WorldWideScience

Sample records for health center focused

  1. Human factors in computing systems: focus on patient-centered health communication at the ACM SIGCHI conference.

    Science.gov (United States)

    Wilcox, Lauren; Patel, Rupa; Chen, Yunan; Shachak, Aviv

    2013-12-01

    Health Information Technologies, such as electronic health records (EHR) and secure messaging, have already transformed interactions among patients and clinicians. In addition, technologies supporting asynchronous communication outside of clinical encounters, such as email, SMS, and patient portals, are being increasingly used for follow-up, education, and data reporting. Meanwhile, patients are increasingly adopting personal tools to track various aspects of health status and therapeutic progress, wishing to review these data with clinicians during consultations. These issues have drawn increasing interest from the human-computer interaction (HCI) community, with special focus on critical challenges in patient-centered interactions and design opportunities that can address these challenges. We saw this community presenting and interacting at the ACM SIGCHI 2013, Conference on Human Factors in Computing Systems, (also known as CHI), held April 27-May 2nd, 2013 at the Palais de Congrès de Paris in France. CHI 2013 featured many formal avenues to pursue patient-centered health communication: a well-attended workshop, tracks of original research, and a lively panel discussion. In this report, we highlight these events and the main themes we identified. We hope that it will help bring the health care communication and the HCI communities closer together. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  2. Barriers to Implementing Person-Centered Recovery Planning in Public Mental Health Organizations in Texas: Results from Nine Focus Groups.

    Science.gov (United States)

    Lodge, Amy C; Kaufman, Laura; Stevens Manser, Stacey

    2017-05-01

    Despite being an established practice in the disabilities service systems, person-centered planning is a relatively new practice in the behavioral health system. As a result, little is known about the barriers that mental health organizations face in implementing person-centered recovery planning (PCRP). To fill this gap, results are presented from a qualitative analysis of nine focus groups at three public mental health organizations in Texas that have been implementing PCRP for at least 2 years. Findings suggest that organizations experienced 12 distinct barriers to PCRP implementation which were categorized into the Consolidated Framework for Implementation Research domains of intervention characteristics, the outer setting, the inner setting, characteristics of individuals, and the implementation process. Half of these 12 barriers fell within the inner setting domain, suggesting that implementation efforts should be flexible and adaptable to organizational culture and context. One-quarter of the barriers fell into the domain of characteristics of individuals involved in the intervention, which further suggests implementation efforts should assess the impact that both staff and consumers have on implementation success.

  3. Sustaining a Focus on Health Equity at the Centers for Disease Control and Prevention Through Organizational Structures and Functions.

    Science.gov (United States)

    Dean, Hazel D; Roberts, George W; Bouye, Karen E; Green, Yvonne; McDonald, Marian

    2016-01-01

    The public health infrastructure required for achieving health equity is multidimensional and complex. The infrastructure should be responsive to current and emerging priorities and capable of providing the foundation for developing, planning, implementing, and evaluating health initiatives. This article discusses these infrastructure requirements by examining how they are operationalized in the organizational infrastructure for promoting health equity at the Centers for Disease Control and Prevention, utilizing the nation's premier public health agency as a lens. Examples from the history of the Centers for Disease Control and Prevention's work in health equity from its centers, institute, and offices are provided to identify those structures and functions that are critical to achieving health equity. Challenges and facilitators to sustaining a health equity organizational infrastructure, as gleaned from the Centers for Disease Control and Prevention's experience, are noted. Finally, we provide additional considerations for expanding and sustaining a health equity infrastructure, which the authors hope will serve as "food for thought" for practitioners in state, tribal, or local health departments, community-based organizations, or nongovernmental organizations striving to create or maintain an impactful infrastructure to achieve health equity.

  4. Find a Health Center

    Data.gov (United States)

    U.S. Department of Health & Human Services — HRSA Health Centers care for you, even if you have no health insurance – you pay what you can afford based on your income. Health centers provide services that...

  5. A systematic strategic planning process focused on improved community engagement by an academic health center: the University of Kansas Medical Center's story.

    Science.gov (United States)

    Cook, David C; Nelson, Eve-Lynn; Ast, Cori; Lillis, Teresa

    2013-05-01

    A growing number of academic health centers (AHCs) are considering approaches to expand collaboration with their communities in order to address complex and multisystem health concerns. In 2010, internal leaders at the University of Kansas Medical Center undertook a strategic planning process to enhance both community engagement activities and the scholarship resulting from these engagement activities. The authors describe the strategic planning process, recommendations, and actions associated with elevating community engagement within the AHC's mission and priorities. The strategic planning process included conducting an inventory of community engagement activities within the AHC; analyzing strengths, weaknesses, opportunities, and threats for community engagement work; and identifying goals and strategies to improve future community engagement activities and scholarship. The resulting road map for enhancing community engagement at their institution through 2015 consists of four main strategies: emphasize scholarship in community engagement, revise organizational structures to better facilitate community engagement, prioritize current engagement activities to ensure appropriate use of resources, and enhance communication of engagement initiatives to further develop stakeholder relationships.The authors also discuss implementation of the plan to date and highlight lessons learned that may inform other AHCs as they enhance and expand similar endeavors.

  6. Effects of Education Based on Focus Group Discussions on Menstrual Health Behaviors of Female Adolescents in Boarding Centers of the Welfare Organization, Tehran, Iran

    Directory of Open Access Journals (Sweden)

    Shayesteh Shirzadi

    2015-03-01

    Full Text Available Background and Objectives: Problems caused by menstruation are common among women. Focus group discussions are a method of data collection in which a small group of participants discuss a specified topic or issue. This study mainly aimed to determine the effects of health education based on focus group discussions on the promotion of health behaviors of female adolescents residing boarding centers of the Welfare Organization (Tehran, Iran during their menstruation periods. Materials and Methods: This quasi-experimental interventional study recruited all eligible 12-19-year-old female residents (n=61 of the boarding centers affiliated to the Welfare Organization, Tehran, Iran. The data collection tool was a questionnaire including demographic information and puberty health behaviors (health behaviors during the menstruation period. The questionnaires were completed through interviews before and one month after training. The educational intervention lasted for three months. Data were analyzed using paired t and Kolmogorov-Smirnov tests in SPSS16. Results: The mean scores of performance increased from 12.11±4.43 before the intervention to 16.50±2.79 after the intervention (P<0.001. Conclusion: Since the educational intervention based on focus group discussions had positive effects on the participants’ puberty health, such discussions are recommended to educate adolescent girls about puberty issues.

  7. Predictors of health-related quality of life in neurosurgical brain tumor patients: focus on patient-centered perspective.

    Science.gov (United States)

    Bunevicius, Adomas; Tamasauskas, Sarunas; Deltuva, Vytenis; Tamasauskas, Arimantas; Radziunas, Andrius; Bunevicius, Robertas

    2014-02-01

    In brain tumor (BT) patients, the association between health-related quality of life (HRQoL) and psychological characteristics remains largely unknown. We evaluated the association of personality traits, clinical factors, psychological distress symptoms, and cognitive state with HRQoL in BT patients. On admission for BT surgery, 200 patients (69 % women; age 55.8 ± 14.5 years) were evaluated for HRQoL (SF-36 scale), Big-Five personality traits (Ten-Item Personality Inventory), psychological distress symptoms (Hospital Anxiety and Depression Scale or HADS), cognitive function (Mini-Mental State Examination or MMSE) and clinical characteristics, including functional status (Barthel index or BI). The most common BT diagnoses were meningioma (39 %) and high-grade glioma (18 %). Only factors significantly associated with SF-36 domains in univariable regression analyses were included in their respective multivariable models and predicted from 6 %-49 % of the total variance of SF-36 scores. Greater TIPI emotional stability score was independently associated with greater SF-36 emotional well-being (β = 0.23, p emotional well-being score (β = 0.13, p = 0.02). HADS-anxiety and HADS-depression scores were the strongest independent determinants of all, except physical functioning, SF-36 scores (β-values range from 0.14 to 0.56; p values ≤ 0.03). BI score was the strongest independent determinant of SF-36 physical functioning score (β = 0.36, p emotional well-being and social functioning SF-36 scores. Consciousness and emotional stability should be considered important personality-related determinants of HRQoL in BT patients. Psychological distress, functional disability, and cognitive impairment are also important predictors of HRQoL.

  8. Mental Health Screening Center

    Science.gov (United States)

    ... Releases & Announcements Public Service Announcements Partnering with DBSA Mental Health Screening Center These online screening tools are not ... you have any concerns, see your doctor or mental health professional. Depression Screening for Adult Depression Screening for ...

  9. School Based Health Centers

    Science.gov (United States)

    Children's Aid Society, 2012

    2012-01-01

    School Based Health Centers (SBHC) are considered by experts as one of the most effective and efficient ways to provide preventive health care to children. Few programs are as successful in delivering health care to children at no cost to the patient, and where they are: in school. For many underserved children, The Children's Aid Society's…

  10. Interior's Climate Science Centers: Focus or Fail

    Science.gov (United States)

    Udall, B.

    2012-12-01

    After a whirlwind two years of impressive and critical infrastructure building, the Department of Interior's Climate Science Centers are now in a position to either succeed or fail. The CSCs have a number of difficult structural problems including too many constituencies relative to the available resources, an uneasy relationship among many of the constituencies including the DOI agencies themselves, a need to do science in a new, difficult and non-traditional way, and a short timeframe to produce useful products. The CSCs have built a broad and impressive network of scientists and stakeholders. These entities include science providers of the universities and the USGS, and decision makers from the states, tribes, DOI land managers and other federal agencies and NGOs. Rather than try to support all of these constituencies the CSCs would be better served by refocusing on a core mission of supporting DOI climate related decision making. The CSCs were designed to service the climate science needs of DOI agencies, many of which lost their scientific capabilities in the 1990s due to a well-intentioned but ultimately harmful re-organization at DOI involving the now defunct National Biological Survey. Many of these agencies would like to have their own scientists, have an uneasy relationship with the nominal DOI science provider, the USGS, and don't communicate effectively among themselves. The CSCs must not succumb to pursuing science in either the traditional mode of the USGS or in the traditional mode of the universities, or worse, both of them. These scientific partners will need to be flexible, learn how to collaborate and should expect to see fewer resources. Useful CSC processes and outputs should start with the recommendations of the 2009 NRC Report Informing Decisions in a Changing Climate: (1) begin with users' needs; (2) give priority to process over products; (3) link information producers and users; (4) build connections across disciplines and organizations

  11. School-Based Health Centers

    Science.gov (United States)

    ... care group, such as a community health center, hospital, or health department. A few are run by the school district itself. Centers often get money from charities and the government so they can give care ...

  12. Reinventing the academic health center.

    Science.gov (United States)

    Kirch, Darrell G; Grigsby, R Kevin; Zolko, Wayne W; Moskowitz, Jay; Hefner, David S; Souba, Wiley W; Carubia, Josephine M; Baron, Steven D

    2005-11-01

    Academic health centers have faced well-documented internal and external challenges over the last decade, putting pressure on organizational leaders to develop new strategies to improve performance while simultaneously addressing employee morale, patient satisfaction, educational outcomes, and research growth. In the aftermath of a failed merger, new leaders of The Pennsylvania State University College of Medicine and Milton S. Hershey Medical Center encountered a climate of readiness for a transformational change. In a case study of this process, nine critical success factors are described that contributed to significant performance improvement: performing a campus-wide cultural assessment and acting decisively on the results; making values explicit and active in everyday decisions; aligning corporate structure and governance to unify the academic enterprise and health system; aligning the next tier of administrative structure and function; fostering collaboration and accountability-the creation of unified campus teams; articulating a succinct, highly focused, and compelling vision and strategic plan; using the tools of mission-based management to realign resources; focusing leadership recruitment on organizational fit; and "growing your own" through broad-based leadership development. Outcomes assessment data for academic, research, and clinical performance showed significant gains between 2000 and 2004. Organizational transformation as a result of the nine factors is possible in other institutional settings and can facilitate a focus on crucial quality initiatives.

  13. Center for Environmental Health Sciences

    Data.gov (United States)

    Federal Laboratory Consortium — The primary research objective of the Center for Environmental Health Sciences (CEHS) at the University of Montana is to advance knowledge of environmental impacts...

  14. National Center for Health Statistics

    Science.gov (United States)

    ... Submit Search the CDC National Center for Health Statistics Note: Javascript is disabled or is not supported ... Survey of Family Growth Vital Records National Vital Statistics System National Death Index Vital Statistics Rapid Release ...

  15. School Health Centers

    Science.gov (United States)

    Gordon, Douglas

    2010-01-01

    Maintaining student health, safety, and welfare is a primary goal for any K-12 school system. If a child becomes sick, is injured, or seems in any other way incapacitated at school, it is the understood responsibility that the school will provide care and, if necessary, contact the parents and direct the child to outside treatment. Beyond that…

  16. Academic Medical Centers as digital health catalysts.

    Science.gov (United States)

    DePasse, Jacqueline W; Chen, Connie E; Sawyer, Aenor; Jethwani, Kamal; Sim, Ida

    2014-09-01

    Emerging digital technologies offer enormous potential to improve quality, reduce cost, and increase patient-centeredness in healthcare. Academic Medical Centers (AMCs) play a key role in advancing medical care through cutting-edge medical research, yet traditional models for invention, validation and commercialization at AMCs have been designed around biomedical initiatives, and are less well suited for new digital health technologies. Recently, two large bi-coastal Academic Medical Centers, the University of California, San Francisco (UCSF) through the Center for Digital Health Innovation (CDHI) and Partners Healthcare through the Center for Connected Health (CCH) have launched centers focused on digital health innovation. These centers show great promise but are also subject to significant financial, organizational, and visionary challenges. We explore these AMC initiatives, which share the following characteristics: a focus on academic research methodology; integration of digital technology in educational programming; evolving models to support "clinician innovators"; strategic academic-industry collaboration and emergence of novel revenue models. Copyright © 2014 Elsevier Inc. All rights reserved.

  17. 76 FR 17139 - Health Center Program

    Science.gov (United States)

    2011-03-28

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Health Center Program AGENCY: Health Resources and Services Administration, HHS. ACTION: Notice of Noncompetitive... Improvement Project (CIP) from Saint Vincent's Catholic Medical Centers (SVCMC) of New York, current grantee...

  18. 76 FR 1441 - Health Center Program

    Science.gov (United States)

    2011-01-10

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Health Center Program AGENCY: Health Resources and Services Administration, HHS. ACTION: Notice of Noncompetitive... for Services (IDS) and a portion of the Capital Improvement Project (CIP) from Saint Vincent's...

  19. Center for Maritime Safety and Health Studies

    Data.gov (United States)

    Federal Laboratory Consortium — Established in November 2015, the Center for Maritime Safety and Health Studies (CMSHS) promotes safety and health for all maritime workers, including those employed...

  20. Promoting Ecological Health Resilience for Minority Youth: Enhancing Health Care Access through the School Health Center.

    Science.gov (United States)

    Clauss-Ehlers, Caroline C. C.

    2003-01-01

    Discusses the demographic realities of children of color in the U.S., with a focus on health care needs and access issues that have an enormous influence on health status. An ecologic model is presented that incorporates cultural values and community structures into the school health center. (Contains 50 references.) (GCP)

  1. Focusing on reproductive health for adolescents.

    Science.gov (United States)

    1995-06-01

    JOICFP is producing a still photo video consisting of three segments from photos shot in Bangladesh (April 22 - May 2), Thailand (May 2-15), and Mexico (June 29 - July 7) in 1995. The first segment highlights the daily life of a husband, aged 20, and his wife, Moni, aged 14. Moni married at age 13, before the onset of menstruation, and now serves and feeds her husband's large extended family. The Family Planning Association of Bangladesh (FPAB), the local implementing agent of the Sustainable Community-based Family Planning/Maternal and Child Health (FP/MCH) Project with Special Focus on Women, which is supported by the United Nations Population Fund (UNFPA) and executed by JOICFP, introduced Moni to the concept of reproductive health and encouraged her to join other women in activities designed to improve their health and raise their economic status. The second segment depicts the life of a former commercial sex worker who is undergoing occupational skill development training promoted by the Population and Community Development Association. The girl is now a leader of teenagers in her village; she works to change attitudes that sent her to work as a prostitute with an estimated 150,000 other poor rural teenage women. The third segment focuses on teen pregnancy and the efforts of the Mexican Foundation for Family Planning (MEXFAM) in the areas of health care and education for adolescents.

  2. 75 FR 2549 - Health Center Program

    Science.gov (United States)

    2010-01-15

    ... Program AGENCY: Health Resources and Services Administration, HHS ACTION: Notice of Noncompetitive Replacement Award to Regional Health Care Affiliates. SUMMARY: The Health Resources and Services Administration (HRSA) will be transferring Health Center Program (section 330 of the Public Health Service Act...

  3. National Center for Environmental Health

    Science.gov (United States)

    ... R S T U V W X Y Z # Environmental Health Topics Emergency and Environmental Health Services Chemical Weapons Elimination Environmental Health Services Healthy Homes Healthy Places – Community ...

  4. Marketing and Community Mental Health Centers.

    Science.gov (United States)

    Ferniany, Isaac W.; Garove, William E.

    1983-01-01

    Suggests that a marketing approach can be applied to community mental health centers. Marketing is a management orientation of providing services for, not to, patients in a systematic manner, which can help mental health centers improve services, strengthen community image, achieve financial independence and aid in staff recruitment. (Author)

  5. Mental health and wellbeing: focus on men's health.

    Science.gov (United States)

    Patrick, Sarah; Robertson, Steve

    2016-11-24

    All nurses have a responsibility to ensure that they actively promote both mental and physical health and wellbeing. This article aims to bring together current thinking and evidence about nursing and men's mental health promotion. Key areas of concern outlined are the high rate of suicide in men, the expression of depression in men and the problems of masculinity when related to seeking help for mental health. The article highlights the importance of language and the normalising of distressing feelings when working with men and suggests that nurses need to recognise how men can experience depression differently, actively identify and address suicidal thinking, and provide gender-sensitive interventions. Additionally, nurses working with men need to demonstrate 'male-positive' values and offer future-focused and action-oriented interventions (such as solution-focused, coaching or cognitive behavioural therapy approaches) that contribute to a sense of agency, promote hope and are more engaging for many men.

  6. Medical Waste Management in Community Health Centers.

    Science.gov (United States)

    Tabrizi, Jafar Sadegh; Rezapour, Ramin; Saadati, Mohammad; Seifi, Samira; Amini, Behnam; Varmazyar, Farahnaz

    2018-02-01

    Non-standard management of medical waste leads to irreparable side effects. This issue is of double importance in health care centers in a city which are the most extensive system for providing Primary Health Care (PHC) across Iran cities. This study investigated the medical waste management standards observation in Tabriz community health care centers, northwestern Iran. In this triangulated cross-sectional study (qualitative-quantitative), data collecting tool was a valid checklist of waste management process developed based on Iranian medical waste management standards. The data were collected in 2015 through process observation and interviews with the health center's staff. The average rate of waste management standards observance in Tabriz community health centers, Tabriz, Iran was 29.8%. This case was 22.8% in dimension of management and training, 27.3% in separating and collecting, 31.2% in transport and temporary storage, and 42.9% in sterilization and disposal. Lack of principal separation of wastes, inappropriate collecting and disposal cycle of waste and disregarding safety tips (fertilizer device performance monitoring, microbial cultures and so on) were among the observed defects in health care centers supported by quantitative data. Medical waste management was not in a desirable situation in Tabriz community health centers. The expansion of community health centers in different regions and non-observance of standards could predispose to incidence the risks resulted from medical wastes. So it is necessary to adopt appropriate policies to promote waste management situation.

