usual condition, RAs in the Peer Hero Training program made more than 10 times as many first-aid efforts for possible alcohol problems, almost 14 times the number of first-aid efforts for possible drug use, almost 3 times the number of first-aid efforts for possible mental health problems, and 3 times the number of first-aid efforts for academic problems. There was no evidence that measured RA attitudes mediated the effects of the intervention. Results of this preliminary evaluation trial suggest that online training using interactive video dramatizations is a viable approach to strengthening RAs' ability to provide alcohol, other drugs, and mental health first-aid to undergraduates.

Measurement properties of tools measuring mental health knowledge: a systematic review.

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Wei, Yifeng; McGrath, Patrick J; Hayden, Jill; Kutcher, Stan

2016-08-23

Mental health literacy has received great attention recently to improve mental health knowledge, decrease stigma and enhance help-seeking behaviors. We conducted a systematic review to critically appraise the qualities of studies evaluating the measurement properties of mental health knowledge tools and the quality of included measurement properties. We searched PubMed, PsycINFO, EMBASE, CINAHL, the Cochrane Library, and ERIC for studies addressing psychometrics of mental health knowledge tools and published in English. We applied the COSMIN checklist to assess the methodological quality of each study as "excellent", "good", "fair", or "indeterminate". We ranked the level of evidence of the overall quality of each measurement property across studies as "strong", "moderate", "limited", "conflicting", or "unknown". We identified 16 mental health knowledge tools in 17 studies, addressing reliability, validity, responsiveness or measurement errors. The methodological quality of included studies ranged from "poor" to "excellent" including 6 studies addressing the content validity, internal consistency or structural validity demonstrating "excellent" quality. We found strong evidence of the content validity or internal consistency of 6 tools; moderate evidence of the internal consistency, the content validity or the reliability of 8 tools; and limited evidence of the reliability, the structural validity, the criterion validity, or the construct validity of 12 tools. Both the methodological qualities of included studies and the overall evidence of measurement properties are mixed. Based on the current evidence, we recommend that researchers consider using tools with measurement properties of strong or moderate evidence that also reached the threshold for positive ratings according to COSMIN checklist.

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

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Singh, Hardeep; Sittig, Dean F

2016-04-01

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

Motivation of health surveillance assistants in Malawi: A qualitative study.

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Chikaphupha, Kingsley R; Kok, Maryse C; Nyirenda, Lot; Namakhoma, Ireen; Theobald, Sally

2016-06-01

Motivation of health workers is a critical component of performance and is shaped by multiple factors. This study explored factors that influence motivation of health surveillance assistants (HSAs) in Malawi, with the aim of identifying interventions that can be applied to enhance motivation and performance of HSAs. A qualitative study capturing the perspectives of purposively selected participants was conducted in two districts: Salima and Mchinji. Participants included HSAs, health managers, and various community members. Data were collected through focus group discussions (n = 16) and in-depth interviews (n = 44). The study sample was comprised of 112 women and 65 men. Qualitative data analysis was informed by existing frameworks on factors influencing health worker motivation. Our analysis identified five key themes shaping HSA motivation: salary, accommodation, human resource management, supplies and logistics, and community links. Each of these played out at different levels-individual, family, community, and organisational-with either positive or negative effects. Demotivating factors related primarily to the organisational level, while motivating factors were more often related to individual, family, and community levels. A lack of financial incentives and shortages of basic supplies and materials were key factors demotivating HSAs. Supervision was generally perceived as unsupportive, uncoordinated, and top-down. Most HSAs complained of heavy workload. Many HSAs felt further recognition and support from the Ministry of Health, and the development of a clear career pathway would improve their motivation. Factors shaping motivation of HSAs are complex and multilayered; experiences at one level will impact other levels. Interventions are required to enhance HSA motivation, including strengthening the supervision system, developing career progression pathways, and ensuring clear and transparent incentives. HSAs have unique experiences, and there is need to hear

Sector-wide or disease-specific? Implications of trends in development assistance for health for the SDG era.

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Buffardi, Anne L

2018-04-01

The record of the Millennium Development Goals broadly reflects the trade-offs of disease-specific financing: substantial progress in particular areas, facilitated by time-bound targets that are easy to measure and communicate, which shifted attention and resources away from other areas, masked inequalities and exacerbated fragmentation. In many ways, the Sustainable Development Goals reflect a profound shift towards a more holistic, system-wide approach. To inform responses to this shift, this article builds upon existing work on aggregate trends in donor financing, bringing together what have largely been disparate analyses of sector-wide and disease-specific financing approaches. Looking across the last 26 years, the article examines how international donors have allocated development assistance for health (DAH) between these two approaches and how attempts to bridge them have fared in practice. Since 1990, DAH has overwhelmingly favoured disease-specific earmarks over health sector support, with the latter peaking in 1998. Attempts to integrate system strengthening elements into disease-specific funding mechanisms have varied by disease, and more integrated funding platforms have failed to gain traction. Health sector support largely remains an unfulfilled promise: proportionately low amounts (albeit absolute increases) which have been inconsistently allocated, and the overall approach inconsistently applied in practice. Thus, the expansive orientation of the Sustainable Development Goals runs counter to trends over the last several decades. Financing proposals and efforts to adapt global health institutions must acknowledge and account for the persistent challenges in the financing and implementation of integrated, cross-sector policies. National and subnational experimentation may offer alternatives within and beyond the health sector.

Synergism in work site adoption of employee assistance programs and health promotion activities.

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Blum, T C; Roman, P M; Patrick, L

1990-05-01

As workplaces increasingly adopt proactive programs directed toward employee health issues, the interrelation between different programs becomes an important issue. Of interest here is the "synergy" in patterns of program adoption between employee assistance programs (EAPs) and health promotion activities (HPAs). We utilize the 1985 National Survey of Worksite Health Promotion Activities (N = 1358) for analyses of the dual presence of EAPs and HPAs, and in multivariate analyses we consider factors affecting such dual presence. The data suggest that synergy occurs, with EAP adoption appearing to influence HPA adoption to a greater extent than the reverse. In multivariate analyses, synergy is confirmed by the finding that, among a variety of relevant organizational characteristics, EAP presence and HPA presence are the best predictors of each other's presence. The analyses also indicate that there is minimal commonality in program ingredients across organizations reporting the presence of HPAs. Implications of the data for the future development of these two programming strategies are discussed.

Memory-assisted measurement-device-independent quantum key distribution

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Panayi, Christiana; Razavi, Mohsen; Ma, Xiongfeng; Lütkenhaus, Norbert

2014-04-01

A protocol with the potential of beating the existing distance records for conventional quantum key distribution (QKD) systems is proposed. It borrows ideas from quantum repeaters by using memories in the middle of the link, and that of measurement-device-independent QKD, which only requires optical source equipment at the user's end. For certain memories with short access times, our scheme allows a higher repetition rate than that of quantum repeaters with single-mode memories, thereby requiring lower coherence times. By accounting for various sources of nonideality, such as memory decoherence, dark counts, misalignment errors, and background noise, as well as timing issues with memories, we develop a mathematical framework within which we can compare QKD systems with and without memories. In particular, we show that with the state-of-the-art technology for quantum memories, it is potentially possible to devise memory-assisted QKD systems that, at certain distances of practical interest, outperform current QKD implementations.

Memory-assisted measurement-device-independent quantum key distribution

International Nuclear Information System (INIS)

Panayi, Christiana; Razavi, Mohsen; Ma, Xiongfeng; Lütkenhaus, Norbert

2014-01-01

A protocol with the potential of beating the existing distance records for conventional quantum key distribution (QKD) systems is proposed. It borrows ideas from quantum repeaters by using memories in the middle of the link, and that of measurement-device-independent QKD, which only requires optical source equipment at the user's end. For certain memories with short access times, our scheme allows a higher repetition rate than that of quantum repeaters with single-mode memories, thereby requiring lower coherence times. By accounting for various sources of nonideality, such as memory decoherence, dark counts, misalignment errors, and background noise, as well as timing issues with memories, we develop a mathematical framework within which we can compare QKD systems with and without memories. In particular, we show that with the state-of-the-art technology for quantum memories, it is potentially possible to devise memory-assisted QKD systems that, at certain distances of practical interest, outperform current QKD implementations. (paper)

Substitution of Assisted Living Services by Assistive Technology - Experts Opinions and Technical Feasibility.

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Schwartze, Jonas; Prekazi, Arianit; Schrom, Harald; Marschollek, Michael

2017-01-01

Ambient assisted living (AAL) may support ageing in place but is primarily driven by technology. The aim of this work is, to identifying reasons to move into assisted living institutions, their range of service and possible substitutability. We did semi-structured interviews with five experts from assisted living institutions and used results to design and implement assistive technologies in an AAL environment using BASIS, a cross domain bus system for smart buildings. Reasons for moving to assisted living institutions are expected benefits for chronic health problems, safety, social isolation and carefree living. We implemented six application systems for inactivity monitoring, stove shutdown, air quality monitoring, medication and appointment reminders, detection of unwanted situations before leaving and optical ringing of the doorbell. Substitution of selected assisted living services is feasible and has potential to delay necessity to move into assisted living institution if complement social services are installed.

Health of Older Adults in Assisted Living and Implications for Preventive Care.

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Kistler, Christine E; Zimmerman, Sheryl; Ward, Kimberly T; Reed, David; Golin, Carol; Lewis, Carmen L

2017-10-01

Older adults in residential care and assisted living (RC/AL) are less healthy than the general elderly population, and some have needs similar to those in nursing homes, making this an important group in which to assess potential overuse or underuse of preventive services. We determined the health status of RC/AL residents and distinguished characteristics between those who may and may not benefit from preventive services requiring a life expectancy ≥5 years. Cross-sectional survey of a nationally representative sample of RC/AL residents using 2010 data from the National Survey of Residential Care Facilities. The primary outcome was the weighted frequency distribution of health states using three predictive mortality indices: Charlson Comorbidity Index, 4-year mortality index, and 9-year mortality index. A total of 666,700 of 733,300 (weighted) residents met criteria for inclusion. Based on the three indices, 10%-15% were in good health, 11%-70% in intermediate health, and 20%-76% in poor health. Using triangulation between 3 well-validated mortality indices, 10%-15% of RC/AL residents are in good health and highly likely to benefit from preventive services that require ≥5 year life expectancy. In addition, many residents have uncertain benefit and would benefit from shared decision making. © 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.

Improving Public Health Through Access to and Utilization of Medication Assisted Treatment

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Thomas F. Kresina

2011-10-01

Full Text Available Providing access to and utilization of medication assisted treatment (MAT for the treatment of opioid abuse and dependence provides an important opportunity to improve public health. Access to health services comprising MAT in the community is fundamental to achieve broad service coverage. The type and placement of the health services comprising MAT and integration with primary medical care including human immunodeficiency virus (HIV prevention, care and treatment services are optimal for addressing both substance abuse and co-occurring infectious diseases. As an HIV prevention intervention, integrated (same medical record for HIV services and MAT services MAT with HIV prevention, care and treatment programs provides the best “one stop shopping” approach for health service utilization. Alternatively, MAT, medical and HIV services can be separately managed but co-located to allow convenient utilization of primary care, MAT and HIV services. A third approach is coordinated care and treatment, where primary care, MAT and HIV services are provided at distinct locations and case managers, peer facilitators, or others promote direct service utilization at the various locations. Developing a continuum of care for patients with opioid dependence throughout the stages MAT enhances the public health and Recovery from opioid dependence. As a stigmatized and medical disenfranchised population with multiple medical, psychological and social needs, people who inject drugs and are opioid dependent have difficulty accessing services and navigating medical systems of coordinated care. MAT programs that offer comprehensive services and medical care options can best contribute to improving the health of these individuals thereby enhancing the health of the community.

Health outcome after major trauma: what are we measuring?

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Hoffman, Karen; Cole, Elaine; Playford, E Diane; Grill, Eva; Soberg, Helene L; Brohi, Karim

2014-01-01

Trauma is a global disease and is among the leading causes of disability in the world. The importance of outcome beyond trauma survival has been recognised over the last decade. Despite this there is no internationally agreed approach for assessment of health outcome and rehabilitation of trauma patients. To systematically examine to what extent outcomes measures evaluate health outcomes in patients with major trauma. MEDLINE, EMBASE, and CINAHL (from 2006-2012) were searched for studies evaluating health outcome after traumatic injuries. Studies of adult patients with injuries involving at least two body areas or organ systems were included. Information on study design, outcome measures used, sample size and outcomes were extracted. The World Health Organisation International Classification of Function, Disability and Health (ICF) were used to evaluate to what extent outcome measures captured health impacts. 34 studies from 755 studies were included in the review. 38 outcome measures were identified. 21 outcome measures were used only once and only five were used in three or more studies. Only 6% of all possible health impacts were captured. Concepts related to activity and participation were the most represented but still only captured 12% of all possible concepts in this domain. Measures performed very poorly in capturing concepts related to body function (5%), functional activities (11%) and environmental factors (2%). Outcome measures used in major trauma capture only a small proportion of health impacts. There is no inclusive classification for measuring disability or health outcome following trauma. The ICF may provide a useful framework for the development of a comprehensive health outcome measure for trauma care.

Creating a Screening Measure of Health Literacy for the Health Information National Trends Survey.

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Champlin, Sara; Mackert, Michael

2016-03-01

Create a screening measure of health literacy for use with the Health Information National Trends Survey (HINTS). Participants completed a paper-based survey. Items from the survey were used to construct a health literacy screening measure. A population-based survey conducted in geographic areas of high and low minority frequency and in Central Appalachia. Two thousand nine hundred four English-speaking participants were included in this study: 66% white, 93% completed high school, mean age = 52.53 years (SD = 16.24). A health literacy screening measure was created using four items included in the HINTS survey. Scores could range from 0 (no questions affirmative/correct) to 4 (all questions answered affirmatively/correctly). Multiple regression analysis was used to determine whether demographic variables known to predict health literacy were indeed associated with the constructed health literacy screening measure. The weighted average health literacy score was 2.63 (SD = 1.00). Those who were nonwhite (p = .0005), were older (p literacy screening measure scores. This study highlights the need to assess health literacy in national surveys, but also serves as evidence that screening measures can be created within existing datasets to give researchers the ability to consider the impact of health literacy. © The Author(s) 2016.

Implementation of a nationwide health economic consultation service to assist substance use researchers: Lessons learned.

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Murphy, Sean M; Leff, Jared A; Linas, Benjamin P; Morgan, Jake R; McCollister, Kathryn; Schackman, Bruce R

2018-03-20

Health economic evaluation findings assist stakeholders in improving the quality, availability, scalability, and sustainability of evidence-based services, and in maximizing the efficiency of service delivery. The Center for Health Economics of Treatment Interventions for Substance Use Disorders, HCV, and HIV (CHERISH) is a NIDA-funded multi-institutional center of excellence whose mission is to develop and disseminate health-economic research on healthcare utilization, health outcomes, and health-related behaviors that informs substance use disorder treatment policy, and HCV and HIV care of people who use substances. We designed a consultation service that is free to researchers whose work aligns with CHERISH's mission. The service includes up to six hours of consulting time. After prospective consultees submit their request online, they receive a screening call from the consultation service director, who connects them with a consultant with relevant expertise. Consultees and consultants complete web-based evaluations following the consultation; consultees also complete a six-month follow-up. We report on the status of the service from its inception in July 2015 through June 2017. We have received 28 consultation requests (54% Early Stage Investigators, 57% MD or equivalent, 28% PhD, 61% women) on projects typically related to planning a study or grant application (93%); 71% were HIV/AIDS-related. Leading topics included cost-effectiveness (43%), statistical-analysis/econometrics (36%), cost (32%), cost-benefit (21%), and quality-of-life (18%). All consultees were satisfied with their overall experience, and felt that consultation expectations and objectives were clearly defined and the consultant's expertise was matched appropriately with their needs. Results were similar for consultants, who spent a median of 3 hours on consultations. There is a need for health-economic methodological guidance among substance use, HCV, and HIV researchers. Lessons learned

Pacific Northwest Laboratory annual report for 1990 to the Assistant Secretary for Environment, Safety, and Health

International Nuclear Information System (INIS)

Faust, L.G.; Moraski, R.V.; Selby, J.M.

1991-05-01

Part 5 of the 1990 Annual Report to the US Department of Energy's Assistant Secretary for Environment, Safety, and Health presents Pacific Northwest Laboratory's progress on work performed for the Office of Environmental Guidance, the Office of Environmental Compliance, the Office of Environmental Audit, the Office of National Environmental Policy Act Project Assistance, the Office of Nuclear Safety, the Office of Safety Compliance, and the Office of Policy and Standards. For each project, as identified by the Field Work Proposal, there is an article describing progress made during fiscal year 1990. Authors of these articles represent a broad spectrum of capabilities derived from five of the seven technical centers of the Laboratory, reflecting the interdisciplinary nature of the work

[Implicit value judgments in the measurement of health inequalities].

Science.gov (United States)

Harper, Sam; King, Nicholas B; Meersman, Stephen C; E Reichman, Marsha; Breen, Nancy; Lynch, John

2014-04-01

Quantitative estimates of the magnitude, direction, and rate of change of health inequalities play a crucial role in creating and assessing policies aimed at eliminating the disproportionate burden of disease in disadvantaged populations. It is generally assumed that the measurement of health inequalities is a value-neutral process, providing objective data that are then interpreted using normative judgments about whether a particular distribution of health is just, fair, or socially acceptable. We discuss five examples in which normative judgments play a role in the measurement process itself, through either the selection of one measurement strategy to the exclusion of others or the selection of the type, significance, or weight assigned to the variables being measured. Overall, we find that many commonly used measures of inequality are value laden and that the normative judgments implicit in these measures have important consequences for interpreting and responding to health inequalities. Because values implicit in the generation of health inequality measures may lead to radically different interpretations of the same underlying data,we urge researchers to explicitly consider and transparently discuss the normative judgments underlying their measures. We also urge policymakers and other consumers of health inequalities data to pay close attention to the measures on which they base their assessments of current and future health policies.

Implicit value judgments in the measurement of health inequalities.

Science.gov (United States)

Harper, Sam; King, Nicholas B; Meersman, Stephen C; Reichman, Marsha E; Breen, Nancy; Lynch, John

2010-03-01

Quantitative estimates of the magnitude, direction, and rate of change of health inequalities play a crucial role in creating and assessing policies aimed at eliminating the disproportionate burden of disease in disadvantaged populations. It is generally assumed that the measurement of health inequalities is a value-neutral process, providing objective data that are then interpreted using normative judgments about whether a particular distribution of health is just, fair, or socially acceptable. We discuss five examples in which normative judgments play a role in the measurement process itself, through either the selection of one measurement strategy to the exclusion of others or the selection of the type, significance, or weight assigned to the variables being measured. Overall, we find that many commonly used measures of inequality are value laden and that the normative judgments implicit in these measures have important consequences for interpreting and responding to health inequalities. Because values implicit in the generation of health inequality measures may lead to radically different interpretations of the same underlying data, we urge researchers to explicitly consider and transparently discuss the normative judgments underlying their measures. We also urge policymakers and other consumers of health inequalities data to pay close attention to the measures on which they base their assessments of current and future health policies.

Health outcome after major trauma: what are we measuring?

Directory of Open Access Journals (Sweden)

Karen Hoffman

Full Text Available Trauma is a global disease and is among the leading causes of disability in the world. The importance of outcome beyond trauma survival has been recognised over the last decade. Despite this there is no internationally agreed approach for assessment of health outcome and rehabilitation of trauma patients.To systematically examine to what extent outcomes measures evaluate health outcomes in patients with major trauma.MEDLINE, EMBASE, and CINAHL (from 2006-2012 were searched for studies evaluating health outcome after traumatic injuries.Studies of adult patients with injuries involving at least two body areas or organ systems were included. Information on study design, outcome measures used, sample size and outcomes were extracted. The World Health Organisation International Classification of Function, Disability and Health (ICF were used to evaluate to what extent outcome measures captured health impacts.34 studies from 755 studies were included in the review. 38 outcome measures were identified. 21 outcome measures were used only once and only five were used in three or more studies. Only 6% of all possible health impacts were captured. Concepts related to activity and participation were the most represented but still only captured 12% of all possible concepts in this domain. Measures performed very poorly in capturing concepts related to body function (5%, functional activities (11% and environmental factors (2%.Outcome measures used in major trauma capture only a small proportion of health impacts. There is no inclusive classification for measuring disability or health outcome following trauma. The ICF may provide a useful framework for the development of a comprehensive health outcome measure for trauma care.

The conceptualization and measurement of cognitive health sophistication.

Science.gov (United States)

Bodie, Graham D; Collins, William B; Jensen, Jakob D; Davis, Lashara A; Guntzviller, Lisa M; King, Andy J

2013-01-01

This article develops a conceptualization and measure of cognitive health sophistication--the complexity of an individual's conceptual knowledge about health. Study 1 provides initial validity evidence for the measure--the Healthy-Unhealthy Other Instrument--by showing its association with other cognitive health constructs indicative of higher health sophistication. Study 2 presents data from a sample of low-income adults to provide evidence that the measure does not depend heavily on health-related vocabulary or ethnicity. Results from both studies suggest that the Healthy-Unhealthy Other Instrument can be used to capture variability in the sophistication or complexity of an individual's health-related schematic structures on the basis of responses to two simple open-ended questions. Methodological advantages of the Healthy-Unhealthy Other Instrument and suggestions for future research are highlighted in the discussion.

Health Physics Measurements Services

International Nuclear Information System (INIS)

Carchon, R.

2001-01-01

SCK-CEN's programme on health physics measurements includes various activities in dosimetry, calibration , instrumentation , gamma-ray spectrometry, whole body counting , the preparation of standard sources, non-destructive assay and the maintenance of Euratom Fork detectors. Main achievements in these topical areas in 2000 are summarised

Skeletal and Clinical Effects of Exoskeletal Assisted - Gait

Science.gov (United States)

2016-10-01

clinical functional outcomes. The hypothesis of the study is that exoskeleton -assisted ambulation has skeletal and general health benefits for...for the use of robotic exoskeletons to enable gait in individuals with a complete SCI, clinical teams are not provided with appropriate tools to...estimate or predict potential health benefits (e.g. bone health) associated with exoskeleton -assisted gait. What was the impact on other disciplines

Client-Centered Employee Assistance Services.

Science.gov (United States)

Bayer, Darryl Lee

This paper addresses delivery aspects and benefits of client-centered Employee Assistance Program (EAP) services through a review of the literature and research. EAP services are described as educational and mental health services utilized to assist employees and their families to respond constructively to job, personal, interpersonal or…

Aid alignment: a longer term lens on trends in development assistance for health in Uganda.

Science.gov (United States)

Stierman, Elizabeth; Ssengooba, Freddie; Bennett, Sara

2013-02-20

Over the past decade, development assistance for health (DAH) in Uganda has increased dramatically, surpassing the government's own expenditures on health. Yet primary health care and other priorities identified in Uganda's health sector strategic plan remain underfunded. Using data available from the Creditor Reporting System (CRS), National Health Accounts (NHA), and government financial reports, we examined trends in how donors channel DAH and the extent to which DAH is aligned with sector priorities. The study follows the flow of DAH from the donor to the implementing organization, specifying the modality used for disbursing funds and categorizing funds based on program area or support function. Despite efforts to improve alignment through the formation of a sector-wide approach (SWAp) for health in 1999 and the creation of a fund to pool resources for identified priorities, increasingly DAH is provided as short-term, project-based support for disease-specific initiatives, in particular HIV/AIDS. These findings highlight the need to better align external resources with country priorities and refocus attention on longer-term sector-wide objectives.

Ultrasound-assisted extraction for total sulphur measurement in mine tailings

International Nuclear Information System (INIS)

Khan, Adnan Hossain; Shang, Julie Q.; Alam, Raquibul

2012-01-01

Highlights: ► We develop a total sulphur measuring procedure of mine tailings. ► Ultrasound is used in the sample pre-treatment process. ► Full factorial design is applied to identify the best level of effecting factors. - Abstract: A sample preparation method for percentage recovery of total sulphur (%S) in reactive mine tailings based on ultrasound-assisted digestion (USAD) and inductively coupled plasma-optical emission spectroscopy (ICP-OES) was developed. The influence of various methodological factors was screened by employing a two-level and three-factor (2 3 ) full factorial design and using KZK-1, a sericite schist certified reference material (CRM), to find the optimal combination of studied factors and %S. Factors such as the sonication time, temperature and acid combination were studied, with the best result identified as 20 min of sonication, 80 °C temperature and 1 ml of HNO 3 :1 ml of HCl, which can achieve 100% recovery for the selected CRM. Subsequently a fraction of the 2 3 full factorial design was applied to mine tailings. The percentage relative standard deviation (%RSD) for the ultrasound method is less than 3.0% for CRM and less than 6% for the mine tailings. The investigated method was verified by X-ray diffraction analysis. The USAD method compared favorably with existing methods such as hot plate assisted digestion method, X-ray fluorescence and LECO™-CNS method.

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

Science.gov (United States)

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

2011-12-01

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

Noncognitive Attributes in Physician Assistant Education.

Science.gov (United States)

Brenneman, Anthony E; Goldgar, Constance; Hills, Karen J; Snyder, Jennifer H; VanderMeulen, Stephane P; Lane, Steven

2018-03-01

Physician assistant (PA) admissions processes have typically given more weight to cognitive attributes than to noncognitive ones, both because a high level of cognitive ability is needed for a career in medicine and because cognitive factors are easier to measure. However, there is a growing consensus across the health professions that noncognitive attributes such as emotional intelligence, empathy, and professionalism are important for success in clinical practice and optimal care of patients. There is also some evidence that a move toward more holistic admissions practices, including evaluation of noncognitive attributes, can have a positive effect on diversity. The need for these noncognitive attributes in clinicians is being reinforced by changes in the US health care system, including shifting patient demographics and a growing emphasis on team-based care and patient satisfaction, and the need for clinicians to help patients interpret complex medical information. The 2016 Physician Assistant Education Association Stakeholder Summit revealed certain behavioral and affective qualities that employers of PAs value and sometimes find lacking in new graduates. Although there are still gaps in the evidence base, some tools and technologies currently exist to more accurately measure noncognitive variables. We propose some possible strategies and tools that PA programs can use to formalize the way they select for noncognitive attributes. Since PA programs have, on average, only 27 months to educate students, programs may need to focus more resources on selecting for these attributes than teaching them.

Walker use, but not falls, is associated with lower physical functioning and health of residents in an assisted-living environment.

Science.gov (United States)

Andersen, Daniel A; Roos, Bernard A; Stanziano, Damian C; Gonzalez, Natasha M; Signorile, Joseph F

2007-01-01

The relationship between perceived health and walker use has seldom been addressed. Concerns over falls and falls risk are precursors to walker use. We compared the SF-36 scores of 26 women and 14 men, mean age 86.8 +/- 6.0 years based on walker use and faller status. An analysis of covariance (ANCOVA) with age as the covariate, compared groups for the SF-36 constructs and totals score. Significant differences were noted between walker users and nonusers in physical functioning, role limitations due to physical problems, general health, and the total SF-36 score. Pairwise comparisons favored nonusers, while no differences were seen due to faller status. Walker use is associated with lower self-perceptions of physical functioning, role limitations due to physical problems, and general health in assisted-living residents. Faller status is not associated with self-perceived health status. Although walker use aids mobility and lowers the probability of falls, further research is needed to determine if the prescription of assistive devices has a more negative impact on self-perceived health than does falling. This possibility could be explained, in part, by the greater activity levels of those individuals who do not depend on walkers.

Views and experiences of mental health nurses working with undergraduate assistants in nursing in an acute mental health setting.

Science.gov (United States)

Cleary, Michelle; Horsfall, Jan; O'Hara-Aarons, Maureen; Mannix, Judy; Jackson, Debra; Hunt, Glenn E

2012-04-01

Undergraduate nurses are employed as assistants in nursing (AIN) in inpatient mental health settings; however, there is a paucity of published research exploring registered nurses' (RN) views about the AIN role in these settings. This qualitative study documents the views and experiences of RN working with undergraduate AIN. Fifty structured face-to-face interviews were analysed, and the results are discussed in three sections. The first section outlines RN perceptions of qualities and skills required of AIN in mental health, and the responses primarily focus on communication skills, initiative, and willingness to learn. The second section targets factors in the workplace that might enhance the interest of AIN in a mental health nursing career; the responses emphasize their need to work with experienced staff. The last section outlines RN expectations of AIN, most of which are met and involve physical observations and technical tasks; less fulfilled activities primarily cluster around interactions with patients. Findings highlight the advantages and disadvantages of drawing on undergraduate nursing students as AIN in mental health settings. Communication skills, personal initiative, safety training to prevent violence, and education to increase knowledge and awareness about mental illness, diagnosis, and mental status-related skills were all important concerns articulated by RN. © 2011 The Authors. International Journal of Mental Health Nursing © 2011 Australian College of Mental Health Nurses Inc.

Few adults with functional limitations advised to exercise more or lose weight in NHANES 2011-14 seek health professional assistance: An opportunity for physical therapists.

Science.gov (United States)

Kinslow, Brian; De Heer, Hendrik D; Warren, Meghan

2018-03-02

Functional limitations are associated with decreased physical activity and increased body mass index. The purpose of this study was to assess the prevalence of functional limitations among adults who reported receiving health professional advice to exercise more or lose weight, and to assess involvement of health professionals, including physical therapists, in weight loss efforts with these individuals. A cross-sectional analysis of U.S. adults from the 2011 to 2014 National Health and Nutrition Examination Survey (n = 5,480). Participant demographics, health history, and functional limitations were assessed via self-report and examination. Frequency distributions were calculated using SAS® analytical software, accounting for the complex survey design. Population estimates were calculated using the American Community Survey. 31.0% of individuals (n = 1,696), representing a population estimate of 35 million adults, advised to exercise more or lose weight by a health professional reported one or more functional limitation. Of the 31%, 57.6% attempted weight loss, and 40.1% used exercise for weight loss. Few sought health professional assistance. Physical therapists were not mentioned. Few individuals with functional limitations advised to lose weight or increase exercise seek health professional assistance for weight loss. Physical therapists have an opportunity to assist those with functional limitations with exercise prescription.

Development assistance for health: should policy-makers worry about its macroeconomic impact?

Science.gov (United States)

Cavagnero, Eleonora; Lane, Christopher; Evans, David B; Carrin, Guy

2008-11-01

Many low-income countries need to substantially increase expenditure to meet universal coverage goals for essential health services but, because they have very low-incomes, most will be unable to raise adequate funds exclusively from domestic sources in the short to medium term. Increased aid for health will be required. However, there has long been a concern that the rapid arrival of large amounts of foreign exchange in a country could lead to an increase in inflation and loss of international competitiveness, with an adverse impact on exports and economic growth, an economic phenomenon termed 'Dutch disease'. We review cross-country and country-level empirical studies and propose a simple framework to gauge the extent of macroeconomic risks. Of the 15 low-income countries that are increasing aid-financed health spending, 7 have high macroeconomic risks that may constrain the sustained expansion of spending. These conditions also apply in one-quarter of the 42 countries not presently increasing spending. Health authorities should be aware of the multiple risk factors at play, including factors that are health-sector specific and others that generally are not. They should also realize that there are effective means for mitigating the risk of Dutch disease associated with increasing development assistance for health. International partners also have an important role to play since more sustainable and predictable flows of donor funding will allow more productivity enhancing investment in physical and human capital, which will also contribute to ensuring there are few harmful macroeconomic effects of increases in aid.

The impact of threshold language assistance programming on the accessibility of mental health services for persons with limited English proficiency in the Medi-Cal setting.

Science.gov (United States)

McClellan, Sean R; Wu, Frances M; Snowden, Lonnie R

2012-06-01

Title VI of the 1964 Civil Rights Act prohibits federal funds recipients from providing care to limited English proficiency (LEP) persons more limited in scope or lower in quality than care provided to others. In 1999, the California Department of Mental Health implemented a "threshold language access policy" to meet its Title VI obligations. Under this policy, Medi-Cal agencies must provide language assistance programming in a non-English language where a county's Medical population contains either 3000 residents or 5% speakers of that language. We examine the impact of threshold language policy-required language assistance programming on LEP persons' access to mental health services by analyzing the county-level penetration rate of services for Russian, Spanish, and Vietnamese speakers across 34 California counties, over 10 years of quarterly data. Exploiting a time series with nonequivalent control group study design, we studied this phenomena using linear regression with random county effects to account for trends over time. Threshold language policy-required assistance programming led to an immediate and significant increase in the penetration rate of mental health services for Russian (8.2, P language speaking persons. Threshold language assistance programming was effective in increasing mental health access for Russian and Vietnamese, but not for Spanish-speaking LEP persons.

Health Physics Measurements Services

Energy Technology Data Exchange (ETDEWEB)

Carchon, R

2001-04-01

SCK-CEN's programme on health physics measurements includes various activities in dosimetry, calibration , instrumentation , gamma-ray spectrometry, whole body counting , the preparation of standard sources, non-destructive assay and the maintenance of Euratom Fork detectors. Main achievements in these topical areas in 2000 are summarised.

Implementing health management information systems: measuring success in Korea's health centers.

Science.gov (United States)

Chae, Y M; Kim, S I; Lee, B H; Choi, S H; Kim, I S

1994-01-01

This article analyses the effects that the introduction and adoption of a health management information system (HMIS) can have on both the productivity of health center staff as well as on user-satisfaction. The focus is upon the service provided by the Kwonsun Health Center located in Suwon City, Korea. Two surveys were conducted to measure the changes in productivity and adoption (knowledge, persuasion, decision, implementation and confirmation) of health center staff over time. In addition, a third survey was conducted to measure the effects of HMIS on the level of satisfaction perceived by the visitors, by comparing the satisfaction level between the study health center and a similar health center identified as a control. The results suggest that HMIS increased the productivity and satisfaction of the staff but did not increase their persuasion and decision levels; and, that is also succeeded in increasing the levels of visitors' satisfaction with the services provided.

Cost analysis of medical assistance in dying in Canada.

Science.gov (United States)

Trachtenberg, Aaron J; Manns, Braden

2017-01-23

The legalization of medical assistance in dying will affect health care spending in Canada. Our aim was to determine the potential costs and savings associated with the implementation of medical assistance in dying. Using published data from the Netherlands and Belgium, where medically assisted death is legal, we estimated that medical assistance in dying will account for 1%-4% of all deaths; 80% of patients will have cancer; 50% of patients will be aged 60-80 years; 55% will be men; 60% of patients will have their lives shortened by 1 month; and 40% of patients will have their lives shortened by 1 week. We combined current mortality data for the Canadian population with recent end-of-life cost data to calculate a predicted range of savings associated with the implementation of medical assistance in dying. We also estimated the direct costs associated with offering medically assisted death, including physician consultations and drug costs. Medical assistance in dying could reduce annual health care spending across Canada by between $34.7 million and $138.8 million, exceeding the $1.5-$14.8 million in direct costs associated with its implementation. In sensitivity analyses, we noted that even if the potential savings are overestimated and costs underestimated, the implementation of mdedical assistance in dying will likely remain at least cost neutral. Providing medical assistance in dying in Canada should not result in any excess financial burden to the health care system, and could result in substantial savings. Additional data on patients who choose medical assistance in dying in Canada should be collected to enable more precise estimates of the impact of medically assisted death on health care spending and to enable further economic evaluation. © 2017 Canadian Medical Association or its licensors.

Skeletal and Clinical Effects of Exoskeleton-Assisted Gait

Science.gov (United States)

2015-10-01

robotic exoskeletons to enable gait in individuals with a complete spinal cord injury, the health benefits of exoskeleton -assisted gait have not been...for the use of robotic exoskeletons to enable gait in individuals with a complete spinal cord injury, clinical teams are not provided with...appropriate tools to estimate or predict potential health benefits (e.g. bone health) associated with exoskeleton -assisted gait. What was the impact on other

Assisted Reproductive Technology: MedlinePlus Health Topic

Science.gov (United States)

... can be prevented or minimized by limiting the number of embryos that are put into the woman's body. Learn More Assisted Reproductive Technologies (American Society for Reproductive Medicine) - PDF Also ...

Health-related quality of life after robotic-assisted laparoscopic hysterectomy for women with endometrial cancer

DEFF Research Database (Denmark)

Herling, Suzanne Forsyth; Møller, Ann M; Palle, Connie

2016-01-01

OBJECTIVE: The aim of this prospective cohort study using patient-reported outcome measures (PROMs) was to detect short term changes in functioning, symptoms and health-related quality of life (HRQoL) after robotic-assisted laparoscopic hysterectomy (RALH) for endometrial cancer or atypical compl......, gastrointestinal symptoms, appetite, ability to perform work and hobbies, change of taste and sexually related problems should be addressed in future research and in the pre- and postoperative care for women undergoing RALH....... postoperatively, but back to baseline level at 5 weeks. Ability to perform work or hobbies and change of taste were still affected at 5 weeks. CONCLUSIONS: HRQoL and postoperative symptoms were overall back to the preoperative level 5 weeks after RALH. These findings indicate fatigue, pain, constipation...... hyperplasia. METHODS/MATERIALS: A total of 139 women answered the EORTC C-30, EN-24 and EQ-5D-3L preoperatively (baseline) by face to face interview and again 1 week, 5 weeks and 4 months postoperatively by telephone interview. The women furthermore reported their level of activity compared to their habitual...

Measuring the Latency of an Augmented Reality System for Robot-Assisted Minimally Invasive Surgery

DEFF Research Database (Denmark)

Jørgensen, Martin Kibsgaard; Kraus, Martin

2017-01-01

visual communication in training for robot-assisted minimally invasive surgery with da Vinci surgical systems. To make sure that our augmented reality system provides the best possible user experience, we investigated the video latency of the da Vinci surgical system and how the components of our system...... affect the overall latency. To measure the photon-to-photon latency, we used a microcontroller to determine the time between the activation of a lightemitting diode in front of the endoscopic camera and the corresponding increase in intensity of the surgeon's display as measured by a phototransistor...

Pacific Northwest Laboratory annual report for 1989 to the Assistant Secretary for Environment, Safety, and Health

International Nuclear Information System (INIS)

Faust, L.G.; Doctor, P.G.; Selby, J.M.

1990-04-01

Part 5 of the 1989 Annual Report to the US Department of Energy's Assistant Secretary for Environment, Safety, and Health presents Pacific Northwest Laboratory's progress on work performed for the Office of Environmental Guidance and Compliance, the Office of Environmental Audit, the Office of National Environmental Policy Act Project Assistance, the Office of Nuclear Safety, the Office of Safety Compliance, and the Office of Policy and Standards. For each project, as identified by the Field Work Proposal, there is an article describing progress made during fiscal year 1989. Authors of these articles represent a broad spectrum of capabilities derived from five of the seven technical centers of the Laboratory, reflecting the interdisciplinary nature of the work. 35 refs., 1 fig

A randomized controlled trial of a brief intervention for illicit drugs linked to the Alcohol, Smoking and Substance Involvement Screening Test (ASSIST) in clients recruited from primary health-care settings in four countries.

Science.gov (United States)

Humeniuk, Rachel; Ali, Robert; Babor, Thomas; Souza-Formigoni, Maria Lucia O; de Lacerda, Roseli Boerngen; Ling, Walter; McRee, Bonnie; Newcombe, David; Pal, Hemraj; Poznyak, Vladimir; Simon, Sara; Vendetti, Janice

2012-05-01

This study evaluated the effectiveness of a brief intervention (BI) for illicit drugs (cannabis, cocaine, amphetamine-type stimulants and opioids) linked to the World Health Organization (WHO) Alcohol, Smoking and Substance Involvement Screening Test (ASSIST). The ASSIST screens for problem or risky use of 10 psychoactive substances, producing a score for each substance that falls into either a low-, moderate- or high-risk category. Prospective, randomized controlled trial in which participants were either assigned to a 3-month waiting-list control condition or received brief motivational counselling lasting an average of 13.8 minutes for the drug receiving the highest ASSIST score. Primary health-care settings in four countries: Australia, Brazil, India and the United States. A total of 731 males and females scoring within the moderate-risk range of the ASSIST for cannabis, cocaine, amphetamine-type stimulants or opioids. ASSIST-specific substance involvement scores for cannabis, stimulants or opioids and ASSIST total illicit substance involvement score at baseline and 3 months post-randomization. Omnibus analyses indicated that those receiving the BI had significantly reduced scores for all measures, compared with control participants. Country-specific analyses showed that, with the exception of the site in the United States, BI participants had significantly lower ASSIST total illicit substance involvement scores at follow-up compared with the control participants. The sites in India and Brazil demonstrated a very strong brief intervention effect for cannabis scores (P Brazil (P illicit substance use and related risks is effective, at least in the short term, and the effect generalizes across countries. © 2011 The Authors, Addiction © 2011 Society for the Study of Addiction.

Including health insurance in poverty measurement: The impact of Massachusetts health reform on poverty.

Science.gov (United States)

Korenman, Sanders D; Remler, Dahlia K

2016-12-01

We develop and implement what we believe is the first conceptually valid health-inclusive poverty measure (HIPM) - a measure that includes health care or insurance in the poverty needs threshold and health insurance benefits in family resources - and we discuss its limitations. Building on the Census Bureau's Supplemental Poverty Measure, we construct a pilot HIPM for the under-65 population under ACA-like health reform in Massachusetts. This pilot demonstrates the practicality, face validity and value of a HIPM. Results suggest that public health insurance benefits and premium subsidies accounted for a substantial, one-third reduction in the health inclusive poverty rate. Copyright © 2016 Elsevier B.V. All rights reserved.

Animal-assisted interventions and quality of life: expectations among

Directory of Open Access Journals (Sweden)

Javier López-Cepero

2014-12-01

Full Text Available The present study assessed expectations among university students (N= 474, X= 22.7, SD=5.6 years towards the possible benefits of animal-assisted interventions on quality of life. Attitudes were measured with the Improving Quality of Life scale, which is an instrument created ad hoc that demonstrated adequate psychometric properties (four easily interpretable factors, with 49% of explained variance and alphas ranging from .76 to .89. The results showed that the participants (from the departments of Social, Health or Educational Sciences had very positive attitudes (high effect sizes, ES>.80 regardless of training. The experience of sharing households with pets was associated with better expectations. These findings emphasize the high expectations that future professionals in different fields hold regarding animal-assisted interventions, and highlight the current shortcomings in training curricula. The implications of these findings for the development of animal-assisted interventions are discussed.

Health and Safety Audit Design Manual

Energy Technology Data Exchange (ETDEWEB)

Ternes, Mark P. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Langley, Brandon R. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Accawi, Gina K. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Malhotra, Mini [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States)

2017-10-01

The Health and Safety Audit is an electronic audit tool developed by the Oak Ridge National Laboratory to assist in the identification and selection of health and safety measures when a home is being weatherized (i.e., receiving home energy upgrades), especially as part of the US Department of Energy (DOE) Weatherization Assistance Program, or during home energy-efficiency retrofit or remodeling jobs. The audit is specifically applicable to existing single-family homes (including mobile homes), and is generally applicable to individual dwelling units in low-rise multifamily buildings. The health and safety issues covered in the audit are grouped in nine categories: mold and moisture, lead, radon, asbestos, formaldehyde and volatile organic compounds (VOCs), combustion, pest infestation, safety, and ventilation. Development of the audit was supported by the US Department of Housing and Urban Development Office of Healthy Homes and Lead Hazard Control and the DOE Weatherization Assistance Program.

Integrated employee assistance program/managed behavioral health plan utilization by persons with substance use disorders.

Science.gov (United States)

Merrick, Elizabeth S Levy; Hodgkin, Dominic; Hiatt, Deirdre; Horgan, Constance M; Greenfield, Shelly F; McCann, Bernard

2011-04-01

New federal parity and health reform legislation, promising increased behavioral health care access and a focus on prevention, has heightened interest in employee assistance programs (EAPs). This study investigated service utilization by persons with a primary substance use disorder (SUD) diagnosis in a managed behavioral health care (MBHC) organization's integrated EAP/MBHC product (N = 1,158). In 2004, 25.0% of clients used the EAP first for new treatment episodes. After initial EAP utilization, 44.4% received no additional formal services through the plan, and 40.4% received regular outpatient services. Overall, outpatient care, intensive outpatient/day treatment, and inpatient/residential detoxification were most common. About half of the clients had co-occurring psychiatric diagnoses. Mental health service utilization was extensive. Findings suggest that for service users with primary SUD diagnoses in an integrated EAP/MBHC product, the EAP benefit plays a key role at the front end of treatment and is often only one component of treatment episodes. Copyright © 2011 Elsevier Inc. All rights reserved.

Two food-assisted maternal and child health nutrition programs helped mitigate the impact of economic hardship on child stunting in Haiti.

Science.gov (United States)

Donegan, Shannon; Maluccio, John A; Myers, Caitlin K; Menon, Purnima; Ruel, Marie T; Habicht, Jean-Pierre

2010-06-01

Rigorous evaluations of food-assisted maternal and child health and nutrition programs are stymied by the ethics of randomizing recipients to a control treatment. Using nonexperimental matching methods, we evaluated the effect of 2 such programs on child linear growth in Haiti. The 2 well-implemented programs offered the same services (food assistance, behavior change communication, and preventive health services) to pregnant and lactating women and young children. They differed in that one (the preventive program) used blanket targeting of all children 6-23 mo, whereas the other (the recuperative program) targeted underweight (weight-for-age Z score effects on height-for-age Z scores (HAZ) and stunting (HAZ growth in a time of deteriorating economic circumstances.

Assisted Living

Science.gov (United States)

... a resident's needs depends as much on the philosophy and services of the assisted living facility as it does on the quality of care. The Administration on Aging, a part of the U.S. Department of Health and Human Services (HHS), offers these suggestions to help you ...

Measuring health: a practical challenge with a philosophical solution?

Science.gov (United States)

Shroufi, Amir; Chowdhury, Rajiv; Aston, Louise M; Pashayan, Nora; Franco, Oscar H

2011-03-01

With the current demographic shift being experienced by populations globally, almost linear increases in life expectancy have been seen and can be expected. However, increases in healthy life expectancy may not keep pace. Among older populations the proportion of time spent in less than full health tends to increase. As a result, the accurate valuation of life spent in states less than full health will become increasingly important. Different techniques and approaches have been used to measure health in populations. The use of summary measures of population health such as DALYs (Disability Adjusted Life Years) has become common, and is widely used to compare health between populations and to evaluate the potential impact of interventions in economic analyses. Most of the commonly used summary measures of health express some measure of life lived in full health and life lived with disability or in a state of sub-optimal health. Critical to the construction of summary health measures are values assigned to health states. Current tools used in determining these values include the standard gamble, time trade off, person trade off, and the visual analogue scale. However, these techniques all have the disadvantage of incorporating individual biases (derived from particular characteristics specific to individuals or populations) into the process through which health state valuations are derived. As a consequence health states are often not directly comparable between populations, since characteristics such as nationality and ethnicity can influence how health states are valued. Furthermore, health can be judged differently by those of different ages, with the young often assigning a lower value to life lived at less than full health compared to older people. The challenge of obtaining opinions which are not influenced by an individual's own circumstances is not new. This issue was encountered and described by the American philosopher John Rawls in 'A Theory of Justice

Population and Australian development assistance.

Science.gov (United States)

Jones, R

1992-07-01

Australia's position on international population issues is consistent with the major international statements on population: the World Population Plan of Action (1974), the Mexico City Declaration (1984), and the Amsterdam Declaration (1989). Australia's policy emphasizes the importance of population policies as an integral part of social, economic, and cultural development aimed at improving the quality of life of the people. Factors that would promote smaller families include improving economic opportunities, old-age security, education and health (particularly for women), as well as improving the accessibility and quality of family planning services. The quality of care approach is directly complementary to the Australian International Development Assistance Bureau (AIDAB)'s Women-In-Development Policy and its Health Policy, which stresses the theme of Women And Their Children's Health (WATCH). Australia's support for population programs and activities has increased considerably over the last few years. Total assistance for the year 1990/91 was around $7 million out of a total aid program of $1216 million. In recent years AIDAB has funded family planning activities or health projects with family planning components in a number of countries in the Asia-Pacific region. In the South Pacific region AIDAB has funded a reproductive health video project taking into consideration the cultural sensitivities and customs of the peoples of the region. AIDAB has supported a UN Population Fund project in Thailand that aims to strengthen the capacity of the National Statistical Office to collect population data. The US currently accounts for around 40% of all population-related development assistance to improve the health of women and children through family planning. The other major donors are Japan, the Scandinavian countries, and the Netherlands. Funding for population has been a relatively low percentage of overall development assistance budgets in OECD countries. In the

Influences on students' assistive technology use at school: the views of classroom teachers, allied health professionals, students with cerebral palsy and their parents.

Science.gov (United States)

Karlsson, Petra; Johnston, Christine; Barker, Katrina

2017-09-07

This study explored how classroom teachers, allied health professionals, students with cerebral palsy, and their parents view high-tech assistive technology service delivery in the classroom. Semi-structured interviews with six classroom teachers and six parents and their children were conducted. Additionally, two focus groups comprising 10 occupational therapists and six speech pathologists were carried out. Ethical and confidentiality considerations meant that the groups were not matched. Results revealed that it is often untrained staff member who determine students' educational needs. The participants' experiences suggested that, particularly in mainstream settings, there is a need for support and guidance from a professional with knowledge of assistive technology who can also take a lead and guide classroom teachers in how to meet students' needs. Students' motivation to use the technology was also found to be critical for its successful uptake. The study points to the need for classroom teachers to be given sufficient time and skill development opportunities to enable them to work effectively with assistive technology in the classroom. The participants' experiences suggest that such opportunities are not generally forthcoming. Only in this way can it be ensured that students with disabilities receive the education that is their right. Implications for Rehabilitation Classroom teachers, allied health professionals, students, parents need ongoing support and opportunities to practise operational, strategic and linguistic skills with the assistive technology equipment. System barriers to the uptake of assistive technology need to be addressed. To address the lack of time available for training, programing and other support activities around assistive technology, dedicated administrative support is crucial. Professional development around the use of the quality low cost ICF-CY checklist is recommended for both school and allied health staff.

Assistance to Brazil, Pakistan and Thailand

Energy Technology Data Exchange (ETDEWEB)

NONE

1959-04-15

IAEA's technical assistance programme for the current year includes aid to atomic energy projects in Brazil, Pakistan and Thailand. It is proposed to establish a radiation measurement service in Brazil where radioactive isotopes are finding increasing use in medicine, industry and research. The assistance to be provided by IAEA will consist of equipment for the proposed service, and experts who would give courses in their respective specializations and co-operate in the testing of equipment, initiation of measurements and organization of working plans. The Agency is putting three specialists at the disposal of the Pakistan Atomic Energy Commission: one of them an expert on research reactors, another on radioisotopes and irradiation by gamma rays, and the third on health physics. The Pakistan Government has decided to set up an Institute of Nuclear Research and Reactor Technology, where it is planned to install a reactor with a power level of 1 MW to be increased later to 5 MW. The main purposes of the reactor project will be: training on reactor operation and reactor physics; training and research in neutron physics; research on radiation physics and nuclear chemistry; production of radioisotopes; biological research on the effects of radiation; radiation protection and shielding, and research in nuclear engineering and metallurgy. Under a third project, IAEA has sent an expert to Thailand to assist in the development of the medical applications of radioisotopes, particularly in diagnosis and clinical research

Assistance to Brazil, Pakistan and Thailand

International Nuclear Information System (INIS)

1959-01-01

IAEA's technical assistance programme for the current year includes aid to atomic energy projects in Brazil, Pakistan and Thailand. It is proposed to establish a radiation measurement service in Brazil where radioactive isotopes are finding increasing use in medicine, industry and research. The assistance to be provided by IAEA will consist of equipment for the proposed service, and experts who would give courses in their respective specializations and co-operate in the testing of equipment, initiation of measurements and organization of working plans. The Agency is putting three specialists at the disposal of the Pakistan Atomic Energy Commission: one of them an expert on research reactors, another on radioisotopes and irradiation by gamma rays, and the third on health physics. The Pakistan Government has decided to set up an Institute of Nuclear Research and Reactor Technology, where it is planned to install a reactor with a power level of 1 MW to be increased later to 5 MW. The main purposes of the reactor project will be: training on reactor operation and reactor physics; training and research in neutron physics; research on radiation physics and nuclear chemistry; production of radioisotopes; biological research on the effects of radiation; radiation protection and shielding, and research in nuclear engineering and metallurgy. Under a third project, IAEA has sent an expert to Thailand to assist in the development of the medical applications of radioisotopes, particularly in diagnosis and clinical research

How is eHealth literacy measured and what do the measurements tell us?

DEFF Research Database (Denmark)

Knudsen, Astrid Karnøe; Kayser, Lars

2015-01-01

The increasing use of digital services and technologies in health care calls for effective tools to evaluate the users’ eHealth literacy in order to better understand the users’ interaction with health technologies. We here present a systematic review of existing tools to measure eHealth literacy...... and for what these tools have been used to investigate. We identified eight tools, of which three of them are bases upon a conceptual model of eHealth literacy and the remaining five are dual tools, i.a. comprised of individual measures for health literacy and digital literacy. Of these eight tools, only one...... tool (The eHealth literacy Scale - eHEALS) was used in other studies than the one it was originally published in. eHEALS has primarily been used to establish eHealth literacy levels in different populations. Five of the studies have been conducted by examining eHealth literacy’s impact on health...

Using resource dependency theory to measure the environment in health care organizational studies: a systematic review of the literature.