  7. Airbreathing Hypersonic Systems Focus at NASA Langley Research Center

    Science.gov (United States)

    Hunt, James L.; Rausch, Vincent L.

    1998-01-01

    This paper presents the status of the airbreathing hypersonic airplane and space-access vehicle design matrix, reflects on the synergies and issues, and indicates the thrust of the effort to resolve the design matrix and to focus/advance systems technology maturation. Priority is given to the design of the vision operational vehicles followed by flow-down requirements to flight demonstrator vehicles and their design for eventual consideration in the Future-X Program.

  8. Art and community health: lessons from an urban health center.

    Science.gov (United States)

    Siegel, Wilma Bulkin; Bartley, Mary Anne

    2004-01-01

    Staff at a nurse-managed urban health center conducted a series of art sessions to benefit the community. The authors believe the program's success clearly communicated the relationship between art and community health. As a result of the success of the sessions, plans are in the works to make art a permanent part of the health center's services.

  9. Focus on climate change and mental health

    Science.gov (United States)

    2018-04-01

    The health impacts of climate change are being increasingly recognized, but mental health is often excluded from this discussion. In this issue we feature a collection of articles on climate change and mental health that highlight important directions for future research.

  10. NASA Human Health and Performance Center (NHHPC)

    Science.gov (United States)

    Davis, Jeffery R.

    2010-01-01

    This slide presentation reviews the purpose, potential members and participants of the NASA Human Health and Performance Center (NHHPC). Included in the overview is a brief description of the administration and current activities of the NHHPC.

  11. [Communication center in public health].

    Science.gov (United States)

    George, W; Grimminger, F; Krause, B

    2002-06-01

    The Communications Center's portfolio covers areas such as marketing, contacts, distribution of information, sales activities and collection of bills by telephone (encashment). A special emphasis is Customer Care Management (Customer Relationship Management) to the patient and his caregivers (relatives), the customers, especially the physicians who send their patients to the hospital and the hospital doctor. By providing communication centers, the hospital would be able to improve the communication with the G.P.s, and identify the wishes and requirements more accurately and easily from the beginning. Dealing effectively with information and communication is already also of special importance for hospital doctors today. One can assume that the demands on doctors in this respect will become even more complex in the future. Doctors who are involved in scientific research are of course fully aware of the growing importance of the Internet with its new information and communication channels. Therefore analysing the current situation, the demands on a future information management system can be formulated: A system that will help doctors to avoid dealing with little goal-oriented information and thus setting up effective communication channels; an information system which is multi-media oriented towards the interests and needs of the patients and patient's relatives and which is further developed continually and directly by those involved.

  12. Job satisfaction survey among health centers staff.

    Science.gov (United States)

    Shahnazi, Hossein; Daniali, Seyede Shahrbanoo; Sharifirad, Gholamreza

    2014-01-01

    Due to the importance of health care organizations with significant responsibility for prevention and care, assessment of job satisfaction among health care staff is essential. Quality of health services will be decreased provided they are not satisfied. This study was a cross-sectional analysis of health care staff in Khomeinishahr (centers, buildings, and networks) If they had at least 6 months work experience, they could enter the study. Data included a two-part questionnaire with a standardized questionnaire, demographic variables, and Smith job descriptive index, which is a questionnaire with six domains. Reliability was obtained for each domain and its validity was reported 0.93. The results showed an overall satisfaction score averages 43.55 ± 12.8 (from 100). Job satisfaction score was not significantly different between the sexes. However, within the current attitude toward job satisfaction, men scores was better than women (P = 0.001). Highest score in job satisfaction was related to relationships with colleagues and lowest score was related to the income, benefits, and job promotion. The more the years of work, the less the job satisfaction was. The attitude toward the current job had a direct relationship with income (P = 0.01). There was a significant inverse relationship between educational level and job satisfaction in domains promotion, income, and benefits (P = 0.01). The staff with higher education levels was less satisfied with income and job promotion qualification. Managers should focus on job qualification to increase job satisfaction and improve the quality of work.

  13. Job satisfaction survey among health centers staff

    OpenAIRE

    Shahnazi, Hossein; Daniali, Seyede Shahrbanoo; Sharifirad, Gholamreza

    2014-01-01

    Background: Due to the importance of health care organizations with significant responsibility for prevention and care, assessment of job satisfaction among health care staff is essential. Quality of health services will be decreased provided they are not satisfied. Materials and Methods: This study was a cross-sectional analysis of health care staff in Khomeinishahr (centers, buildings, and networks) If they had at least 6 months work experience, they could enter the study. Data included a t...

  14. Geothermal Academy: Focus Center for Data Collection, Analysis, and Dissemination

    Energy Technology Data Exchange (ETDEWEB)

    Nakagawa, Masami, Ph.D.; Fujiono, Hendro, Ph.D.; McCartney, John S., Ph.D.; Reed, Adam, J.D., Esq.

    2011-10-31

    Geothermal Academy: A Pathway for Confirmation of Ground-Source Heat Pumps in the United States. In 2008, Oak Ridge National Laboratory issued a report on geothermal heats pumps (GHPs) focused on the market status, barriers to adoption, and actions to overcome these barriers (Hughes 2008). Of the barriers raised in this report, of the most pressing is the lack of performance and energy usage data for GHPs. Further, an associated barrier is a lack of a fair comparison of the energy usage of conventional heating and cooling systems for the same building. Because of these barriers, we are not able to say how much energy is used by well-designed GHP systems on a long-term basis, nor are we able to say how better their energy usage is compared to conventional systems. The need for a fair comparison with conventional systems is particularly relevant as modern versions of conventional air conditioners, gas furnaces, and boilers have also incorporated energy saving technologies. As a first step to address this barrier, the Geothermal Academy has developed a framework for data collection. This framework has already been applied to several geothermal installations in Colorado (Nakagawa etal. 2010). The framework classifies data into different categories based on the relevance of the dat to understanding the energy consumption of a GHP system. The categories are: direct energy consumption data, heat exchange performance data, and GHP design parameter data. The main recommendation of this project is to include a minimal data collection system on each heat pump installed in the U.S., capable of measuring the electrical energy consumed, the entering/exiting fluid temperatures, and circulation rates. This is a viable and cost effective solution which will provide performance data, as data collection systems are only a fraction of the cost of a GHP unit and modern GHP units already incorporate sensors to monitor energy usage and the entering and exiting fluid temperatures

  15. 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.

  16. Mental health literacy: focus on developing countries

    African Journals Online (AJOL)

    Indonesia, Pakistan, Brazil and Chile) found the median prevalence rate of ..... aspects of well-being of their patients.39 Programs aimed at integrating mental health ... tural beliefs and formulate their inclusion in an appropriate referral system.

  17. Public Health Nursing: Public Health Centers

    Science.gov (United States)

    Misuse and Addiction Prevention Finance & Management Services Health Care Services Juvenile Justice , Alaska 99752 Phone: 442-7144 Fax: 442-7292 e-mail: Josephine Oke, Program Manager [back to top] North Phone: 852-0270 Fax: 852-2855 email: Andrey Boskhomdzhiev [back to top] Municipality of Anchorage P.O

  18. Kennedy Space Center environmental health program

    International Nuclear Information System (INIS)

    Marmaro, G.M.; Cardinale, M.A.; Summerfield, B.R.; Tipton, D.A.

    1992-01-01

    The Kennedy Space Center's environmental health organization is responsible for programs which assure its employees a healthful workplace under diverse and varied working conditions. These programs encompass the disciplines of industrial hygiene, radiation protection (health physics), and environmental sanitation/pollution control. Activities range from the routine, such as normal office work, to the highly specialized, such as the processing of highly toxic and hazardous materials

  19. Health Services Cost Analyzing in Tabriz Health Centers 2008

    Directory of Open Access Journals (Sweden)

    Massumeh gholizadeh

    2015-08-01

    Full Text Available Background and objectives : Health Services cost analyzing is an important management tool for evidence-based decision making in health system. This study was conducted with the purpose of cost analyzing and identifying the proportion of different factors on total cost of health services that are provided in urban health centers in Tabriz. Material and Methods : This study was a descriptive and analytic study. Activity Based Costing method (ABC was used for cost analyzing. This cross–sectional survey analyzed and identified the proportion of different factors on total cost of health services that are provided in Tabriz urban health centers. The statistical population of this study was comprised of urban community health centers in Tabriz. In this study, a multi-stage sampling method was used to collect data. Excel software was used for data analyzing. The results were described with tables and graphs. Results : The study results showed the portion of different factors in various health services. Human factors by 58%, physical space 8%, medical equipment 1.3% were allocated with high portion of expenditures and costs of health services in Tabriz urban health centers. Conclusion : Based on study results, since the human factors included the highest portion of health services costs and expenditures in Tabriz urban health centers, balancing workload with staff number, institutionalizing performance-based management and using multidisciplinary staffs may lead to reduced costs of services. ​

  20. Social marketing: consumer focused health promotion.

    Science.gov (United States)

    Blair, J E

    1995-10-01

    1. Social marketing provides a theoretical basis to increase awareness of preventable health conditions and to increase participation in wellness programs. 2. The philosophy of social marketing underscores the necessity to be aware of and responsive to the consumer's perception of needs. 3. Social marketing is distinguished by its emphasis on "non-tangible" products such as ideas, attitudes, and lifestyle changes. 4. "Marketing mix" is a social marketing strategy that intertwines elements of product, price, place, and promotion to satisfy needs and wants of consumers.

  1. Utilization of maternal health services in rural primary health centers ...

    African Journals Online (AJOL)

    Utilization of maternal health services in rural primary health centers in Sub- Saharan Africa. ... their pregnancies were normal during antenatal care visits, hostile attitude of health workers, poverty and mode of payment. Majority of the PHCs provided antenatal, normal delivery, and post natal services. Rural mothers lacked ...

  2. Five focus strategies to organize health care delivery.

    Science.gov (United States)

    Peltokorpi, Antti; Linna, Miika; Malmström, Tomi; Torkki, Paulus; Lillrank, Paul Martin

    2016-01-01

    The focused factory is one of the concepts that decision-makers have adopted for improving health care delivery. However, disorganized definitions of focus have led to findings that cannot be utilized systematically. The purpose of this paper is to discuss strategic options to focus health care operations. First the literature on focus in health care is reviewed revealing conceptual challenges. Second, a definition of focus in terms of demand and requisite variety is defined, and the mechanisms of focus are explicated. A classification of five focus strategies that follow the original idea to reduce variety in products and markets is presented. Finally, the paper examines managerial possibilities linked to the focus strategies. The paper proposes a framework of five customer-oriented focus strategies which aim at reducing variety in different characteristics of care pathways: population; urgency and severity; illnesses and symptoms; care practices and processes; and care outcomes. Empirical research is needed to evaluate the costs and benefits of the five strategies and about system-level effects of focused units on competition and coordination. Focus is an enabling condition that needs to be exploited using specific demand and supply management practices. It is essential to understand how focus mechanisms differ between strategies, and to select focus that fits with organization's strategy and key performance indicators. Compared to previous more resource-oriented approaches, this study provides theoretically solid and practically relevant customer-oriented framework for focusing in health care.

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

    Science.gov (United States)

    Colin, Marie-Pierre; Acker, Dominique

    2009-03-29

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

  4. 42 CFR 124.515 - Compliance alternative for community health centers, migrant health centers and certain National...

    Science.gov (United States)

    2010-10-01

    ..., migrant health centers and certain National Health Service Corps sites. 124.515 Section 124.515 Public... Unable To Pay § 124.515 Compliance alternative for community health centers, migrant health centers and... migrant health center under section 329 of the Act is in substantial compliance with the terms and...

  5. Health care providers' knowledge and practice of focused antenatal ...

    African Journals Online (AJOL)

    ... observational checklist were the instruments for data collection. Findings revealed poor knowledge of concept, components, timing of visits on focused antenatal care and non compliance with the guidelines for the practice of focused antenatal care, because of health workers lack of knowledge on focused antenatal care.

  6. Focus Group in Community Mental Health Research: Need for Adaption.

    Science.gov (United States)

    Zupančič, Vesna; Pahor, Majda; Kogovšek, Tina

    2018-04-27

    The article presents an analysis of the use of focus groups in researching community mental health users, starting with the reasons for using them, their implementation in mental health service users' research, and the adaptations of focus group use when researching the experiences of users. Based on personal research experience and a review of scientific publications in the Google Scholar, Web of Science, ProQuest, EBSCOhost, and Scopus databases, 20 articles published between 2010 and 2016 were selected for targeted content analysis. A checklist for reporting on the use of focus groups with community mental health service users, aiming to improve the comparability, verifiability and validity was developed. Adaptations of the implementation of focus groups in relation to participants' characteristics were suggested. Focus groups are not only useful as a scientific research technique, but also for ensuring service users' participation in decision-making in community mental health and evaluating the quality of the mental health system and services .

  7. A New Method for Research on the Center-Focus Problem of Differential Systems

    OpenAIRE

    Zhou, Zhengxin

    2014-01-01

    We will introduce Mironenko’s method to discuss the Poincaré center-focus problem, and compare the methods of Lyapunov and Mironenko. We apply the Mironenko method to discuss the qualitative behavior of solutions of some planar polynomial differential systems and derive the sufficient conditions for a critical point to be a center.

  8. Community health centers and community development financial institutions: joining forces to address determinants of health.

    Science.gov (United States)

    Kotelchuck, Ronda; Lowenstein, Daniel; Tobin, Jonathan N

    2011-11-01

    Community health centers and community development financial institutions share similar origins and missions and are increasingly working together to meet community needs. Addressing the social and economic determinants of health is a common focus. The availability of new federal grants and tax credits has led these financial institutions to invest in the creation and expansion of community health centers. This article reviews the most recent trends in these two sectors and explores opportunities for further collaboration to transform the health and well-being of the nation's low-income communities.

  9. Health services at the Kennedy Space Center

    Science.gov (United States)

    Ferguson, E. B.; Humbert, P.; Long, I. D.; Tipton, D. A.

    1992-01-01

    Comprehensive occupational health services are provided to approximately 17,000 workers at the Kennedy Space Center and an additional 6000 on Cape Canaveral Air Force Station. These areas cover about 120,000 acres encompassing part of the Merritt Island Wild Life Refuge and wetlands which are the habitat of numerous endangered and protected species of wildlife. The services provided at the Kennedy Space Center optimally assure a safe and healthy working environment for the employees engaged in the preparation and launching of this country's Space Shuttle and other important space exploration programs.

  10. Migration-related detention centers: the challenges of an ecological perspective with a focus on justice.

    Science.gov (United States)

    Esposito, Francesca; Ornelas, José; Arcidiacono, Caterina

    2015-06-06

    In recent years, border control and migration-related detention have become increasingly widespread practices affecting the lives of undocumented migrants, their families, and communities at large. In spite of the concern within academia, few studies have directly witnessed the life and experiences of people confined to migration-related detention centers. In the medical and psychological fields, a considerable body of research has demonstrated the pathogenic nature of detention in terms of mental health, showing an association between length of detention and severity of distress. Nevertheless, it was limited to the assessment of individuals' clinical consequences, mainly focusing on asylum seekers. There currently exists a need to adopt an ecological perspective from which to study detained migrants' experiences as context-dependent, and influenced by power inequalities. This paper addresses this gap. Drawing upon advances in community psychology, we illustrate an ecological framework for the study of migration-related detention contexts, and their effects on the lives of detained migrants and all people exposed to them. Making use of existing literature, Kelly's four principles (interdependence, cycling of resources, adaptation, succession) are analyzed at multiple ecological levels (personal, interpersonal, organizational, communal), highlighting implications for future research in this field. A focus on justice, as a key-dimension of analysis, is also discussed. Wellbeing is acknowledged as a multilevel, dynamic, and value-dependent phenomenon. In presenting this alternative framework, the potential for studying migration-related detention through an ecological lens is highlighted, pointing the way for future fields of study. We argue that ecological multilevel analyses, conceptualized in terms of interdependent systems and with a focus on justice, can enhance the comprehension of the dynamics at play in migration-related detention centers, providing an

  11. [Effectiveness of support for asbestos health consultation in health centers].

    Science.gov (United States)

    Nagamatsu, Yasuko

    2011-09-01

    In this research, we aimed to evaluate the support for asbestos health consultation in health centers. In this exploratory descriptive study, a self-administered original questionnaire was developed and used. Among all 517 health centers, valid responses were returned from 323 (62.5%) consenting centers. Consultations in the previous year ranged from 0-108 cases, with a facility median of 3.0 cases. Among staff members, 86.4% did not receive training and 35.4% had never used the manual. Workplaces that use asbestos within their jurisdiction were recognized by 39.2% of staff members, and 16.7% of these members always supported consultants psychologically. The staff members were not confident about asbestos health consultation: 71.2% for general questions, 76.2% for questions about asbestos-related diseases, and 76.4% for questions about risk of asbestos-related diseases; 51.4% were not confident about the Asbestos-Related Health Damage Relief System. Health center staff members who were significantly more confident were those who had more staff to work with; dealt with many consultations in the previous year; recognized the workplaces using asbestos within their jurisdiction; often used the manual and often psychologically supported consultants. According to the covariance structure analysis model, the 'use of support systems' consisting of 'the use of manual', 'training attendance' and 'recognition of workplaces that use asbestos' positively affected the frequency of psychological support (peffective in building the confidence of health center staff in relation to asbestos health consultation, although the use of these support systems was low.

  12. National Center for Disaster Medicine and Public Health

    Data.gov (United States)

    Federal Laboratory Consortium — The National Center for Disaster Medicine and Public Health (NCDMPH) is an academic center tasked with leading federal, and coordinating national, efforts to develop...

  13. Oral health in Brazil - Part II: Dental Specialty Centers (CEOs

    Directory of Open Access Journals (Sweden)

    Vinícius Pedrazzi

    2008-08-01

    Full Text Available The concepts of health promotion, self-care and community participation emerged during the 1970s and, since then, their application has grown rapidly in the developed world, showing evidence of effectiveness. In spite of this, a major part of the population in the developing countries still has no access to specialized dental care such as endodontic treatment, dental care for patients with special needs, minor oral surgery, periodontal treatment and oral diagnosis. This review focuses on a program of the Brazilian Federal Government named CEOs (Dental Specialty Centers, which is an attempt to solve the dental care deficit of a population that is suffering from oral diseases and whose oral health care needs have not been addressed by the regular programs offered by the SUS (Unified National Health System. Literature published from 2000 to the present day, using electronic searches by Medline, Scielo, Google and hand-searching was considered. The descriptors used were Brazil, Oral health, Health policy, Health programs, and Dental Specialty Centers. There are currently 640 CEOs in Brazil, distributed in 545 municipal districts, carrying out dental procedures with major complexity. Based on this data, it was possible to conclude that public actions on oral health must involve both preventive and curative procedures aiming to minimize the oral health distortions still prevailing in developing countries like Brazil.