Science.gov (United States)

Yeager, Valerie A; Menachemi, Nir; Savage, Grant T; Ginter, Peter M; Sen, Bisakha P; Beitsch, Leslie M

2014-01-01

Studies using the resource dependency theory (RDT) perspective commonly focus on one or more of the following environmental dimensions: munificence, dynamism, and complexity. To date, no one has reviewed the use of this theory in the health care management literature and there exists no consensus on how to operationalize the market environment in health care settings. The purpose of this review is to examine and summarize the ways in which RDT has been applied in empirical studies of the external environments of health care organizations. In so doing, we identify gaps in the literature and examine the extent to which previous empirical findings aligned with hypothesized relationships based on RDT. We conducted a systematic review of the peer-reviewed literature using a bibliographic search of PubMed and ABI/Inform databases. To identify all health care studies that incorporated the RDT perspective, the words "healthcare" or "health care" were searched in combination with any of the following words: resource dependency theory, uncertainty perspective, environment, munificence, dynamism, and complexity. We also performed a hand search of the reference lists of all manuscripts identified in the initial search to identify additional articles. Twenty studies were included in this review. Wide variability existed in the number of variables used to measure the environment, the environmental constructs measured, and the specific variables used to operationalizethe environmental constructs. Of the 198 tests examining the relationship between environmental variables and the outcome of interest, 26.8% resulted in findings that supported the RDT-predicted hypotheses. The RDT literature is limited to studies of hospitals, nursing homes, and medical practices. There is little consensus on how to measure or operationalize the environment in these studies. No previous studies have measured the environment for other health care settings such as ambulatory surgery centers, public

42 CFR 50.209 - Use of Federal financial assistance.

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false Use of Federal financial assistance. 50.209 Section... OF GENERAL APPLICABILITY Sterilization of Persons in Federally Assisted Family Planning Projects § 50.209 Use of Federal financial assistance. (a) Federal financial assistance adminstered by the Public...

How to measure the agroecological performance of farming in order to assist with the transition process.

Science.gov (United States)

Trabelsi, Meriam; Mandart, Elisabeth; Le Grusse, Philippe; Bord, Jean-Paul

2016-01-01

The use of plant protection products enables farmers to maximize economic performance and yields, but in return, the environment and human health can be greatly affected because of their toxicity. There are currently strong calls for farmers to reduce the use of these toxic products for the preservation of the environment and the human health, and it has become urgent to invest in more sustainable models that help reduce these risks. One possible solution is the transition toward agroecological production systems. These new systems must be beneficial economically, socially, and environmentally in terms of human health. There are many tools available, based on a range of indicators, for assessing the sustainability of agricultural systems on conventional farm holdings. These methods are little suitable to agroecological farms and do not measure the performance of agroecological transition farms. In this article, we therefore develop a model for the strategic definition, guidance, and assistance for a transition to agroecological practices, capable of assessing performance of this transition and simulating the consequences of possible changes. This model was built by coupling (i) a decision-support tool and a technico-economic simulator with (ii) a conceptual model built from the dynamics of agroecological practices. This tool is currently being tested in the framework of a Compte d'Affectation Spéciale pour le Développement Agricole et Rural (CASDAR) project (CASDAR: project launched in 2013 by the French Ministry of Agriculture, Food and Forestry, on the theme "collective mobilisation for agroecology," http://agriculture.gouv.fr/Appel-a-projets-CASDAR ) using data from farms, most of which are engaged in agroenvironmental process and reducing plant protection treatments since 2008.

Ultrasound-assisted extraction for total sulphur measurement in mine tailings

Energy Technology Data Exchange (ETDEWEB)

Khan, Adnan Hossain, E-mail: ad_li2@yahoo.com [Department of Civil and Environmental Engineering, University of Western Ontario (Canada); Shang, Julie Q.; Alam, Raquibul [Department of Civil and Environmental Engineering, University of Western Ontario (Canada)

2012-10-15

Highlights: Black-Right-Pointing-Pointer We develop a total sulphur measuring procedure of mine tailings. Black-Right-Pointing-Pointer Ultrasound is used in the sample pre-treatment process. Black-Right-Pointing-Pointer Full factorial design is applied to identify the best level of effecting factors. - Abstract: A sample preparation method for percentage recovery of total sulphur (%S) in reactive mine tailings based on ultrasound-assisted digestion (USAD) and inductively coupled plasma-optical emission spectroscopy (ICP-OES) was developed. The influence of various methodological factors was screened by employing a two-level and three-factor (2{sup 3}) full factorial design and using KZK-1, a sericite schist certified reference material (CRM), to find the optimal combination of studied factors and %S. Factors such as the sonication time, temperature and acid combination were studied, with the best result identified as 20 min of sonication, 80 Degree-Sign C temperature and 1 ml of HNO{sub 3}:1 ml of HCl, which can achieve 100% recovery for the selected CRM. Subsequently a fraction of the 2{sup 3} full factorial design was applied to mine tailings. The percentage relative standard deviation (%RSD) for the ultrasound method is less than 3.0% for CRM and less than 6% for the mine tailings. The investigated method was verified by X-ray diffraction analysis. The USAD method compared favorably with existing methods such as hot plate assisted digestion method, X-ray fluorescence and LECO Trade-Mark-Sign -CNS method.

Cooperative advanced Driver assistance Systems - Technological measures for data privacy compliance

OpenAIRE

Jäger, Hubert; Schnieder, Lars

2016-01-01

Cooperative advanced driver assistance systems (ADAS) will contribute to road traffic safety: Critical situations will be detected, the driver alerted and control of the vehicle interfered with automatically. However, the introduction of such driver assistance systems presupposes that data privacy issues have already been solved in advance. A necessary condition for the driver to accept and trust new Driver assistance systems is that his/her personal and personally identifiable data will be t...

Radon in indoor air. Health risk, measurement methods and remedial measures

International Nuclear Information System (INIS)

Strand, T.

1996-02-01

Radon in indoor air is the main source of ionizing radiation in Norway. The booklet contains a presentation of radon sources, measurement methods, indoor radon concentrations, action levels, health risk and remedial measures

New approaches to ranking countries for the allocation of development assistance for health: choices, indicators and implications

Science.gov (United States)

Ottersen, Trygve; Grépin, Karen A; Henderson, Klara; Pinkstaff, Crossley Beth; Norheim, Ole Frithjof; Røttingen, John-Arne

2018-01-01

Abstract The distributions of income and health within and across countries are changing. This challenges the way donors allocate development assistance for health (DAH) and particularly the role of gross national income per capita (GNIpc) in classifying countries to determine whether countries are eligible to receive assistance and how much they receive. Informed by a literature review and stakeholder consultations and interviews, we developed a stepwise approach to the design and assessment of country classification frameworks for the allocation of DAH, with emphasis on critical value choices. We devised 25 frameworks, all which combined GNIpc and at least one other indicator into an index. Indicators were selected and assessed based on relevance, salience, validity, consistency, and availability and timeliness, where relevance concerned the extent to which the indicator represented country’s health needs, domestic capacity, the expected impact of DAH, or equity. We assessed how the use of the different frameworks changed the rankings of low- and middle-income countries relative to a country’s ranking based on GNIpc alone. We found that stakeholders generally considered needs to be the most important concern to be captured by classification frameworks, followed by inequality, expected impact and domestic capacity. We further found that integrating a health-needs indicator with GNIpc makes a significant difference for many countries and country categories—and especially middle-income countries with high burden of unmet health needs—while the choice of specific indicator makes less difference. This together with assessments of relevance, salience, validity, consistency, and availability and timeliness suggest that donors have reasons to include a health-needs indicator in the initial classification of countries. It specifically suggests that life expectancy and disability-adjusted life year rate are indicators worth considering. Indicators related to other

Integrating medical, assistive, and universally designed products and technologies: assistive technology device classification (ATDC).

Science.gov (United States)

Bauer, Stephen; Elsaesser, Linda-Jeanne

2012-09-01

ISO26000:2010 International Guidance Standard on Organizational Social Responsibility requires that effective organizational performance recognize social responsibility, including the rights of persons with disabilities (PWD), engage stakeholders and contribute to sustainable development. Millennium Development Goals 2010 notes that the most vulnerable people require special attention, while the World Report on Disability 2011 identifies improved data collection and removal of barriers to rehabilitation as the means to empower PWD. The Assistive Technology Device Classification (ATDC), Assistive Technology Service Method (ATSM) and Matching Person and Technology models provide an evidence-based, standardized, internationally comparable framework to improve data collection and rehabilitation interventions. The ATDC and ATSM encompass and support universal design (UD) principles, and use the language and concepts of the International Classification of Functioning, Disability and Health (ICF). Use ATDC and ICF concepts to differentiate medical, assistive and UD products and technology; relate technology "types" to markets and costs; and support provision of UD products and technologies as sustainable and socially responsible behavior. Supply-side and demand-side incentives are suggested to foster private sector development and commercialization of UD products and technologies. Health and health-related professionals should be knowledgeable of UD principles and interventions.

Designing Health Information Technology Tools to Prevent Gaps in Public Health Insurance.

Science.gov (United States)

Hall, Jennifer D; Harding, Rose L; DeVoe, Jennifer E; Gold, Rachel; Angier, Heather; Sumic, Aleksandra; Nelson, Christine A; Likumahuwa-Ackman, Sonja; Cohen, Deborah J

2017-06-23

Changes in health insurance policies have increased coverage opportunities, but enrollees are required to annually reapply for benefits which, if not managed appropriately, can lead to insurance gaps. Electronic health records (EHRs) can automate processes for assisting patients with health insurance enrollment and re-enrollment. We describe community health centers' (CHC) workflow, documentation, and tracking needs for assisting families with insurance application processes, and the health information technology (IT) tool components that were developed to meet those needs. We conducted a qualitative study using semi-structured interviews and observation of clinic operations and insurance application assistance processes. Data were analyzed using a grounded theory approach. We diagramed workflows and shared information with a team of developers who built the EHR-based tools. Four steps to the insurance assistance workflow were common among CHCs: 1) Identifying patients for public health insurance application assistance; 2) Completing and submitting the public health insurance application when clinic staff met with patients to collect requisite information and helped them apply for benefits; 3) Tracking public health insurance approval to monitor for decisions; and 4) assisting with annual health insurance reapplication. We developed EHR-based tools to support clinical staff with each of these steps. CHCs are uniquely positioned to help patients and families with public health insurance applications. CHCs have invested in staff to assist patients with insurance applications and help prevent coverage gaps. To best assist patients and to foster efficiency, EHR based insurance tools need comprehensive, timely, and accurate health insurance information.

Tracking official development assistance for reproductive health in conflict-affected countries: 2002-2011.

Science.gov (United States)

Patel, P; Dahab, M; Tanabe, M; Murphy, A; Ettema, L; Guy, S; Roberts, B

2016-09-01

To provide information on trends on official development assistance (ODA) disbursement patterns for reproductive health activities in 18 conflict-affected countries. Secondary data analysis. 18 conflict-affected countries and 36 non-conflict-affected countries. The Creditor Reporting System (CRS) database was analyzed for ODA disbursement for direct and indirect reproductive health activities to 18 conflict-affected countries (2002-2011). A comparative analysis was also made with 36 non-conflict-affected counties in the same 'least-developed' income category. Multivariate regression analyses examined associations between conflict status and reproductive health ODA and between reproductive needs and ODA disbursements. Patterns of ODA disbursements (constant U.S. dollars) for reproductive health activities. The average annual ODA disbursed for reproductive health to 18 conflict-affected countries from 2002 to 2011 was US$ 1.93 per person per year. There was an increase of 298% in ODA for reproductive health activities to the conflict-affected countries between 2002 and 2011; 56% of this increase was due to increases in HIV/AIDS funding. The average annual per capita reproductive health ODA disbursed to least-developed non-conflict-affected countries was 57% higher than to least-developed conflict-affected countries. Regression analyses confirmed disparities in ODA to and between conflict-affected countries. Despite increases in ODA for reproductive health for conflict-affected countries (albeit largely for HIV/AIDS activities), considerable disparities remains. Study tracking 10 years of aid for reproductive aid shows major disparities for conflict-affected countries. © 2016 The Authors. BJOG An International Journal of Obstetrics and Gynaecology published by John Wiley & Sons Ltd on behalf of Royal College of Obstetricians and Gynaecologists.

The use of a mobile assistant learning system for health education based on project-based learning.

Science.gov (United States)

Wu, Ting-Ting

2014-10-01

With the development of mobile devices and wireless technology, mobile technology has gradually infiltrated nursing practice courses to facilitate instruction. Mobile devices save manpower and reduce errors while enhancing nursing students' professional knowledge and skills. To achieve teaching objectives and address the drawbacks of traditional education, this study presents a mobile assistant learning system to help nursing students prepare health education materials. The proposed system is based on a project-based learning strategy to assist nursing students with internalizing professional knowledge and developing critical thinking skills. Experimental results show that the proposed mobile system and project-based learning strategy can promote learning effectiveness and efficiency. Most nursing students and nursing educators showed positive attitudes toward this mobile learning system and looked forward to using it again in related courses in the future.

The role of health care assistants in supporting district nurses and family carers to deliver palliative care at home: findings from an evaluation project.

Science.gov (United States)

Ingleton, Christine; Chatwin, John; Seymour, Jane; Payne, Sheila

2011-07-01

To examine the role of trained health and personal care assistants in supporting district nurses and family carers in providing palliative and end of life care in the community. In the UK, there is a policy directive to improve end of life care and to enable greater numbers of people to die at home. This places considerable demands on community nursing services and family carers. In response to this, the Complex and Palliative Continuing Care Service employing generic health and personal care assistants was developed as part of the Marie Curie Delivering Choice Programme in one city in the UK. This paper draws on findings from an independent evaluation of the scheme. The wider evaluation used a formative evaluation methodology. This paper draws on in-depth interviews with a range of stakeholders (n = 17), in-depth interviews with bereaved carers (n = 6) and an analysis of documentation. Stakeholders and bereaved carers perceived that the health and personal care assistants made a vital contribution to community palliative care. Careful recruitment, specific training, case management by district nursing with allocation of specific tasks and close ongoing communication were key features which stakeholders indentified. Family carers welcomed the way assistants developed relationships and became familiar and able to meet the care needs of patients. There were some problems reported which related to capacity, work flow and the need for extensive written care plans. Employing health care assistants under the supervision of district nurses appears to support patients and family at home during end of life care and contribute to good quality nursing care. The needs for community-based palliative and end of life care will increase rapidly over the course of the next 20 years, placing pressure on community nursing services and family carers. © 2011 Blackwell Publishing Ltd.

Pacific Northwest Laboratory annual report for 1989 to the Assistant Secretary for Environment, Safety, and Health - Part 5: Environment, Safety, Health, and Quality Assurance

Energy Technology Data Exchange (ETDEWEB)

Faust, L.G.; Doctor, P.G.; Selby, J.M.

1990-04-01

Part 5 of the 1989 Annual Report to the US Department of Energy's Assistant Secretary for Environment, Safety, and Health presents Pacific Northwest Laboratory's progress on work performed for the Office of Environmental Guidance and Compliance, the Office of Environmental Audit, the Office of National Environmental Policy Act Project Assistance, the Office of Nuclear Safety, the Office of Safety Compliance, and the Office of Policy and Standards. For each project, as identified by the Field Work Proposal, there is an article describing progress made during fiscal year 1989. Authors of these articles represent a broad spectrum of capabilities derived from five of the seven technical centers of the Laboratory, reflecting the interdisciplinary nature of the work. 35 refs., 1 fig.

Assisting role redesign: a qualitative evaluation of the implementation of a podiatry assistant role to a community health setting utilising a traineeship approach.

Science.gov (United States)

Moran, Anna M; Nancarrow, Susan A; Wiseman, Leah; Maher, Kerryn; Boyce, Rosalie A; Borthwick, Alan M; Murphy, Karen

2012-11-27

Increasing demands for podiatry combined with workforce shortages due to attrition, part-time working practices and rural healthcare shortages means that in some geographic areas in Australia there are insufficient professionals to meet service demand. Although podiatry assistants have been introduced to help relieve workforce shortages there has been little evaluation of their impact on patient, staff and/or service outcomes. This research explores the processes and outcomes of a 'trainee' approach to introducing a podiatry assistant (PA) role to a community setting in the Australian Capital Territory (ACT) Government Health Service Directorate. A qualitative methodology was employed involving interviews and focus groups with service managers, qualified practitioners, the assistant, service users and consumer representatives. Perspectives of the implementation process; the traineeship approach; the underlying mechanisms that help or hinder the implementation process; and the perceived impact of the role were explored. Data were analysed using the Richie and Spencer Framework approach. Although the impact of the PA role had not been measured at the time of the evaluation, the implementation of the PA traineeship was considered a success in terms of enabling the transfer of a basic foot-care service from nursing back to podiatry; releasing Enrolled Nurses (ENs) from foot-care duties; an increase in the number of treatments delivered by the podiatry service; and high levels of stakeholder satisfaction with the role. It was perceived that the transfer of the basic foot-care role from nursing to podiatry through the use of a PA impacted on communication and feedback loops between the PA and the podiatry service; the nursing-podiatry relationship; clinical governance around the foot-care service; and continuity of care for clients through the podiatry service. The traineeship was considered successful in terms of producing a PA whose skills were shaped by and directly

Assisting role redesign: a qualitative evaluation of the implementation of a podiatry assistant role to a community health setting utilising a traineeship approach

Directory of Open Access Journals (Sweden)

Moran Anna M

2012-11-01

Full Text Available Abstract Background Increasing demands for podiatry combined with workforce shortages due to attrition, part-time working practices and rural healthcare shortages means that in some geographic areas in Australia there are insufficient professionals to meet service demand. Although podiatry assistants have been introduced to help relieve workforce shortages there has been little evaluation of their impact on patient, staff and/or service outcomes. This research explores the processes and outcomes of a ‘trainee’ approach to introducing a podiatry assistant (PA role to a community setting in the Australian Capital Territory (ACT Government Health Service Directorate. Method A qualitative methodology was employed involving interviews and focus groups with service managers, qualified practitioners, the assistant, service users and consumer representatives. Perspectives of the implementation process; the traineeship approach; the underlying mechanisms that help or hinder the implementation process; and the perceived impact of the role were explored. Data were analysed using the Richie and Spencer Framework approach. Results Although the impact of the PA role had not been measured at the time of the evaluation, the implementation of the PA traineeship was considered a success in terms of enabling the transfer of a basic foot-care service from nursing back to podiatry; releasing Enrolled Nurses (ENs from foot-care duties; an increase in the number of treatments delivered by the podiatry service; and high levels of stakeholder satisfaction with the role. It was perceived that the transfer of the basic foot-care role from nursing to podiatry through the use of a PA impacted on communication and feedback loops between the PA and the podiatry service; the nursing-podiatry relationship; clinical governance around the foot-care service; and continuity of care for clients through the podiatry service. The traineeship was considered successful in terms of

Amicus Curiae Brief for the United States Supreme Court on Mental Health Issues Associated with "Physician-Assisted Suicide"

Science.gov (United States)

Werth, James L., Jr.; Gordon, Judith R.

2002-01-01

After providing background material related to the Supreme Court cases on "physician-assisted suicide" (Washington v. Glucksberg, 1997, and Vacco v. Quill, 1997), this article presents the amicus curiae brief that was submitted to the United States Supreme Court by 2 national mental health organizations, a state psychological association, and an…

Complications and health-related quality of life after robot-assisted versus open radical cystectomy

DEFF Research Database (Denmark)

Lauridsen, Susanne Vahr; Tønnesen, Hanne; Jensen, Bente Thoft

2017-01-01

Background: Radical cystectomy is associated with high rates of perioperative morbidity. Robotic-assisted radical cystectomy (RARC) is widely used today despite limited evidence for clinical superiority. The aim of this review was to evaluate the effect of RARC compared to open radical cystectomy...... (ORC) on complications and secondary on length of stay, time back to work and health-related quality of life (HRQoL). Methods: The databases PubMed, The Cochrane Library, Embase and CINAHL were searched. A systematic review according to the PRISMA guidelines and cumulative analysis was conducted...

Measurement-based management of mental health quality and access in VHA: SAIL mental health domain.

Science.gov (United States)

Lemke, Sonne; Boden, Matthew Tyler; Kearney, Lisa K; Krahn, Dean D; Neuman, Matthew J; Schmidt, Eric M; Trafton, Jodie A

2017-02-01

We outline the development of a Mental Health Domain to track accessibility and quality of mental health care in the United States Veterans Health Administration (VHA) as part of a broad-based performance measurement system. This domain adds an important element to national performance improvement efforts by targeting regional and facility leadership and providing them a concise yet comprehensive measure to identify facilities facing challenges in their mental health programs. We present the conceptual framework and rationale behind measure selection and development. The Mental Health Domain covers three important aspects of mental health treatment: Population Coverage, Continuity of Care, and Experience of Care. Each component is a composite of existing and newly adapted measures with moderate to high internal consistency; components are statistically independent or moderately related. Development and dissemination of the Mental Health Domain involved a variety of approaches and benefited from close collaboration between local, regional, and national leadership and from coordination with existing quality-improvement initiatives. During the first year of use, facilities varied in the direction and extent of change. These patterns of change were generally consistent with qualitative information, providing support for the validity of the domain and its component measures. Measure maintenance remains an iterative process as the VHA mental health system and potential data resources continue to evolve. Lessons learned may be helpful to the broader mental health-provider community as mental health care consolidates and becomes increasingly integrated within healthcare systems. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Health surveillance assistants as intermediates between the community and health sector in Malawi: exploring how relationships influence performance.

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Kok, Maryse C; Namakhoma, Ireen; Nyirenda, Lot; Chikaphupha, Kingsley; Broerse, Jacqueline E W; Dieleman, Marjolein; Taegtmeyer, Miriam; Theobald, Sally

2016-05-03

There is increasing global interest in how best to support the role of community health workers (CHWs) in building bridges between communities and the health sector. CHWs' intermediary position means that interpersonal relationships are an important factor shaping CHW performance. This study aimed to obtain in-depth insight into the facilitators of and barriers to interpersonal relationships between health surveillance assistants (HSAs) and actors in the community and health sector in hard-to-reach settings in two districts in Malawi, in order to inform policy and practice on optimizing HSA performance. The study followed a qualitative design. Forty-four semi-structured interviews and 16 focus group discussions were conducted with HSAs, different community members and managers in Mchinji and Salima districts. Data were recorded, transcribed, translated, coded and thematically analysed. HSAs had relatively strong interpersonal relationships with traditional leaders and volunteers, who were generally supportive of their work. From the health sector side, HSAs linked to health professionals and managers, but found them less supportive. Accountability structures at the community level were not well-established and those within the health sector were executed irregularly. Mistrust from the community, volunteers or HSAs regarding incentives and expectations that could not be met by "higher levels" undermined support structures and led to demotivation and hampered performance. Supervision and training were sometimes a source of mistrust and demotivation for HSAs, because of the perceived disinterest of supervisors, uncoordinated supervision and favouritism in selection of training participants. Rural HSAs were seen as more disadvantaged than HSAs in urban areas. HSAs' intermediary position necessitates trusting relationships between them and all actors within the community and the health sector. There is a need to improve support and accountability structures that

A Systematic Review on Existing Measures for the Subjective Assessment of Rehabilitation and Assistive Robot Devices

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Yiannis Koumpouros

2016-01-01

Full Text Available The objective of the current study is to identify and classify outcome measures currently used for the assessment of rehabilitation or assistive robot devices. We conducted a systematic review of the literature using PubMed, MEDLINE, CIRRIE, and Scopus databases for studies that assessed rehabilitation or assistive robot devices from 1980 through January 2016. In all, 31 articles met all inclusion criteria. Tailor-made questionnaires were the most commonly used tool at 66.7%, while the great majority (93.9% of the studies used nonvalidated instruments. The study reveals the absence of a standard scale which makes it difficult to compare the results from different researchers. There is a great need, therefore, for a valid and reliable instrument to be available for use by the intended end users for the subjective assessment of robot devices. The study concludes by identifying two scales that have been validated in general assistive technology devices and could support the scope of subjective assessment in rehabilitation or assistive robots (however, with limited coverage and a new one called PYTHEIA, recently published. The latter intends to close the gap and help researchers and developers to evaluate, assess, and produce products that satisfy the real needs of the end users.

[Food assistance programs in Mexico, coverage and targeting].

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Morales-Ruán, Ma del Carmen; Shamah-Levy, Teresa; Mundo-Rosas, Verónica; Cuevas-Nasu, Lucía; Romero-Martínez, Martín; Villalpando, Salvador; Rivera-Dommarco, Juan Ángel

2013-01-01

To describe the distribution of social food assistance programs in Mexico. Information about 36 150 households from the National Health and Nutrition Survey (ENSANUT 2012) was included. The distribution of the social assistance food programs by characteristics as rural/urban locality, country region, ethnicity, socioeconomic level and nutritional status was observed. At the national level, food assistance programs with the greater coverage are Oportunidades (reaching 18.8% of the population), Liconsa (milk distribution, 9.7%) and School Breakfasts (12.2%). The program that assists in the best way the target population is Oportunidades, where 75% of its beneficiaries belong to the "low" and "lower" socioeconomic levels, in contrast to Liconsa and School Breakfasts programs, where only 42% and 55% of the beneficiaries are in such levels, respectively. Current focus and application of the food assistance programs must be adjusted under the perspective of wellness, health and nutrition of the children population.

Health smart home: towards an assistant tool for automatic assessment of the dependence of elders.

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Le, Xuan Hoa Binh; Di Mascolo, Maria; Gouin, Alexia; Noury, Norbert

2007-01-01

In order to help elders living alone to age in place independently and safely, it can be useful to have an assistant tool that can automatically assess their dependence and issue an alert if there is any loss of autonomy. The dependence can be assessed by the degree of performance, by the elders, of activities of daily living. This article presents an approach enabling the activity recognition for an elder living alone in a Health Smart Home equipped with noninvasive sensors.

Children's health care assistance according to their families: a comparison between models of Primary Care

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Vanessa Bertoglio Comassetto Antunes de Oliveira

2015-02-01

Full Text Available OBJECTIVE To compare the health assistance models of Basic Traditional Units (UBS with the Family Health Strategy (ESF units for presence and extent of attributes of Primary Health Care (APS, specifically in the care of children. METHOD A cross-sectional study of a quantitative approach with families of children attended by the Public Health Service of Colombo, Paraná. The Primary Care Assessment Tool (PCA-Tool was applied to parents of 482 children, 235 ESF units and 247 UBS units covering all primary care units of the municipality, between June and July 2012. The results were analyzed according to the PCA-Tool manual. RESULTS ESF units reached a borderline overall score for primary health care standards. However, they fared better in their attributes of Affiliation, Integration of care coordination, Comprehensiveness, Family Centeredness and Accessibility of use, while the attributes of Community Guidance/Orientation, Coordination of Information Systems, Longitudinality and Access attributes were rated as insufficient for APS. UBS units had low scores on all attributes. CONCLUSION The ESF units are closer to the principles of APS (Primary Health Care, but there is need to review actions of child care aimed at the attributes of APS in both care models, corroborating similar studies from other regions of Brazil.

Pharmaceutical assistance in local public health services in Santa Catarina (Brazil: characteristics of its organization

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Ana Paula Veber

2011-03-01

Full Text Available This study outlines the diagnosis stage of 201 Municipal Pharmaceutical Assistance Plans sent to the Directorate of Pharmaceutical Assistance of the State Secretariat for Health of Santa Catarina (DIAF-SES/SC between November 12, 2005 and July 6, 2006. Multiple Correspondence Analysis was used in conjunction with SPAD 3.5 software, followed by hypothesis testing. The variables "pharmacist presence" and "population" were those which most contributed to the formation of the three clusters of municipalities observed. The number of drugs contained in the Municipal Lists of Essential Drugs (REMUMEs ranged from 15 to 413. A total of 67 towns had between 101 and 200 drugs- a range considered ideal in this study according to the 2006 National List of Essential Drugs. No tendency toward correlation between number of drugs listed in the REMUMES and municipality population size was found. Results confirmed the known disparity in Pharmaceutical Assistance among municipalities of different sizes and highlighted the need for structuring the activities of Pharmaceutical Assistance in the municipalities studied. There is also a need for greater commitment from all management spheres so that activities of Pharmaceutical Assistance at a local level ensure access to quality drugs and services, while fostering rational use.Este estudo retrata a etapa de diagnóstico de 201 Planos Municipais de Assistência Farmacêutica enviados entre 12 de novembro de 2005 a 06 de julho de 2006 à Diretoria de Assistência Farmacêutica da Secretaria de Estado da Saúde de Santa Catarina (DIAF-SES/SC. Utilizou-se a Análise de Correspondência Múltipla, através do programa SPAD 3.5 e posteriormente realizou-se teste de hipótese. As variáveis "presença de farmacêutico" e "população" foram as que mais contribuíram para a formação dos três agrupamentos de municípios evidenciados. O número de medicamentos constantes das Relações Municipais de Medicamentos Essenciais

Accelerated Adoption of Advanced Health Information Technology in Beacon Community Health Centers.

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Jones, Emily; Wittie, Michael

2015-01-01

To complement national and state-level HITECH Act programs, 17 Beacon communities were funded to fuel community-wide use of health information technology to improve quality. Health centers in Beacon communities received supplemental funding. This article explores the association between participation in the Beacon program and the adoption of electronic health records. Using the 2010-2012 Uniform Data System, trends in health information technology adoption among health centers located within and outside of Beacon communities were explored using differences in mean t tests and multivariate logistic regression. Electronic health record adoption was widespread and rapidly growing in all health centers, especially quality improvement functionalities: structured data capture, order and results management, and clinical decision support. Adoption lagged for functionalities supporting patient engagement, performance measurement, care coordination, and public health. The use of advanced functionalities such as care coordination grew faster in Beacon health centers, and Beacon health centers had 1.7 times higher odds of adopting health records with basic safety and quality functionalities in 2010-2012. Three factors likely underlie these findings: technical assistance, community-wide activation supporting health information exchange, and the layering of financial incentives. Additional technical assistance and community-wide activation is needed to support the use of functionalities that are currently lagging. © Copyright 2015 by the American Board of Family Medicine.

Validation of the French version of the alcohol, smoking and substance involvement screening test (ASSIST in the elderly

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Khan Riaz

2012-06-01

Full Text Available Abstract Background Substance use disorders seem to be an under considered health problem amongst the elderly. The Alcohol, Smoking and Substance Involvement Screening Test (ASSIST, was developed by the World Health Organization to detect substance use disorders. The present study evaluates the psychometric properties of the French version of ASSIST in a sample of elderly people attending geriatric outpatient facilities (primary care or psychiatric facilities. Methods One hundred persons older than 65 years were recruited from clients attending a geriatric policlinic day care centre and from geriatric psychiatric facilities. Measures included ASSIST, Addiction Severity Index (ASI, Mini-International Neuropsychiatric Interview (MINI-Plus, Alcohol Use Disorders Identification Test (AUDIT, Revised Fagerstrom Tolerance Questionnaire-Smoking (RTQ and MiniMental State(MMS. Results Concurrent validity was established with significant correlations between ASSIST scores, scores from ASI, AUDIT, RTQ, and significantly higher ASSIST scores for patients with a MINI-Plus diagnosis of abuse or dependence. The ASSIST questionnaire was found to have high internal consistency for the total substance involvement along with specific substance involvement as assessed by Cronbach’s α, ranging from 0.66, to 0.89 . Conclusions The findings demonstrate that ASSIST is a valid screening test for identifying substance use disorders in elderly.

21 CFR 884.6100 - Assisted reproduction needles.

Science.gov (United States)

2010-04-01

... vitro fertilization (IVF), gamete intrafallopian transfer (GIFT), or other assisted reproduction... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Assisted reproduction needles. 884.6100 Section 884.6100 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES...

21 CFR 884.6110 - Assisted reproduction catheters.

Science.gov (United States)

2010-04-01

... vitro fertilization (IVF), gamete intrafallopian transfer (GIFT), or other assisted reproduction... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Assisted reproduction catheters. 884.6110 Section 884.6110 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES...

Does job satisfaction improve the health of workers? New evidence using panel data and objective measures of health.

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Fischer, Justina A V; Sousa-Poza, Alfonso

2009-01-01

This paper evaluates the relationship between job satisfaction and measures of health of workers using the German Socio-Economic Panel. Methodologically, it addresses two important design problems encountered frequently in the literature: (a) cross-sectional causality problems and (b) the absence of objective measures of physical health that complement self-reported measures of health status. Not only does using the panel structure with individual fixed effects mitigate the bias from omitting unobservable personal psycho-social characteristics, but employing more objective health measures such as health-system contacts and disability addresses such measurement problems relating to self-report assessments of health status.We find a positive link between job satisfaction (and changes over time therein) and subjective health measures (and changes therein); that is, employees with higher or improved job satisfaction levels feel healthier and are more satisfied with their health. This observation also holds true for more objective measures of health. Particularly, improvements in job satisfaction over time appear to prevent workers from (further) health deterioration. Copyright (c) 2008 John Wiley & Sons, Ltd.

Measuring up: Implementing a dental quality measure in the electronic health record context.

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Bhardwaj, Aarti; Ramoni, Rachel; Kalenderian, Elsbeth; Neumann, Ana; Hebballi, Nutan B; White, Joel M; McClellan, Lyle; Walji, Muhammad F

2016-01-01

Quality improvement requires using quality measures that can be implemented in a valid manner. Using guidelines set forth by the Meaningful Use portion of the Health Information Technology for Economic and Clinical Health Act, the authors assessed the feasibility and performance of an automated electronic Meaningful Use dental clinical quality measure to determine the percentage of children who received fluoride varnish. The authors defined how to implement the automated measure queries in a dental electronic health record. Within records identified through automated query, the authors manually reviewed a subsample to assess the performance of the query. The automated query results revealed that 71.0% of patients had fluoride varnish compared with the manual chart review results that indicated 77.6% of patients had fluoride varnish. The automated quality measure performance results indicated 90.5% sensitivity, 90.8% specificity, 96.9% positive predictive value, and 75.2% negative predictive value. The authors' findings support the feasibility of using automated dental quality measure queries in the context of sufficient structured data. Information noted only in free text rather than in structured data would require using natural language processing approaches to effectively query electronic health records. To participate in self-directed quality improvement, dental clinicians must embrace the accountability era. Commitment to quality will require enhanced documentation to support near-term automated calculation of quality measures. Copyright © 2016 American Dental Association. Published by Elsevier Inc. All rights reserved.

The global financial crisis has led to a slowdown in growth of funding to improve health in many developing countries.

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Leach-Kemon, Katherine; Chou, David P; Schneider, Matthew T; Tardif, Annette; Dieleman, Joseph L; Brooks, Benjamin P C; Hanlon, Michael; Murray, Christopher J L

2012-01-01

How has funding to developing countries for health improvement changed in the wake of the global financial crisis? The question is vital for policy making, planning, and advocacy purposes in donor and recipient countries alike. We measured the total amount of financial and in-kind assistance that flowed from both public and private channels to improve health in developing countries during the period 1990-2011. The data for the years 1990-2009 reflect disbursements, while the numbers for 2010 and 2011 are preliminary estimates. Development assistance for health continued to grow in 2011, but the rate of growth was low. We estimate that assistance for health grew by 4 percent each year from 2009 to 2011, reaching a total of $27.73 billion. This growth was largely driven by the World Bank's International Bank for Reconstruction and Development and appeared to be a deliberate strategy in response to the global economic crisis. Assistance for health from bilateral agencies grew by only 4 percent, or $444.08 million, largely because the United States slowed its development assistance for health. Health funding through UN agencies stagnated, and the Global Fund to Fight AIDS, Tuberculosis, and Malaria announced that it would make no new grants for the next two years because of declines in funding. Given the international community's focus on meeting the Millennium Development Goals by 2015 and persistent economic hardship in donor countries, continued measurement of development assistance for health is essential for policy making.

The measurement of community benefit: issues, options, and questions for further research.

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Longo, D R

1994-01-01

Community benefit from a conceptual perspective can be traced to the philanthropic and humanitarian spirit that dominated the earliest foundations of the hospital as a social institution. However, the measurement of community benefit is a recent development and one rarely addressed in the literature in any detail. This article outlines the various concepts integral to community benefit measurement that must be taken into account for a program to demonstrate community accountability in an era where hospitals and health care institutions are increasingly required to evaluate and document their value to society. The perspective taken is that of a practicing health care executive. The use of the discussed concepts will assist health care executives and their staff in designing and evaluating programs, and will also assist academics in preparing students for this important professional responsibility.

Certified Nursing Assistants Balancing Family Caregiving Roles: Health Care Utilization Among Double- and Triple-Duty Caregivers.

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DePasquale, Nicole; Bangerter, Lauren R; Williams, Jessica; Almeida, David M

2016-12-01

This study examines how certified nursing assistants (CNAs) balancing family caregiving roles-child care (double-duty child caregivers), elder care (double-duty elder caregivers), and both child and elder care (triple-duty caregivers)-utilize health care services relative to nonfamily caregiving counterparts (formal-only caregivers). A sample of 884 CNAs from the Work, Family and Health Study was drawn on to assess the number of acute care (i.e., emergency room or urgent care facility) and other health care (i.e., outpatient treatment or counseling) visits made during the past 6 months. Double-duty elder and triple-duty caregivers had higher acute care utilization rates than formal-only caregivers. CNAs with and without family caregiving roles had similar rates of other health care visits. CNAs providing informal care for older adults have higher acute care visit rates. Given the increasing need for family caregivers and the vital importance of the health of the nursing workforce for the health of others, future research on how double- and triple-duty caregivers maintain their health amidst constant caregiving should be a priority. © The Author 2015. 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.

Development and Dissemination of the El Centro Health Disparities Measures Library.

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Mitrani, Victoria Behar; O'Day, Joanne E; Norris, Timothy B; Adebayo, Oluwamuyiwa Winifred

2017-09-01

This report describes the development and dissemination of a library of English measures, with Spanish translations, on constructs relevant to social determinants of health and behavioral health outcomes. The El Centro Measures Library is a product of the Center of Excellence for Health Disparities Research: El Centro, a program funded by the National Institute on Minority Health and Health Disparities of the U.S. National Institutes of Health. The library is aimed at enhancing capacity for minority health and health disparities research, particularly for Hispanics living in the United States and abroad. The open-access library of measures (available through www.miami.edu/sonhs/measureslibrary) contains brief descriptions of each measure, scoring information (where available), links to related peer-reviewed articles, and measure items in both languages. Links to measure websites where commercially available measures can be purchased are included, as is contact information for measures that require author permission. Links to several other measures libraries are hosted on the library website. Other researchers may contribute to the library. El Centro investigators began the library by electing to use a common set of measures across studies to assess demographic information, culture-related variables, proximal outcomes of interest, and major outcomes. The collection was expanded to include other health disparity research studies. In 2012, a formal process was developed to organize, expand, and centralize the library in preparation for a gradual process of dissemination to the national and international community of researchers. The library currently contains 61 measures encompassing 12 categories of constructs. Thus far, the library has been accessed 8,883 times (unique page views as generated by Google Analytics), and responses from constituencies of users and measure authors have been favorable. With the paucity of availability and accessibility of translated

Stakeholders' views of the introduction of assistive technology in the classroom: How family-centred is Australian practice for students with cerebral palsy?

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Karlsson, P; Johnston, C; Barker, K

2017-07-01

With family-centred care widely recognized as a cornerstone for effective assistive technology service provision, the current study was undertaken to investigate to what extent such approaches were used by schools when assistive technology assessments and implementation occurred in the classroom. In this cross-sectional study, we compare survey results from parents (n = 76), school staff (n = 33) and allied health professionals (n = 65) with experience in the use of high-tech assistive technology. Demographic characteristics and the stakeholders' perceived helpfulness and frequency attending assessment and set-up sessions were captured. To evaluate how family-centred the assistive technology services were perceived to be, the parents filled out the Measure of Processes of Care for Caregivers, and the professionals completed the Measure of Processes of Care for Service Providers. Descriptive statistics and one-way analysis of variance were used to conduct the data analysis. Findings show that parents are more involved during the assessment stage than during the implementation and that classroom teachers are often not involved in the initial stage. Speech pathologists in particular are seen to be to a great extent helpful when implementing assistive technology in the classroom. This study found that family-centred service is not yet fully achieved in schools despite being endorsed in early intervention and disability services for over 20 years. No statistically significant differences were found with respect to school staff and allied health professionals' roles, their years of experience working with students with cerebral palsy and the scales in the Measure of Processes of Care for Service Providers. To enhance the way technology is matched to the student and successfully implemented, classroom teachers need to be fully involved in the whole assistive technology process. The findings also point to the significance of parents' involvement, with the support of

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

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Yang, Chih-Ching

2016-02-03

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

Health Plan Performance Measurement within Medicare Subvention.

Science.gov (United States)

1998-06-01

the causes of poor performance (Siren & Laffel, 1996). Although outcomes measures such as nosocomial infection rates, admission rates for select...defined. Traditional outcomes measures include infection rates, morbidity, and mortality. The problem with these traditional measures is... Maternal /Child Care Indicators Nursing Staffing Indicators Outcome Indicators Technical Outcomes Plan Performance Stability of Health Plan

The productivity of physician assistants and nurse practitioners and health work force policy in the era of managed health care.

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Scheffler, R M; Waitzman, N J; Hillman, J M

1996-01-01

Managed care is spreading rapidly in the United States and creating incentives for physician practices to find the most efficient combination of health professionals to deliver care to an enrolled population. Given these trends, it is appropriate to reexamine the roles of physician assistants (PAs) and nurse practitioners (NPs) in the health care workforce. This paper briefly reviews the literature on PA and NP productivity, managed care plans' use of PAs and NPs, and the potential impact of PAs and NPs on the size and composition of the future physician workforce. In general, the literature supports the idea that PAs and NPs could have a major impact on the future health care workforce. Studies show significant opportunities for increased physician substitution and even conservative assumptions about physician task delegation imply a large increase in the number of PAs and NPs that can be effectively deployed. However, the current literature has certain limitations that make it difficult to quantify the future impact of PAs and NPs. Among these limitations is the fact that virtually all formal productivity studies were conducted in fee-for-service settings during the 1970s, rather than managed care settings. In addition, the vast majority of PA and NP productivity studies have viewed PAs and NPs as physician substitutes rather than as members of interdisciplinary health care teams, which may become the dominant health care delivery model over the next 10-20 years.

Psychological Assistance and Violence against Women

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Heloisa Hanada

2010-01-01

Full Text Available The aim of this research was to identify and analyze the insertion of psychologists into the network of services assisting violence against women. Interviews with psychologists working for specific services in Greater Sao Paulo (police, health, psychosocial assistance, shelter, basic assistance were analyzed. Psychologists are present and their work is requested in all types of services. Their work consists in training and supervising other professionals, as well as assisting women. There is a great diversity of practices, with frequent adjustment of the interventions to the objectives, institutional culture and assistance vocation of the services. There is a relative impreciseness in the psychologists’ work, and this can stand as a barrier to better team and network integration. However, it can also create opportunities for innovations in practices.

Development Assistance for Health (DAH | L’aide au développement en faveur de la santé (ADS

Directory of Open Access Journals (Sweden)

2012-05-01

Full Text Available Deaths by Disease vs Development Assistance for Health (DAH*, 2008 (in percentage of total DAH and total deaths by regionDécès par maladie et aide au développement en faveur de la santé (ADS*, 2008 (en pourcentage de l’ADS totale et du nombre total des décès par région*DAH includes both financial and in-kind contributions for activities aimed at improving health in low- and middleincome countries. | L’ADS comprend les contributions financières et en nature aux actions pour améliorer la sa...

Health Literacy, Cognitive Ability, and Functional Health Status among Older Adults

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Serper, Marina; Patzer, Rachel E; Curtis, Laura M; Smith, Samuel G; O'Conor, Rachel; Baker, David W; Wolf, Michael S

2014-01-01

Objective To investigate whether previously noted associations between health literacy and functional health status might be explained by cognitive function. Data Sources/Study Setting Health Literacy and Cognition in Older Adults (“LitCog,” prospective study funded by National Institute on Aging). Data presented are from interviews conducted among 784 adults, ages 55–74 years receiving care at an academic general medicine clinic or one of four federally qualified health centers in Chicago from 2008 to 2010. Study Design Study participants completed structured, in-person interviews administered by trained research assistants. Data Collection Health literacy was measured using the Test of Functional Health Literacy in Adults, Rapid Estimate of Adult Literacy in Medicine, and Newest Vital Sign. Cognitive function was assessed using measures of long-term and working memory, processing speed, reasoning, and verbal ability. Functional health was assessed with SF-36 physical health summary scale and Patient Reported Outcomes Measurement Information System short form subscales for depression and anxiety. Principal Findings All health literacy measures were significantly correlated with all cognitive domains. In multivariable analyses, inadequate health literacy was associated with worse physical health and more depressive symptoms. After adjusting for cognitive abilities, associations between health literacy, physical health, and depressive symptoms were attenuated and no longer significant. Conclusions Cognitive function explains a significant proportion of the associations between health literacy, physical health, and depression among older adults. Interventions to reduce literacy disparities in health care should minimize the cognitive burden in behaviors patients must adopt to manage personal health. PMID:24476068

Measuring and Assuring the Quality of Home Health Care

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Shaughnessy, Peter W.; Crisler, Kathryn S.; Schlenker, Robert E.; Arnold, Angela G.; Kramer, Andrew M.; Powell, Martha C.; Hittle, David F.

1994-01-01

The growth in home health care in the United States since 1970, and the exponential increase in the provision of Medicare-covered home health services over the past 5 years, underscores the critical need to assess the effectiveness of home health care in our society. This article presents conceptual and applied topics and approaches involved in assessing effectiveness through measuring the outcomes of home health care. Definitions are provided for a number of terms that relate to quality of care, outcome measures, risk adjustment, and quality assurance (QA) in home health care. The goal is to provide an overview of a potential systemwide approach to outcome-based QA that has its basis in a partnership between the home health industry and payers or regulators. PMID:10140157

2014 Child and Adult Health Care Quality Measures

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U.S. Department of Health & Human Services — Performance rates on frequently reported health care quality measures in the CMS Medicaid/CHIP Child and Adult Core Sets, for FFY 2014 reporting. Dataset contains...

2016 Child and Adult Health Care Quality Measures

Data.gov (United States)

U.S. Department of Health & Human Services — Performance rates on frequently reported health care quality measures in the CMS Medicaid/CHIP Child and Adult Core Sets, for FFY 2016 reporting. Source: Mathematica...

2015 Child and Adult Health Care Quality Measures

Data.gov (United States)

U.S. Department of Health & Human Services — Performance rates on frequently reported health care quality measures in the CMS Medicaid/CHIP Child and Adult Core Sets, for FFY 2015 reporting. Source: Mathematica...

Potential Suitable Methods for Measuring the Effects of Animal-Assisted Activities and Therapy: a Review

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Machová K.

2016-09-01

Full Text Available Dogs are companions of humans since time beyond memory and their use in rehabilitation processes is increasingly frequent. Dogs can be used for animal-assisted activities (AAA as well as animal-assisted therapy (AAT. The effects, however, have not been fully demonstrated, reasons for this including difficulties in providing evidence of positive action. According to previous studies, there is a decrease in heart and respiratory rate, blood pressure reduction, more positive mood as well as warming of muscles, which promotes relaxation of spastic areas. Regulation of hormone levels might also occur as a result of AAA/AAT. Indeed, increases in oxytocin levels and decreases of cortisol have been found. However, a unified methodology for clear measuring the entire impact of AAA/AAT on patients is missing. This survey evaluated different methods for measuring the effects of AAA/AAT, with results showing that the most suitable ones, selected on the basis of the effect of rehabilitation, comprise thermography, spectral analysis of heart rate, electromyography (EMG, polyelectromyography (PEMG, and blood sampling. Because AAT making use of dogs has not yet been recognized as an official method of treatment, it is very important to find out objective means to evidence its beneficial effects. Highlights:

Measuring the diffusion of innovative health promotion programs.

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Steckler, A; Goodman, R M; McLeroy, K R; Davis, S; Koch, G

1992-01-01

Once a health promotion program has proven to be effective in one or two initial settings, attempts may be made to transfer the program to new settings. One way to conceptualize the transference of health promotion programs from one locale to another is by considering the programs to be innovations that are being diffused. In this way, diffusion of innovation theory can be applied to guide the process of program transference. This article reports on the development of six questionnaires to measure the extent to which health promotion programs are successfully disseminated: Organizational Climate, Awareness-Concern, Rogers's Adoption Variables, Level of Use, Level of Success, and Level of Institutionalization. The instruments are being successfully used in a study of the diffusion of health promotion/tobacco prevention curricula to junior high schools in North Carolina. The instruments, which measure the four steps of the diffusion process, have construct validity since they were developed within existing theories and are derived from the work of previous researchers. No previous research has attempted to use instruments like these to measure sequentially the stages of the diffusion process.

Performance Evaluation Methods for Assistive Robotic Technology

Science.gov (United States)

Tsui, Katherine M.; Feil-Seifer, David J.; Matarić, Maja J.; Yanco, Holly A.

Robots have been developed for several assistive technology domains, including intervention for Autism Spectrum Disorders, eldercare, and post-stroke rehabilitation. Assistive robots have also been used to promote independent living through the use of devices such as intelligent wheelchairs, assistive robotic arms, and external limb prostheses. Work in the broad field of assistive robotic technology can be divided into two major research phases: technology development, in which new devices, software, and interfaces are created; and clinical, in which assistive technology is applied to a given end-user population. Moving from technology development towards clinical applications is a significant challenge. Developing performance metrics for assistive robots poses a related set of challenges. In this paper, we survey several areas of assistive robotic technology in order to derive and demonstrate domain-specific means for evaluating the performance of such systems. We also present two case studies of applied performance measures and a discussion regarding the ubiquity of functional performance measures across the sampled domains. Finally, we present guidelines for incorporating human performance metrics into end-user evaluations of assistive robotic technologies.

Rural Embedded Assistants for Community Health (REACH) network: first-person accounts in a community-university partnership.

Science.gov (United States)

Brown, Louis D; Alter, Theodore R; Brown, Leigh Gordon; Corbin, Marilyn A; Flaherty-Craig, Claire; McPhail, Lindsay G; Nevel, Pauline; Shoop, Kimbra; Sterner, Glenn; Terndrup, Thomas E; Weaver, M Ellen

2013-03-01

Community research and action projects undertaken by community-university partnerships can lead to contextually appropriate and sustainable community improvements in rural and urban localities. However, effective implementation is challenging and prone to failure when poorly executed. The current paper seeks to inform rural community-university partnership practice through consideration of first-person accounts from five stakeholders in the Rural Embedded Assistants for Community Health (REACH) Network. The REACH Network is a unique community-university partnership aimed at improving rural health services by identifying, implementing, and evaluating innovative health interventions delivered by local caregivers. The first-person accounts provide an insider's perspective on the nature of collaboration. The unique perspectives identify three critical challenges facing the REACH Network: trust, coordination, and sustainability. Through consideration of the challenges, we identified several strategies for success. We hope readers can learn their own lessons when considering the details of our partnership's efforts to improve the delivery infrastructure for rural healthcare.

Measuring Self-perceived Social Health of Iranians; Finding from Iran Social Health Survey

Directory of Open Access Journals (Sweden)

kambiz Abachizadeh

2017-06-01

Full Text Available Background: The novelty of the study is to measure self-perceived social health of Iranians as one of the main dimensions of health.Materials and Methods: This cross-sectional study was conducted in all provinces of Iran in September 2014 with 10500 participants to measure self-perceived social health on a scale from 33 to 165 arranged in three areas; family, friends and relatives, and community. Area of "family" was measure in a range from 6 to 30; area of "friends and relatives" was from 9 to 45; and area of "community" was from 19 to 95. The psychometrics of scale was examined in separate previous study.Results: From a total of 10500 participants, 10244 fulfilled questionnaire (Response rate= 97.6%. 49.2% of participants were male. Mean of the total social health score was 99.91; area of "family" was 22; area of "friends and relatives" was 27.6; and area of "community" was 51.2. The main factors negatively influences on social health were low house size, unemployment, being divorced or widow and being at the age of 18-30. There was no significant relationship between social health score and educational level.Conclusion: It is magnificently attained that standardized social health rate in the present study was 3.9% lower than the rate has been estimated in comparison to similar previously conducted study in three big cities of Iran, two years earlier. Area of "community" is also the main accountant for this drop. To continue monitoring the social health of Iranians, we recommend conducting the next rounds every 3-5 years.

Internet treatment for depression: a randomized controlled trial comparing clinician vs. technician assistance.

Science.gov (United States)

Titov, Nickolai; Andrews, Gavin; Davies, Matthew; McIntyre, Karen; Robinson, Emma; Solley, Karen

2010-06-08

Internet-based cognitive behavioural therapy (iCBT) for depression is effective when guided by a clinician, less so if unguided. Would guidance from a technician be as effective as guidance from a clinician? Randomized controlled non-inferiority trial comparing three groups: Clinician-assisted vs. technician-assisted vs. delayed treatment. Community-based volunteers applied to the VirtualClinic (www.virtualclinic.org.au) research program, and 141 participants with major depressive disorder were randomized. Participants in the clinician- and technician-assisted groups received access to an iCBT program for depression comprising 6 online lessons, weekly homework assignments, and weekly supportive contact over a treatment period of 8 weeks. Participants in the clinician-assisted group also received access to a moderated online discussion forum. The main outcome measures were the Beck Depression Inventory (BDI-II) and the Patient Health QUESTIONnaire-9 Item (PHQ-9). Completion rates were high, and at post-treatment, both treatment groups reduced scores on the BDI-II (ptechnician-assisted groups respectively, and on the PHQ-9, were 1.54 and 1.60 respectively. At 4-month follow-up participants in the technician group had made further improvements and had significantly lower scores on the PHQ-9 than those in the clinician group. A total of approximately 60 minutes of clinician or technician time was required per participant during the 8-week treatment program. Both clinician- and technician-assisted treatment resulted in large effect sizes and clinically significant improvements comparable to those associated with face-to-face treatment, while a delayed treatment control group did not improve. These results provide support for large scale trials to determine the clinical effectiveness and acceptability of technician-assisted iCBT programs for depression. This form of treatment has potential to increase the capacity of existing mental health services. Australian New

Is Cognitive Status Related to Oral Hygiene Level and Appropriate for Determining Need for Oral Hygiene Assistance?