  14. Coordinated Management of Academic Health Centers.

    Science.gov (United States)

    Balser, Jeffrey R; Stead, William W

    2017-01-01

    Academic health centers (AHCs) are the nation's primary resource for healthcare discovery, innovation, and training. US healthcare revenue growth has declined sharply since 2009, and is forecast to remain well below historic levels for the foreseeable future. As the cost of education and research at nearly all AHCs is heavily subsidized through large transfers from clinical care margins, our institutions face a mounting crisis. Choices centering on how to increase the cost-effectiveness of the AHC enterprise require unprecedented levels of alignment to preserve an environment that nurtures creativity. Management processes require governance models that clarify decision rights while harnessing the talents and the intellectual capital of a large, diverse enterprise to nimbly address unfamiliar organizational challenges. This paper describes key leadership tactics aimed at propelling AHCs along this journey - one that requires from all leaders a commitment to resilience, optimism, and willingness to embrace change.

  15. CMS Innovation Center Health Care Innovation Awards

    Science.gov (United States)

    Berry, Sandra H.; Concannon, Thomas W.; Morganti, Kristy Gonzalez; Auerbach, David I.; Beckett, Megan K.; Chen, Peggy G.; Farley, Donna O.; Han, Bing; Harris, Katherine M.; Jones, Spencer S.; Liu, Hangsheng; Lovejoy, Susan L.; Marsh, Terry; Martsolf, Grant R.; Nelson, Christopher; Okeke, Edward N.; Pearson, Marjorie L.; Pillemer, Francesca; Sorbero, Melony E.; Towe, Vivian; Weinick, Robin M.

    2013-01-01

    Abstract The Center for Medicare and Medicaid Innovation within the Centers for Medicare & Medicaid Services (CMS) has funded 108 Health Care Innovation Awards, funded through the Affordable Care Act, for applicants who proposed compelling new models of service delivery or payment improvements that promise to deliver better health, better health care, and lower costs through improved quality of care for Medicare, Medicaid, and Children's Health Insurance Program enrollees. CMS is also interested in learning how new models would affect subpopulations of beneficiaries (e.g., those eligible for Medicare and Medicaid and complex patients) who have unique characteristics or health care needs that could be related to poor outcomes. In addition, the initiative seeks to identify new models of workforce development and deployment, as well as models that can be rapidly deployed and have the promise of sustainability. This article describes a strategy for evaluating the results. The goal for the evaluation design process is to create standardized approaches for answering key questions that can be customized to similar groups of awardees and that allow for rapid and comparable assessment across awardees. The evaluation plan envisions that data collection and analysis will be carried out on three levels: at the level of the individual awardee, at the level of the awardee grouping, and as a summary evaluation that includes all awardees. Key dimensions for the evaluation framework include implementation effectiveness, program effectiveness, workforce issues, impact on priority populations, and context. The ultimate goal is to identify strategies that can be employed widely to lower cost while improving care. PMID:28083297

  16. Academic health centers in competitive markets.

    Science.gov (United States)

    Reuter, J; Gaskin, D

    1997-01-01

    Academic health center (AHC) hospitals and other major teaching hospitals have funded a portion of their academic missions through patient care revenues. Using all-payer state discharge data, this DataWatch presents information on how these institutions are being affected by market changes. Although AHCs are not as successful as other hospitals are in attracting managed care patients, competitive pressures had not eroded AHCs' financial status as of 1994. However, increasing enrollment in managed care and potential changes in both Medicare and Medicaid suggest that pressure on the financing of these institutions' social missions will continue to grow over time.

  17. Health Promotion: A developing focus area over the years.

    Science.gov (United States)

    Povlsen, Lene; Borup, Ina

    2015-08-01

    In 1953 when the Nordic School of Public Health was founded, the aim of public health programmes was disease prevention more than health promotion. This was not unusual, since at this time health usually was seen as the opposite of disease and illness. However, with the Ottawa Charter of 1986, the World Health Organization made a crucial change to view health not as a goal in itself but as the means to a full life. In this way, health promotion became a first priority and fundamental action for the modern society. This insight eventually reached NHV and in 2002 - 50 years after the foundation - an associate professorship was established with a focus on health promotion. Nevertheless, the concept of health promotion had been integrated with or mentioned in courses run prior to the new post. Subsequently, a wide spectrum of courses in health promotion was introduced, such as 'Empowerment for Child and Adolescent Health Promotion', 'Salutogenesis--from theory to practice' and 'Health, Stress and Coping'. More than half of all doctoral theses undertaken at NHV during these years had health promotion as their theme. As a derivative, the Nordic Health Promotion Research Network (NHPRN) was established in 2007 with bi-annual meetings at NHV. © 2015 the Nordic Societies of Public Health.

  18. Perceptions of focused prenatal care among women attending two tertiary centers in Nigeria.

    Science.gov (United States)

    Eleje, George U; Onwusulu, Daniel N; Ezeama, Chukwuemeka O; Afiadigwe, Evaristus A; Eke, Ahizechukwu C; Ikechebelu, Joseph I; Ugboaja, Joseph O; Okwuosa, Ayodele O

    2015-11-01

    To determine women's perceptions and expectations of focused prenatal care visits. The present questionnaire-based, cross-sectional survey was performed among pregnant women in their third trimester attending two tertiary health centers in southern Nigeria between January and March 2012. Obstetric data, histories, and information on preferences for prenatal visits were obtained using questionnaires. A total of 353 questionnaires were appropriately completed. Among 277 participants who stated a preference for the number of prenatal care visits, 241 (87.0%) reported a preference of more than four. Among 203 parous women, 132 (65.0%) had no previous negative obstetric experience. Only previous stillbirth (odds ratio [OR] 2.67, 95% confidence interval [CI] 1.05-6.77; P = 0.039) among multiparous women, and HIV/AIDS (OR 0.27, 95% CI 0.06-1.17; P = 0.048) among all women were significantly associated with a preference for more prenatal visits. Previous negative obstetric experiences did not generally affect preference for prenatal visits. However, pregnant women expressed dissatisfaction with a reduced number of visits. Copyright © 2015 International Federation of Gynecology and Obstetrics. Published by Elsevier Ireland Ltd. All rights reserved.

  19. Health Status and Health Care Experiences among Homeless Patients in Federally Supported Health Centers: Findings from the 2009 Patient Survey

    Science.gov (United States)

    Lebrun-Harris, Lydie A; Baggett, Travis P; Jenkins, Darlene M; Sripipatana, Alek; Sharma, Ravi; Hayashi, A Seiji; Daly, Charles A; Ngo-Metzger, Quyen

    2013-01-01

    Objective To examine health status and health care experiences of homeless patients in health centers and to compare them with their nonhomeless counterparts. Data Sources/Study Setting Nationally representative data from the 2009 Health Center Patient Survey. Study Design Cross-sectional analyses were limited to adults (n = 2,683). We compared sociodemographic characteristics, health conditions, access to health care, and utilization of services among homeless and nonhomeless patients. We also examined the independent effect of homelessness on health care access and utilization, as well as factors that influenced homeless patients' health care experiences. Data Collection Computer-assisted personal interviews were conducted with health center patients. Principal Findings Homeless patients had worse health status—lifetime burden of chronic conditions, mental health problems, and substance use problems—compared with housed respondents. In adjusted analyses, homeless patients had twice the odds as housed patients of having unmet medical care needs in the past year (OR = 1.98, 95 percent CI: 1.24–3.16) and twice the odds of having an ED visit in the past year (OR = 2.00, 95 percent CI: 1.37–2.92). Conclusions There is an ongoing need to focus on the health issues that disproportionately affect homeless populations. Among health center patients, homelessness is an independent risk factor for unmet medical needs and ED use. PMID:23134588

  20. Health at the center of health systems reform: how philosophy can inform policy.

    Science.gov (United States)

    Sturmberg, Joachim P; Martin, Carmel M; Moes, Mark M

    2010-01-01

    Contemporary views hold that health and disease can be defined as objective states and thus should determine the design and delivery of health services. Yet health concepts are elusive and contestable. Health is neither an individual construction, a reflection of societal expectations, nor only the absence of pathologies. Based on philosophical and sociological theory, empirical evidence, and clinical experience, we argue that health has simultaneously objective and subjective features that converge into a dynamic complex-adaptive health model. Health (or its dysfunction, illness) is a dynamic state representing complex patterns of adaptation to body, mind, social, and environmental challenges, resulting in bodily homeostasis and personal internal coherence. The "balance of health" model-emergent, self-organizing, dynamic, and adaptive-underpins the very essence of medicine. This model should be the foundation for health systems design and also should inform therapeutic approaches, policy decision-making, and the development of emerging health service models. A complex adaptive health system focused on achieving the best possible "personal" health outcomes must provide the broad policy frameworks and resources required to implement people-centered health care. People-centered health systems are emergent in nature, resulting in locally different but mutually compatible solutions across the whole health system.

  1. Achieving excellence in community health centers: implications for health reform.

    Science.gov (United States)

    Gurewich, Deborah; Capitman, John; Sirkin, Jenna; Traje, Diana

    2012-02-01

    Existing studies tell us little about care quality variation within the community health center (CHC) delivery system. They also tell us little about the organizational conditions associated with CHCs that deliver especially high quality care. The purpose of this study was to examine the operational practices associated with a sample of high performing CHCs. Qualitative case studies of eight CHCs identified as delivering high-quality care relative to other CHCs were used to examine operational practices, including systems to facilitate care access, manage patient care, and monitor performance. Four common themes emerged that may contribute to high performance. At the same time, important differences across health centers were observed, reflecting differences in local environments and CHC capacity. In the development of effective, community-based models of care, adapting care standards to meet the needs of local conditions may be important.

  2. Employee health benefit redesign at the academic health center: a case study.

    Science.gov (United States)

    Marshall, Julie; Weaver, Deirdre C; Splaine, Kevin; Hefner, David S; Kirch, Darrell G; Paz, Harold L

    2013-03-01

    The rapidly escalating cost of health care, including the cost of providing health care benefits, is a significant concern for many employers. In this article, the authors examine a case study of an academic health center that undertook a complete redesign of its health benefit structure to control rising costs, encourage use of its own provider network, and support employee wellness. With the implementation in 2006 of a high-deductible health plan combined with health reimbursement arrangements and wellness incentives, the Penn State Hershey Medical Center (PSHMC) was able to realize significant cost savings and increase use of its own network while maintaining a high level of employee satisfaction. By contracting with a single third-party administrator for its self-insured plan, PSHMC reduced its administrative costs and simplified benefit choices for employees. In addition, indexing employee costs to salary ensured that this change was equitable for all employees, and the shift to a consumer-driven health plan led to greater employee awareness of health care costs. The new health benefit plan's strong focus on employee wellness and preventive health has led to significant increases in the use of preventive health services, including health risk assessments, cancer screenings, and flu shots. PSHMC's experience demonstrates the importance of clear and ongoing communication with employees throughout--before, during, and even after--the process of health benefit redesign.

  3. Improvements in Off-Center Focusing in an X-ray Streak Camera

    International Nuclear Information System (INIS)

    McDonald, J W; Weber, F; Holder, J P; Bell, P M

    2003-01-01

    Due to the planar construction of present x-ray streak tubes significant off-center defocusing is observed in both static and dynamic images taken with one-dimensional resolution slits. Based on the streak tube geometry curved photocathodes with radii of curvature ranging from 3.5 to 18 inches have been fabricated. We report initial off-center focusing performance data on the evaluation of these ''improved'' photocathodes in an X-ray streak camera and an update on the theoretical simulations to predict the optimum cathode curvature

  4. 78 FR 9055 - National Center for Health Statistics (NCHS), Classifications and Public Health Data Standards...

    Science.gov (United States)

    2013-02-07

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Health Statistics (NCHS), Classifications and Public Health Data Standards Staff, Announces the..., Medical Systems Administrator, Classifications and Public Health Data Standards Staff, NCHS, 3311 Toledo...

  5. Clinical Perspective Qualitative adolescent health research — focus ...

    African Journals Online (AJOL)

    This paper introduces nine steps that are recommended in conducting focus group discussions in rural communities and gives an example of how they can appropriately and fruitfully be employed in adolescent health behavioural research. The paper also reviewed issues related to methods of data collection, data analysis, ...

  6. 78 FR 42788 - School-Based Health Center Program

    Science.gov (United States)

    2013-07-17

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration School-Based... Gadsden County. SUMMARY: HRSA will be transferring a School-Based Health Center Capital (SBHCC) Program... support the expansion of services at school-based health centers will continue. SUPPLEMENTARY INFORMATION...

  7. Special Issue on Global Health Disparities Focus on Cancer.

    Science.gov (United States)

    Lee, Haeok

    2016-01-01

    Haeok Lee, PhD, RN, FAAN who is a Korean-American nurse scientist, received her doctor al degree from the Nursing Physiology Department, College of Nursing, University of California, San Francisco (UCSF), in 1993, and her post doctor al training from College of Medicine, UCSF. Dr. Lee worked at Case Western Reserve University and University of Colorado Health Sciences Center. She has worked at the UMass Boston since 2008. Dr. Lee has established a long-term commitment to minority health, especially Asian American Pacific Islanders, as a community leader, community health educator, and community researcher, and all these services have become a foundation for her community-based participatory research. Dr. Lee's research addresses current health problems framed in the context of social, political, and economic settings, and her studies have improved racial and ethnic data and developed national health policies to address health disparities in hepatitis B virus (HBV) infections and liver cancer among minorities. Dr. Lee's research, which is noteworthy for its theoretical base, is clearly filling the gap. Especially, Dr. Lee's research is beginning to have a favorable impact on national and international health policies and continuing education programs directed toward the global elimination of cervical and liver cancer-related health disparities in underserved and understudied populations.

  8. Improving Pain Care with Project ECHO in Community Health Centers.

    Science.gov (United States)

    Anderson, Daren; Zlateva, Ianita; Davis, Bennet; Bifulco, Lauren; Giannotti, Tierney; Coman, Emil; Spegman, Douglas

    2017-10-01

    Pain is an extremely common complaint in primary care, and patient outcomes are often suboptimal. This project evaluated the impact of Project ECHO Pain videoconference case-based learning sessions on knowledge and quality of pain care in two Federally Qualified Health Centers. Quasi-experimental, pre-post intervention, with comparison group. Two large, multisite federally qualified health centers in Connecticut and Arizona. Intervention (N = 10) and comparison (N = 10) primary care providers. Primary care providers attended 48 weekly Project ECHO Pain sessions between January and December 2013, led by a multidisciplinary pain specialty team. Surveys and focus groups assessed providers' pain-related knowledge and self-efficacy. Electronic health record data were analyzed to evaluate opioid prescribing and specialty referrals. Compared with control, primary care providers in the intervention had a significantly greater increase in pain-related knowledge and self-efficacy. Providers who attended ECHO were more likely to use formal assessment tools and opioid agreements and refer to behavioral health and physical therapy compared with control providers. Opioid prescribing decreased significantly more among providers in the intervention compared with those in the control group. Pain is an extremely common and challenging problem, particularly among vulnerable patients such as those cared for at the more than 1,200 Federally Qualified Health Centers in the United States. In this study, attendance at weekly Project ECHO Pain sessions not only improved knowledge and self-efficacy, but also altered prescribing and referral patterns, suggesting that knowledge acquired during ECHO sessions translated into practice changes. © 2017 American Academy of Pain Medicine.

  9. Center for Devices and Radiological Health Publications Index, August 1988

    International Nuclear Information System (INIS)

    1988-08-01

    This is the first Publications Index to be published by the Center for Devices and Radiological Health. Previous indexes, titled 'Bureau of Radiological Health Publications Index', were published before the Center was formed in 1982 through the merger of the Bureau of Radiological Health and the Bureau of Medical Devices; the last of these indexes was published in October 1980. The 1988 edition contains records of medical device and radiological health documents authored or published by the Center from 1978 through 1986. It should not be considered all-inclusive since those documents for which bibliographic information was not available have been excluded. The Publications Index is being distributed to Center staff, state radiological health programs, and libraries on the Center's publication mailing list. The Center plans to update and publish the Index every other year to provide a convenient record of published Center documents

  10. Area health education centers and health science library services.

    Science.gov (United States)

    West, R T; Howard, F H

    1977-07-01

    A study to determine the impact that the Area Health Education Center type of programs may have on health science libraries was conducted by the Extramural Programs, National Library of Medicine, in conjunction with a contract awarded by the Bureau of Health Manpower, Health Resources Administration, to develop an inventory of the AHEC type of projects in the United States. Specific study tasks included a review of these programs as they relate to library and information activities, on-site surveys on the programs to define their needs for library services and information, and a categorization of library activities. A major finding was that health science libraries and information services are generally not included in AHEC program planning and development, although information and information exchange is a fundamental part of the AHEC type of programs. This study suggests that library inadequacies are basically the result of this planning failure and of a lack of financial resources; however, many other factors may be contributory. The design and value of library activities for these programs needs explication.

  11. Evaluation of health care services provided for older adults in primary health care centers and its internal environment. A step towards age-friendly health centers.

    Science.gov (United States)

    Alhamdan, Adel A; Alshammari, Sulaiman A; Al-Amoud, Maysoon M; Hameed, Tariq A; Al-Muammar, May N; Bindawas, Saad M; Al-Orf, Saada M; Mohamed, Ashry G; Al-Ghamdi, Essam A; Calder, Philip C

    2015-09-01

    To evaluate the health care services provided for older adults by primary health care centers (PHCCs) in Riyadh, Kingdom of Saudi Arabia (KSA), and the ease of use of these centers by older adults. Between October 2013 and January 2014, we conducted a descriptive cross-sectional study of 15 randomly selected PHCCs in Riyadh City, KSA. The evaluation focused on basic indicators of clinical services offered and factors indicative of the ease of use of the centers by older adults. Evaluations were based upon the age-friendly PHCCs toolkit of the World Health Organization. Coverage of basic health assessments (such as blood pressure, diabetes, and blood cholesterol) was generally good. However, fewer than half of the PHCCs offered annual comprehensive screening for the common age-related conditions. There was no screening for cancer. Counseling on improving lifestyle was provided by most centers. However, there was no standard protocol for counseling. Coverage of common vaccinations was poor. The layout of most PHCCs and their signage were good, except for lack of Braille signage. There may be issues of access of older adults to PHCCs through lack of public transport, limited parking opportunities, the presence of steps, ramps, and internal stairs, and the lack of handrails. Clinical services and the internal environment of PHCCs can be improved. The data will be useful for health-policy makers to improve PHCCs to be more age-friendly.

  12. Evaluation of health care services provided for older adults in primary health care centers and its internal environment. A step towards age-friendly health centers

    Directory of Open Access Journals (Sweden)

    Adel A. Alhamdan

    2015-09-01

    Full Text Available Objectives: To evaluate the health care services provided for older adults by primary health care centers (PHCCs in Riyadh, Kingdom of Saudi Arabia (KSA, and the ease of use of these centers by older adults. Methods: Between October 2013 and January 2014, we conducted a descriptive cross-sectional study of 15 randomly selected PHCCs in Riyadh City, KSA. The evaluation focused on basic indicators of clinical services offered and factors indicative of the ease of use of the centers by older adults. Evaluations were based upon the age-friendly PHCCs toolkit of the World Health Organization. Results: Coverage of basic health assessments (such as blood pressure, diabetes, and blood cholesterol was generally good. However, fewer than half of the PHCCs offered annual comprehensive screening for the common age-related conditions. There was no screening for cancer. Counseling on improving lifestyle was provided by most centers. However, there was no standard protocol for counseling. Coverage of common vaccinations was poor. The layout of most PHCCs and their signage were good, except for lack of Braille signage. There may be issues of access of older adults to PHCCs through lack of public transport, limited parking opportunities, the presence of steps, ramps, and internal stairs, and the lack of handrails. Conclusions: Clinical services and the internal environment of PHCCs can be improved. The data will be useful for health-policy makers to improve PHCCs to be more age-friendly.

  13. University of Washington Center for Child Environmental Health Risks Research

    Data.gov (United States)

    Federal Laboratory Consortium — The theme of the University of Washington based Center for Child Environmental Health Risks Research (CHC) is understanding the biochemical, molecular and exposure...

  14. Analysis of suffering at work in Family Health Support Centers.

    Science.gov (United States)

    Nascimento, Débora Dupas Gonçalves do; Oliveira, Maria Amélia de Campos

    2016-01-01

    Analyzing the work process in the Family Health Support Center. An exploratory, descriptive case study using a qualitative approach. Focus groups were conducted with 20 workers of a Family Health Support Center, and the empirical material was subjected to content analysis technique and analyzed in light of Work Psychodynamics. The category of suffering is presented herein as arising from the dialectical contradiction between actual work and prescribed work, from resistance to the Family Health Support Center's proposal and a lack of understanding of their role; due to an immediatist and curative culture of the users and the Family Health Strategy; of the profile, overload and identification with work. The dialectical contradiction between expectations from Family Health Strategy teams and the work in the Family Health Support Center compromises its execution and creates suffering for workers. Analisar o processo de trabalho no Núcleo de Apoio à Saúde da Família. Estudo de caso exploratório, descritivo e de abordagem qualitativa. Grupos focais foram realizados com 20 trabalhadores do Núcleo de Apoio à Saúde da Família, o material empírico foi submetido à técnica de análise de conteúdo e analisado à luz da Psicodinâmica do Trabalho. Apresenta-se aqui a categoria sofrimento que neste estudo decorre da contradição dialética entre o trabalho real e o trabalho prescrito, da resistência à proposta do Núcleo de Apoio à Saúde da Família e da falta de compreensão de seu papel; da cultura imediatista e curativa do usuário e da Estratégia Saúde da Família; do perfil, sobrecarga e identificação com o trabalho. A contradição dialética entre expectativas das equipes da Estratégia Saúde da Família e o trabalho no Núcleo de Apoio à Saúde da Família compromete sua efetivação e gera sofrimento aos trabalhadores.

  15. Clinical quality performance in U.S. health centers.

    Science.gov (United States)

    Shi, Leiyu; Lebrun, Lydie A; Zhu, Jinsheng; Hayashi, Arthur S; Sharma, Ravi; Daly, Charles A; Sripipatana, Alek; Ngo-Metzger, Quyen

    2012-12-01

    To describe current clinical quality among the nation's community health centers and to examine health center characteristics associated with performance excellence. National data from the 2009 Uniform Data System. Health centers reviewed patient records and reported aggregate data to the Uniform Data System. Six measures were examined: first-trimester prenatal care, childhood immunization completion, Pap tests, low birth weight, controlled hypertension, and controlled diabetes. The top 25 percent performing centers were compared with lower performing (bottom 75 percent) centers on these measures. Logistic regressions were utilized to assess the impact of patient, provider, and institutional characteristics on health center performance. Clinical care and outcomes among health centers were generally comparable to national averages. For instance, 67 percent of pregnant patients received timely prenatal care (national = 68 percent), 69 percent of children achieved immunization completion (national = 67 percent), and 63 percent of hypertensive patients had blood pressure under control (national = 48 percent). Depending on the measure, centers with more uninsured patients were less likely to do well, while centers with more physicians and enabling service providers were more likely to do well. Health centers provide quality care at rates comparable to national averages. Performance may be improved by increasing insurance coverage among patients and increasing the ratios of physicians and enabling service providers to patients. © Health Research and Educational Trust.

  16. Department of Defense, Deployment Health Clinical Center

    Science.gov (United States)

    ... general public of trends in mental health and mental health care within the Military Health System Get The Numbers Real Warriors Campaign Real Warriors Campaign A multimedia public awareness campaign designed to combat the stigma associated with ...

  17. National Maternal and Child Oral Health Resource Center

    Science.gov (United States)

    ... State Offices Search the Organizations Database Center for Oral Health Systems Integration and Improvement (COHSII) COHSII is a ... needs of the MCH population. Brush Up on Oral Health This monthly newsletter provides Head Start staff with ...

  18. Self-focused and other-focused resiliency: Plausible mechanisms linking early family adversity to health problems in college women.

    Science.gov (United States)

    Coleman, Sulamunn R M; Zawadzki, Matthew J; Heron, Kristin E; Vartanian, Lenny R; Smyth, Joshua M

    2016-01-01

    This study examined whether self-focused and other-focused resiliency help explain how early family adversity relates to perceived stress, subjective health, and health behaviors in college women. Female students (N = 795) participated between October 2009 and May 2010. Participants completed self-report measures of early family adversity, self-focused (self-esteem, personal growth initiative) and other-focused (perceived social support, gratitude) resiliency, stress, subjective health, and health behaviors. Using structural equation modeling, self-focused resiliency associated with less stress, better subjective health, more sleep, less smoking, and less weekend alcohol consumption. Other-focused resiliency associated with more exercise, greater stress, and more weekend alcohol consumption. Early family adversity was indirectly related to all health outcomes, except smoking, via self-focused and other-focused resiliency. Self-focused and other-focused resiliency represent plausible mechanisms through which early family adversity relates to stress and health in college women. This highlights areas for future research in disease prevention and management.

  19. Discovery of and Interest in Health Apps Among Those With Mental Health Needs: Survey and Focus Group Study.

    Science.gov (United States)

    Schueller, Stephen M; Neary, Martha; O'Loughlin, Kristen; Adkins, Elizabeth C

    2018-06-11

    A large number of health apps are available directly to consumers through app marketplaces. Little information is known, however, about how consumers search for these apps and which factors influence their uptake, adoption, and long-term use. The aim of this study was to understand what people look for when they search for health apps and the aspects and features of those apps that consumers find appealing. Participants were recruited from Northwestern University's Center for Behavioral Intervention Technologies' research registry of individuals with mental health needs. Most participants (n=811) completed a survey asking about their use and interest in health and mental health apps. Local participants were also invited to participate in focus groups. A total of 7 focus groups were conducted with 30 participants that collected more detailed information about their use and interest in health and mental health apps. Survey participants commonly found health apps through social media (45.1%, 366/811), personal searches (42.7%, 346/811), or word of mouth (36.9%, 299/811), as opposed to professional sources such as medical providers (24.6%, 200/811). From the focus groups, common themes related to uptake and use of health apps included the importance of personal use before adoption, specific features that users found desirable, and trusted sources either developing or promoting the apps. As the number of mental health and health apps continue to increase, it is imperative to better understand the factors that impact people's adoption and use of such technologies. Our findings indicated that a number of factors-ease of use, aesthetics, and individual experience-drove adoption and use and highlighted areas of focus for app developers and disseminators. ©Stephen M Schueller, Martha Neary, Kristen O'Loughlin, Elizabeth C Adkins. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 11.06.2018.

  20. 75 FR 6402 - Board of Scientific Counselors, National Center for Health Marketing (BSC, NCHM)

    Science.gov (United States)

    2010-02-09

    ... on the future course for health communications and marketing at CDC; and a discussion of focus areas... Scientific Counselors, National Center for Health Marketing (BSC, NCHM) In accordance with section 10(a)(2..., goals and organizational structure of the new Office of Communications; discussions on program...

  1. UNDER-UTILIZATION OF COMMUNITY HEALTH CENTERS IN PURWOREJO REGENCY, CENTRAL JAVA

    Directory of Open Access Journals (Sweden)

    Atik Triratnawati

    2006-06-01

    Full Text Available The basic strategy of the Ministry of Health to achieve Health For All In Indonesia 2010 is through health paradigm, decentralization, professionalism and health service management. Community health centers play an important role to achieve the goal. Unfortunately, underutilization of community health centers is still a problem in Purworejo. The purpose of this study was to know the utilization of community health centers using a sociological health approach. Qualitative research by observation, in-depth interview and focus group discussion were done among different types of group. The study was done in Purworejo District on February and March 2000. The main problems related to underutilization of community health centers are mostly on administration (less quality services, un-efficient, long hours waiting, strong bureaucratic system (physician has a dominant power, overlapping programs, poor coordination and integration with other divisions and cultural behavior of the community (labeling/stigma, self-care dominant, lack of community participation. To overcome under-utilization of community health centers the administration and bureaucracy should be changed into more efficient, not bureaucratic management. In addition social changes of the community culture is needed. As a consequence through these changes the staff of the health centers will be more efficient and effective.

  2. 78 FR 49357 - National Health Center Week, 2013

    Science.gov (United States)

    2013-08-14

    ... America A Proclamation Community health centers play a critical role in providing affordable, high-quality... people living in the United States depends on their services. They are an important source of jobs in... extend our thanks to the women and men who operate America's health centers. NOW, THEREFORE, I, BARACK...

  3. The Community Mental Health Center as a Matrix Organization.

    Science.gov (United States)

    White, Stephen L.

    1978-01-01

    This article briefly reviews the literature on matrix organizational designs and discusses the ways in which the matrix design might be applied to the special features of a community mental health center. The phases of one community mental health center's experience in adopting a matrix organizational structure are described. (Author)

  4. Shifting Focus: From Hydration for Performance to Hydration for Health.

    Science.gov (United States)

    Perrier, Erica T

    2017-01-01

    Over the past 10 years, literature on hydration biomarkers has evolved considerably - from (de)hydration assessment towards a more global definition of biomarkers of hydration in daily life. This shift in thinking about hydration markers was largely driven by investigating the differences that existed between otherwise healthy individuals whose habitual, ad-libitum drinking habits differ, and by identifying physiological changes in low-volume drinkers who subsequently increase their water intake. Aside from obvious differences in urinary volume and concentration, a growing body of evidence is emerging that links differences in fluid intake with small, but biologically significant, differences in vasopressin (copeptin), glomerular filtration rate, and markers of metabolic dysfunction or disease. Taken together, these pieces of the puzzle begin to form a picture of how much water intake should be considered adequate for health, and represent a shifting focus from hydration for performance, toward hydration for health outcomes. This narrative review outlines the key areas of research in which the global hydration process - including water intake, urinary hydration markers, and vasopressin - has been associated with health outcomes, focusing on kidney and metabolic endpoints. It will also provide a commentary on how various hydration biomarkers may be used in hydration for health assessment. Finally, if adequate water intake can play a role in maintaining health, how might we tell if we are drinking enough? Urine output is easily measured, and can take into account differences in daily physical activity, climate, dietary solute load, and other factors that influence daily water needs. Today, targets have been proposed for urine osmolality, specific gravity, and color that may be used by researchers, clinicians, and individuals as simple indicators of optimal hydration. However, there remain a large number of incomplete or unanswered research questions regarding the

  5. Factors Affecting Sexual History Taking in a Health Center Serving Homeless Persons.

    Science.gov (United States)

    Sowicz, Timothy Joseph; Bradway, Christine K

    2018-03-01

    Low rates of documentation of sexual histories have been reported and research on sexual history taking (SHT) has focused on the content of, barriers to collecting, and interventions to improve documentation of sexual histories. Absent from this literature is an understanding of the contextual factors affecting SHT. To address this gap, a focused ethnography of one health center was conducted. Data were collected through observations of health care encounters and interviews with health care providers (HCPs). No SHT was observed and this was likely influenced by patients' characteristics, communication between patients and HCPs, the prioritization of patients' basic needs, and time constraints imposed upon encounters. Given that the health center studied serves patients experiencing homelessness, behavioral health concerns, and opioid use disorder, findings illuminate areas for future inquiry into a patient population affected by social as well as physiologic determinants of health and potentially at high risk for adverse sexual health outcomes.

  6. Defining the medical imaging requirements for a rural health center

    CERN Document Server

    2017-01-01

    This book establishes the criteria for the type of medical imaging services that should be made available to rural health centers, providing professional rural hospital managers with information that makes their work more effective and efficient. It also offers valuable insights into government, non-governmental and religious organizations involved in the planning, establishment and operation of medical facilities in rural areas. Rural health centers are established to prevent patients from being forced to travel to distant urban medical facilities. To manage patients properly, rural health centers should be part of regional and more complete systems of medical health care installations in the country on the basis of a referral and counter-referral program, and thus, they should have the infrastructure needed to transport patients to urban hospitals when they need more complex health care. The coordination of all the activities is only possible if rural health centers are led by strong and dedicated managers....

  7. Health professionals’ experiences of person-centered collaboration in mental health care

    Directory of Open Access Journals (Sweden)

    Rita Sommerseth

    2008-10-01

    Full Text Available Rita Sommerseth, Elin DysvikUniversity of Stavanger, Faculty of Social Sciences, Department of Health Studies, Stavanger, NorwayObjective: The basic aim in this paper is to discuss health care professionals’ experiences of person-centered collaboration and involvement in mental health rehabilitation and suggest ways of improving this perspective. Furthermore, the paper explains the supportive systems that are at work throughout the process of rehabilitation.Method: The study design is a qualitative approach using three focus group interviews with a total of 17 informants with different professional backgrounds such as nurses, social workers, and social pedagogies. In addition, one nurse and one social worker participated in a semistructured in-depth interview to judge validity.Results: Our results may demonstrate deficits concerning mental health care on several levels. This understanding suggests firstly, that a person-centered perspective and involvement still are uncommon. Secondly, multidisciplinary work seems uncommon and only sporadically follows recommendations. Thirdly, family support is seldom involved. Lastly, firm leadership and knowledge about laws and regulations seems not to be systematically integrated in daily care.Conclusion: Taking these matters together, the improvement of a person-centered perspective implies cooperation between different services and levels in mental health care. In order to bring about improvement the health care workers must critically consider their own culture, coordination of competence must be increased, and leadership at an institutional and organizational level must be improved so that scarce rehabilitation resources are used to the optimal benefit of people with a mental illness.Keywords: multidisciplinary teams, person-centered collaboration, supportive systems, rehabilitation

  8. 42 CFR 405.2462 - Payment for rural health clinic and Federally qualified health center services.

    Science.gov (United States)

    2010-10-01

    ... integral and subordinate part of a hospital, skilled nursing facility or home health agency participating... 42 Public Health 2 2010-10-01 2010-10-01 false Payment for rural health clinic and Federally qualified health center services. 405.2462 Section 405.2462 Public Health CENTERS FOR MEDICARE & MEDICAID...

  9. Deployment Health Centers Review, 2016-2017

    Science.gov (United States)

    2017-08-21

    the short and long-term adverse effects of military service on the physical and mental health of veterans. We recommend that the DHB continue to...adverse effects of military service on the physical and mental health of veterans” by expanding on current clinical, surveillance, and research efforts...the ability to identify, treat, and minimize the short- and long-term adverse effects of military service on the mental and physical health of

  10. South Florida Health Care Centers | NSU

    Science.gov (United States)

    diagnosed with autism spectrum disorder. Optometric Care Complete range of personalized eye care delays or symptoms on the autism spectrum. Support services are also available for families with a child Segal Center provides programs for early childhood, parenting, and autism. Institutes Distance Education

  11. Naval Health Research Center 1985 Annual Report

    Science.gov (United States)

    1985-01-01

    strengthening programs for the entire crew. Aerobic programs for select populations (e.g., overweight personnel), however, were found on 20% of the...Institute, Lima Detachment, Peru (Command) 25-26 UCOR R. Kallal, CUP W. J. Lambert, & M. Nave, Naval Data Services Center, Bethesda, Maryland (Dr

  12. St. Luke's Medical Center: technologizing health care

    International Nuclear Information System (INIS)

    Tumanguil, S.S.

    1994-01-01

    The computerization of the St. Luke's Medical Center improved the hospital administration and management, particularly in nuclear medicine department. The use of computer-aided X-ray simulator machine and computerized linear accelerator machine in diagnosing and treating cancer are the most recent medical technological breakthroughs that benefited thousands of Filipino cancer patients. 4 photos

  13. Chronic Childhood Trauma, Mental Health, Academic Achievement, and School-Based Health Center Mental Health Services

    OpenAIRE

    Larson, S; Chapman, S; Spetz, J; Brindis, CD

    2017-01-01

    Children and adolescents exposed to chronic trauma have a greater risk for mental health disorders and school failure. Children and adolescents of minority racial/ethnic groups and those living in poverty are at greater risk of exposure to trauma and less likely to have access to mental health services. School-based health centers (SBHCs) may be one strategy to decrease health disparities.Empirical studies between 2003 and 2013 of US pediatric populations and of US SBHCs were included if rese...

  14. The role of clinical toxicologists and poison control centers in public health.

    Science.gov (United States)

    Sutter, Mark E; Bronstein, Alvin C; Heard, Stuart E; Barthold, Claudia L; Lando, James; Lewis, Lauren S; Schier, Joshua G

    2010-06-01

    Poison control centers and clinical toxicologists serve many roles within public health; however, the degree to which these entities collaborate is unknown. The objective of this survey was to identify successful collaborations of public health agencies with clinical toxicologists and poison control centers. Four areas including outbreak identification, syndromic surveillance, terrorism preparedness, and daily public health responsibilities amenable to poison control center resources were assessed. An online survey was sent to the directors of poison control centers, state epidemiologists, and the most senior public health official in each state and selected major metropolitan areas. This survey focused on three areas: service, structure within the local or state public health system, and remuneration. Questions regarding remuneration and poison control center location within the public health structure were asked to assess if these were critical factors of successful collaborations. Senior state and local public health officials were excluded because of a low response rate. The survey was completed in October 2007. A total of 111 respondents, 61 poison control centers and 50 state epidemiologists, were eligible for the survey. Sixty-nine (62%) of the 111 respondents, completed and returned the survey. Thirty-three (54%) of the 61 poison control centers responded, and 36 of the 50 state epidemiologists (72%) responded. The most frequent collaborations were terrorism preparedness and epidemic illness reporting. Additional collaborations also exist. Important collaborations exist outside of remuneration or poison control centers being a formal part of the public health structure. Poison control centers have expanded their efforts to include outbreak identification, syndromic surveillance, terrorism preparedness, and daily public health responsibilities amenable to poison control center resources. Collaboration in these areas and others should be expanded. Published

  15. Comparing Performance of Public and Cooperative Health Centers

    Directory of Open Access Journals (Sweden)

    Mostafa Farahbakhsh

    2012-04-01

    Full Text Available Background: Health cooperatives in similar structure of health network in Iran, give primary health cares to defined population with supervisory of public sector. Materials and method: This study compares health system performance between public (PHC and cooperative (CHC health centers. Results: Client's satisfaction was 4.14 in CHC and 3.9 in PHC in 5 point Likert scale. The mean for daily health services of CHC and PHC were 110.8 and 85 respectively. Conclusion: Health cooperatives are appropriate strategy for downsizing of government in health sector

  16. 75 FR 48853 - National Health Center Week, 2010

    Science.gov (United States)

    2010-08-11

    ... communities by conducting outreach and education, ensuring patients can communicate with their providers, and... information technology systems, and meet their critical care needs. The reforms in the landmark new health.... Community health centers are at the heart of a modern, reformed health care system in America. We must...