Science.gov (United States)

Steinmassl, Patricia-Anca; Steinmassl, Otto; Kraus, Gabriela; Dumfahrt, Herbert; Grunert, Ingrid

2016-01-01

With declining general health, the maintenance of oral health becomes increasingly difficult. Unfortunately, health care resources are limited. An assessment tool for detecting a patient's need for oral health care assistance would promote its adequate distribution. The aim of this study is to evaluate if the Shulman clock-drawing test score is a suitable assessment tool for determining the need for oral hygiene assistance. Data collected from recent dental checkups of 126 inhabitants of five Austrian residential care facilities were analyzed. The Shulman clock-drawing test score was used as a measure for cognitive abilities and related to tooth and denture hygiene indices, which were assessed using the approximal space plaque index (API) and the denture plaque index (DPI). Shulman score values were distributed almost evenly in the study population. The mean API was 83.6% (SD 20.2%) for the maxilla and 94.9% (SD 15.6%) for the mandible. The mean DPI was 43.9% (SD 31.4%). Cognitive impairment was not statistically related to the dental or denture hygiene index. A high Shulman clock-drawing test score indicates the need for oral hygiene assistance, but it is not suitable as a single tool to assess this need. Patients with other disabilities might equally qualify for assistance. Dentures, however, can be cleaned quickly and efficiently independently of patient compliance; therefore, cleaning the patients' dentures should be part of nursing personnel's daily care routine for every patient.

Predictors of changes in health status between and within patients 12 months post left ventricular assist device implantation

DEFF Research Database (Denmark)

Brouwers, Corline; de Jonge, Nicolaas; Caliskan, Kadir

2014-01-01

improvements in health status between baseline and 3 months follow-up as assessed by the KCCQ (clinical summary score: F = 33.49, P physical component score: F = 31.59, P ... 3 months and 12 months follow-up (P > 0.05 for all). Higher scores on anxiety and depression over time, older age, lower ejection fraction, and more co-morbidity were associated with poorer health status scores on one or both of the KCCQ and SF-12 subscales. The majority of the between......BACKGROUND: Improving patient-reported outcomes (e.g. health status) has become an important goal in left ventricular assist device (LVAD) therapy, in addition to reducing mortality and morbidity. We examined predictors of changes in health status scores between and within patients 12 months post...

[Suicide Prevention and Mental Health Measures for Japanese University Students].

Science.gov (United States)

Ohnishi, Masaru; Koyama, Shihomi; Senoo, Akiko; Kawahara, Hiroko; Shimizu, Yukito

2016-01-01

According to the nationwide survey of the National University students in Japan, the annual suicide rate in 2012 was 15.7 per 100,000 undergraduate students. In many universities, suicide prevention is an important issue regarding mental health measures, and each university is actively examining this. The current situation concerning measures for suicide prevention in the Japanese National Universities was investigated in 2009. In 2010, the "college student's suicide prevention measures guideline, 2010" was established based on the results of this investigation. This guideline refers to the basic philosophy of suicide prevention in Chapter 1, risk factors for suicide in Chapter 2, and systems and activities for suicide prevention in Chapter 3. The Health Service Center, Okayama University plays central roles in mental health and suicide prevention measures on the Medical Campus. The primary prevention includes a mini-lecture on mental health, classes on mental health, and periodic workshops and lectures for freshmen. The secondary prevention includes interviews with students with mental health disorders by a psychiatrist during periodic health check-ups and introducing them to a hospital outside the university. The tertiary prevention includes support for students taking a leave of absence to return to school, periodic consultation with such students with mental disorders, and postvention following a suicide. We believe that for mental health measures on the university campus, it is important to efficiently make use of limited resources, and that these efforts will eventually lead to suicide prevention.

Informal Caregivers Assisting People with Multiple Sclerosis

Science.gov (United States)

Huang, Chunfeng

2011-01-01

The objective of this study was to identify characteristics of informal caregivers, caregiving, and people with multiple sclerosis (MS) receiving this assistance that are associated with the strength of the care-giver/care recipient relationship. Data were collected in a national survey of informal caregivers and analyzed using an ordered logistic regression model to identify factors associated with caregiver perceptions of the strength of the relationship with the person with MS. The overall health of the person with MS was significantly associated with caregiver perceptions that providing assistance strengthened the caregiver/care recipient relationship, with poor health having a negative impact on the relationship. A spousal relationship between the caregiver and the person with MS was associated with significantly lower perceptions of a strengthened relationship. Conversely, caregiver perceptions that MS symptoms interfered with the independence of the person with MS in daily life were associated with caregiver perceptions of a strengthened relationship. Longer duration of caregiving and more hours per week spent providing assistance also were associated with a stronger relationship. In contrast, we found a significant negative association between caregiver perceptions that assisting the person with MS was burdensome and the strength of the relationship. Similarly, higher levels of education among caregivers tended to have a significantly negative impact on the caregiver/care recipient relationship. Our findings highlight the importance of addressing the needs and concerns of spousal caregivers. Health professionals who treat informal caregivers, as well as those treating people with MS, should be sensitive to the impact caregiving has on caregivers, especially spouses providing assistance. PMID:24453723

Perceived barriers to effective job performance among nursing assistants in long-term care.

Science.gov (United States)

Parmelee, Patricia A; Laszlo, Mary C; Taylor, Jo A

2009-10-01

This research explored perceived barriers to job performance among a national sample of nursing assistants (NAs). Specific objectives were (1) to clarify which of the problems identified by previous research are most troublesome for NAs, (2) to develop a reliable quantitative measure of perceived barriers to job performance, and (3) to test construct validity of the measure vis-à-vis work-related psychological empowerment and job satisfaction. Nursing assistants attending the 2006 national conference of the National Association of Health Care Assistants completed a paper-and-pencil survey including 33 barriers to job performance and standardized measures of empowerment and job satisfaction. The barriers were also rated by a small sample of NAs at a single Georgia nursing home. Factor analysis of barriers items yielded a 30-item Nursing Assistants Barriers Scale (NABS) comprising 6 subscales: Teamwork, Exclusion, Respect, Workload, Work Stress, and New NAs. Lack of teamwork and exclusion from communication processes were rated as most problematic by both samples. The 6 NABS subscales were significantly and independently associated with empowerment and satisfaction; different barriers predicted the 2 constructs. This study is a first step toward quantitative assessment of NAs' perceptions of barriers to doing their jobs. Primary limitations are the select sample and use of a job satisfaction measure that may have artificially inflated correlations with the NABS. Nonetheless, results confirm the validity of the new scale as an operationalization of the barriers construct. The concept of barriers to job performance is a unique construct from work empowerment and satisfaction with one's job. Nursing assistants clearly differentiate various barriers, converging on workload and lack of teamwork as most problematic. Further work is needed to substantiate validity and reliability of the NABS, particularly with respect to NAs' actual job performance, intent to stay on the

Measuring Geographic Inequalities: Dealing with Multiple Health Resources by Data Envelopment Analysis.

Science.gov (United States)

Dlouhý, Martin

2018-01-01

The existence of geographic differences in health resources, health expenditures, the utilization of health services, and health outcomes have been documented by a lot of studies from various countries of the world. In a publicly financed health system, equal access is one of the main objectives of the national health policy. That is why inequalities in the geographic allocation of health resources are an important health policy issue. Measures of inequality express the complexity of variation in the observed variable by a single number, and there is a variety of inequality measures available. The objective of this study is to develop a measure of the geographic inequality in the case of multiple health resources. The measure uses data envelopment analysis (DEA), which is a non-parametric method of production function estimation, to transform multiple resources into a single virtual health resource. The study shows that the DEA originally developed for measuring efficiency can be used successfully to measure inequality. For the illustrative purpose, the inequality measure is calculated for the Czech Republic. The values of separate Robin Hood Indexes (RHIs) are 6.64% for physicians and 3.96% for nurses. In the next step, we use combined RHI for both health resources. Its value 5.06% takes into account that the combinations of two health resources serve regional populations.

Measuring Geographic Inequalities: Dealing with Multiple Health Resources by Data Envelopment Analysis

Science.gov (United States)

Dlouhý, Martin

2018-01-01

The existence of geographic differences in health resources, health expenditures, the utilization of health services, and health outcomes have been documented by a lot of studies from various countries of the world. In a publicly financed health system, equal access is one of the main objectives of the national health policy. That is why inequalities in the geographic allocation of health resources are an important health policy issue. Measures of inequality express the complexity of variation in the observed variable by a single number, and there is a variety of inequality measures available. The objective of this study is to develop a measure of the geographic inequality in the case of multiple health resources. The measure uses data envelopment analysis (DEA), which is a non-parametric method of production function estimation, to transform multiple resources into a single virtual health resource. The study shows that the DEA originally developed for measuring efficiency can be used successfully to measure inequality. For the illustrative purpose, the inequality measure is calculated for the Czech Republic. The values of separate Robin Hood Indexes (RHIs) are 6.64% for physicians and 3.96% for nurses. In the next step, we use combined RHI for both health resources. Its value 5.06% takes into account that the combinations of two health resources serve regional populations. PMID:29541631

Assistive technology use and human rights enjoyment: a cross-sectional study in Bangladesh.

Science.gov (United States)

Borg, Johan; Larsson, Stig; Ostergren, Per-Olof; Rahman, Asm Atiqur; Bari, Nazmul; Khan, Ahm Noman

2012-09-19

About half a billion people with disabilities in developing countries have limited access to assistive technology. The Convention on the Rights of persons with Disabilities requires governments to take measures to ensure provision of such technologies. To guide implementation of these measures there is a need for understanding health outcomes from a human rights perspective. The objective of this study was therefore to explore the relation between assistive technology use and enjoyment of human rights in a low-income country. Data was collected in eight districts of Bangladesh through interviews of people with hearing impairments using and not using hearings aids, and people with ambulatory impairments using and not using manual wheelchairs (N = 583). Using logistic regression, self-reported outcomes on standard of living, health, education, work, receiving information and movement were analyzed. The adjusted likelihood of reporting greater enjoyment of human rights was significantly higher among people using hearing aids compared to non-users for all outcomes except working status. Compared to non-users, users of wheelchairs reported a significantly higher adjusted likelihood of good ambulatory performance and a significantly lower adjusted likelihood of reporting a positive working status. Further analyses indicated that physical accessibility to working places and duration of wheelchair use had a statistically significant impact on the likelihood of reporting positive work outcomes. The findings support the notion that assistive technology use increases the likelihood of human rights enjoyment, particularly hearing aid use. Physical accessibility should always be addressed in wheelchair provision.

Walker use, but not falls, is associated with lower physical functioning and health of residents in an assisted-living environment

Directory of Open Access Journals (Sweden)

Daniel A Andersen

2007-04-01

Full Text Available Daniel A Andersen1,5, Bernard A Roos1–4, Damian C Stanziano1,3, Natasha M Gonzalez3, Joseph F Signorile1–31Stein Gerontological Institute, Miami, FL; 2Geriatric Research, Education, and Clinical Center, Veterans Affairs Medical Center, Miami, FL; 3Department of Exercise and Sport Sciences, University of Miami, Coral Gables, FL; 4Departments of Medicine and Neurology, University of Miami Miller School of Medicine, Miami, FL; 5Department of Epidemiology and Public Health, University of Miami School of Medicine, Miami, FL, USAAbstract: The relationship between perceived health and walker use has seldom been addressed. Concerns over falls and falls risk are precursors to walker use. We compared the SF-36 scores of 26 women and 14 men, mean age 86.8 ± 6.0 years based on walker use and faller status. An analysis of covariance (ANCOVA with age as the covariate, compared groups for the SF-36 constructs and totals score. Significant differences were noted between walker users and nonusers in physical functioning, role limitations due to physical problems, general health, and the total SF-36 score. Pairwise comparisons favored nonusers, while no differences were seen due to faller status. Walker use is associated with lower self-perceptions of physical functioning, role limitations due to physical problems, and general health in assisted-living residents. Faller status is not associated with self-perceived health status. Although walker use aids mobility and lowers the probability of falls, further research is needed to determine if the prescription of assistive devices has a more negative impact on self-perceived health than does falling. This possibility could be explained, in part, by the greater activity levels of those individuals who do not depend on walkers.Keywords: physical function, threshold, walking aid, elderly, perceived health

Nursing Assistants for Long-Term Care. Performance-Based Instructional Materials.

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Indiana Univ., Bloomington. Vocational Education Services.

This guide is intended to assist students enrolled in programs to train nursing assistants for employment in an Indiana long-term health care facility. The first part discusses human development (growth, aging, and dying); communication with residents; sexuality; legal, ethical, and professional responsibilities of nursing assistants in long-term…

Pharmaceutical costs of assisted reproduction in Spain.

Science.gov (United States)

Lorente, Maria-Reyes; Hernández, Juana; Antoñanzas, Fernando

2013-11-01

Assisted reproduction is one of the health services currently being considered for possible limitation or exclusion from the public health services portfolio in Spain. One of the main reasons claimed for this is the impact on the budget for pharmaceutical expenditure. The objective of this study was to assess the significance of the pharmaceutical costs of assisted reproduction in Spain. This study focused on medical practice in Spain, and is based on the opinions of experts in assisted reproduction and the results provided by professional societies' publications. The reference year is 2012 and the setting was secondary care. We have included all existing pharmaceutical modalities for assisted reproduction, as well as the most common drug for each modality. We have considered the pharmaceutical cost per cycle for artificial insemination, in vitro fertilisation with or without intracytoplasmic sperm injection (IVF_ICSI), and cryotransfer and donated fresh oocytes reception. In Spain, artificial insemination has a pharmaceutical cost per cycle of between €69.36 and €873.79. This amounts to an average cycle cost of €364.87 for partner's sperm and €327.10 for donor sperm. The pharmaceutical cost of IVF_ICSI ranges between €278.16 and €1,902.66, giving an average cost per cycle of €1,139.65. In the case of cryotransfer and donated fresh oocytes reception, the pharmaceutical cost per cycle is between €22.61 and €58.73, yielding an average cost of €40.67. The budgetary impact of pharmaceutical expenditure for assisted reproduction in Spain for the year 2012 was estimated at €98.7 million. In Spain, the total pharmaceutical cost of assisted reproduction is substantial. According to our results, we can say that about 29% of the total pharmaceutical expenditure for assisted reproduction techniques is funded by the National Health System and the rest represents 2.4% of the total annual out-of-pocket family expenditure on drugs.

Medical Assistant-based care management for high risk patients in small primary care practices

DEFF Research Database (Denmark)

Freund, Tobias; Peters-Klimm, Frank; Boyd, Cynthia M.

2016-01-01

Background: Patients with multiple chronic conditions are at high risk of potentially avoidable hospital admissions, which may be reduced by care coordination and self-management support. Medical assistants are an increasingly available resource for patient care in primary care practices. Objective......: To determine whether protocol-based care management delivered by medical assistants improves patient care in patients at high risk of future hospitalization in primary care. Design: Two-year cluster randomized clinical trial. Setting: 115 primary care practices in Germany. Patients: 2,076 patients with type 2......, and monitoring delivered by medical assistants with usual care. Measurements: All-cause hospitalizations at 12 months (primary outcome) and quality of life scores (Short Form 12 Health Questionnaire [SF-12] and the Euroqol instrument [EQ-5D]). Results: Included patients had, on average, four co-occurring chronic...

Active assistance technology for health-related behavior change: an interdisciplinary review.

Science.gov (United States)

Kennedy, Catriona M; Powell, John; Payne, Thomas H; Ainsworth, John; Boyd, Alan; Buchan, Iain

2012-06-14

many pilot studies showing a preference for those features. We found few studies that focused on interactive education (3 studies) and self-monitoring (2 studies). Some recent research is emerging in dynamic tailoring (15 studies) and theoretically grounded ontologies for automated semantic processing (4 studies). The potential capabilities and risks of active assistance technologies are not being fully explored in most current behavior change research. Designers of health behavior interventions need to consider the relevant informatics methods and algorithms more fully. There is also a need to analyze the possibilities that can result from interaction between different technology components. This requires deep interdisciplinary collaboration, for example, between health psychology, computer science, health informatics, cognitive science, and educational methodology.

Pacific Northwest Laboratory annual report for 1984 to the DOE Office of the Assistant Secretary for Policy, Safety, and Environment. Part 5. Overview and assessment

International Nuclear Information System (INIS)

Bair, W.J.

1985-02-01

Research conducted in 1984 is briefly described. Research areas include: (1) uncertainties in modeling source/receptor relations for acidic deposition; (2) health physics support and assistance to the DOE; (3) technical guidelines for radiological calibrations; (4) personnel neutron dosemeter evaluation and upgrade program; (5) beta measurement evaluation and upgrade; (6) accreditation program for occupational exposure measurements; (7) assurance program for Remedial Action; (8) environmental protection support and assistance; (9) hazardus waste risk assessment; and (10) radiation policy studies

Using and interpreting mental health measures in the National Social Life, Health, and Aging Project.

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Payne, Carolyn; Hedberg, E C; Kozloski, Michael; Dale, William; McClintock, Martha K

2014-11-01

National Social Life, Health, and Aging Project (NSHAP) included five unique mental health measures in Waves 1 and 2 that researchers can use to measure the overall emotional health of participants: depressive symptoms, happiness-unhappiness, anxiety symptoms, perceived stress, and felt loneliness. For each, we detail the rationale for its development and explain how to score, analyze, and interpret results. NSHAP developed its measures by modifying traditional short-form scales to improve response efficiency and reduce respondent burden. Scoring protocols and interpretations were developed for each measure. U.S. population estimates for older adults born between 1920 and 1947 were generated using age-eligible samples from Waves 1 and 2. NSHAP's protocols yielded U.S. prevalence rates similar to other nationally representative studies of older adults and comparable between waves. Higher estimates of anxiety symptoms and perceived stress in Wave 2 compared with Wave 1 were explained by age, administration mode, and time period. Analytic strategies for longitudinal analyses are provided. In Wave 2, mental health generally was worse at older ages, with women having more symptoms at younger ages than men. Women had fewer anxiety symptoms at the oldest ages. NSHAP's mental health measures were successfully integrated into the project's survey and showed acceptable external reliability as well as moderately stable individual characteristics across the 5 years between Waves 1 and 2. Depressive symptoms and unhappiness may form a mental health cluster in the elderly, distinct from anxiety symptoms, perceived stress, and felt loneliness. Gender differences in age-specific patterns of mental health were evident using the exact age of participants rather than the traditional decade groupings. Administration mode and time period (between 2005-2006 and 2010-2011) were determined to be potential confounds that need to be accommodated in longitudinal analyses of aging, whereas

Measuring physical neighborhood quality related to health.

Science.gov (United States)

Rollings, Kimberly A; Wells, Nancy M; Evans, Gary W

2015-04-29

Although sociodemographic factors are one aspect of understanding the effects of neighborhood environments on health, equating neighborhood quality with socioeconomic status ignores the important role of physical neighborhood attributes. Prior work on neighborhood environments and health has relied primarily on level of socioeconomic disadvantage as the indicator of neighborhood quality without attention to physical neighborhood quality. A small but increasing number of studies have assessed neighborhood physical characteristics. Findings generally indicate that there is an association between living in deprived neighborhoods and poor health outcomes, but rigorous evidence linking specific physical neighborhood attributes to particular health outcomes is lacking. This paper discusses the methodological challenges and limitations of measuring physical neighborhood environments relevant to health and concludes with proposed directions for future work.

The effect of improvisation-assisted desensitization, and music-assisted progressive muscle relaxation and imagery on reducing pianists' music performance anxiety.

Science.gov (United States)

Kim, Youngshin

2008-01-01

The purpose of this study was to investigate the effects of two music therapy approaches, improvisation-assisted desensitization, and music-assisted progressive muscle relaxation and imagery on ameliorating the symptoms of music performance anxiety (MPA) among student pianists. Thirty female college pianists (N = 30) were randomly assigned to one of two conditions: (a) improvised music-assisted desensitization group (n = 15), or (b) music-assisted progressive muscle relaxation (PMR) and imagery group (n = 15). All participants received 6 weekly music therapy sessions according to their assigned group. Two lab performances were provided; one before and one after the 6 music therapy sessions, as the performance stimuli for MPA. All participants completed pretest and posttest measures that included four types of visual analogue scales (MPA, stress, tension, and comfort), the state portion of Spielberger's State-Trait Anxiety Inventory (STAI), and the Music Performance Anxiety Questionnaire (MPAQ) developed by Lehrer, Goldman, and Strommen (1990). Participants' finger temperatures were also measured. When results of the music-assisted PMR and imagery condition were compared from pretest to posttest, statistically significant differences occurred in 6 out of the 7 measures-MPA, tension, comfort, STAI, MPAQ, and finger temperature, indicating that the music-assisted PMR and imagery treatment was very successful in reducing MPA. For the improvisation-assisted desensitization condition, the statistically significant decreases in tension and STAI, with increases in finger temperature indicated that this approach was effective in managing MPA to some extent. When the difference scores for the two approaches were compared, there was no statistically significant difference between the two approaches for any of the seven measures. Therefore, no one treatment condition appeared more effective than the other. Although statistically significant differences were not found between

42 CFR 403.822 - Reimbursement of transitional assistance and associated sponsor requirements.

Science.gov (United States)

2010-10-01

... 42 Public Health 2 2010-10-01 2010-10-01 false Reimbursement of transitional assistance and associated sponsor requirements. 403.822 Section 403.822 Public Health CENTERS FOR MEDICARE & MEDICAID... Prescription Drug Discount Card and Transitional Assistance Program § 403.822 Reimbursement of transitional...

Taiwan's Travel and Border Health Measures in Response to Zika

Science.gov (United States)

Ho, Li-Li; Tsai, Yu-Hui; Lee, Wang-Ping; Liao, Szu-Tsai; Wu, Li-Gin

2017-01-01

Zika virus has recently emerged as a worldwide public health concern. Travel and border health measures stand as one of the main strategies and frontline defenses in responding to international epidemics. As of October 31, 2016, Taiwan has reported 13 imported cases, 5 of which were detected through routine entry screening and active monitoring at international airports. This article shares Taiwan's disease surveillance activities at designated points of entry and travel and border health measures in response to Zika. The Taiwan government collaborates with its tourism industry to disseminate information about precautionary measures and encourages tour guides to report suspected individuals or events to activate early response measures. Taiwan also engages in vector control activities at points of entry, including targeting aircraft from countries where vector-borne diseases are endemic, implementing mosquito sweep measures, and collecting vector surveillance data. In future emerging and reemerging disease events, entry surveillance at designated points of entry may enable early detection of diseases of international origin and more rapid activation of public health preparedness activities and international collaboration. Taiwan will continue to maximize border and travel health measures in compliance with IHR (2005) requirements, which rely on continued risk assessment, practical implementation activities, and engagement with all stakeholders. PMID:28418744

Taiwan's Travel and Border Health Measures in Response to Zika.

Science.gov (United States)

Ho, Li-Li; Tsai, Yu-Hui; Lee, Wang-Ping; Liao, Szu-Tsai; Wu, Li-Gin; Wu, Yi-Chun

Zika virus has recently emerged as a worldwide public health concern. Travel and border health measures stand as one of the main strategies and frontline defenses in responding to international epidemics. As of October 31, 2016, Taiwan has reported 13 imported cases, 5 of which were detected through routine entry screening and active monitoring at international airports. This article shares Taiwan's disease surveillance activities at designated points of entry and travel and border health measures in response to Zika. The Taiwan government collaborates with its tourism industry to disseminate information about precautionary measures and encourages tour guides to report suspected individuals or events to activate early response measures. Taiwan also engages in vector control activities at points of entry, including targeting aircraft from countries where vector-borne diseases are endemic, implementing mosquito sweep measures, and collecting vector surveillance data. In future emerging and reemerging disease events, entry surveillance at designated points of entry may enable early detection of diseases of international origin and more rapid activation of public health preparedness activities and international collaboration. Taiwan will continue to maximize border and travel health measures in compliance with IHR (2005) requirements, which rely on continued risk assessment, practical implementation activities, and engagement with all stakeholders.

Effects of computer-assisted oral anticoagulant therapy

DEFF Research Database (Denmark)

Rasmussen, Rune Skovgaard; Corell, Pernille; Madsen, Poul

2012-01-01

: Patients randomized to computer-assisted anticoagulation and the CoaguChek® system reached the therapeutic target range after 8 days compared to 14 days by prescriptions from physicians (p = 0.04). Time spent in the therapeutic target range did not differ between groups. The median INR value measured...... prescribed by physicians, and the total time spent within the therapeutic target range was similar. Thus computer-assisted oral anticoagulant therapy may reduce the cost of anticoagulation therapy without lowering the quality. INR values measured by CoaguChek® were reliable compared to measurements......UNLABELLED: BACKGROUND: Computer-assistance and self-monitoring lower the cost and may improve the quality of anticoagulation therapy. The main purpose of this clinical investigation was to use computer-assisted oral anticoagulant therapy to improve the time to reach and the time spent within...

A National Initiative to Advance School Mental Health Performance Measurement in the US

Science.gov (United States)

Connors, Elizabeth Halsted; Stephan, Sharon Hoover; Lever, Nancy; Ereshefsky, Sabrina; Mosby, Amanda; Bohnenkamp, Jill

2016-01-01

Standardized health performance measurement has increasingly become an imperative for assuring quality standards in national health care systems. As compared to somatic health performance measures, behavioral health performance measures are less developed. There currently is no national standardized performance measurement system for monitoring…

Killing us softly: the dangers of legalizing assisted suicide.

Science.gov (United States)

Golden, Marilyn; Zoanni, Tyler

2010-01-01

This article is an overview of the problems with the legalization of assisted suicide as public policy. The disability community's opposition to assisted suicide stems in part from factors that directly impact the disability community as well as all of society. These factors include the secrecy in which assisted suicide operates today, in states where it is legal; the lack of robust oversight and the absence of investigation of abuse; the reality of who uses it; the dangerous potential of legalization to further erode the quality of the U.S. health care system; and its potential for other significant harms. Legalizing assisted suicide would augment real dangers that negate genuine choice and self-determination. In view of this reality, we explore many of the disability-related effects of assisted suicide, while also addressing the larger social context that inseparably impacts people with disabilities and the broader public. First, after addressing common misunderstandings, we examine fear and bias toward disability, and the deadly interaction of assisted suicide and our profit-driven health care system. Second, we review the practice of assisted suicide in Oregon, the first U.S. state to legalize it, and debunk the merits of the so-called Oregon model. Third and finally, we explore the ways that so-called "narrow" assisted suicide proposals threaten inevitable expansion. Copyright © 2010 Elsevier Inc. All rights reserved.

Center for Disaster & Humanitarian Assistance Medicine

Data.gov (United States)

Federal Laboratory Consortium — The Center for Disaster and Humanitarian Assistance Medicine (CDHAM) was formally established at the Uniformed Services University of the Health Sciences (USUHS) by...