  17. Power relations in the family health team: focus on nursing.

    Science.gov (United States)

    Silva, Iramildes Souza; Arantes, Cássia Irene Spinelli

    2017-01-01

    to analyze the power relations that permeate the work of the family health team, and to discuss perspectives of emancipation of these subjects, focusing on nursing and community health agents. a qualitative study with a family health team from a municipality in the countryside of the state of São Paulo. Data were collected through systematic observation and interview with workers. A thematic content analysis was performed. three categories were identified: the work of the family health team and power relations; power relations between the nurse and the healthcare team; and the relations among the nursing team and between community agents and the nurse. The team produces relations of power moved by hierarchical knowledge that move in the search for the reordering of powers. it is necessary to review the contradictions present in the performance scenario of the family health teams, with a view toward making power relations more flexible. analisar as relações de poder que permeiam o trabalho da equipe de saúde da família e discutir perspectivas de emancipação desses sujeitos, com enfoque na enfermagem e agentes comunitários de saúde. estudo qualitativo com equipe de saúde da família de município do interior paulista. Os dados foram coletados por meio de observação sistemática e entrevista com os trabalhadores. Foi realizada análise de conteúdo temática. foram identificadas três categorias: o trabalho da equipe de saúde da família e as relações de poder; a relação de poder entre enfermeira e equipe de saúde; as relações da enfermagem e agentes comunitários com a enfermeira. A equipe produz relações de poder movidas por saberes hierarquizados que se movimentam na busca pelo reordenamento dos poderes. é necessário rever as contradições presentes no cenário de atuação das equipes de saúde da família, com vistas à flexibilidade nas relações de poder.

  18. Center for the Advancement of Health

    Science.gov (United States)

    ... More Prepared Patient Blogs » WHAT IS PATIENT ENGAGEMENT? HEALTH BEHAVIOR NEWS Urban Parks and Trails Are Cost-Effective Ways to Promote Exercise December 8, 2014 Military Culture Enables Tobacco Use ...

  19. Planning for the Mercy Center for Breast Health.

    Science.gov (United States)

    Olivares, V Ed

    2002-01-01

    During the last months of 2000, administrators at the Mercy San Juan Medical Center in Carmichael, Calif., convened a steering committee to plan the Mercy Center for Breast Health. The Steering Committee was composed of the director of ancillary and support services, the oncology clinical nurse specialist, the RN manager of the oncology nursing unit, the RN surgery center manager, and me, the manager of imaging services. The committee was responsible for creating a new business with five specific objectives: to position the Center as a comprehensive diagnostic and resource center for women; to generate physician referrals to the Breast Center through various vehicles; to create awareness of the Breast Center's capabilities among area radiologists; to create awareness of the Breast Center among employees of six sister facilities; to create "brand awareness" for the Mercy Center for Breast Health among referring physicians and patients who could use competing centers in the area. The Steering Committee's charter was to design a center with a feminine touch and ambience and to provide a "one-stop shopping" experience for patients. A major component of the Breast Center is the Dianne Haselwood Resource Center, which provides patients with educational support and information. The Steering Committee brought its diverse experience and interests to bear on arranging for equipment acquisition, information and clerical systems, staffing, clinic office design, patient care and marketing. Planning the Mercy Center for Breast Health has been a positive challenge that brought together many elements of the organization and people from different departments and specialties to create a new business venture. Our charge now is to grow and to live up to our vision of offering complete breast diagnostic, education and support services in one location.

  20. Building research infrastructure in community health centers: a Community Health Applied Research Network (CHARN) report.

    Science.gov (United States)

    Likumahuwa, Sonja; Song, Hui; Singal, Robbie; Weir, Rosy Chang; Crane, Heidi; Muench, John; Sim, Shao-Chee; DeVoe, Jennifer E

    2013-01-01

    This article introduces the Community Health Applied Research Network (CHARN), a practice-based research network of community health centers (CHCs). Established by the Health Resources and Services Administration in 2010, CHARN is a network of 4 community research nodes, each with multiple affiliated CHCs and an academic center. The four nodes (18 individual CHCs and 4 academic partners in 9 states) are supported by a data coordinating center. Here we provide case studies detailing how CHARN is building research infrastructure and capacity in CHCs, with a particular focus on how community practice-academic partnerships were facilitated by the CHARN structure. The examples provided by the CHARN nodes include many of the building blocks of research capacity: communication capacity and "matchmaking" between providers and researchers; technology transfer; research methods tailored to community practice settings; and community institutional review board infrastructure to enable community oversight. We draw lessons learned from these case studies that we hope will serve as examples for other networks, with special relevance for community-based networks seeking to build research infrastructure in primary care settings.

  1. The Union Health Center: a working model of clinical care linked to preventive occupational health services.

    Science.gov (United States)

    Herbert, R; Plattus, B; Kellogg, L; Luo, J; Marcus, M; Mascolo, A; Landrigan, P J

    1997-03-01

    As health care provision in the United States shifts to primary care settings, it is vital that new models of occupational health services be developed that link clinical care to prevention. The model program described in this paper was developed at the Union Health Center (UHC), a comprehensive health care center supported by the International Ladies Garment Workers Union (now the Union of Needletrades, Industrial and Textile Employees) serving a population of approximately 50,000 primarily minority, female garment workers in New York City. The objective of this paper is to describe a model occupational medicine program in a union-based comprehensive health center linking accessible clinical care with primary and secondary disease prevention efforts. To assess the presence of symptoms suggestive of occupational disease, a health status questionnaire was administered to female workers attending the UHC for routine health maintenance. Based on the results of this survey, an occupational medicine clinic was developed that integrated direct clinical care with worker and employer education and workplace hazard abatement. To assess the success of this new approach, selected cases of sentinel health events were tracked and a chart review was conducted after 3 years of clinic operation. Prior to initiation of the occupational medicine clinic, 64% (648) of the workers surveyed reported symptoms indicative of occupational illnesses. However, only 42 (4%) reported having been told by a physician that they had an occupational illness and only 4 (.4%) reported having field a workers' compensation claim for an occupational disease. In the occupational medicine clinic established at the UHC, a health and safety specialist acts as a case manager, coordinating worker and employer education as well as workplace hazard abatement focused on disease prevention, ensuring that every case of occupational disease is treated as a potential sentinel health event. As examples of the success

  2. University of Illinois at Chicago Health Policy Center - Funding

    Data.gov (United States)

    U.S. Department of Health & Human Services — 1991-2015. Centers for Disease Control and Prevention (CDC). State Tobacco Activities Tracking and Evaluation (STATE) System. Funding Data, Appropriations...

  3. San Joaquin Valley Aerosol Health Effects Research Center (SAHERC)

    Data.gov (United States)

    Federal Laboratory Consortium — At the San Joaquin Valley Aerosol Health Effects Center, located at the University of California-Davis, researchers will investigate the properties of particles that...

  4. Tri-Service Center for Oral Health Studies (TSCOHS)

    Data.gov (United States)

    Federal Laboratory Consortium — The Tri-Service Center for Oral Health Studies (TSCOHS), a service of the Postgraduate Dental College, is chartered by the Department of Defense TRICARE Management...

  5. Plan for radiological security at a university health center

    International Nuclear Information System (INIS)

    Huiaman Mendoza, G.M.; Sanchez Riojas, M.M.; Felix JImenez, D.

    1998-01-01

    This work shows a radiological security plan applied to a Basic Radiological Service at a university health center. Factors taken into account were installation designs, equipment operation parameters, work procedures, image system and responsibilities

  6. Utilization of Mental Health Services in School-Based Health Centers

    Science.gov (United States)

    Bains, Ranbir M.; Cusson, Regina; White-Frese, Jesse; Walsh, Stephen

    2017-01-01

    Background: We summarize utilization patterns for mental health services in school-based health centers. Methods: Administrative data on school-based health center visits in New Haven, Connecticut were examined for the 2007-2009 school years. Relative frequencies of mental health visits by age were calculated as a percentage of all visits and were…

  7. 75 FR 56549 - National Center for Health Statistics (NCHS), Classifications and Public Health Data Standards...

    Science.gov (United States)

    2010-09-16

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Health Statistics (NCHS), Classifications and Public Health Data Standards Staff, Announces the... Public Health Data Standards Staff, NCHS, 3311 Toledo Road, Room 2337, Hyattsville, Maryland 20782, e...

  8. 75 FR 39265 - National Center for Health Statistics (NCHS), Classifications and Public Health Data Standards...

    Science.gov (United States)

    2010-07-08

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Health Statistics (NCHS), Classifications and Public Health Data Standards Staff, Announces the... Prevention, Classifications and Public Health Data Standards, 3311 Toledo Road, Room 2337, Hyattsville, MD...

  9. 78 FR 53148 - National Center for Health Statistics (NCHS), Classifications and Public Health Data Standards...

    Science.gov (United States)

    2013-08-28

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Center for Health Statistics (NCHS), Classifications and Public Health Data Standards Staff, Announces the... Administrator, Classifications and Public Health Data Standards Staff, NCHS, 3311 Toledo Road, Room 2337...

  10. 78 FR 24756 - Health Center Program

    Science.gov (United States)

    2013-04-26

    ...'s funded section 330 grant application. Genesee County Community Mental Health (GCCMH)--now Genesee... operations of the grant program since its award in June 2012. On January 1, 2013, the State of Michigan... care services on the County of Genesee's behalf and has indicated an ability to continue operations...

  11. Making Value-Based Payment Work for Academic Health Centers.

    Science.gov (United States)

    Miller, Harold D

    2015-10-01

    Under fee-for-service payment systems, physicians and hospitals can be financially harmed by delivering higher-quality, more efficient care. The author describes how current "value-based purchasing" initiatives fail to address the underlying problems in fee-for-service payment and can be particularly problematic for academic health centers (AHCs). Bundled payments, warranties, and condition-based payments can correct the problems with fee-for-service payments and enable physicians and hospitals to redesign care delivery without causing financial problems for themselves. However, the author explains several specific actions that are needed to ensure that payment reforms can be a "win-win-win" for patients, purchasers, and AHCs: (1) disconnecting funding for teaching and research from payment for service delivery, (2) providing predictable payment for essential hospital services, (3) improving the quality and efficiency of care at AHCs, and (4) supporting collaborative relationships between AHCs and community providers by allowing each to focus on their unique strengths and by paying AHC specialists to assist community providers in diagnosis and treatment. With appropriate payment reforms and a commitment by AHCs to redesign care delivery, medical education, and research, AHCs could provide the leadership needed to improve care for patients, lower costs for health care purchasers, and maintain the financial viability of both AHCs and community providers.

  12. Review: Health Management in Disasters with Focusing on Rehabilitation

    Directory of Open Access Journals (Sweden)

    Hamid Reza Khankeh

    2008-07-01

    Full Text Available Disasters should never be considered as routine. Disasters of any kind—natural or manmade—clearly disrupt the normal functioning of any community and frequently overwhelm both personal and community resources. In the post-disaster context, following the initial shock of the disaster, returning lives and livelihoods to normalcy becomes a primary concern of the affected communities and nations. Traditionally, this has been known as the recovery and rehabilitation phase, where "normalcy" refers to the return of the community to the state it was in prior to the disaster event. Rehabilitation is this process of returning the community to “normal” that may extend for many years and involves the physical, social and economic components of the community. Disasters can take on a life of their own, therefore being prepared is the single most effective way to improve outcomes. Proper pre-event planning and providing mechanisms for resource coordination are critical which will be resulted a successful response. It should focus on increasing the participation of civil authorities in order to reestablish local authorities. In order to develop safer communities with fewer deaths, physical injuries, and psycho-social trauma following disasters, health systems must be capable of providing a coordinated response during disasters and of delivering effective mitigation and preparedness programs before disaster impact. The health sector has a vested interest and a key role in this process. In addition, prior to the occurrence of disasters, national, provincial, and local planning should be blueprinted by managers. The public must be educated regarding the importance of individual and family preparation for disaster

  13. Health tourism: definition focused on the Swiss market and conceptualisation of health(i)ness.

    Science.gov (United States)

    Hofer, Susanne; Honegger, Franziska; Hubeli, Jonas

    2012-01-01

    This paper's purpose is to give an overview of current research regarding the concept of "health tourism" with a focus on Switzerland, and to determine whether a consensus on this concept and its embedding in existing/future markets can be found. The paper is an explorative study combining literature review, questionnaires and qualitative interviews. Grounded theory was employed. A service from the field of health care must have been provided prior to health tourism, allowing it to be classified under the health care system. Thus, health tourism is classified under the market for the sick and not under tourism which targets the healthy. Furthermore a new market for the healthy is emerging, which needs to be defined. As an example health(i)ness could help to clarify the terminology, to be seen as a gatekeeper of health and as a cultural paradigm change from cure to prevention. Further research is needed, regarding the positioning and development of health tourism and its synergies, as the cost pressures in health care increase and will continue to have a sustainable impact on health tourism. The paper provides better knowledge of the term health tourism, its general classification, and particular reference to Switzerland, and information about upcoming changes in health care. The findings add to the knowledge of how health tourism is embedded into health care and tourism, and show potential within the market for the healthy. It provides information to members of the tourism and health care market.

  14. Preparedness and Emergency Response Learning Centers: supporting the workforce for national health security.

    Science.gov (United States)

    Richmond, Alyson L; Sobelson, Robyn K; Cioffi, Joan P

    2014-01-01

    The importance of a competent and prepared national public health workforce, ready to respond to threats to the public's health, has been acknowledged in numerous publications since the 1980s. The Preparedness and Emergency Response Learning Centers (PERLCs) were funded by the Centers for Disease Control and Prevention in 2010 to continue to build upon a decade of focused activities in public health workforce preparedness development initiated under the Centers for Public Health Preparedness program (http://www.cdc.gov/phpr/cphp/). All 14 PERLCs were located within Council on Education for Public Health (CEPH) accredited schools of public health. These centers aimed to improve workforce readiness and competence through the development, delivery, and evaluation of targeted learning programs designed to meet specific requirements of state, local, and tribal partners. The PERLCs supported organizational and community readiness locally, regionally, or nationally through the provision of technical consultation and dissemination of specific, practical tools aligned with national preparedness competency frameworks and public health preparedness capabilities. Public health agencies strive to address growing public needs and a continuous stream of current and emerging public health threats. The PERLC network represented a flexible, scalable, and experienced national learning system linking academia with practice. This system improved national health security by enhancing individual, organizational, and community performance through the application of public health science and learning technologies to frontline practice.

  15. Johnson Space Center Health and Medical Technical Authority

    Science.gov (United States)

    Fogarty, Jennifer A.

    2010-01-01

    1.HMTA responsibilities: a) Assure program/project compliance with Agency health and medical requirements at identified key decision points. b) Certify that programs/projects comply with Agency health and medical requirements prior to spaceflight missions. c) Assure technical excellence. 2. Designation of applicable NASA Centers for HMTA implementation and Chief Medical Officer (CMO) appointment. 3. Center CMO responsible for HMTA implementation for programs and projects at the center. JSC HMTA captured in "JSC HMTA Implementation Plan". 4. Establishes specifics of dissenting opinion process consistent with NASA procedural requirements.

  16. Health Literacy Innovations in California Community College Health Centers

    Science.gov (United States)

    Armenia, Joanne Elizabeth

    2013-01-01

    Limited health literacy is a national public health problem contributing to adverse health outcomes and increasing healthcare costs. Both health and educational systems are intervention points for improvement; however, there is paucity in empirical research regarding the role of educational systems. This needs assessment study explored health…

  17. Quality and Electronic Health Records in Community Health Centers

    Science.gov (United States)

    Lesh, Kathryn A.

    2014-01-01

    Adoption and use of health information technology, the electronic health record (EHR) in particular, has the potential to help improve the quality of care, increase patient safety, and reduce health care costs. Unfortunately, adoption and use of health information technology has been slow, especially when compared to the adoption and use of…

  18. Focus on People: Rethinking the Power and Potential of Personal Health Records - Part 1

    Centers for Disease Control (CDC) Podcasts

    2008-06-23

    Dr. Patricia Brennan discusses how Project HealthDesign is working to enhance the utility and flexibility of personal health records as a critical tool to help people take action to improve their health and improve the health care of all Americans.  Created: 6/23/2008 by Coordinating Center for Health Information Service, Coordinating Center for Health Promotion, Healthcare Setting Goal Team.   Date Released: 7/29/2008.

  19. Focus on People: Rethinking the Power and Potential of Personal Health Records - Q and A

    Centers for Disease Control (CDC) Podcasts

    2008-06-23

    Dr. Patricia Brennan discusses how Project HealthDesign is working to enhance the utility and flexibility of personal health records as a critical tool to help people take action to improve their health and improve the health care of all Americans.  Created: 6/23/2008 by Coordinating Center for Health Information Service, Coordinating Center for Health Promotion, Healthcare Setting Goal Team.   Date Released: 7/29/2008.

  20. Focus on People: Rethinking the Power and Potential of Personal Health Records - Part 2

    Centers for Disease Control (CDC) Podcasts

    2008-06-23

    Dr. Patricia Brennan discusses how Project HealthDesign is working to enhance the utility and flexibility of personal health records as a critical tool to help people take action to improve their health and improve the health care of all Americans.  Created: 6/23/2008 by Coordinating Center for Health Information Service, Coordinating Center for Health Promotion, Healthcare Setting Goal Team.   Date Released: 7/29/2008.

  1. 3 CFR - Medicare Demonstration To Test Medical Homes in Federally Qualified Health Centers

    Science.gov (United States)

    2010-01-01

    ... buy equipment, modernize clinic facilities, expand into new facilities, and adopt or expand the use of... interdisciplinary teams to treat the “whole patient” and focus on chronic disease management to reduce the use of costlier providers of care, such as emergency rooms and hospitals. Federally qualified health centers...

  2. 75 FR 12766 - National Center on Minority Health and Health Disparities; Notice of Closed Meetings

    Science.gov (United States)

    2010-03-17

    ... Health and Health Disparities; Notice of Closed Meetings Pursuant to section 10(d) of the Federal... and Health Disparities Special Emphasis Panel Loan Repayment Program for Health Disparities Research... Review, National Center on Minority Health and Health Disparities, 6707 Democracy Boulevard, Suite 800...

  3. 75 FR 9421 - National Center on Minority Health and Health Disparities; Notice of Closed Meeting

    Science.gov (United States)

    2010-03-02

    ... Health and Health Disparities; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... and Health Disparities Special Emphasis Panel; Loan Repayment Program for Health Disparities Research..., National Center on Minority Health and Health Disparities, 6707 Democracy Boulevard, Suite 800, Bethesda...

  4. Enhancing the Effectiveness of Consumer-Focused Health Information Technology Systems Through eHealth Literacy

    DEFF Research Database (Denmark)

    Kayser, Lars; Kushniruk, Andre; Osborne, Richard H

    2015-01-01

    BACKGROUND: eHealth systems and applications are increasingly focused on supporting consumers to directly engage with and use health care services. Involving end users in the design of these systems is critical to ensure a generation of usable and effective eHealth products and systems. Often...... the end users engaged for these participatory design processes are not actual representatives of the general population, and developers may have limited understanding about how well they might represent the full range of intended users of the eHealth products. As a consequence, resulting information...... model with the domains of a new concept of eHealth literacy. METHODS: This approach expands an existing method for supporting health IT system development, which advocates use of a three-dimensional user-task-context matrix to comprehensively identify the users of health IT systems, and what their needs...

  5. Forging successful academic-community partnerships with community health centers: the California statewide Area Health Education Center (AHEC) experience.

    Science.gov (United States)

    Fowkes, Virginia; Blossom, H John; Mitchell, Brenda; Herrera-Mata, Lydia

    2014-01-01

    Increased access to insurance under the Affordable Care Act will increase demands for clinical services in community health centers (CHCs). CHCs also have an increasingly important educational role to train clinicians who will remain to practice in community clinics. CHCs and Area Health Education Centers (AHECs) are logical partners to prepare the health workforce for the future. Both are sponsored by the Health Resources and Services Administration, and they share a mission to improve quality of care in medically underserved communities. AHECs emphasize the educational side of the mission, and CHCs the service side. Building stronger partnerships between them can facilitate a balance between education and service needs.From 2004 to 2011, the California Statewide AHEC program and its 12 community AHECs (centers) reorganized to align training with CHC workforce priorities. Eight centers merged into CHC consortia; others established close partnerships with CHCs in their respective regions. The authors discuss issues considered and approaches taken to make these changes. Collaborative innovative processes with program leadership, staff, and center directors revised the program mission, developed common training objectives with an evaluation plan, and defined organizational, functional, and impact characteristics for successful AHECs in California. During this planning, centers gained confidence as educational arms for the safety net and began collaborations with statewide programs as well as among themselves. The AHEC reorganization and the processes used to develop, strengthen, and identify standards for centers forged the development of new partnerships and established academic-community trust in planning and implementing programs with CHCs.

  6. 76 FR 40733 - National Institute for Occupational Safety and Health, (NIOSH), World Trade Center Health Program...

    Science.gov (United States)

    2011-07-11

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention National Institute for Occupational Safety and Health, (NIOSH), World Trade Center Health Program Science/Technical Advisory Committee (WTCHP-STAC) Correction: This notice was published in the Federal Register on June 23...

  7. Patients' satisfaction evaluation with the health center of elis province.

    Science.gov (United States)

    Karavida, Angeliki; Stamouli, Maria-Aggeliki; Balis, Charalampos

    2014-01-01

    Patient satisfaction related to the provided health services is a key indicator of the quality of the health sector. The SERVQUAL model was employed as a way of measuring the level of patient satisfaction with the services of the Health Center of Elis Province. Although certain aspects such as "Assurance" and "Empathy" meet the users' needs, improvements like a detailed medical record and an overhaul of the equipment need to be introduced.

  8. Patient-centered medical home model: do school-based health centers fit the model?

    Science.gov (United States)

    Larson, Satu A; Chapman, Susan A

    2013-01-01

    School-based health centers (SBHCs) are an important component of health care reform. The SBHC model of care offers accessible, continuous, comprehensive, family-centered, coordinated, and compassionate care to infants, children, and adolescents. These same elements comprise the patient-centered medical home (PCMH) model of care being promoted by the Affordable Care Act with the hope of lowering health care costs by rewarding clinicians for primary care services. PCMH survey tools have been developed to help payers determine whether a clinician/site serves as a PCMH. Our concern is that current survey tools will be unable to capture how a SBHC may provide a medical home and therefore be denied needed funding. This article describes how SBHCs might meet the requirements of one PCMH tool. SBHC stakeholders need to advocate for the creation or modification of existing survey tools that allow the unique characteristics of SBHCs to qualify as PCMHs.

  9. in_focus - Health: An Ecosystem Approach | IDRC - International ...

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

    It recognizes the inextricable links between humans and their biophysical, social, and economic ... Home · Resources · Publications ... Reconciling an ecosystem's health with the health of its human inhabitants is a new area of research, ...

  10. health care providers' knowledge and practice of focused antenatal

    African Journals Online (AJOL)

    of complete health supervision of the pregnant women in order to maintain, protect and ... and sexually transmitted infections including. HIV/ AIDS, urinary tract infection and tetanus. -. Prophylaxis refers to an ..... PATHS Geneva. World Health ...

  11. Oral health knowledge of health care workers in special?children?s center

    OpenAIRE

    Wyne, Amjad; Hammad, Nouf; Splieth, Christian

    2015-01-01

    Objective: To determine the oral health knowledge of health care workers in special children?s center. Methods: A self-administered questionnaire was used to collect following information: demographics, oral hygiene practices, importance of fluoride, dental visits, cause of tooth decay, gingival health, and sources of oral health information. The study was conducted at Riyadh Center for Special Children in Riyadh City from December 2013 to May 2014. Results: All 60 health care workers in the ...

  12. The role of health centers in preventive care provision

    Directory of Open Access Journals (Sweden)

    Shemetova G.N.

    2017-12-01

    Full Text Available Aim: to assess the importance of the Centers of Health in the organization and provision of preventive care to the population, in the early detection of risk factors for the development of chronic non-communicable diseases and the development of a healthy lifestyle. Material and Methods. On the basis of the Health Center of Engels Center for Medical Prevention in the Saratov Region, the detection of risk factors for 2011-2015 was analyzed according to statistical reporting (form No. 68 and health cards (form025-CZ/y of 207 patients. To assess the satisfaction of visitors with the work of the Center, a specially developed questionnaire was conducted, which included 22 questions that characterize the patient profile, his attitude to the organization and the results of the survey, and the motivation to modify the way of life. Results. The study confirmed the important role of the Centers of Health in the organization and provision of preventive care to the population, the formation of a healthy lifestyle and the early detection of diseases and risk factors for their development. Conclusion. Only joint efforts of medical institutions, authorities, educational organizations, mass media can lead to the formation of the population's responsibility for their health and readiness to modify the way of life.

  13. Academic health centers and society: an ethical reflection.

    Science.gov (United States)

    Pellegrino, E D

    1999-08-01

    Academic health centers--which combine university, medical school, and hospital--exist to satisfy universal human needs and thus are by definition instruments of social purpose. Their core mission is threefold: to provide medical knowledge that can help relieve and prevent illness and suffering, to supply practitioners able to apply that knowledge wisely, and to serve as sites where optimal use of medical knowledge can be demonstrated and investigated. Maintaining a balance between core mission and responsiveness to social trends is a delicate exercise. Overly close accommodation to such trends can endanger the core mission, as has occurred in the United States with regard to managed care. Society and academic health centers have mutual obligations. Obligations of society include giving academic health centers financial and other support and allowing them sufficient freedom to pursue their mission; obligations of academic medical centers include accepting greater scrutiny by society and providing social criticism on matters relating to health. A task for the future is to discern how academic health centers can be responsive to social needs without being totally subservient to societal desires.

  14. Role of the health center in health crisis management, especially in a radiation disaster

    International Nuclear Information System (INIS)

    Kurahashi, Toshiyuki

    2013-01-01

    In a disaster, in particular a radiation disaster, health centers should play an active role in taking advantage of its own expertise. There are various causes of a health crisis; the response to a health crisis is defined according to each cause. However, it should be adequately addressed by assuming the worst case for a health crisis of unknown cause. The role of health centers, in addition to the implementation of appropriate and timely treatment of any health crisis, is prevention of a future health crisis, advanced preparation, and damage recovery; activities during normal times are also important to maintain. Regarding the specific activities of the health center, judgment in the preference of measures to be performed is important. That the information is collected properly based on the idea of risk communication, coordination, and public relations transmission is required also for health centers. (author)

  15. A user-centered model for designing consumer mobile health (mHealth) applications (apps).

    Science.gov (United States)

    Schnall, Rebecca; Rojas, Marlene; Bakken, Suzanne; Brown, William; Carballo-Dieguez, Alex; Carry, Monique; Gelaude, Deborah; Mosley, Jocelyn Patterson; Travers, Jasmine

    2016-04-01

    Mobile technologies are a useful platform for the delivery of health behavior interventions. Yet little work has been done to create a rigorous and standardized process for the design of mobile health (mHealth) apps. This project sought to explore the use of the Information Systems Research (ISR) framework as guide for the design of mHealth apps. Our work was guided by the ISR framework which is comprised of 3 cycles: Relevance, Rigor and Design. In the Relevance cycle, we conducted 5 focus groups with 33 targeted end-users. In the Rigor cycle, we performed a review to identify technology-based interventions for meeting the health prevention needs of our target population. In the Design Cycle, we employed usability evaluation methods to iteratively develop and refine mock-ups for a mHealth app. Through an iterative process, we identified barriers and facilitators to the use of mHealth technology for HIV prevention for high-risk MSM, developed 'use cases' and identified relevant functional content and features for inclusion in a design document to guide future app development. Findings from our work support the use of the ISR framework as a guide for designing future mHealth apps. Results from this work provide detailed descriptions of the user-centered design and system development and have heuristic value for those venturing into the area of technology-based intervention work. Findings from this study support the use of the ISR framework as a guide for future mHealth app development. Use of the ISR framework is a potentially useful approach for the design of a mobile app that incorporates end-users' design preferences. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. A revisionist view of the integrated academic health center.

    Science.gov (United States)

    Rodin, Judith

    2004-02-01

    Like many academic health centers that had expanded aggressively during the 1990s, the nation's first vertically integrated academic health center, the University of Pennsylvania Health System, was profoundly challenged by the dramatic and unanticipated financial impacts of the Balanced Budget Act of 1997. The author explains why-although Penn's Health System had lost $300 million over two years and its debts threatened to cause serious financial and educational damage to the rest of the University-Penn chose to manage its way out of the financial crisis (instead of selling or spinning off its four hospitals, clinical practices, and possibly even its medical school). A strategy of comprehensive integration has not only stabilized Penn's Health System financially, but strengthened its position of leadership in medical education, research, and health care delivery. The author argues that a strategy of greater horizontal integration offers important strategic advantages to academic health centers. In an era when major social and scientific problems demand broadly multidisciplinary and highly-integrated approaches, such horizontally integrated institutions will be better able to educate citizens and train physicians, develop new approaches to health care policy, and answer pressing biomedical research questions. Institutional cultural integration is also crucial to create new, innovative organizational structures that bridge traditional disciplinary, school, and clinical boundaries.

  17. [Public health and mental health: methodological tools to evaluate the Brazilian Network of Referral Centers for Psycho-Social Care (CAPS) in the Brazilian Unified Health System].

    Science.gov (United States)

    Onocko-Campos, Rosana Teresa; Furtado, Juarez Pereira

    2006-05-01

    This article presents a preliminary discussion of potential methodological tools for qualitative research on the Network of Referral Centers for Psycho-Social Care (CAPS) in the Brazilian Unified Health System (SUS). The relevance of mental health within the field of public health is examined. The study focuses on the high prevalence of mental disorders and the disproportionate lack of studies on the interface between mental health and public health. The establishment of an interdisciplinary field between public health and mental health is proposed to meet common needs by achieving similar perspectives in knowledge and practice. A particular group of tools is proposed, emphasizing the importance of reclaiming and guaranteeing the roles of various social actors to shape the assessment process, the need for collecting and standardizing academic studies on the topic, and the importance of promoting a new research field focusing on public health policies to support policymakers, managers, and health teams in reshaping their practices.

  18. Health Extension in New Mexico: An Academic Health Center and the Social Determinants of Disease

    Science.gov (United States)

    Kaufman, Arthur; Powell, Wayne; Alfero, Charles; Pacheco, Mario; Silverblatt, Helene; Anastasoff, Juliana; Ronquillo, Francisco; Lucero, Ken; Corriveau, Erin; Vanleit, Betsy; Alverson, Dale; Scott, Amy

    2010-01-01

    The Agricultural Cooperative Extension Service model offers academic health centers methodologies for community engagement that can address the social determinants of disease. The University of New Mexico Health Sciences Center developed Health Extension Rural Offices (HEROs) as a vehicle for its model of health extension. Health extension agents are located in rural communities across the state and are supported by regional coordinators and the Office of the Vice President for Community Health at the Health Sciences Center. The role of agents is to work with different sectors of the community in identifying high-priority health needs and linking those needs with university resources in education, clinical service and research. Community needs, interventions, and outcomes are monitored by county health report cards. The Health Sciences Center is a large and varied resource, the breadth and accessibility of which are mostly unknown to communities. Community health needs vary, and agents are able to tap into an array of existing health center resources to address those needs. Agents serve a broader purpose beyond immediate, strictly medical needs by addressing underlying social determinants of disease, such as school retention, food insecurity, and local economic development. Developing local capacity to address local needs has become an overriding concern. Community-based health extension agents can effectively bridge those needs with academic health center resources and extend those resources to address the underlying social determinants of disease. PMID:20065282

  19. Results of the Community Health Applied Research Network (CHARN) National Research Capacity Survey of Community Health Centers.

    Science.gov (United States)

    Song, Hui; Li, Vivian; Gillespie, Suzanne; Laws, Reesa; Massimino, Stefan; Nelson, Christine; Singal, Robbie; Wagaw, Fikirte; Jester, Michelle; Weir, Rosy Chang

    2015-01-01

    The mission of the Community Health Applied Research Network (CHARN) is to build capacity to carry out Patient-Centered Outcomes Research at community health centers (CHCs), with the ultimate goal to improve health care for vulnerable populations. The CHARN Needs Assessment Staff Survey investigates CHCs' involvement in research, as well as their need for research training and resources. Results will be used to guide future training. The survey was developed and implemented in partnership with CHARN CHCs. Data were collected across CHARN CHCs. Data analysis and reports were conducted by the CHARN data coordinating center (DCC). Survey results highlighted gaps in staff research training, and these gaps varied by staff role. There is considerable variation in research involvement, partnerships, and focus both within and across CHCs. Development of training programs to increase research capacity should be tailored to address the specific needs and roles of staff involved in research.

  20. Cultural health capital and the interactional dynamics of patient-centered care.

    Science.gov (United States)

    Dubbin, Leslie A; Chang, Jamie Suki; Shim, Janet K

    2013-09-01

    As intuitive and inviting as it may appear, the concept of patient-centered care has been difficult to conceptualize, institutionalize and operationalize. Informed by Bourdieu's concepts of cultural capital and habitus, we employ the framework of cultural health capital to uncover the ways in which both patients' and providers' cultural resources, assets, and interactional styles influence their abilities to mutually achieve patient-centered care. Cultural health capital is defined as a specialized collection of cultural skills, attitudes, behaviors and interactional styles that are valued, leveraged, and exchanged by both patients and providers during clinical interactions. In this paper, we report the findings of a qualitative study conducted from 2010 to 2011 in the Western United States. We investigated the various elements of cultural health capital, how patients and providers used cultural health capital to engage with each other, and how this process shaped the patient-centeredness of interactions. We find that the accomplishment of patient-centered care is highly dependent upon habitus and the cultural health capital that both patients and providers bring to health care interactions. Not only are some cultural resources more highly valued than others, their differential mobilization can facilitate or impede engagement and communication between patients and their providers. The focus of cultural health capital on the ways fundamental social inequalities are manifest in clinical interactions enables providers, patients, and health care organizations to consider how such inequalities can confound patient-centered care. Copyright © 2013 Elsevier Ltd. All rights reserved.

  1. Equity-focused health impact assessment: A tool to assist policy makers in addressing health inequalities

    International Nuclear Information System (INIS)

    Simpson, Sarah; Mahoney, Mary; Harris, Elizabeth; Aldrich, Rosemary; Stewart-Williams, Jenny

    2005-01-01

    In Australasia (Australia and New Zealand) the use of health impact assessment (HIA) as a tool for improved policy development is comparatively new. The public health workforce do not routinely assess the potential health and equity impacts of proposed policies or programs. The Australasian Collaboration for Health Equity Impact Assessment was funded to develop a strategic framework for equity-focused HIA (EFHIA) with the intent of strengthening the ways in which equity is addressed in each step of HIA. The collaboration developed a draft framework for EFHIA that mirrored, but modified the commonly accepted steps of HIA; tested the draft framework in six different health service delivery settings; analysed the feedback about application of the draft EFHIA framework and modified it accordingly. The strategic framework shows promise in providing a systematic process for identifying potential differential health impacts and assessing the extent to which these are avoidable and unfair. This paper presents the EFHIA framework and discusses some of the issues that arose in the case study sites undertaking equity-focused HIA

  2. Factors That Influence Vaccination Decision-Making by Parents Who Visit an Anthroposophical Child Welfare Center: A Focus Group Study

    Directory of Open Access Journals (Sweden)

    Irene A. Harmsen

    2012-01-01

    Full Text Available In recent years, parents have become more disparaging towards childhood vaccination. One group that is critical about the National Immunization Program (NIP and participates less comprises parents with an anthroposophical worldview. Despite the fact that various studies have identified anthroposophists as critical parents with lower vaccination coverage, no research has been done to explore the beliefs underlying their childhood vaccination decision-making. We conducted a qualitative study using three focus groups ( of parents who visit an anthroposophical child welfare center. Our findings show that participants did not refuse all vaccinations within the Dutch NIP, but mostly refused the Mumps, Measles, and Rubella (MMR vaccination. Vaccination decisions are influenced by participants’ lifestyle, perception of health, beliefs about childhood diseases, perceptions about the risks of diseases, perceptions about vaccine effectiveness and vaccine components, and trust in institutions. Parents indicated that they felt a need for more information. Sufficient references should be provided to sources containing more information about childhood vaccination, especially about the effectiveness of vaccines and vaccine components and the risks, such as possible side effects and benefits of vaccination. This may satisfy parents’ information needs and enable them to make a sufficiently informed choice whether or not to vaccinate their child.

  3. COLLAGE 360: A Model of Person-Centered Care To Promote Health Among Older Adults.

    Science.gov (United States)

    Howard, Elizabeth P; Schreiber, Robert; Morris, John N; Russotto, Aline; Flashner-Fineman, Susan

    2016-01-01

    Health care leaders and providers have introduced the assumption the typical elder, even in the presence of complex, chronic disease and prevailing illness, is capable of assuming greater personal responsibility for their health care, with a shift from provider-centered to a person-centered model of care. For older adults who often and repeatedly face challenges managing and maintaining their health status, guidance and support is needed. In this study, COLLAGE 360 , a comprehensive assessment system and wellness coaching program that focuses on prevention and wellness, care coordination and self-management of health care was implemented in one continuing care retirement community. Following completion of two assessment tools via directed conversation with a wellness coach, older adults developed an individualized vitality plan that outlined life goals, supporting goals and action plans for goal achievement. Results from this program suggest engagement in the assessment and wellness coaching process via the COLLAGE 360 program translated into sample older adults sensing that they live in a more supportive environment when compared with elders not receiving any wellness coaching. In addition, the older adults had positive effects in the areas of mood, loneliness, social interaction, health status, and life satisfaction. Strategies to improve health and well being need an extended focus beyond the older adult's medical conditions and consider psychological, spiritual and social needs with personal preferences being paramount. These issues are foundational to a person-centered, health promotion approach needed among this population.