Costs of medically assisted reproduction treatment at specialized fertility clinics in the Danish public health care system: results from a 5-year follow-up cohort study.

Science.gov (United States)

Christiansen, Terkel; Erb, Karin; Rizvanovic, Amra; Ziebe, Søren; Mikkelsen Englund, Anne L; Hald, Finn; Boivin, Jacky; Schmidt, Lone

2014-01-01

To examine the costs to the public health care system of couples in medically assisted reproduction. Longitudinal cohort study of infertile couples initiating medically assisted reproduction treatment. Specialized public fertility clinics in Denmark. Seven hundred and thirty-nine couples having no child at study entry and with data on kind of treatment and live birth (yes/no) for each treatment attempt at the specialized public fertility clinic. Treatment data for medically assisted reproduction attempts conducted at the public fertility clinics were abstracted from medical records. Flow diagrams were drawn for different standard treatment cycles and direct costs at each stage in the flow charts were measured and valued by a bottom-up procedure. Indirect costs were distributed to each treatment cycle on the basis of number of visits as basis. Costs were adjusted to 2012 prices using a constructed medical price index. Live birth, costs. Total costs per live birth in 2012 prices were estimated to 10,755€. Costs per treated couple - irrespective of whether the treatment was terminated by a live birth or not - were estimated at 6607€. Costs per live birth of women <35 years at treatment initiation were 9338€ and 15,040€ for women ≥35 years. The public costs for live births after conception with medically assisted reproduction treatment are relatively modest. The results can be generalized to public fertility treatment in Denmark and to other public treatment settings with similar limitations in numbers of public treatment cycles offered. © 2013 Nordic Federation of Societies of Obstetrics and Gynecology.

The Agency's Health and Safety Measures

Energy Technology Data Exchange (ETDEWEB)

NONE

1960-05-31

The Agency's health and safety measures as approved by the Board of Governors on 31 March 1960 in implementation of Articles III. A. 6 and XII of the Statute of the Agency are reproduced in this document for the information of all Members.

Mental health measurement among women veterans receiving co-located, collaborative care services.

Science.gov (United States)

Lilienthal, Kaitlin R; Buchholz, Laura J; King, Paul R; Vair, Christina L; Funderburk, Jennifer S; Beehler, Gregory P

2017-12-01

Routine use of measurement to identify patient concerns and track treatment progress is critical to high quality patient care. This is particularly relevant to the Primary Care Behavioral Health model, where rapid symptom assessment and effective referral management are critical to sustaining population-based care. However, research suggests that women who receive treatment in co-located collaborative care settings utilizing the PCBH model are less likely to be assessed with standard measures than men in these settings. The current study utilized regional retrospective data obtained from the Veterans Health Administration's electronic medical record system to: (1) explore rates of mental health measurement for women receiving co-located collaborative care services (N = 1008); and (2) to identify predictors of mental health measurement in women veterans in these settings. Overall, only 8% of women had documentation of standard mental health measures. Measurement was predicted by diagnosis, facility size, length of care episode and care setting. Specifically, women diagnosed with depression were less likely than those with anxiety disorders to have standard mental health measurement documented. Several suggestions are offered to increase the quality of mental health care for women through regular use of measurement in integrated care settings.

Health Care System Measures to Advance Preconception Wellness: Consensus Recommendations of the Clinical Workgroup of the National Preconception Health and Health Care Initiative.

Science.gov (United States)

Frayne, Daniel J; Verbiest, Sarah; Chelmow, David; Clarke, Heather; Dunlop, Anne; Hosmer, Jennifer; Menard, M Kathryn; Moos, Merry-K; Ramos, Diana; Stuebe, Alison; Zephyrin, Laurie

2016-05-01

Preconception wellness reflects a woman's overall health before conception as a strategy to affect health outcomes for the woman, the fetus, and the infant. Preconception wellness is challenging to measure because it attempts to capture health status before a pregnancy, which may be affected by many different service points within a health care system. The Clinical Workgroup of the National Preconception Health and Health Care Initiative proposes nine core measures that can be assessed at initiation of prenatal care to index a woman's preconception wellness. A two-stage web-based modified Delphi survey and a face-to-face meeting of key opinion leaders in women's reproductive health resulted in identifying seven criteria used to determine the core measures. The Workgroup reached unanimous agreement on an aggregate of nine preconception wellness measures to serve as a surrogate but feasible assessment of quality preconception care within the larger health community. These include indicators for: 1) pregnancy intention, 2) access to care, 3) preconception multivitamin with folic acid use, 4) tobacco avoidance, 5) absence of uncontrolled depression, 6) healthy weight, 7) absence of sexually transmitted infections, 8) optimal glycemic control in women with pregestational diabetes, and 9) teratogenic medication avoidance. The focus of the proposed measures is to quantify the effect of health care systems on advancing preconception wellness. The Workgroup recommends that health care systems adopt these nine preconception wellness measures as a metric to monitor performance of preconception care practice. Over time, monitoring these baseline measures will establish benchmarks and allow for comparison within and among regions, health care systems, and communities to drive improvements.

Environmental correlates of mental health measures for women in Western Australia.

Science.gov (United States)

Fearnley, Emily Jane; Magalhães, Ricardo Jorge Soares; Speldewinde, Peter; Weinstein, Philip; Dobson, Annette

2014-12-01

A recent study in Western Australia identified area level associations between soil salinisation and hospital admissions for depression. Our study assessed the quantitative relationship between mental health measures at the individual level and location specific environmental measurements on salinity, as well as two other indicators of environmental degradation and change: land surface temperature and normalised difference vegetation index, a proxy for rainfall. Location-specific environmental measurements were linked to individual mental health scores of women in three age cohorts from the Australian Longitudinal Study on Women's Health using a geographic information system. Bayesian geostatistical linear regression models were developed to assess associations between environmental exposures and mental health scores of women. In contrast to previous studies using area level measures, our study found no associations between individual level measurements of mental health scores for women in south-west Western Australia and salinity, LST or NDVI.

How to Measure Critical Health Competences: Development and Validation of the Critical Health Competence Test (CHC Test)

Science.gov (United States)

Steckelberg, Anke; Hulfenhaus, Christian; Kasper, Jurgen; Rost, Jurgen; Muhlhauser, Ingrid

2009-01-01

Consumers' autonomy regarding health increasingly requires competences to critically appraise health information. Critical health literacy refers to the concept of evidence-based medicine. Instruments to measure these competences in curriculum evaluation and surveys are lacking. We aimed to develop and validate an instrument to measure critical…

Attitudes towards assisted suicide and life-prolonging measures in Swiss ALS patients and their caregivers

Directory of Open Access Journals (Sweden)

Ralf eStutzki

2012-10-01

Full Text Available Objectives: In Switzerland, assisted suicide (AS is legal, provided that the person seeking assistance has decisional capacity and the person assisting is not motivated by reasons of self-interest. However, in this particular setting nothing is known about patients’ and their caregivers’ attitudes towards AS and life-prolonging measures. Methods: Data was retrieved through validated questionnaires and personal interviews in 33 patients and their caregivers covering the following domains: physical function according to the revised Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS-R, demographic data, quality of life (QoL, anxiety, depression, social situation, spirituality, burden of disease, life-prolonging and life-shortening acts.Results: In patients the median time after diagnosis was 9 months (2-90 and the median ALS FRS-R score was 37 (22-48. The majority of patients (94%; n=31 had no desire to hasten death. Patients’ and caregivers’ attitudes towards Percutaneous Endoscopic Gastrostomy (PEG and Non-Invasive Ventilation (NIV differed. Significantly more patients than caregivers (21.2% versus 3.1% stated that they were against NIV (p=0.049 and against PEG (27.3% versus 3.1%; p=0.031. Answers regarding tracheotomy were not significantly different (p= 0.139. Caregivers scored significantly higher levels of suffering (p=0.007, loneliness (p=0.006 and emotional distress answering the questionnaires (p<0.001. Suffering (p<0.026 and loneliness (p<0.016 were related to the score of the Hospital Anxiety and Depression Scale (HADS in patients. Conclusion: A liberal legal setting does not necessarily promote the wish for AS. However, the desire to discuss assisted suicide is prevalent in ALS patients. There is a higher level of suffering and loneliness on the caregivers’ side. A longitudinal study is warranted.

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.

42 CFR 1001.1701 - Billing for services of assistant at surgery during cataract operations.

Science.gov (United States)

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Billing for services of assistant at surgery during..., DEPARTMENT OF HEALTH AND HUMAN SERVICES OIG AUTHORITIES PROGRAM INTEGRITY-MEDICARE AND STATE HEALTH CARE PROGRAMS Permissive Exclusions § 1001.1701 Billing for services of assistant at surgery during cataract...

On the measurement of the (multidimensional) inequality of health distributions

DEFF Research Database (Denmark)

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

2013-01-01

a standard mathematical structure. We single out two families of (absolute and relative) multidimensional health inequality indices, inspired by the classical normative approach to income inequality measurement. We also discuss how to extend the analysis to deal with the related problem of health deprivation......Health outcomes are often described according to two dimensions: quality of life and quantity of life. We analyze the measurement of inequality of health distributions referring to these two dimensions. Our analysis relies on a novel treatment of the quality-of-life dimension, which might not have...

Environment-assisted precision measurement

DEFF Research Database (Denmark)

Goldstein, G.; Cappellaro, P.; Maze, J. R.

2011-01-01

We describe a method to enhance the sensitivity of precision measurements that takes advantage of the environment of a quantum sensor to amplify the response of the sensor to weak external perturbations. An individual qubit is used to sense the dynamics of surrounding ancillary qubits, which...... are in turn affected by the external field to be measured. The resulting sensitivity enhancement is determined by the number of ancillas that are coupled strongly to the sensor qubit; it does not depend on the exact values of the coupling strengths and is resilient to many forms of decoherence. The method...... achieves nearly Heisenberg-limited precision measurement, using a novel class of entangled states. We discuss specific applications to improve clock sensitivity using trapped ions and magnetic sensing based on electronic spins in diamond...

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

Science.gov (United States)

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

2015-03-01

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

?Sometimes I?ve gone home feeling that my voice hasn?t been heard?: a focus group study exploring the views and experiences of health care assistants when caring for dying residents

OpenAIRE

Fryer, Susan; Bellamy, Gary; Morgan, Tessa; Gott, Merryn

2016-01-01

Background In most developed countries, Health Care Assistants comprise a significant, and growing, proportion of the residential aged care workforce. Despite the fact that they provide the majority of direct care for residents, little is known about a?key care aspect of their work, namely their experience of caring for dying residents. Methods Twenty-six Health Care Assistants working in aged residential care facilities in Auckland, New Zealand participated in six focus group discussions. Fo...

Measuring the health effects of gender.

Science.gov (United States)

Phillips, S P

2008-04-01

The health effects of gender are mediated via group-level constraints of sex roles and norms, discrimination and marginalisation of individuals, and internalisation of the stresses of role discordance. Although gender is frequently a lens through which data are interpreted there are few composite measures that insert gender as an independent variable into research design. Instead, sex disaggregation of data is often conflated with gender, identifying statistically significant but sometimes clinically insignificant sex differences. To directly assess the impact of gender on wellbeing requires development of group and individual-level derived variables. At the ecological level such a summative variable could be composed of a selection of group-level measures of equality between sexes. This gender index could be used in ecological and individual-level studies of health outcomes. A quantitative indicator of gender role acceptance and of the personal effects of gender inequities could insert the often hidden variable of gender into individual-level clinical research.

Three Paradigms of Social Assistance

Directory of Open Access Journals (Sweden)

Pierre-Marc Daigneault

2014-11-01

Full Text Available “Ideas,” which are defined as the normative and cognitive beliefs of actors, are fundamental to a full understanding of the welfare state and, in particular, of social assistance. However, policy ideas have been neglected in most typologies of social assistance regimes. Based on a selective review of the literature, this article proposes a brief but systematic analysis of policy paradigms in the field of social assistance. Three ideal types that emphasize the ideational dimension of social assistance are analyzed, namely, the entitlement, workfare, and activation paradigms. The value of the typology lies in its utility for characterizing the ideational orientation of social assistance regimes. Specifically, the typology provides a yardstick for measuring the ideas of policy actors with respect to social assistance and can facilitate the conduct of case studies, comparative research, and causal analyses on this policy sector.

Have geopolitics influenced decisions on American health foreign assistance efforts during the Obama presidency?

Science.gov (United States)

Gupta, Vin; Tsai, Alexander C; Mason-Sharma, Alexandre; Goosby, Eric P; Jha, Ashish K; Kerry, Vanessa B

2018-06-01

This study sought to characterize the possible relationship between US geopolitical priorities and annual decisions on health foreign assistance among recipient nations between 2009 and 2016. Data on total planned United States (US) foreign aid and health aid were collected for the 194 member nations of the World Health Organization (WHO) from publicly available databases. Trends in per-capita spending were examined between 2009 and 2016 across the six regions of the WHO (Africa, Americas, Eastern Mediterranean, Europe, Southeast Asia, and the Western Pacific). Data on US national security threats were obtained from the Council on Foreign Relations' annual Preventive Priorities Survey. Multivariable regression models were fitted specifying planned health aid as the dependent variable and threat level of a recipient aid nation as the primary independent variable. Across the aggregate 80 planned recipient countries of US health aid over the duration of the study period, cumulative planned per-capita spending was stable (US$ 0.65 in both 2009 and 2016). The number of annual planned recipients of this aid declined from 74 in 2009 to 56 in 2016 (24.3% decline), with planned allocations decreasing in the Americas, Eastern Mediterranean, and Europe; corresponding increases were observed in Africa, Southeast Asia, and the Western Pacific. Regression analyses demonstrated a dose-response, whereby higher levels of threat were associated with larger declines in planned spending (critical threat nations: b = -3.81; 95% confidence interval (CI) -5.84 to -1.78, P  ≤ 0.001) and one-year lagged (critical threat nations: b = -3.91; 95% CI, -5.94 to -1.88, P  ≤ 0.001) analyses. Higher threat levels are associated with less health aid. This is a novel finding, as prior studies have demonstrated a strong association between national security considerations and decisions on development aid.

Health Status Measurement Instruments in Chronic Obstructive Pulmonary Disease

Directory of Open Access Journals (Sweden)

Yves Lacasse

1997-01-01

Full Text Available Chronic obstructive pulmonary disease (COPD is associated with primary respiratory impairment, disability and handicap, as well as with secondary impairments not necessarily confined to the respiratory system. Because the primary goals of managing patients with COPD include relief of dyspnea and the improvement of health-related quality of life (HRQL, a direct measurement of HRQL is important. Fourteen disease-specific and nine generic questionnaires (four health profiles and five utility measures most commonly used to measure health status in patients with COPD were reviewed. The measures were classified according to their domain of interest, and their measurement properties - specifications, validity, reliability, responsiveness and interpretability - were described. This review suggests several findings. Currently used health status instruments usually refer to the patients’ perception of performance in three major domains of HRQL - somatic sensation, physical and occupational function, and psychological state. The choice of a questionnaire must be related to its purpose, with a clear distinction being made between its evaluative and discriminative function. In their evaluative function, only a few instruments fulfilled the criteria of responsiveness, and the interpretability of most questionnaires is limited. Generic questionnaires should not be used alone in clinical trials as evaluative instruments because of their inability to detect change over time. Further validation and improved interpretability of existing instruments would be of greater benefit to clinicians and scientists than the development of new questionnaires.

Aerobic fitness and metabolic health in children: A clinical validation of directly measured maximal oxygen consumption versus performance measures as markers of health.

Science.gov (United States)

Aadland, Eivind; Kvalheim, Olav Martin; Rajalahti, Tarja; Skrede, Turid; Resaland, Geir Kåre

2017-09-01

High aerobic fitness is consistently associated with a favorable metabolic health profile in children. However, measurement of oxygen uptake, regarded as the gold standard for evaluating aerobic fitness, is often not feasible. Thus, the aim of the present study was to perform a clinical validation of three measures of aerobic fitness (peak oxygen consumption [VO 2peak ] and time to exhaustion [TTE] determined from a graded treadmill protocol to exhaustion, and the Andersen intermittent running test) with clustered metabolic health in 10-year-old children. We included 93 children (55 boys and 38 girls) from Norway during 2012-2013 in the study. Associations between aerobic fitness and three different composite metabolic health scores (including lipoprotein subgroup particle concentrations, triglyceride, glucose, systolic blood pressure, and waist-to-height ratio) were determined by regression analyses adjusting for sex. The relationships among the measures of aerobic fitness were r  = 0.78 for VO 2peak vs. TTE, r  = 0.63 for VO 2peak vs. the Andersen test, and r  = 0.67 for TTE vs. the Andersen test. The Andersen test showed the strongest associations across all markers of metabolic health ( r  = - 0.45 to - 0.31, p  fitness do not stand back as markers of metabolic health status in children, compared to VO 2peak . This is of great importance as good field tests provide opportunities for measuring aerobic fitness in many settings where measuring VO 2peak are impossible.

Physical activity measurement in older adults: relationships with mental health.

Science.gov (United States)

Parker, Sarah J; Strath, Scott J; Swartz, Ann M

2008-10-01

This study examined the relationship between physical activity (PA) and mental health among older adults as measured by objective and subjective PA-assessment instruments. Pedometers (PED), accelerometers (ACC), and the Physical Activity Scale for the Elderly (PASE) were administered to measure 1 week of PA among 84 adults age 55-87 (mean = 71) years. General mental health was measured using the Positive and Negative Affect Scale (PANAS) and the Satisfaction With Life Scale (SWL). Linear regressions revealed that PA estimated by PED significantly predicted 18.1%, 8.3%, and 12.3% of variance in SWL and positive and negative affect, respectively, whereas PA estimated by the PASE did not predict any mental health variables. Results from ACC data were mixed. Hotelling-William tests between correlation coefficients revealed that the relationship between PED and SWL was significantly stronger than the relationship between PASE and SWL. Relationships between PA and mental health might depend on the PA measure used.

Employee assistance programs: a primer for buyer and seller.

Science.gov (United States)

Dixon, K

1988-06-01

A growing number of firms in private industry now sponsor or contract with groups of mental health professionals to provide employee assistance programs (EAPs). Factors that have influenced the increasing demand for EAPs include corporations' humanitarian concern for employees with mental health problems, a desire to contain rising health costs and reduce corporate losses, and the need for effective supervisory systems for managing troubled employees. To assist corporate consumers in judging the quality of EAP services and to guide mental health practitioners who wish to enter the EAP field, criteria are provided for evaluating the following aspects of EAP programs: policy development, employee orientation, supervisor training, availability during nonbusiness hours, assessment and diagnostic services, crisis counseling, referral, quality assurance, program evaluation, and cost.

The feasibility of measuring social networks among older adults in assisted living and dementia special care units.

Science.gov (United States)

Abbott, Katherine M; Bettger, Janet Prvu; Hampton, Keith N; Kohler, Hans-Peter

2015-03-01

Studies indicate that social integration has a significant influence on physical and mental health. Older adults experience an increased risk of social isolation as their social networks decline with fewer traditional opportunities to add new social relationships. Deaths of similar aged friends, cognitive and functional impairments, and relocating to a nursing home (NH) or assisted-living (AL) facility contribute to difficulties in maintaining one's social network. Due to the paucity of research examining the social networks of people residing in AL and NH, this study was designed to develop and test the feasibility of using a combination of methodological approaches to capture social network data among older adults living in AL and a dementia special care unit NH. Social network analysis of both egocentric and sociocentric networks was conducted to visualize the social networks of 15 residents of an AL neighborhood and 12 residents of a dementia special care unit NH and to calculate measures network size, centrality, and reciprocity. The combined egocentric and sociocentric method was feasible and provided a robust indicator of resident social networks highlighting individuals who were socially integrated as well as isolated. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Trends in measurement models and methods in understanding occupational health psychology.

Science.gov (United States)

Tetrick, Lois E

2017-07-01

Measurement of occupational health psychology constructs is the cornerstone to developing our understanding of occupational health and safety. It also is critical in the design, evaluation, and implementation of interventions to improve employees and organizations well-being. The purpose of this article is a brief review of the current state of measurement theory and practice in occupational health psychology. Also included are a discussion of development of newer measurement models and methods, which are in use in other disciplines of psychology, but have not been incorporated into the occupational health psychology. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The mini mental status exam as a surrogate measure of health literacy.

Science.gov (United States)

Dahlke, Allison R; Curtis, Laura M; Federman, Alex D; Wolf, Michael S

2014-04-01

Studies have documented strong associations between cognitive function, health literacy skills, and health outcomes, such that outcome performance may be partially explained by cognitive ability. Common cognitive assessments such as the Mini Mental Status Exam (MMSE) therefore may be measuring the same latent construct as existing health literacy tools. We evaluated the potential of the MMSE as a surrogate measure of health literacy by comparing its convergent and predictive validity to the three most commonly used health literacy assessments and education. 827 older adults recruited from an academic general internal medicine ambulatory care clinic or one of five federally qualified health centers in Chicago, IL. Non-English speakers and those with severe cognitive impairment were excluded. Pearson correlations were completed to test the convergent validity of the MMSE with assessments of health literacy and education. Receiver Operating Characteristic (ROC) curves and the d statistic were calculated to determine the optimal cut point on the MMSE for classifying participants with limited health literacy. Multivariate logistic regression models were completed to measure the predictive validity of the new MMSE cut point. The MMSE was found to have moderate to high convergent validity with the existing health literacy measures. The ROC and d statistic analyses suggested an optimal cut point of ≤ 27 on the MMSE. The new threshold score was found to predict health outcomes at least as well as, or better than, existing health literacy measures or education alone. The MMSE has considerable face validity as a health literacy measure that could be easily administered in the healthcare setting. Further research should aim to validate this cut point and examine the constructs being measured by the MMSE and other literacy assessments.

Analysis of policy implications and challenges of the Cuban health assistance program related to human resources for health in the Pacific

Directory of Open Access Journals (Sweden)

Asante Augustine D

2012-05-01

Full Text Available Abstract Background Cuba has extended its medical cooperation to Pacific Island Countries (PICs by supplying doctors to boost service delivery and offering scholarships for Pacific Islanders to study medicine in Cuba. Given the small populations of PICs, the Cuban engagement could prove particularly significant for health systems development in the region. This paper reviews the magnitude and form of Cuban medical cooperation in the Pacific and analyses its implications for health policy, human resource capacity and overall development assistance for health in the region. Methods We reviewed both published and grey literature on health workforce in the Pacific including health workforce plans and human resource policy documents. Further information was gathered through discussions with key stakeholders involved in health workforce development in the region. Results Cuba formalised its relationship with PICs in September 2008 following the first Cuba-Pacific Islands ministerial meeting. Some 33 Cuban health personnel work in Pacific Island Countries and 177 Pacific island students are studying medicine in Cuba in 2010 with the most extensive engagement in Kiribati, the Solomon Islands, Tuvalu and Vanuatu. The cost of the Cuban medical cooperation to PICs comes in the form of countries providing benefits and paying allowances to in-country Cuban health workers and return airfares for their students in Cuba. This has been seen by some PICs as a cheaper alternative to training doctors in other countries. Conclusions The Cuban engagement with PICs, while smaller than engagement with other countries, presents several opportunities and challenges for health system strengthening in the region. In particular, it allows PICs to increase their health workforce numbers at relatively low cost and extends delivery of health services to remote areas. A key challenge is that with the potential increase in the number of medical doctors, once the local students

How best to measure implementation of school health curricula: a comparison of three measures.

Science.gov (United States)

Resnicow, K; Davis, M; Smith, M; Lazarus-Yaroch, A; Baranowski, T; Baranowski, J; Doyle, C; Wang, D T

1998-06-01

The impact of school health education programs is often attenuated by inadequate teacher implementation. Using data from a school-based nutrition education program delivered in a sample of fifth graders, this study examines the discriminant and predictive validity of three measures of curriculum implementation: class-room observation of fidelity, and two measures of completeness, teacher self-report questionnaire and post-implementation interview. A fourth measure, obtained during teacher observations, that assessed student and teacher interaction and student receptivity to the curriculum (labeled Rapport) was also obtained. Predictive validity was determined by examining the association of implementation measures with three study outcomes; health knowledge, asking behaviors related to fruit and vegetables, and fruit and vegetable intake, assessed by 7-day diary. Of the 37 teachers observed, 21 were observed for two sessions and 16 were observed once. Implementation measures were moderately correlated, an indication of discriminant validity. Predictive validity analyses indicated that the observed fidelity, Rapport and interview measures were significantly correlated with post-test student knowledge. The association between health knowledge and observed fidelity (based on dual observation only), Rapport and interview measures remained significant after adjustment for pre-test knowledge values. None of the implementation variables were significantly associated with student fruit and vegetable intake or asking behaviors controlling for pre-test values. These results indicate that the teacher self-report questionnaire was not a valid measure of implementation completeness in this study. Post-implementation completeness interviews and dual observations of fidelity and Rapport appear to be more valid, and largely independent methods of implementation assessment.

Impact of robot-assisted spine surgery on health care quality and neurosurgical economics: A systemic review.

Science.gov (United States)

Fiani, Brian; Quadri, Syed A; Farooqui, Mudassir; Cathel, Alessandra; Berman, Blake; Noel, Jerry; Siddiqi, Javed

2018-04-03

Whenever any new technology is introduced into the healthcare system, it should satisfy all three pillars of the iron triangle of health care, which are quality, cost-effectiveness, and accessibility. There has been quite advancement in the field of spine surgery in the last two decades with introduction of new technological modalities such as CAN and surgical robotic devices. MAZOR SpineAssist/Renaissance was the first robotic system to be approved for the use in spine surgeries in the USA in 2004. In this review, the authors sought to determine if the current literature supports this technology to be cost-effective, accessible, and improve the quality of care for individuals and populations by increasing the likelihood of desired health outcomes. Robotic-assisted surgery seems to provide perfection in surgical ergonomics and surgical dexterity, consequently improving patient outcomes. A lot of data is present on the accuracy, effectiveness, and safety of the robotic-guided technology which reflects remarkable improvements in quality of care, making its utility convincingly undisputable. The technology has been claimed to be cost-effective but there seems to be lack of data in the literature on this topic to validate this claim. Apart from just the outcome parameters, there is an immense need of studies on real-time cost-efficacy, patient perspective, surgeon and resident learning curve, and their experience with this new technology. Furthermore, new studies looking into increased utilities of this technology, such as brain and spine tumor resection, deep brain stimulation procedures, and osteotomies in deformity surgery, might authenticate the cost of the equipment.

Work demands and health consequences of organizational and technological measures introduced to enhance the quality of home care services--A subgroup analysis.