  4. Value-Driven Population Health: An Emerging Focus for Improving Stakeholder Role Performance.

    Science.gov (United States)

    Allen, Harris; Burton, Wayne N; Fabius, Raymond

    2017-12-01

    Health and health care in the United States are being jeopardized by top-end spending whose share of the gross domestic product continues to increase even as aggregate health outcomes remain mediocre. This paper focuses on a new approach for improving stakeholder role performance in the marketplace, value-driven population health (VDPH SM ). Devoted to maximizing the value of every dollar spent on population health, VDPH holds much promise for ameliorating this dilemma and exerting a constructive influence on the reshaping of the Affordable Care Act. This paper introduces VDPH and differentiates the science underlying it from the management that serves to make good on its potential. To highlight what VDPH brings to the table, comparisons are made with 3 like-minded approaches to health reform. Next, 2 areas are highlighted, workplace wellness and the quality and cost of health care, where without necessarily being recognized as such, VDPH has gained real traction among 2 groups: leading employers and, more recently, leading providers. Key findings with respect to workplace wellness are assessed in terms of psychometric performance to evaluate workplace wellness and to point out how VDPH can help direct future employer initiatives toward firmer scientific footing. Then, insights gleaned from the employer experience are applied to illustrate how VDPH can help guide future provider efforts to build on the model developed. This paper concludes with a framework for the use of VDPH by each of 5 stakeholder groups. The discussion centers on how VDPH transcends and differentiates these groups. Implications for health reform in the recently altered political landscape are explored.

  5. Focus on CSIR research in pollution and waste: environmental health

    CSIR Research Space (South Africa)

    Godfrey, Linda K

    2007-08-01

    Full Text Available A healthy population is seen as an important precondition for economic growth and competitiveness. Research into environmental health is therefore concerned with understanding the exposure and magnitude of impact on humans from environmental hazards...

  6. Metabolic Networks Integrative Cardiac Health Project (ICHP) - Center of Excellence

    Science.gov (United States)

    2016-04-01

    points) 4.2 ± 1.9 3.3 ± 2.0 0.03 Conclusion: A comprehensive health program emphasizing combined improvements in nutrition , exercise, stress and sleep...Military Health System Research (MHSRS) Symposium 2016, 15-18 August 2016, Kissimmee, FL (submitted for oral presentation). Abstract Background...focusing on nutrition and exercise have shown substantial health benefits and are becoming increasing popular. We conducted a year-long lifestyle

  7. Strategies to improve chronic disease management in seven metro Boston community health centers.

    Science.gov (United States)

    Ndumele, Chima D; Russell, Beverley E; Ayanian, John Z; Landon, Bruce E; Keegan, Thomas; O'Malley, A James; Hicks, Leroi S

    2009-01-01

    The Community, Health Center, and Academic Medicine Partnership Project (CHAMPP) is a partnership between medical researchers, community health centers (CHCs), and a community advisory committee focused on reducing cardiovascular morbidity related to hypertension and diabetes for non-Hispanic Black and Hispanic populations in Boston, Massachusetts. We conducted site visits at seven participating CHCs, located in Boston. The visits were to solicit health center staff opinions about site-specific barriers and enabling factors for optimum preventative cardiovascular care for racial/ethnic minority patients receiving hypertension and diabetes care at their centers. Site visits included a tour of each health center and a series of directed interviews with center personnel. Site visit notes were reviewed to identify themes that emerged during the course of each site visit. A summary matrix was developed for each health center, which included information regarding the most salient and persistent themes of the visit. Site visits uncovered several patient-, provider-, CHC-, and community-based factors that either facilitate or hinder optimal care of chronic disease patients. Commonly referenced barriers included the need for improved patient adherence to provider recommendations; insufficient time for providers to address complex health issues presented by patients and the need for a broader range of healthier food options in surrounding communities. Interactive patient groups and community health workers (CHWs) have been well received when implemented. Recommendations included adopting case management as a part of usual care for chronic disease patients; additionally, widespread implementation of CHWs may to provide a platform for more comprehensive care for patients.

  8. Health care employee perceptions of patient-centered care.

    Science.gov (United States)

    Balbale, Salva Najib; Turcios, Stephanie; LaVela, Sherri L

    2015-03-01

    Given the importance of health care employees in the delivery of patient-centered care, understanding their unique perspectives is essential for quality improvement. The purpose of this study was to use photovoice to evaluate perceptions and experiences around patient-centered care among U.S. Veterans Affairs (VA) health care employees. We asked participants to take photographs of salient features in their environment related to patient-centered care. We used the photographs to facilitate dialogue during follow-up interviews. Twelve VA health care employees across two VA sites participated in the project. Although most participants felt satisfied with their work environment and experiences at the VA, they identified several areas for improvement. These included a need for more employee health and wellness initiatives and a need for enhanced opportunities for training and professional growth. Application of photovoice enabled us to learn about employees' unique perspectives around patient-centered care while engaging them in an evaluation of care delivery. © The Author(s) 2014.

  9. The Evolving Academic Health Center: Challenges and Opportunities for Psychiatry

    Science.gov (United States)

    Mirin, Steven; Summergrad, Paul

    2011-01-01

    Objective: Regardless of the outcome of current efforts at healthcare reform, the resources that academic health centers need--to provide care for increasingly complex patient populations, support clinical innovation, grow the clinical enterprise, and carry out their research and teaching missions--are in jeopardy. This article examines the value…

  10. Mental Health Services in School-Based Health Centers: Systematic Review

    Science.gov (United States)

    Bains, Ranbir Mangat; Diallo, Ana F.

    2016-01-01

    Mental health issues affect 20-25% of children and adolescents, of which few receive services. School-based health centers (SBHCs) provide access to mental health services to children and adolescents within their schools. A systematic review of literature was undertaken to review evidence on the effectiveness of delivery of mental health services…

  11. Estimate the Health Literacy in Health Centers in the Border of Yazd City: Cross sectional study

    Directory of Open Access Journals (Sweden)

    Sakineh Gerayllo

    2017-06-01

    Conclusion: Health literacy of women in general was unacceptable, and recommendations were made to establish continuous training for women to improve their views. Also consideration should be given to centers to plan the transformation of health literacy which has been launched, to increase the Health literacy of the population being studied as recipients of health services.

  12. Campus Health Centers' Lack of Information Regarding Providers: A Content Analysis of Division-I Campus Health Centers' Provider Websites.

    Science.gov (United States)

    Perrault, Evan K

    2018-07-01

    Campus health centers are a convenient, and usually affordable, location for college students to obtain health care. Staffed by licensed and trained professionals, these providers can generally offer similar levels of care that providers at off-campus clinics can deliver. Yet, previous research finds students may forgo this convenient, on-campus option partially because of a lack of knowledge regarding the quality of providers at these campus clinics. This study sought to examine where this information deficit may come from by analyzing campus health centers' online provider information. All Division-I colleges or universities with an on-campus health center, which had information on their websites about their providers (n = 294), had their providers' online information analyzed (n = 2,127 providers). Results revealed that schools commonly offer professional information (e.g., provider specialties, education), but very little about their providers outside of the medical context (e.g., hobbies) that would allow a prospective student patient to more easily relate. While 181 different kinds of credentials were provided next to providers' names (e.g., MD, PA-C, FNP-BC), only nine schools offered information to help students understand what these different credentials meant. Most schools had information about their providers within one-click of the homepage. Recommendations for improving online information about campus health center providers are offered.

  13. District focus: oral rehydration, primary health care and the scientist.

    Science.gov (United States)

    Jansen, A A; Ebangit, M L

    1986-09-01

    The discovery that a solution of salt and sugar is an excellent way to treat and prevent dehydration was an important advance in the primary health care field, as it was expected that mothers, even illiterate mothers, could easily learn to prepare the solution at home, thus preventing serious consequences of untreated diarrhea. In addition to the low price, an important quality of this simple solution is that it gives the mother a sense of responsibility and the knowledge that she herself can do much to alleviate the suffering of her children. Unfortunately, the pharmaceutical industry and chemists were quick to realize that big profits can be made from oral rehydration and to package ready-made solutions. Consequently, there has been a movement away from teaching the mother how to make a simple solution at home, using salt, sugar, and water. The responsibility for this situation needs to be shared by both the scientist and the health worker. Scientists seem to have some difficulty accepting the fact that simple can be good and better is not always best. By adding 1.5 grams of potassium chloride or 2.9 grams of trisodium citrate to improve the mixture, it becomes a medicine, which only can be given/prescribed/sold by health personnel or chemists. The improved formula is good in a clinic setting, but in terms of primary health care and self-help this is not the best approach. The solution is being put beyond the reach of the poor child, certainly in the rural areas of the developing world. All health workers should know how to prepare a salt-sugar solution and also should show mothers/parents/caretakers how to make it. If one is serious about primary health care and self-help, it is best to return to using sugar and salt.

  14. Role of public health center for nuclear disaster

    International Nuclear Information System (INIS)

    Okada, Tsuyoshi

    2012-01-01

    The role of public health center such as surveillance screening, mass decontamination, health consultation and management, and dosage of stable iodine tablets are thought by Nuclear Safety Commission in 2008. The pollution screening and decontamination, internal exposure screening and valuation, dosage of iodine tablets, health consultation of residents and risk communication, comparative evaluation of health risks, health management under the low dose exposure are discussed to handle problems by the government and local government, and to protect the right to know information. In order to prepare the serious health hazard, the children's thyroid gland test and internal exposure test and the follow-up system have to be practiced by the local government. (S.Y.)

  15. Women-Centered and Culturally Responsive Heart Health Promotion Among Indigenous Women in Canada.

    Science.gov (United States)

    Ziabakhsh, Shabnam; Pederson, Ann; Prodan-Bhalla, Natasha; Middagh, Diane; Jinkerson-Brass, Sharon

    2016-11-01

    Most women in Canada confront a combination of bio-psychosocial factors that put them at risk for cardiovascular disease. The challenge for health planners is to address these factors while contextualizing interventions that meet the specific needs of particular social and cultural groupings. The article will discuss a women-centered, group-based heart health pilot initiative designed to engage with indigenous approaches to healing. The nurse practitioners co-led the group with a representative from the indigenous community to balance women-centered practices with more traditional and culturally appropriate ones. In particular, indigenous processes, such as a Talking Circle, combined with indigenous knowledge/content were integrated into the pilot program. The project was evaluated to investigate its outcomes (how the intervention impacted the participants) and processes (how participants perceived the intervention). Evaluation involved analysis of the Talking Circle's content, a focus group, field observations, and self-completed surveys. Most women made changes regarding their diet, some began physical activities, and others focused on better managing their emotional health. Women viewed the group as successful because it embraced both women-centered and culturally appropriate health promotion practices. The intervention created a culturally safe space for learning and transformation. The findings confirm the need for employing culturally relevant, gender-specific approaches to heart health promotion that are situated in and responsive to community needs. © 2016 Society for Public Health Education.

  16. in_focus - Health: An Ecosystem Approach | CRDI - Centre de ...

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

    Côte d'Ivoire | Kenya | Brazil | Ecuador (Pesticides) | India | Ethiopia | Nepal | Mexico (Air Pollution) | Mexico (Malaria) | Cuba | Chile | Ecuador (Mining). Ecohealth Works Series: Agricultural Transformation · Environmental Pollution · Health in Urban Environments · Infectious Diseases. Lasting Impacts: Ecohealth: Improving ...

  17. Mental health literacy: focus on developing countries | Ganasen ...

    African Journals Online (AJOL)

    ... is of particular concern in low and middle-income countries where mental health services are already scarce. It is likely that strategies for improvement will need to be comprehensive and innovative, taking advantage of opportunities and meeting challenges faced in the developing world. African Journal of Psychiatry Vol.

  18. The relationship between media literacy and health literacy among pregnant women in health centers of Isfahan.

    Science.gov (United States)

    Akbarinejad, Farideh; Soleymani, Mohammad Reza; Shahrzadi, Leila

    2017-01-01

    The ability to access, analyze, evaluate, and convey information in various forms of media including print and nonprint requires media literacy, but the capacity to obtain, process, and understand basic information and services needed for appropriate decisions regarding health, considered an important element in a woman's ability to participate in health promotion and prevention activities for herself and her children, is needed to a level of health literacy. The purpose of this study was to determine the relationship between media literacy and health literacy among pregnant women in health centers in Isfahan. This study used a descriptive correlation study. Data collection tools include Shahin media literacy and functional health literacy in adults' questionnaires. The population include pregnant women in health centers of Isfahan (4080 people). Ten out of the 351 health centers in Isfahan were selected as cluster. Data were analyzed using both descriptive and inferential statistics. Media literacy of respondents in the five dimensions was significantly lower than average 61.5% of pregnant women have inadequate health literacy, 18.8% had marginal health literacy, and only 19.7% of them have had adequate health literacy. There was a significant positive relationship between media literacy and health literacy among pregnant women. This study showed that the majority of pregnant women covered by health centers had limited health literacy and media literacy. Since one of the basic requirements for the utilization of health information is needed for adequate media literacy, promotion of media literacy is necessary for the respondents.

  19. Stennis Space Center observes 2009 Safety and Health Day

    Science.gov (United States)

    2009-01-01

    Sue Smith, a medical clinic employee at NASA's John C. Stennis Space Center, takes the temperature of colleague Karen Badon during 2009 Safety and Health Day activities Oct. 22. Safety Day activities included speakers, informational sessions and a number of displays on safety and health issues. Astronaut Dominic Gorie also visited the south Mississippi rocket engine testing facility during the day to address employees and present several Silver Snoopy awards for outstanding contributions to flight safety and mission success. The activities were part of an ongoing safety and health emphasis at Stennis.

  20. Building diversity in a complex academic health center.

    Science.gov (United States)

    South-Paul, Jeannette E; Roth, Loren; Davis, Paula K; Chen, Terence; Roman, Anna; Murrell, Audrey; Pettigrew, Chenits; Castleberry-Singleton, Candi; Schuman, Joel

    2013-09-01

    For 30 years, the many diversity-related health sciences programs targeting the University of Pittsburgh undergraduate campus, school of medicine, schools of the health sciences, clinical practice plan, and medical center were run independently and remained separate within the academic health center (AHC). This lack of coordination hampered their overall effectiveness in promoting diversity and inclusion. In 2007, a group of faculty and administrators from the university and the medical center recognized the need to improve institutional diversity and to better address local health disparities. In this article, the authors describe the process of linking the efforts of these institutions in a way that would be successful locally and applicable to other academic environments. First, they engaged an independent consultant to conduct a study of the AHC's diversity climate, interviewing current and former faculty and trainees to define the problem and identify areas for improvement. Next, they created the Physician Inclusion Council to address the findings of this study and to coordinate future efforts with institutional leaders. Finally, they formed four working committees to address (1) communications and outreach, (2) cultural competency, (3) recruitment, and (4) mentoring and retention. These committees oversaw the strategic development and implementation of all diversity and inclusion efforts. Together these steps led to structural changes within the AHC and the improved allocation of resources that have positioned the University of Pittsburgh to achieve not only diversity but also inclusion and to continue to address the health disparities in the Pittsburgh community.

  1. Managing the risks of on-site health centers.

    Science.gov (United States)

    Gorman, Kathleen M; Miller, Ross M

    2011-11-01

    This review sought to assess compliance concerns, determine risk management strategies, and identify opportunities for future research to contribute to employers' understanding of the laws and regulations that apply to on-site care. A comprehensive review of databases, professional organizations' websites, and journals resulted in 22 publications reporting on the consequences of noncompliance among on-site health centers accepted for inclusion. None of those studies reported a study design or quantifiable outcome data. Two noncompliance themes were repeated among the publications. First, direct penalties included fines, civil actions, loss of licensure, and, potentially, criminal charges. Second, noncompliance also resulted in indirect costs such as employee mistrust and lowered standards of care, which jeopardize on-site health centers' ability to demonstrate a return on investment. Further research with rigorous methodology is needed to inform employer decisions about on-site health services and associated risk management. Copyright 2011, SLACK Incorporated.

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

    Science.gov (United States)

    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.

  3. Violence against health workers in Family Medicine Centers

    Science.gov (United States)

    Al-Turki, Nouf; Afify, Ayman AM; AlAteeq, Mohammed

    2016-01-01

    Background Health care violence is a significant worldwide problem with negative consequences on both the safety and well-being of health care workers as well as workplace activities. Reports examining health care violence in Saudi Arabia are limited and the results are conflicting. Objective To estimate the prevalence and determine the demographic and occupational characteristics associated with workplace violence in primary care centers in Riyadh, Saudi Arabia. Methods A cross-sectional study included 270 health care workers in 12 family medicine centers in Riyadh during November and December 2014. A structured self-administered questionnaire was used to estimate the frequency, timing, causes, reactions, and consequences of workplace violence plus participants’ demographic and occupational data. Results A total 123 health care workers (45.6%) experienced some kind of violence over 12 months prior to the study. These included physical (6.5%) and nonphysical violence (99.2%), including verbal violence (94.3%) and intimidation (22.0%). Offenders were patients (71.5%) in the majority of cases, companions (20.3%), or both (3.3%). Almost half (48.0%) of health care workers who experienced violence did nothing, 38.2% actively reported the event, and 13.8% consulted a colleague. A significant association of workplace violence was found with working multiple shifts, evening or night shift, and lack of an encouraging environment to report violence. Conclusion Workplace violence is still a significant problem in primary care centers. The high frequency of violence together with underreporting may indicate the inefficiency of the current safety program. More safety programs and training activities for health care workers, efficient reporting system, and zero tolerance policies need to be implemented to minimize workplace violence against health workers. PMID:27330300

  4. Violence against health workers in Family Medicine Centers.

    Science.gov (United States)

    Al-Turki, Nouf; Afify, Ayman Am; AlAteeq, Mohammed

    2016-01-01

    Health care violence is a significant worldwide problem with negative consequences on both the safety and well-being of health care workers as well as workplace activities. Reports examining health care violence in Saudi Arabia are limited and the results are conflicting. To estimate the prevalence and determine the demographic and occupational characteristics associated with workplace violence in primary care centers in Riyadh, Saudi Arabia. A cross-sectional study included 270 health care workers in 12 family medicine centers in Riyadh during November and December 2014. A structured self-administered questionnaire was used to estimate the frequency, timing, causes, reactions, and consequences of workplace violence plus participants' demographic and occupational data. A total 123 health care workers (45.6%) experienced some kind of violence over 12 months prior to the study. These included physical (6.5%) and nonphysical violence (99.2%), including verbal violence (94.3%) and intimidation (22.0%). Offenders were patients (71.5%) in the majority of cases, companions (20.3%), or both (3.3%). Almost half (48.0%) of health care workers who experienced violence did nothing, 38.2% actively reported the event, and 13.8% consulted a colleague. A significant association of workplace violence was found with working multiple shifts, evening or night shift, and lack of an encouraging environment to report violence. Workplace violence is still a significant problem in primary care centers. The high frequency of violence together with underreporting may indicate the inefficiency of the current safety program. More safety programs and training activities for health care workers, efficient reporting system, and zero tolerance policies need to be implemented to minimize workplace violence against health workers.

  5. Health Services Research and Health Economy - Quality Care Training in Gynaecology, with Focus On Gynaecological Oncology.