Science.gov (United States)

Andersen, Gunn Robstad; Bendal, Synne; Westgaard, Rolf H

2015-11-01

This study of home care workers in a Norwegian municipality aimed to examine the effect of two measures involving organizational (job checklists) and technological (personal digital assistants) job aids on perceived work demands and musculoskeletal health. Questionnaire data was collected in 2009 (n = 138, response rate 76.2%) and 2011 (n = 80, response rate 54%). Forty-six home care workers responded at both waves. Respondents were assigned into 'high', 'moderate' and 'low' strain groups based on their responses to open and closed survey questions regarding impact of the two measures. One-way ANOVA with post-hoc t-tests and regression analyses investigated group differences and examined development in variables. Perceived work demands and health effects over the two-year study period were unchanged overall, yet significant differences between subgroups were highlighted. Work demands and shoulder-neck pain remained high for high-strain workers, but were reduced for low and moderate strain workers. Management should be aware of diversity in worker responses to rationalizations and give priority to supplementary, targeted measures to counteract adverse effects. Copyright © 2015 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Development of the Digital Health Literacy Instrument : Measuring a Broad Spectrum of Health 1.0 and Health 2.0 Skills

NARCIS (Netherlands)

van der Vaart, Rosalie; Drossaert, Constance

2017-01-01

Background: With the digitization of health care and the wide availability of Web-based applications, a broad set of skills is essential to properly use such facilities; these skills are called digital health literacy or eHealth literacy. Current instruments to measure digital health literacy focus

Training the physician assistant in the Netherlands

NARCIS (Netherlands)

Spenkelink-Schut, G.; ten Cate, O.Th.J.; Kort, H.S.M.

2008-01-01

The concept of the physician assistant (PA) in the United States has served as a model for other countries in providing one solution for the challenges in their health care systems. In the Netherlands there is a growing shortage of adequately trained health care workers, an increasing demand for

Factors predicting dropout in student nursing assistants

DEFF Research Database (Denmark)

Svensson, Annemarie Lyng; Strøyer, Jesper; Ebbehøj, Niels Erik

2008-01-01

BACKGROUND: The dropout rate among student nursing assistants (NAs) in Danish health and social care education is high at >20%. AIMS: To explore if recent low back pain (LBP) history is a predictor of dropout among NA students, taking into account conventional risk factors for LBP, general health...

What is needed to implement a computer-assisted health risk assessment tool? An exploratory concept mapping study

Directory of Open Access Journals (Sweden)

Ahmad Farah

2012-12-01

Full Text Available Abstract Background Emerging eHealth tools could facilitate the delivery of comprehensive care in time-constrained clinical settings. One such tool is interactive computer-assisted health-risk assessments (HRA, which may improve provider-patient communication at the point of care, particularly for psychosocial health concerns, which remain under-detected in clinical encounters. The research team explored the perspectives of healthcare providers representing a variety of disciplines (physicians, nurses, social workers, allied staff regarding the factors required for implementation of an interactive HRA on psychosocial health. Methods The research team employed a semi-qualitative participatory method known as Concept Mapping, which involved three distinct phases. First, in face-to-face and online brainstorming sessions, participants responded to an open-ended central question: “What factors should be in place within your clinical setting to support an effective computer-assisted screening tool for psychosocial risks?” The brainstormed items were consolidated by the research team. Then, in face-to-face and online sorting sessions, participants grouped the items thematically as ‘it made sense to them’. Participants also rated each item on a 5-point scale for its ‘importance’ and ‘action feasibility’ over the ensuing six month period. The sorted and rated data was analyzed using multidimensional scaling and hierarchical cluster analyses which produced visual maps. In the third and final phase, the face-to-face Interpretation sessions, the concept maps were discussed and illuminated by participants collectively. Results Overall, 54 providers participated (emergency care 48%; primary care 52%. Participants brainstormed 196 items thought to be necessary for the implementation of an interactive HRA emphasizing psychosocial health. These were consolidated by the research team into 85 items. After sorting and rating, cluster analysis

Accounting for health and health care: approaches to measuring the sources and costs of their improvement

National Research Council Canada - National Science Library

Panel to Advance a Research Program on the Design of National Health Accounts

.... Accounting for Health and Health Care addresses both these issues. The government agencies responsible for measuring unit prices for medical services have taken steps in recent years that have greatly improved the accuracy of those measures. Nonetheless, this book has several recommendations aimed at further improving the price indices.

Exoskeleton plantarflexion assistance for elderly.

Science.gov (United States)

Galle, S; Derave, W; Bossuyt, F; Calders, P; Malcolm, P; De Clercq, D

2017-02-01

Elderly are confronted with reduced physical capabilities and increased metabolic energy cost of walking. Exoskeletons that assist walking have the potential to restore walking capacity by reducing the metabolic cost of walking. However, it is unclear if current exoskeletons can reduce energy cost in elderly. Our goal was to study the effect of an exoskeleton that assists plantarflexion during push-off on the metabolic energy cost of walking in physically active and healthy elderly. Seven elderly (age 69.3±3.5y) walked on treadmill (1.11ms 2 ) with normal shoes and with the exoskeleton both powered (with assistance) and powered-off (without assistance). After 20min of habituation on a prior day and 5min on the test day, subjects were able to walk with the exoskeleton and assistance of the exoskeleton resulted in a reduction in metabolic cost of 12% versus walking with the exoskeleton powered-off. Walking with the exoskeleton was perceived less fatiguing for the muscles compared to normal walking. Assistance resulted in a statistically nonsignificant reduction in metabolic cost of 4% versus walking with normal shoes, likely due to the penalty of wearing the exoskeleton powered-off. Also, exoskeleton mechanical power was relatively low compared to previously identified optimal assistance magnitude in young adults. Future exoskeleton research should focus on further optimizing exoskeleton assistance for specific populations and on considerate integration of exoskeletons in rehabilitation or in daily life. As such, exoskeletons should allow people to walk longer or faster than without assistance and could result in an increase in physical activity and resulting health benefits. Copyright © 2016 Elsevier B.V. All rights reserved.

‘Active citizenship’ and feeding assistive robotics

DEFF Research Database (Denmark)

Nickelsen, Niels Christian Mossfeldt

2018-01-01

Would you want to be fed by a robot? This question may or may not sound attractive to a severely disabled citizen striving for self-reliance. Recently assistive robotics have become a new factor to rely on in relation to a number of aspects of social work and health care. These initiatives have...... study, I discuss the ways humans engage with them, how they co-produce everyday life in housing institutions, and the sensitivity of assistive robotics. During the latest years, Feeding Assistive Robotics (FAR) have enjoyed strong political endorsement in Denmark. Nevertheless, I argue, it is difficult...

Measuring physical and mental health using the SF-12: implications for community surveys of mental health.

Science.gov (United States)

Windsor, Timothy D; Rodgers, Bryan; Butterworth, Peter; Anstey, Kaarin J; Jorm, Anthony F

2006-09-01

The effects of using different approaches to scoring the SF-12 summary scales of physical and mental health were examined with a view to informing the design and interpretation of community-based survey research. Data from a population-based study of 7485 participants in three cohorts aged 20-24, 40-44 and 60-64 years were used to examine relationships among measures of physical and mental health calculated from the same items using the SF-12 and RAND-12 approaches to scoring, and other measures of chronic physical conditions and psychological distress. A measure of physical health constructed using the RAND-12 scoring showed a monotonic negative association with psychological distress as measured by the Goldberg depression and anxiety scales. However, a non-monotonic association was evident in the relationship between SF-12 physical health scores and distress, with very high SF-12 physical health scores corresponding with high levels of distress. These relationships highlight difficulties in interpretation that can arise when using the SF-12 summary scales in some analytical contexts. It is recommended that community surveys that measure physical and mental functioning using the SF-12 items generate summary scores using the RAND-12 protocol in addition to the SF-12 approach. In general, researchers should be wary of using factor scores based on orthogonal rotation, which assumes that measures are uncorrelated, to represent constructs that have an actual association.

The Appropriateness of Canine-Assisted Interventions (CAIs) on the Health and Social Care of Older People Residing in Long Term Care: A Systematic Review.

Science.gov (United States)

Stern, Cindy; Pearson, Alan; Chur-Hansen, Anna

2011-01-01

Background: Canine-assisted interventions are used frequently in long term care settings, even though their effectiveness has not been definitively proven. One concern commonly described in the literature is the risk of zoonotic infection or animal-related injury/allergy associated with this type of interaction. To date, no systematic review has been undertaken to determine the appropriateness of canine-assisted interventions in relation to these issues. The aim of the review was to synthesise the best available evidence on the appropriateness of canine-assisted interventions on the health and social care of the older population residing in long term care with regards to zoonotic infection or animal-related injury/allergy. A comprehensive search was undertaken on 32 electronic databases and two reputable websites from their inception to 2009. The search was restricted to English language and both published and unpublished studies and papers were considered. The review took an inclusive approach and considered quantitative and qualitative studies that focussed on zoonotic risk/exposure/infection or animal-related injury/allergy from canine-assisted interventions used in long term care settings. In the absence of research studies, text and opinion were also considered. Critical appraisal of papers was to be undertaken using the appropriate Joanna Briggs Institute critical appraisal instrument and data extraction was to be via the Joanna Briggs Institute data extraction forms, dependant on design. There were no studies located the met the inclusion requirements of this review. There were also no text and opinion pieces that were specific to long term care, older people and canines. There is currently no evidence available to determine the appropriateness of canine-assisted interventions used for older people in long term care in regards to zoonotic risk/exposure/infection or animal-related injuries/allergies. There is a small body of literature available that focuses

A survey tool for measuring evidence-based decision making capacity in public health agencies

Directory of Open Access Journals (Sweden)

Jacobs Julie A

2012-03-01

Full Text Available Abstract Background While increasing attention is placed on using evidence-based decision making (EBDM to improve public health, there is little research assessing the current EBDM capacity of the public health workforce. Public health agencies serve a wide range of populations with varying levels of resources. Our survey tool allows an individual agency to collect data that reflects its unique workforce. Methods Health department leaders and academic researchers collaboratively developed and conducted cross-sectional surveys in Kansas and Mississippi (USA to assess EBDM capacity. Surveys were delivered to state- and local-level practitioners and community partners working in chronic disease control and prevention. The core component of the surveys was adopted from a previously tested instrument and measured gaps (importance versus availability in competencies for EBDM in chronic disease. Other survey questions addressed expectations and incentives for using EBDM, self-efficacy in three EBDM skills, and estimates of EBDM within the agency. Results In both states, participants identified communication with policymakers, use of economic evaluation, and translation of research to practice as top competency gaps. Self-efficacy in developing evidence-based chronic disease control programs was lower than in finding or using data. Public health practitioners estimated that approximately two-thirds of programs in their agency were evidence-based. Mississippi participants indicated that health department leaders' expectations for the use of EBDM was approximately twice that of co-workers' expectations and that the use of EBDM could be increased with training and leadership prioritization. Conclusions The assessment of EBDM capacity in Kansas and Mississippi built upon previous nationwide findings to identify top gaps in core competencies for EBDM in chronic disease and to estimate a percentage of programs in U.S. health departments that are evidence

Inverse correlation between reactive oxygen species in unwashed semen and sperm motion parameters as measured by a computer-assisted semen analyzer.

Science.gov (United States)

Takeshima, Teppei; Yumura, Yasushi; Yasuda, Kengo; Sanjo, Hiroyuki; Kuroda, Shinnosuke; Yamanaka, Hiroyuki; Iwasaki, Akira

2017-01-01

This study investigated the correlation between sperm motion parameters obtained by a computer-assisted semen analyzer and levels of reactive oxygen species in unwashed semen. In total, 847 patients, except for azoospermic patients were investigated. At the time of each patient's first consultation, semen parameters were measured using SMAS™ or CellSoft 3000™, and production of reactive oxygen species was measured using a computer-driven LKB Wallac Luminometer 1251 Analyzer. The patients were divided into two groups: reactive oxygen species - positive and negative. The semen parameters within each group were measured using one of the two computer-assisted semen analyzer systems and then compared. Correlations between reactive oxygen species levels and sperm motion parameters in semen from the reactive oxygen species - positive group were also investigated. Reactive oxygen species were detected in semen samples of 282 cases (33.3%). Sperm concentration (P semen damage sperm concentration, motility, and other sperm motion parameters.

Needs, Acceptability, and Value of Humanitarian Medical Assistance in Remote Peruvian Amazon Riverine Communities

Science.gov (United States)

Sanchez, Juan F.; Halsey, Eric S.; Bayer, Angela M.; Beltran, Martin; Razuri, Hugo R.; Velasquez, Daniel E.; Cama, Vitaliano A.; Graf, Paul C. F.; Quispe, Antonio M.; Maves, Ryan C.; Montgomery, Joel M.; Sanders, John W.; Lescano, Andres G.

2015-01-01

Much debate exists regarding the need, acceptability, and value of humanitarian medical assistance. We conducted a cross-sectional study on 457 children under 5 years from four remote riverine communities in the Peruvian Amazon and collected anthropometric measures, blood samples (1–4 years), and stool samples. Focus groups and key informant interviews assessed perspectives regarding medical aid delivered by foreigners. The prevalence of stunting, anemia, and intestinal parasites was 20%, 37%, and 62%, respectively. Infection with multiple parasites, usually geohelminths, was detected in 41% of children. The prevalence of intestinal parasites both individual and polyparasitism increased with age. Participants from smaller communities less exposed to foreigners expressed lack of trust and fear of them. However, participants from all communities were positive about foreigners visiting to provide health support. Prevalent health needs such as parasitic infections and anemia may be addressed by short-term medical interventions. There is a perceived openness to and acceptability of medical assistance delivered by foreign personnel. PMID:25846293

Development of measures of organizational leadership for health promotion.

Science.gov (United States)

Barrett, Linda; Plotnikoff, Ronald C; Raine, Kim; Anderson, Donna

2005-04-01

This study describes the development and psychometric evaluation of four scales measuring leadership for health promotion at an organizational level in the baseline survey (n=144) of the Alberta Heart Health Project. Content validity was established through a series of focus groups and expert opinion appraisals, pilot testing of a draft based on capacity assessment instruments developed by other provinces involved in the Canadian Heart Health Initiative, and the literature. Psychometric analyses provided empirical evidence of the construct validity and reliability of the organizational leadership scales. Principal component analysis verified the unidimensionality of the leadership scales of (a) Practices for Organizational Learning, (b) Wellness Planning, (c) Workplace Climate, and (d) Organization Member Development. Scale alpha coefficients ranged between .79 and .91 thus establishing good to high scale internal consistencies. These measures can be used by both researchers and practitioners for the assessment of organizational leadership for health promotion and heart health promotion.

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

Science.gov (United States)

2017-05-20

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

The challenge of change in acute mental health services: measuring staff perceptions of barriers to change and their relationship to job status and satisfaction using a new measure (VOCALISE).

Science.gov (United States)

Laker, Caroline; Callard, Felicity; Flach, Clare; Williams, Paul; Sayer, Jane; Wykes, Til

2014-02-20

Health services are subject to frequent changes, yet there has been insufficient research to address how staff working within these services perceive the climate for implementation. Staff perceptions, particularly of barriers to change, may affect successful implementation and the resultant quality of care. This study measures staff perceptions of barriers to change in acute mental healthcare. We identify whether occupational status and job satisfaction are related to these perceptions, as this might indicate a target for intervention that could aid successful implementation. As there were no available instruments capturing staff perceptions of barriers to change, we created a new measure (VOCALISE) to assess this construct. All nursing staff from acute in-patient settings in one large London mental health trust were eligible. Using a participatory method, a nurse researcher interviewed 32 staff to explore perceptions of barriers to change. This generated a measure through thematic analyses and staff feedback (N = 6). Psychometric testing was undertaken according to standard guidelines for measure development (N = 40, 42, 275). Random effects models were used to explore the associations between VOCALISE, occupational status, and job satisfaction (N = 125). VOCALISE was easy to understand and complete, and showed acceptable reliability and validity. The factor analysis revealed three underlying constructs: 'confidence,' 'de-motivation' and 'powerlessness.' Staff with negative perceptions of barriers to change held more junior positions, and had poorer job satisfaction. Qualitatively, nursing assistants expressed a greater sense of organisational unfairness in response to change. VOCALISE can be used to explore staff perceptions of implementation climate and to assess how staff attitudes shape the successful outcomes of planned changes. Negative perceptions were linked with poor job satisfaction and to those occupying more junior roles, indicating a

The effectiveness of Technology-assisted Cascade Training and Supervision of community health workers in delivering the Thinking Healthy Program for perinatal depression in a post-conflict area of Pakistan - study protocol for a randomized controlled trial.

Science.gov (United States)

Zafar, Shamsa; Sikander, Siham; Hamdani, Syed Usman; Atif, Najia; Akhtar, Parveen; Nazir, Huma; Maselko, Joanna; Rahman, Atif

2016-04-06

Rates of perinatal depression in low and middle income countries are reported to be very high. Perinatal depression not only has profound impact on women's health, disability and functioning, it is associated with poor child health outcomes such as pre-term birth, under-nutrition and stunting, which ultimately have an adverse trans-generational impact. There is strong evidence in the medical literature that perinatal depression can be effectively managed with psychological treatments delivered by non-specialists. Our previous research in Pakistan led to the development of a successful perinatal depression intervention, the Thinking Healthy Program (THP). The THP is a psychological treatment delivered by community health workers. The burden of perinatal depression can be reduced through scale-up of this proven intervention; however, training of health workers at scale is a major barrier. To enhance access to such interventions there is a need to look at technological solutions to training and supervision. This is a non-inferiority, single-blinded randomized controlled trial. Eighty community health workers called Lady Health Workers (LHWs) working in a post-conflict rural area in Pakistan (Swat) will be recruited through the LHW program. LHWs will be randomly allocated to Technology-assisted Cascade Training and Supervision (TACTS) or to specialist-delivered training (40 in each group). The TACTS group will receive training in THP through LHW supervisors using a tablet-based training package, whereas the comparison group will receive training directly from mental health specialists. Our hypothesis is that both groups will achieve equal competence. Primary outcome measure will be competence of health workers at delivering THP using a modified ENhancing Assessment of Common Therapeutic factors (ENACT) rating scale immediately post training and after 3 months of supervision. Independent assessors will be blinded to the LHW allocation status. Women living in post

Pacific Northwest Laboratory annual report for 1979 to the DOE Assistant Secretary for Environment. Part 5. Environmental assessment, control, health, and safety

International Nuclear Information System (INIS)

Baalman, R.W.; Dotson, C.W.

1980-02-01

Part 5 of the 1979 Annual Report to the Department of Energy Assistant Secretary for the Environment presents Pacific Northwest Laboratory's progress on work performed for the Office of Technology Impacts, the Office of Environmental Compliance and Overview, and the Office of Health and Environmental Research. The report is in four sections, corresponding to the program elements: technology impacts, environmental control engineering, operational and environmental compliance, and human health studies. In each section, articles describe progress made during FY 1979 on individual projects

Assessment of the ABC/2 Method of Epidural Hematoma Volume Measurement as Compared to Computer-Assisted Planimetric Analysis.

Science.gov (United States)

Hu, Ting-Ting; Yan, Ling; Yan, Peng-Fei; Wang, Xuan; Yue, Ge-Fen

2016-01-01

Epidural hematoma volume (EDHV) is an independent predictor of prognosis in patients with epidural hematoma (EDH) and plays a central role in treatment decision making. This study's objective was to determine the accuracy and reliability of the widely used volume measurement method ABC/2 in estimating EDHV by comparing it to the computer-assisted planimetric method. A data set of computerized tomography (CT) scans of 35 patients with EDH was evaluated to determine the accuracy of ABC/2 method, using computer-assisted planimetric technique to establish the reference criterion of EDHV for each patient. Another data set was constructed by randomly selecting 5 patients then replicating each case twice to yield 15 patients. Intra- and interobserver reliability were evaluated by asking four observers to independently estimate EDHV for the latter data set using the ABC/2 method. Estimation of EDHV using the ABC/2 method showed high intra- and interobserver reliability (intra-class correlation coefficient = .99). These estimates were closely correlated with planimetric measures (r = .99). But the ABC/2 method generally overestimated EDHV, especially in the nonellipsoid-like group. The difference between the ABC/2 measures and planimetric measures was statistically significant (p ABC/2 method could be used for EDHV measurement, which would contribute to treatment decision making as well as clinical outcome prediction. However, clinicians should be aware that the ABC/2 method results in a general volume overestimation. Future studies focusing on justification of the technique to improve its accuracy would be of practical value. © The Author(s) 2015.

Health Care Professionals' Attitudes About Physician-Assisted Death: An Analysis of Their Justifications and the Roles of Terminology and Patient Competency.

Science.gov (United States)

Braverman, Derek W; Marcus, Brian S; Wakim, Paul G; Mercurio, Mark R; Kopf, Gary S

2017-10-01

Health care professionals (HCPs) are crucial to physician-assisted death (PAD) provision. To quantitatively assess the favorability of justifications for or against PAD legalization among HCPs, the effect of the terms "suicide" and "euthanasia" on their views and their support for three forms of PAD. Our questionnaire presented three cases: physician-assisted suicide, euthanasia for a competent patient, and euthanasia for an incompetent patient with an advance directive for euthanasia. Respondents judged whether each case was ethical and should be legal and selected their justifications from commonly cited reasons. The sample included physician clinicians, researchers, nonphysician clinicians, and other nonclinical staff at a major academic medical center. Of 221 HCPs, the majority thought that each case was ethical and should be legal. In order of declining favorability, justifications supporting PAD legalization were relief of suffering, right to die, mercy, acceptance of death, nonabandonment, and saving money for the health care system; opposing justifications were the slippery slope argument, unnecessary due to palliative care, killing patients is wrong, religious views, and suicide is wrong. The use of suicide and euthanasia terminology did not affect responses. Participants preferred physician-assisted suicide to euthanasia for a competent patient (P euthanasia for an incompetent patient to euthanasia for a competent patient (P euthanasia language did not bias HCPs against PAD, challenging claims that such value-laden terms hinder dialogue. More research is required to understand the significance of competency in shaping attitudes toward PAD. Published by Elsevier Inc.

Assisted reproduction and distributive justice.

Science.gov (United States)

Panitch, Vida

2015-02-01

The Canadian province of Quebec recently amended its Health Insurance Act to cover the costs of In Vitro Fertilization (IVF). The province of Ontario recently de-insured IVF. Both provinces cited cost-effectiveness as their grounds, but the question as to whether a public health insurance system ought to cover IVF raises the deeper question of how we should understand reproduction at the social level, and whether its costs should be a matter of individual or collective responsibility. In this article I examine three strategies for justifying collective provisions in a liberal society and assess whether public reproductive assistance can be defended on any of these accounts. I begin by considering, and rejecting, rights-based and needs-based approaches. I go on to argue that instead we ought to address assisted reproduction from the perspective of the contractarian insurance-based model for public health coverage, according to which we select items for inclusion based on their unpredictability in nature and cost. I argue that infertility qualifies as an unpredictable incident against which rational agents would choose to insure under ideal conditions and that assisted reproduction is thereby a matter of collective responsibility, but only in cases of medical necessity or inability to pay. The policy I endorse by appeal to this approach is a means-tested system of coverage resembling neither Ontario nor Quebec's, and I conclude that it constitutes a promising alternative worthy of serious consideration by bioethicists, political philosophers, and policy-makers alike. © 2013 John Wiley & Sons Ltd.

Measuring and understanding motivation among community health workers in rural health facilities in India-a mixed method study

OpenAIRE

Tripathy, Jaya Prasad; Goel, Sonu; Kumar, Ajay M. V.

2016-01-01

Background Motivated human resource is the key to improve health system performance and retention of health workers. There is scanty literature on measuring motivation of health workers in India. Thus, the objective of this study was to measure and identify important aspects of health workers? motivation in North India. Methods A mixed method study design was adopted. Under the quantitative component, we interviewed randomly selected 62 community health workers (CHWs) in 18 sub-centres in two...

Cost of employee assistance programs: comparison of national estimates from 1993 and 1995.

Science.gov (United States)

French, M T; Zarkin, G A; Bray, J W; Hartwell, T D

1999-02-01

The cost and financing of mental health services is gaining increasing importance with the spread of managed care and cost-cutting measures throughout the health care system. The delivery of mental health services through structured employee assistance programs (EAPs) could be undermined by revised health insurance contracts and cutbacks in employer-provided benefits at the workplace. This study uses two recently completed national surveys of EAPs to estimate the costs of providing EAP services during 1993 and 1995. EAP costs are determined by program type, worksite size, industry, and region. In addition, information on program services is reported to determine the most common types and categories of services and whether service delivery changes have occurred between 1993 and 1995. The results of this study will be useful to EAP managers, mental health administrators, and mental health services researchers who are interested in the delivery and costs of EAP services.

"Sometimes I've gone home feeling that my voice hasn't been heard": a focus group study exploring the views and experiences of health care assistants when caring for dying residents.

Science.gov (United States)

Fryer, Susan; Bellamy, Gary; Morgan, Tessa; Gott, Merryn

2016-08-19

In most developed countries, Health Care Assistants comprise a significant, and growing, proportion of the residential aged care workforce. Despite the fact that they provide the majority of direct care for residents, little is known about a key care aspect of their work, namely their experience of caring for dying residents. Twenty-six Health Care Assistants working in aged residential care facilities in Auckland, New Zealand participated in six focus group discussions. Focus groups were designed to explore the experiences of Health Care Assistants caring for imminently dying residents in aged care facilities and to identify barriers and facilitators to their work in this area. The focus groups were digitally recorded, transcribed verbatim and analysed using a general inductive approach. Participants confirmed that Health Care Assistants provide the majority of hands on care to dying residents and believed they had a valuable role to play at this time due to their unique 'familial' relationship with residents and families. However, it was apparent that a number of barriers existed to them maximising their contribution to supporting dying residents, most notably the lack of value placed on their knowledge and experience by other members of the multidisciplinary team. Whilst a need for additional palliative and end of life care education was identified, a preference was identified for hands on education delivered by peers, rather than the didactic education they currently receive. Given ageing populations internationally coupled with a constrained health budget, the role of Health Care Assistants in most developed countries is likely to become even more significant in the short to medium term. This study makes a unique contribution to the international literature by identifying the barriers to caring for dying residents experienced by this valuable sector of the aged care workforce. These data have the potential to inform new, innovative, interventions to address

The Living Challenges of Ambient Assisted Living - A Literature Review

DEFF Research Database (Denmark)

Bygholm, Ann; Kanstrup, Anne Marie

2015-01-01

Ambient Assisted Living (AAL) is a rapidly evolving research and development area propelled by scarcity of health resources caused by an aging workforce and increase of Citizens in need of health care and health assistance on a regular basis. This paper presents a literature review of the current...... state-of-the-art of AAL. The objective is to point towards methodological actions to be taken into account in AAL research on this basis. Searches were conducted in five research databases. The search identified 86 papers. 10 of these papers were review papers chosen for analysis. The analysis presents...... an overview of the current status of AAL within the following categories: technology, users, application domains, rationales, successes and challenges of AAL. The paper concludes that the living part, i.e. the everyday practice of people living with Assistive Technology, is the primary challenge to the field...

Job satisfaction of practice assistants in general practice in Germany: an observational study.

Science.gov (United States)

Goetz, Katja; Campbell, Stephen; Broge, Bjoern; Brodowski, Marc; Steinhaeuser, Jost; Wensing, Michel; Szecsenyi, Joachim

2013-08-01

Job satisfaction of practice staff is important for optimal health care delivery and for minimizing the turnover of non-medical professions. To document the job satisfaction of practice assistants in German general practice and to explore associations between job satisfaction, staff characteristics and culture in general practice organizations. The study was based on data from the European Practice Assessment accreditation scheme for general practices and used an observational design. The study population consisted of 1158 practice assistants from 345 general practices across Germany. Job satisfaction was measured with the 10-item Warr-Cook-Wall questionnaire. Organizational culture was evaluated with four items. A linear regression analysis was performed in which each of the job satisfaction items was handled as dependent variable. Out of 1716 staff member questionnaires handed out to practice assistants, 1158 questionnaires were completed (response rate: 67.5%). Practice assistants were most satisfied with their colleagues and least satisfied with their income. Higher job satisfaction was associated with issues of organizational culture, particularly a good working atmosphere, opportunities to suggest and influence areas for improvement and clear responsibilities within the practice team. Prioritizing initiatives to maintain high levels of, or to improve the job satisfaction of practice assistants, is important for recruitment and retention. It will also help to improve working conditions for both practice assistants and GPs and create an environment to provide better quality care.

77 FR 42738 - Request for Information on Quality Measurement Enabled by Health IT

Science.gov (United States)

2012-07-20

... Information on Quality Measurement Enabled by Health IT AGENCY: Agency for Healthcare Research and Quality... diversified stakeholders (health information technology (IT) system developers, including vendors; payers... strategies and challenges regarding quality measurement enabled by health IT. Quality measurement--the...

An educational strategy for using physician assistant students to provide health promotion education to community adolescents.

Science.gov (United States)

Ruff, Cathy C

2012-01-01

The "Competencies for the Physician Assistant Profession" identify core competencies that physician assistants (PAs) are expected to acquire and maintain throughout their career (see http://www.nccpa.net/pdfs/Definition%20of%20PA%20Competencies% 203.5%20for%20Publication.pdf). Two categories of competencies relate to patient care and interpersonal and communication skills and articulate the need for PAs to be effective communicators and patient educators. The value of a health education curriculum for the adolescent population has been recognized since the early 1900s. PA student-designed health promotion presentations aimed at the adolescent population are an innovative educational strategy involving students in community education. PA student-designed presentations based upon previously identified topics were presented in the community. Students presented topics including Smoking Cessation, The Effects of Drugs and Alcohol, Self-Esteem, and others to adolescents. Community audiences were varied and included alternative high schools and teens within the Department of Youth Corrections facilities. PA students created 17 portable presentations for community adolescents. Two hundred sixty-eight students gave presentations to more than 700 adolescents ranging from 11-22 years of age between the years 2005-2010. Eighty-two percent (646/791) of adolescent participants either strongly agreed or agreed that they learned at least one new piece of information from the presentations. Sixty percent (12/20) of community leaders requested that the PA students return to give additional health promotion presentations. Analysis of comments by PA students revealed that 98% of students found the experience beneficial. Students identified the experience as helping them better understand how to design presentations to meet the needs of their audience, feel more comfortable with adolescents, and gain confidence in communicating. Seventy-five percent stated they would continue to be

Training and technical assistance for compliance with beverage and physical activity components of New York City's regulations for early child care centers.

Science.gov (United States)

Kakietek, Jakub; Dunn, Lillian; O'Dell, Sarah Abood; Jernigan, Jan; Kettel Khan, Laura

2014-10-16

In 2006, the New York City Department of Health and Mental Hygiene (DOHMH) passed regulations for child care centers that established standards for beverages provided to children and set a minimum amount of time for daily physical activity. DOHMH offered several types of training and technical assistance to support compliance with the regulations. This article analyzes the association between training and technical assistance provided and compliance with the regulations in a sample of 174 group child care centers. Compliance was measured by using a site inventory of beverages stored on premises and a survey of centers' teachers regarding the amount of physical activity provided. Training and technical assistance measures were based on the DOHMH records of training and technical assistance provided to the centers in the sample and on a survey of center directors. Ordinal logistic regression was used to assess the association between training and technical assistance measures and compliance with the regulations. Measures of training related to physical activity the center received: the number of staff members who participated in Sport, Play and Active Recreation for Kids (SPARK) and other training programs in which a center participated were associated with better compliance with the physical activity regulations. Neither training nor technical assistance were associated with compliance with the regulations related to beverages. Increased compliance with regulations pertaining to physical activity was not related to compliance with beverage regulations. Future trainings should be targeted to the specific regulation requirements to increase compliance.

Handbook of laboratory health and safety measures

International Nuclear Information System (INIS)

Pal, S.B.

1985-01-01

The application of radioactive isotopes and various scientific instruments based on different ionizing and non-ionizing radiation have brought new safety problems to laboratory workers today. Therefore, there is a need to revise present knowledge of safety measures to deal with new hazards, thus broadening the outlook towards health and safety measures for contemporary laboratory staff. This handbook presents a series of articles on current knowledge regarding laboratory safety

Systems Health Care: daily measurement and lifestyle change

Science.gov (United States)

Nakajima, Hiroshi; Tsuchiya, Naoki; Shiga, Toshikazu; Hata, Yutaka

2012-06-01

Health is quite important to be realized in our daily life. However, its idea covers wide area and has individual dependency. Activities in health care have been widely developed by medical, drag, insurance, food, and other types of industries mainly centering diseases. In this article, systems approach named Systems Health Care is introduced and discussed to generate new and precious values based on measurements in daily life to change lifestyle habits for realizing each health. Firstly, issues related to health such as its definitions are introduced and discussed by centering health rather than disease. In response to the discussions on health, Home and Medical Care is continuously introduced to point out the important role causality between life style and vital signal such as exercise and blood pressure based on detailed sampling time. Systems approaches of Systems Health Care are discussed from various points of views. Real applications of devices and services are used to make the studies and discussions deeper on the subjects of the article.

Assessing the Impact of Food Assistance on Stigma Among People Living with HIV in Uganda Using the HIV/AIDS Stigma Instrument-PLWA (HASI-P).

Science.gov (United States)

Maluccio, John A; Wu, Fan; Rokon, Redwan B; Rawat, Rahul; Kadiyala, Suneetha

2017-03-01

HIV-related stigma among persons living with HIV/AIDS (PLHIV) is prevalent throughout sub-Saharan Africa. There is limited evidence, however, on which interventions are effective in reducing it. We used data from a prospective impact evaluation of a 12-month food assistance intervention among 904 antiretroviral therapy (ART)- naïve PLHIV in Uganda to examine the program impact on stigma. Stigma was measured using the comprehensive HASI-P scale, which demonstrated good internal consistency (Cronbach's alpha = 0.87) and was correlated with several related constructs including physical and mental health-related quality of life, disclosure, and physical health symptoms in the sample. Using quasi-experimental difference-in-difference matching methods to better infer causality, we tested whether the intervention improved the overall stigma scale and its subscales. The food assistance intervention had a significant effect on reported internalized (but not external) stigma of approximately 0.2 SD (p stigma scale is a useful tool for measuring and tracking stigma. Food assistance interventions, embedded in an HIV care program, can reduce internalized stigma.

Measured moisture in buildings and adverse health effects: a review.

Science.gov (United States)

Mendell, Mark J; Macher, Janet M; Kumagai, Kazukiyo

2018-04-23

It has not yet been possible to quantify dose-related health risks attributable to indoor dampness or mold (D/M), to support the setting of health-related limits for D/M. An overlooked target for assessing D/M is moisture in building materials, the critical factor allowing microbial growth. A search for studies of quantified building moisture and occupant health effects identified three eligible studies. Two studies assessed associations between measured wall moisture content and respiratory health in the UK. Both reported dose-related increases in asthma exacerbation with higher measured moisture, with one study reporting an adjusted odds ratio (OR) of 7.0 for night-time asthma symptoms with higher bedroom moisture. The third study assessed relationships between infrared camera-determined wall moisture and atopic dermatitis in South Korea, reporting an adjusted OR of 14.5 for water-damaged homes and moderate or severe atopic dermatitis. Measuring building moisture has, despite extremely limited available findings, potential promise for detecting unhealthy D/M in homes and merits more research attention. Further research to validate these findings should include measured "water activity," which directly assesses moisture availability for microbial growth. Ultimately, evidence-based, health-related thresholds for building moisture, across specific materials and measurement devices, could better guide assessment and remediation of D/M in buildings. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

Health 2020 – Achieving Health and Development in Today’s Europe

Directory of Open Access Journals (Sweden)

Zsuzsanna Jakab

2014-09-01

CONCLUSION: This article presents the development process of Health 2020 and its main strategic goals, objectives and content. Further, it describes what is needed to successfully implement Health 2020 in countries and how WHO can provide technical assistance to countries that embark on developing health policy aligned with the Health 2020 policy framework. The development and implementation of Health 2020 is a powerful vehicle for concerted inter-sectoral action across the WHO European Region for improving health and well-being of present and future generations. Successful implementation of Health 2020 needs providing technical assistance by WHO to the countries to embark on developing health policy aligned with the Health 2020 policy framework.

Durability of Expanded Physician Assistant Training Positions Following the End of Health Resources and Services Administration Expansion of Physician Assistant Training Funding.

Science.gov (United States)

Rolls, Joanne; Keahey, David

2016-09-01

The purpose of this study was to assess the number of Health Resources and Services Administration Expansion of Physician Assistant Training (EPAT)-funded physician assistant (PA) programs planning to maintain class size at expanded levels after grant funds expire and to report proposed financing methods. The 5-year EPAT grant expired in 2015, and the effect of this funding on creating a durable expansion of PA training seats has not yet been investigated. The study used an anonymous, 9-question, Web-based survey sent to the program directors at each of the PA programs that received EPAT funding. Data were analyzed in Excel and using SAS statistical analysis software for both simple percentages and for Fisher's exact test. The survey response rate was 81.48%. Eighty-two percent of responding programs indicated that they planned to maintain all expanded positions. Fourteen percent will revert to their previous student class size, and 4% will maintain a portion of the expanded positions. A majority of the 18 programs (66%) maintaining all EPAT seats will be funded by tuition pass-through, and one program (6%) will increase tuition. There was no statistical association between the program type and the decision to maintain expanded positions (P = .820). This study demonstrates that the one-time EPAT PA grant funding opportunity created a durable expansion in PA training seats. Future research should focus on the effectiveness of the program in increasing the number of graduates choosing to practice in primary care and the durability of expansion several years after funding expiration.

Economic modeling of surgical disease: a measure of public health interventions.

Science.gov (United States)

Corlew, D Scott

2013-07-01

The measurement of the burden of disease and the interventions that address that burden can be done in various units. Reducing these measures to the common denominator of economic units (i.e., currency) enables comparison with other health entities, interventions, and even other fields. Economic assessment is complex, however, because of the multifactorial components of what constitutes health and what constitutes health interventions, as well as the coupling of those data to economic means. To perform economic modeling in a meaningful manner, it is necessary to: (1) define the health problem to be addressed; (2) define the intervention to be assessed; (3) define a measure of the effect of the health entity with and without the intervention (which includes defining the counterfactual); and (4) determine the appropriate method of converting the health effect to economics. This paper discusses technical aspects of how economic modeling can be done both of disease entities and of interventions. Two examples of economic modeling applied to surgical problems are then given.

Sickness absence in student nursing assistants following a preventive intervention programme

DEFF Research Database (Denmark)

Svensson, A L; Marott, J L; Suadicani, P

2011-01-01

reduced SF-36 scores for general health perception [general health (GH)], psychological well-being [mental health (MH)] and energy/fatigue [vitality (VT)] compared with the intervention group, which remained at the baseline level for all three measures. AIMS: To ascertain whether this effect remained......BACKGROUND: We have previously shown that a multidimensional programme combining physical training, patient transfer techniques and stress management significantly reduced sickness absence rates in student nurse assistants (NAs) after 14 months of follow-up. At follow-up, the control group had...... after a further 36 months of follow-up and to analyse the association of GH, MH and VT scores with sickness absence. METHODS: This was a cluster randomized prospective study. The original study involved assessment at baseline and follow-up at 14 months (the duration of the student NA course). Of 568...

Radiological assistance program: Region I. Part I

International Nuclear Information System (INIS)

Musolino, S.V.; Kuehner, A.V.; Hull, A.P.

1985-01-01

The purpose of the Radiological Assistance Program (RAP) is to make DOE resources available and provide emergency assistance to state and local agencies in order to control radiological hazards, protect the public health and safety, and minimize the loss of property. This plan is an integral part of a nationwide program of radiological assistance established by the US DOE, and is implemented on a regional basis. The Brookhaven Area Office (BHO) Radiological Assistance Program is applicable to DOE Region I, which consists of the New England States, New York, New Jersey, Pennsylvania, Delaware, Maryland and the District of Columbia. The BHO RAP-1 has been developed to: (a) ensure the availability of an effective radiological assistance capability to ensure the protection of persons and property; (b) provide guidelines to RAP-1 Team personnel for the evaluation of radiological incidents and implementation of corrective actions; (c) maintain liaison with other DOE installations, Federal, State and local organizations which may become involved in radiological assistance operations in Region I; and (d) encourage development of a local capability to cope with radiological incidents

Pacific Northwest Laboratory annual report for 1979 to the DOE Assistant Secretary for Environment. Part 5. Environmental assessment, control, health, and safety

Energy Technology Data Exchange (ETDEWEB)

Baalman, R.W.; Dotson, C.W. (eds.)

1980-02-01

Part 5 of the 1979 Annual Report to the Department of Energy Assistant Secretary for the Environment presents Pacific Northwest Laboratory's progress on work performed for the Office of Technology Impacts, the Office of Environmental Compliance and Overview, and the Office of Health and Environmental Research. The report is in four sections, corresponding to the program elements: technology impacts, environmental control engineering, operational and environmental compliance, and human health studies. In each section, articles describe progress made during FY 1979 on individual projects.

Compact Hip-Force Sensor for a Gait-Assistance Exoskeleton System

Directory of Open Access Journals (Sweden)

Hyundo Choi

2018-02-01

Full Text Available In this paper, we propose a compact force sensor system for a hip-mounted exoskeleton for seniors with difficulties in walking due to muscle weakness. It senses and monitors the delivered force and power of the exoskeleton for motion control and taking urgent safety action. Two FSR (force-sensitive resistors sensors are used to measure the assistance force when the user is walking. The sensor system directly measures the interaction force between the exoskeleton and the lower limb of the user instead of a previously reported force-sensing method, which estimated the hip assistance force from the current of the motor and lookup tables. Furthermore, the sensor system has the advantage of generating torque in the walking-assistant actuator based on directly measuring the hip-assistance force. Thus, the gait-assistance exoskeleton system can control the delivered power and torque to the user. The force sensing structure is designed to decouple the force caused by hip motion from other directional forces to the sensor so as to only measure that force. We confirmed that the hip-assistance force could be measured with the proposed prototype compact force sensor attached to a thigh frame through an experiment with a real system.

Compact Hip-Force Sensor for a Gait-Assistance Exoskeleton System.

Science.gov (United States)

Choi, Hyundo; Seo, Keehong; Hyung, Seungyong; Shim, Youngbo; Lim, Soo-Chul

2018-02-13

In this paper, we propose a compact force sensor system for a hip-mounted exoskeleton for seniors with difficulties in walking due to muscle weakness. It senses and monitors the delivered force and power of the exoskeleton for motion control and taking urgent safety action. Two FSR (force-sensitive resistors) sensors are used to measure the assistance force when the user is walking. The sensor system directly measures the interaction force between the exoskeleton and the lower limb of the user instead of a previously reported force-sensing method, which estimated the hip assistance force from the current of the motor and lookup tables. Furthermore, the sensor system has the advantage of generating torque in the walking-assistant actuator based on directly measuring the hip-assistance force. Thus, the gait-assistance exoskeleton system can control the delivered power and torque to the user. The force sensing structure is designed to decouple the force caused by hip motion from other directional forces to the sensor so as to only measure that force. We confirmed that the hip-assistance force could be measured with the proposed prototype compact force sensor attached to a thigh frame through an experiment with a real system.

Measuring Religiousness in Health Research: Review and Critique

OpenAIRE

Hall, Daniel E.; Meador, Keith G.; Koenig, Harold G.

2008-01-01

Although existing measures of religiousness are sophisticated, no single approach has yet emerged as a standard. We review the measures of religiousness most commonly used in the religion and health literature with particular attention to their limitations, suggesting that vigilance is required to avoid over-generalization. After placing the development of these scales in historical context, we discuss measures of religious attendance, private religious practice, and intrinsic/extrinsic relig...

Post-operative benefits of animal-assisted therapy in pediatric surgery: a randomised study.

Science.gov (United States)

Calcaterra, Valeria; Veggiotti, Pierangelo; Palestrini, Clara; De Giorgis, Valentina; Raschetti, Roberto; Tumminelli, Massimiliano; Mencherini, Simonetta; Papotti, Francesca; Klersy, Catherine; Albertini, Riccardo; Ostuni, Selene; Pelizzo, Gloria

2015-01-01

Interest in animal-assisted therapy has been fuelled by studies supporting the many health benefits. The purpose of this study was to better understand the impact of an animal-assisted therapy program on children response to stress and pain in the immediate post-surgical period. Forty children (3-17 years) were enrolled in the randomised open-label, controlled, pilot study. Patients were randomly assigned to the animal-assisted therapy-group (n = 20, who underwent a 20 min session with an animal-assisted therapy dog, after surgery) or the standard-group (n = 20, standard postoperative care). The study variables were determined in each patient, independently of the assigned group, by a researcher unblinded to the patient's group. The outcomes of the study were to define the neurological, cardiovascular and endocrinological impact of animal-assisted therapy in response to stress and pain. Electroencephalogram activity, heart rate, blood pressure, oxygen saturation, cerebral prefrontal oxygenation, salivary cortisol levels and the faces pain scale were considered as outcome measures. After entrance of the dog faster electroencephalogram diffuse beta-activity (> 14 Hz) was reported in all children of the animal-assisted therapy group; in the standard-group no beta-activity was recorded (100% vs 0%, panimal-assisted therapy, though a higher variability in diastolic pressure was observed. Salivary cortisol levels did not show different behaviours over time between groups (p=0.70). Lower pain perception was noted in the animal-assisted group in comparison with the standard-group (p = 0.01). Animal-assisted therapy facilitated rapid recovery in vigilance and activity after anaesthesia, modified pain perception and induced emotional prefrontal responses. An adaptative cardiovascular response was also present. ClinicalTrials.gov NCT02284100.

Developmental assistance for child and adolescent mental health in low- and middle-income countries (2007-2014): Annual trends and allocation by sector, project type, donors and recipients.

Science.gov (United States)

Turner, Jasmine; Pigott, Hugo; Tomlinson, Mark; Jordans, Mark Jd

2017-12-01

Globally, mental disorders are the leading cause of disability among children and adolescents. To date, there has been no estimate of developmental assistance supporting mental health projects that target children and adolescents (DAMH-CA). This study aimed to identify, describe and analyse DAMH-CA with respect to annual trends (2007-2014), sector, project type, recipient regions, and top donor and recipient countries, and estimate annual DAMH-CA per child/adolescent by region. Developmental assistance for all projects focused on children and adolescent mental health between 2007 and 2014 was identified on the Organisation for Economic Co-operation and Development's (OECD) Creditor Reporting System, and analysed by target population, sector, project type, donors, and recipients. The study did not include governmental or private organisation funds, nor funding for projects that targeted the community or those that included mental health but not as a primary objective. Between 2007 and 2014, 704 projects were identified, constituting US$ 88.35 million in DAMH-CA, with an average of 16.9% of annual development assistance for mental health. Three quarters of DAMH-CA was used to fund projects in the humanitarian sector, while less than 10% was directed at mental health projects within the education, HIV/AIDS, rights, and neurology sectors. DAMH-CA was predominantly invested in psychosocial support projects (US$ 63.24 million, 72%), while little in absolute and relative terms supported capacity building, prevention, promotion or research, with the latter receiving just US$ 1.2 million over the eight years (1.4% of total DAMH-CA). For 2014, DAMH-CA per child/adolescent was US$ 0.02 in Europe, less than US$ 0.01 in Asia, Africa, and Latin America and the Caribbean, and US$ 0 in Oceania. To mitigate the growing burden of mental and neurological disorders, increased financial aid must be invested in child and adolescent mental health, especially with respect to capacity

Comparing frailty measures in their ability to predict adverse outcome among older residents of assisted living

Directory of Open Access Journals (Sweden)

Hogan David B

2012-09-01

Full Text Available Abstract Background Few studies have directly compared the competing approaches to identifying frailty in more vulnerable older populations. We examined the ability of two versions of a frailty index (43 vs. 83 items, the Cardiovascular Health Study (CHS frailty criteria, and the CHESS scale to accurately predict the occurrence of three outcomes among Assisted Living (AL residents followed over one year. Methods The three frailty measures and the CHESS scale were derived from assessment items completed among 1,066 AL residents (aged 65+ participating in the Alberta Continuing Care Epidemiological Studies (ACCES. Adjusted risks of one-year mortality, hospitalization and long-term care placement were estimated for those categorized as frail or pre-frail compared with non-frail (or at high/intermediate vs. low risk on CHESS. The area under the ROC curve (AUC was calculated for select models to assess the predictive accuracy of the different frailty measures and CHESS scale in relation to the three outcomes examined. Results Frail subjects defined by the three approaches and those at high risk for decline on CHESS showed a statistically significant increased risk for death and long-term care placement compared with those categorized as either not frail or at low risk for decline. The risk estimates for hospitalization associated with the frailty measures and CHESS were generally weaker with one of the frailty indices (43 items showing no significant association. For death and long-term care placement, the addition of frailty (however derived or CHESS significantly improved on the AUC obtained with a model including only age, sex and co-morbidity, though the magnitude of improvement was sometimes small. The different frailty/risk models did not differ significantly from each other in predicting mortality or hospitalization; however, one of the frailty indices (83 items showed significantly better performance over the other measures in predicting long

The public health disaster trust scale: validation of a brief measure.

Science.gov (United States)

Eisenman, David P; Williams, Malcolm V; Glik, Deborah; Long, Anna; Plough, Alonzo L; Ong, Michael

2012-01-01

Trust contributes to community resilience by the critical influence it has on the community's responses to public health recommendations before, during, and after disasters. However, trust in public health is a multifactorial concept that has rarely been defined and measured empirically in public health jurisdictional risk assessment surveys. Measuring trust helps public health departments identify and ameliorate a threat to effective risk communications and increase resilience. Such a measure should be brief to be incorporated into assessments conducted by public health departments. We report on a brief scale of public health disaster-related trust, its psychometric properties, and its validity. On the basis of a literature review, our conceptual model of public health disaster-related trust and previously conducted focus groups, we postulated that public health disaster-related trust includes 4 major domains: competency, honesty, fairness, and confidentiality. A random-digit-dialed telephone survey of the Los Angeles county population, conducted in 2004-2005 in 6 languages. Two thousand five hundred eighty-eight adults aged 18 years and older including oversamples of African Americans and Asian Americans. Trust was measured by 4 items scored on a 4-point Likert scale. A summary score from 4 to 16 was constructed. Scores ranged from 4 to 16 and were normally distributed with a mean of 8.5 (SD 2.7). Cronbach α = 0.79. As hypothesized, scores were lower among racial/ethnic minority populations than whites. Also, trust was associated with lower likelihood of following public health recommendations in a hypothetical disaster and lower likelihood of household disaster preparedness. The Public Health Disaster Trust scale may facilitate identifying communities where trust is low and prioritizing them for inclusion in community partnership building efforts under Function 2 of the Centers for Disease Control and Prevention's Public Health Preparedness Capability 1. The

Measuring social inclusion--a key outcome in global mental health.

Science.gov (United States)

Baumgartner, Joy Noel; Burns, Jonathan K

2014-04-01

Social inclusion is increasingly recognized as a key outcome for evaluating global mental health programmes and interventions. Whereas social inclusion as an outcome is not a new concept in the field of mental health, its measurement has been hampered by varying definitions, concepts and instruments. To move the field forward, this paper reviews the currently available instruments which measure social inclusion and are reported in the literature, realizing that no single measure will be appropriate for all studies or contexts. A systematic literature search of English language peer-reviewed articles published through February 2013 was undertaken to identify scales specifically developed to measure social inclusion or social/community integration among populations with mental disorders. Five instruments were identified through the search criteria. The scales are discussed in terms of their theoretical underpinnings, domains and/or key items and their potential for use in global settings. Whereas numerous reviewed abstracts discussed mental health and social inclusion or social integration, very few were concerned with direct measurement of the construct. All identified scales were developed in high-income countries with limited attention paid to how the scale could be adapted for cross-cultural use. Social inclusion is increasingly highlighted as a key outcome for global mental health policies and programmes, yet its measurement is underdeveloped. There is need for a global cross-cultural measure that has been developed and tested in diverse settings. However, until that need is met, some of the scales presented here may be amenable to adaptation.

Grasp Assist Device with Automatic Mode Control Logic

Science.gov (United States)

Davis, Donald R. (Inventor); Ihrke, Chris A. (Inventor); Laske, Evan (Inventor)

2018-01-01

A system includes a glove, sensors, actuator assemblies, and controller. The sensors include load sensors which measure an actual grasping force and attitude sensors which determine a glove attitude. The actuator assembly provides a grasp assist force to the glove. Respective locations of work cells in the work environment and permitted work tasks for each work cell are programmed into the controller. The controller detects the glove location and attitude. A work task is selected by the controller for the location. The controller calculates a required grasp assist force using measured actual grasping forces from the load sensors. The required grasp assist force is applied via the glove using the actuator assembly to thereby assist the operator in performing the identified work task.

Measuring Health Literacy in Individuals with Diabetes: A Systematic Review and Evaluation of Available Measures

Science.gov (United States)

Al Sayah, Fatima; Williams, Beverly; Johnson, Jeffrey A.

2013-01-01

Objective: To identify instruments used to measure health literacy and numeracy in people with diabetes; evaluate their use, measurement scope, and properties; discuss their strengths and weaknesses; and propose the most useful, reliable, and applicable measure for use in research and practice settings. Methods" A systematic literature review…

Assistive products and the Sustainable Development Goals (SDGs).

Science.gov (United States)

Tebbutt, Emma; Brodmann, Rebecca; Borg, Johan; MacLachlan, Malcolm; Khasnabis, Chapal; Horvath, Robert

2016-11-29

The Sustainable Development Goals (SDGs) have placed great emphasis on the need for much greater social inclusion, and on making deliberate efforts to reach marginalized groups. People with disabilities are often marginalized through their lack of access to a range of services and opportunities. Assistive products can help people overcome impairments and barriers enabling them to be active, participating and productive members of society. Assistive products are vital for people with disabilities, frailty and chronic illnesses; and for those with mental health problems, and gradual cognitive and physical decline characteristic of aging populations. This paper illustrates how the achievement of each of the 17 SDGs can be facilitated by the use of assistive products. Without promoting the availability of assistive products the SDGs cannot be achieved equitably. We highlight how assistive products can be considered as both a mediator and a moderator of SDG achievement. We also briefly describe how the Global Cooperation on Assistive Technology (GATE) is working to promote greater access to assistive products on a global scale.