    Science.gov (United States)

    Lux, M P; Fasching, P A; Loehberg, C R; Jud, S M; Schrauder, M G; Bani, M R; Thiel, F C; Hack, C C; Hildebrandt, T; Beckmann, M W

    2011-12-01

    In the era of cost increases and reduced resources in the German healthcare system, the value of health services research and health economics is increasing more and more. Health services research attempts to develop concepts for the most effective ways to organise, manage, finance and deliver high-quality care and evaluates the implementation of these concepts with regard to daily routine conditions. Goals are the assessment of benefits and the economic advantages and disadvantages of new and established diagnostic methods, drugs and vaccines. Regarding these goals, it is clear that health services research goes hand in hand with health economics, which evaluates the benefits of diagnostic and therapeutic procedures in relation to the costs. Both scientific fields have focus principally on gynaecology and particularly on gynaecological oncology in Germany, as can be seen by numerous publications. These present several advantages compared with clinical trials - they uncover gaps in health care, question the material, staffing and consequently the financial resources required and they allow the estimation of value and the comparison of different innovations to identify the best options for our patients.

  6. Are health centers in Thailand ready for health information technology? : a national survey.

    Science.gov (United States)

    Kijsanayotin, Boonchai; Speedie, Stuart

    2006-01-01

    The Thailand universal health care coverage scheme was instituted in 2001 and The Thailand Ministry of Public Health (MOPH) is restructuring its information systems to support this reform. The MOPH anticipates developing computerized health information systems which can provide information for administration tasks and can improve both healthcare delivery and public health services. To achieve these target goals, knowledge about users and organizations is vital. The knowledge of how health center workers currently use information technology (IT), their knowledge of IT, and acceptance of IT are not only beneficial to policy makers but also to system designers and implementers. The primary objective of this study is to learn how health centers in Thailand use IT, the level of basic IT knowledge among their workers, and their acceptance of health IT. We surveyed a random cross sectional sample of 1,607 health centers representing the total of 9,806 in Thailand in 2005. With an 82% response rate, the preliminary results indicate that information technology usage is pervasive in health centers. The respondents showed a moderately high degree of health information technology acceptance with a modest level of basic IT knowledge. There were no differences in degrees of acceptance among the four geographic regions. The mean score of "intention to use IT" was 5.6 on a scale of 7 and the average basic IT knowledge score was 13 out of 20. These results suggests the possibility of project success if the national health center information system projects are developed and implemented.

  7. Focusing effects by one and two Coulomb centers in the autoionization of He

    Energy Technology Data Exchange (ETDEWEB)

    MartInez, S; Otranto, S [CONICET and Dto. de Fisica, Universidad Nacional del Sur, 8000 Bahia Blanca (Argentina); Suarez, S; Garibotti, C R, E-mail: smartine@criba.edu.a, E-mail: sotranto@uns.edu.a [CONICET and Centro Atomico Bariloche, 8400 S. C. de Bariloche (Argentina)

    2009-11-01

    In this work we consider the autoionization of He following double electron capture in He{sup 2+} + H{sub 2} collisions at an impact energy of 14 keV/amu. The post-collisional interaction with the two Coulomb centers is treated within the Barrachina-Macek model by employing the {Phi}{sub 2} correlated wave function introduced by Gasaneo et al to represent the continuum of the emitted electron in the field of two Coulomb centers. We compare the angular profiles in the electron spectrum with those obtained following double electron capture for the collision system He{sup 2+}+ He. Clear differences are observed in the spectra obtained for the atomic and molecular targets.

  8. Evaluation of the FOCUS (Feedback on Counseling Using Simulation) instrument for assessment of client-centered nutrition counseling behaviors.

    Science.gov (United States)

    Henry, Beverly W; Smith, Thomas J

    2010-01-01

    To develop an instrument to assess client-centered counseling behaviors (skills) of student-counselors in a standardized patient (SP) exercise. Descriptive study of the accuracy and utility of a newly developed counseling evaluation instrument. Study participants included 11 female student-counselors at a Midwestern university-10 Caucasian, 1 African-American-for the simulated counseling sessions, in which the Feedback on Counseling Using Simulation (FOCUS) instrument was applied in 2 SP scenarios (cardiovascular disease and diabetes). FOCUS ratings of student-counselors by 4 SPs during 22 sessions were compared with ratings from a 3-member panel of experts who independently viewed the 22 videotaped sessions. Quantitative analysis of instrument validity included inter-rater reliability by computing generalizability coefficients, Pearson correlations, and Spearman rank-order correlations. FOCUS criteria encompassed relevant dimensions of nutrition counseling based in a client-centered perspective. The critical points of information gathering and counseling behaviors showed internal consistency overall and good inter-rater reliability with the cardiovascular disease scenario. For both scenarios, pooled ratings of 3 experts agreed with ratings carried out by SPs. Initial findings suggest that the FOCUS instrument with client-centered criteria may enhance evaluation of counseling skills in SP exercises, meriting further study with larger groups.

  9. Assistance Focus: Asia/Pacific Region; Clean Energy Solutions Center (CESC)

    Energy Technology Data Exchange (ETDEWEB)

    None

    2015-05-11

    The Clean Energy Solutions Center Ask an Expert service connects governments seeking policy information and advice with one of more than 30 global policy experts who can provide reliable and unbiased quick-response advice and information. The service is available at no cost to government agency representatives from any country and the technical institutes assisting them. This publication presents summaries of assistance provided to governments in the Asia/Pacific region, including the benefits of that assistance.

  10. Using mHealth to Deliver Behavior Change Interventions Within Prenatal Care at Community Health Centers.

    Science.gov (United States)

    Mauriello, Leanne M; Van Marter, Deborah F; Umanzor, Cindy D; Castle, Patricia H; de Aguiar, Emma L

    2016-09-01

    To test an iPad-delivered multiple behavior tailored intervention (Healthy Pregnancy: Step by Step) for pregnant women that addresses smoking cessation, stress management, and fruit and vegetable consumption. A randomized 2 × 5 factorial repeated measures design was employed with randomization on the individual level stratified on behavior risk. Women completed three sessions during pregnancy and two postpartum at postdelivery months 1 and 4. Women were recruited from six locations of federally funded health centers across three states. Participants (N = 335) were English- and Spanish-speaking women at up to 18 weeks gestation. The treatment group received three interactive sessions focused on two priority health behavior risks. The sessions offered individually tailored and stage-matched change strategies based on the transtheoretical model of behavior change. The usual care group received March of Dimes brochures. The primary outcome was the number of behavior risks. Stage of change and continuous measures for all behaviors also were assessed. Data were analyzed across all time points using generalized estimating equations examining repeated measures effects. Women in the treatment group reported significantly fewer risks than those in usual care at 1 month (.85 vs. 1.20, odds ratio [OR] = .70) and 4 months postpartum (.72 vs. .91, OR = .81). Healthy Pregnancy is an evidence-based and personalized program that assists pregnant women with reducing behavior risks and sustaining healthy lifestyle behaviors. © 2016 by American Journal of Health Promotion, Inc.

  11. Adolescent health promotion based on community-centered arts education

    Directory of Open Access Journals (Sweden)

    Anny Giselly Milhome da Costa Farre

    Full Text Available ABSTRACT Objective: To evaluate the contribution of arts education to health promotion of adolescents in situations of urban social vulnerability. Method: Participatory evaluative research, with a qualitative approach, using as a reference the theoretical constructs of Paulo Freire's Conscientization and the Empowerment Evaluation as a method of collecting with adolescents and teachers of an arts education program in the field of the Family Health Strategy. Results: Participants constructed a collective mission that represented the concept of adolescent health promotion. Arts education activities were prioritized and ranked with a mission focus, and over a three-month period, the program implemented health goals through art. In the reevaluation, the group presented a broad look at the implementation of activities and self-determination for change. Final considerations: Arts education is a potential space for nurses to act in the conscientization and empowerment of adolescent health in Primary Health Care.

  12. New York State Health Foundation grant helps health centers win federal expansion funds.

    Science.gov (United States)

    Sandman, David; Cozine, Maureen

    2012-11-01

    With approximately 1.2 million New Yorkers poised to gain health insurance coverage as a result of federal health reform, demand for primary care services is likely to increase greatly. The Affordable Care Act includes $11 billion in funding to enhance primary care access at community health centers. Recognizing a need and an opportunity, in August 2010 the New York State Health Foundation made a grant of nearly $400,000 to the Community Health Care Association of New York State to work with twelve health centers to develop successful proposals for obtaining and using these federal funds. Ultimately, eleven of the twelve sites are expected to receive $25.6 million in federal grants over a five-year period-a sixty-four-fold return on the foundation's investment. This article describes the strategy for investing in community health centers; identifies key project activities, challenges, and lessons; and highlights its next steps for strengthening primary care.

  13. Holistic Health Care for the Medically Uninsured: The Church Health Center of Memphis

    OpenAIRE

    Morris, G. Scott

    2015-01-01

    The Church Health Center (CHC) in Memphis was founded in 1987 to provide quality, affordable health care for working, uninsured people and their families. With numerous, dedicated financial supporters and health care volunteers, CHC has become the largest faith-based health care organization of its type nationally, serving >61,000 patients. CHC embraces a holistic approach to health by promoting wellness in every dimension of life. It offers on-site services including medical care, dentistry,...

  14. The Carter Center Mental Health Program: addressing the public health crisis in the field of mental health through policy change and stigma reduction.

    Science.gov (United States)

    Palpant, Rebecca G; Steimnitz, Rachael; Bornemann, Thomas H; Hawkins, Katie

    2006-04-01

    Some of the most pervasive and debilitating illnesses are mental illnesses, according to World Health Organization's The World Health Report 2001--Mental Health: New Understanding, New Hope. Neuropsychiatric conditions account for four of the top five leading causes of years of life lived with disability in people aged 15 to 44 in the Western world. Many barriers prevent people with mental illnesses from seeking care, such as prohibitive costs, lack of insurance, and the stigma and discrimination associated with mental illnesses. The Carter Center Mental Health Program, established in 1991, focuses on mental health policy issues within the United States and internationally. This article examines the public health crisis in the field of mental health and focuses on The Carter Center Mental Health Program's initiatives, which work to increase public knowledge of and decrease the stigma associated with mental illnesses through their four strategic goals: reducing stigma and discrimination against people with mental illnesses; achieving equity of mental health care comparable with other health services; advancing early promotion, prevention, and early intervention services for children and their families; and increasing public awareness about mental illnesses and mental health issues.

  15. PPACA and public health: creating a framework to focus on prevention and wellness and improve the public's health.

    Science.gov (United States)

    Majette, Gwendolyn Roberts

    2011-01-01

    PPACA epitomizes comprehensive health care reform legislation. Public health, disease prevention, and wellness were integral considerations in its development. This article reveals the author's personal experiences while working on the framework for health care reform in the United States Senate and reviews activity in the United States House of Representatives. This insider's perspective delineates PPACA's positive effect on public health by examining the infrastructure Congress designed to focus on prevention, wellness, and public health, with a particular focus on the National Prevention, Health Promotion and Public Health Council; the National Prevention, Health Promotion, Public Health, and Integrative Health Care Strategy; and the Prevention and Public Health Fund. The Council, strategy, and fund are especially important because they reflect compliance with some of the Institute of Medicine's recommendations to improve public health in the United States, as well as international health and human rights norms that protect the right to health. © 2011 American Society of Law, Medicine & Ethics, Inc.

  16. Adolescent Health Care in School-Based Health Centers. Position Statement

    Science.gov (United States)

    National Assembly on School-Based Health Care, 2008

    2008-01-01

    School-based health centers (SBHCs) are considered one of the most effective strategies for delivering preventive care, including reproductive and mental health care services, to adolescents--a population long considered difficult to reach. National Assembly on School-Based Health Care (NASBHC) recommends practices and policies to assure…

  17. 75 FR 42448 - Board of Scientific Counselors (BSC), Coordinating Center for Health Promotion (CCHP): Notice of...

    Science.gov (United States)

    2010-07-21

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention (CDC) Board of Scientific Counselors (BSC), Coordinating Center for Health Promotion (CCHP): Notice of Charter Amendment... Disease Prevention and Health Promotion (NCCDPHP). [[Page 42449

  18. Violence against health workers in Family Medicine Centers

    Directory of Open Access Journals (Sweden)

    Al-Turki N

    2016-05-01

    Full Text Available Nouf Al-Turki,1 Ayman AM Afify,1 Mohammed AlAteeq2 1Family Medicine Department, Prince Sultan Military Medical City, 2Department of Family Medicine and PHC, King Abdul-Aziz Medical City, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia Background: Health care violence is a significant worldwide problem with negative consequences on both the safety and well-being of health care workers as well as workplace activities. Reports examining health care violence in Saudi Arabia are limited and the results are conflicting.Objective: To estimate the prevalence and determine the demographic and occupational characteristics associated with workplace violence in primary care centers in Riyadh, Saudi Arabia.Methods: A cross-sectional study included 270 health care workers in 12 family medicine centers in Riyadh during November and December 2014. A structured self-administered questionnaire was used to estimate the frequency, timing, causes, reactions, and consequences of workplace violence plus participants’ demographic and occupational data.Results: A total 123 health care workers (45.6% experienced some kind of violence over 12 months prior to the study. These included physical (6.5% and nonphysical violence (99.2%, including verbal violence (94.3% and intimidation (22.0%. Offenders were patients (71.5% in the majority of cases, companions (20.3%, or both (3.3%. Almost half (48.0% of health care workers who experienced violence did nothing, 38.2% actively reported the event, and 13.8% consulted a colleague. A significant association of workplace violence was found with working multiple shifts, evening or night shift, and lack of an encouraging environment to report violence.Conclusion: Workplace violence is still a significant problem in primary care centers. The high frequency of violence together with underreporting may indicate the inefficiency of the current safety program. More safety programs and training activities for health care

  19. Biosecurity and Health Monitoring at the Zebrafish International Resource Center.

    Science.gov (United States)

    Murray, Katrina N; Varga, Zoltán M; Kent, Michael L

    2016-07-01

    The Zebrafish International Resource Center (ZIRC) is a repository and distribution center for mutant, transgenic, and wild-type zebrafish. In recent years annual imports of new zebrafish lines to ZIRC have increased tremendously. In addition, after 15 years of research, we have identified some of the most virulent pathogens affecting zebrafish that should be avoided in large production facilities, such as ZIRC. Therefore, while importing a high volume of new lines we prioritize safeguarding the health of our in-house fish colony. Here, we describe the biosecurity and health-monitoring program implemented at ZIRC. This strategy was designed to prevent introduction of new zebrafish pathogens, minimize pathogens already present in the facility, and ensure a healthy zebrafish colony for in-house uses and shipment to customers.

  20. User-Centered Design and Interactive Health Technologies for Patients

    Science.gov (United States)

    De Vito Dabbs, Annette; Myers, Brad A.; Mc Curry, Kenneth R.; Dunbar-Jacob, Jacqueline; Hawkins, Robert P.; Begey, Alex; Dew, Mary Amanda

    2010-01-01

    Despite recommendations that patients be involved in the design and testing of health technologies, few reports describe how to involve patients in systematic and meaningful ways to ensure that applications are customized to meet their needs. User-centered design (UCD) is an approach that involves end-users throughout the development process so that technology support tasks, are easy to operate, and are of value to users. In this paper we provide an overview of UCD and use the development of Pocket Personal Assistant for Tracking Health (Pocket PATH), to illustrate how these principles and techniques were applied to involve patients in the development of this interactive health technology. Involving patient-users in the design and testing ensured functionality and usability, therefore increasing the likelihood of promoting the intended health outcomes. PMID:19411947

  1. Changing structure to improve function: one academic health center's experience.

    Science.gov (United States)

    Alexander, B; Davis, L; Kohler, P O

    1997-04-01

    Academic health centers (AHCs) have been under siege for the past few years, with decreased federal and state funding for educational and research programs and increasing competition in the health care marketplace. In addition, many AHCs are burdened with the bureaucratic red tape of large educational institutions, which makes agility in responding to a demanding health care market difficult. The authors describe the response to these threats by Oregon Health Sciences University (OHSU), an approach that has been different from those of most similar institutions. OHSU chose to change its structure from being part of the state system of higher education to being an independent public corporation. The authors outline the political process of building widespread support for the legislation passed in 1995, the key features of the restructuring, the challenges faced before and after the transition to a public corporation, and lessons learned in this metamorphosis to a new form.

  2. Health science center faculty attitudes towards interprofessional education and teamwork.

    Science.gov (United States)

    Gary, Jodie C; Gosselin, Kevin; Bentley, Regina

    2018-03-01

    The attitudes of faculty towards interprofessional education (IPE) and teamwork impact the education of health professions education (HPE) students. This paper reports on a study evaluating attitudes from health professions educators towards IPE and teamwork at one academic health science center (HSC) where modest IPE initiatives have commenced. Drawing from the results of a previous investigation, this study was conducted to examine current attitudes of the faculty responsible for the training of future healthcare professionals. Survey data were collected to evaluate attitudes from HSC faculty, dentistry, nursing, medicine, pharmacy and public health. In general, positive HSC faculty attitudes towards interprofessional learning, education, and teamwork were significantly predicted by those affiliated with the component of nursing. Faculty development aimed at changing attitudes and increasing understanding of IPE and teamwork are critical. Results of this study serve as an underpinning to leverage strengths and evaluate weakness in initiating IPE.

  3. Big Data and Population Health: Focusing on the Health Impacts of the Social, Physical, and Economic Environment.

    Science.gov (United States)

    Hu, Howard; Galea, Sandro; Rosella, Laura; Henry, David

    2017-11-01

    We are at the dawn of a data deluge in health that carries extraordinary promise for improving the health of populations. However, current associated efforts, which generally center on the 'precision medicine' agenda, may well fall short in terms of its overall impact. The main challenges, it is argued, are less technical than the following: (1) identifying the data that matter most; (2) ensuring that we make better use of existing data; and (3) extending our efforts from the individual to the population by exploiting new, complex, and sometimes unstructured, data sources. Advances in Epidemiology have shown that policies, features of institutions, characteristics of communities, living and environmental conditions, and social relationships all contribute, together with individual behaviors and factors such as poverty and race, to the production of health. Examples are discussed, leading to recommendations that focus on core priorities for data linkage, including those relating to marginalized populations, better data on socioeconomic status, micro- and macro-environments, collaborating with researchers in the fields of education, environment, and social sciences to ensure the validity and accuracy of multilevel data, aligning research aims with policy decisions that must be made, and heightening efforts to protect privacy.

  4. A Estratégia Saúde da Família para a equidade de acesso dirigida à população em situação de rua em grandes centros urbanos The Family Health Strategy focused on access equity and targeted at the homeless population living in large urban centers

    Directory of Open Access Journals (Sweden)

    Nivaldo Carneiro Junior

    2010-09-01

    ' difficulties in using the health services are due to their misconceptions about illness and care, health teams' and users' preconceptions, services' technical-administrative organization, and fragile intersector actions, among others. Additionally, this population is highly vulnerable to some health disorders, as shown by the high rates of alcoholism, tuberculosis and even pregnancy. Innovative actions as well as adequate health strategies addressing a real improvement in the access should be considered as essential. In this sense, the Family Health Strategy is a useful tool of the primary health care services. Since 2004, a Project named "A Gente na Rua", which resulted from a partnership between the Municipal Health Department of São Paulo and philanthropic institutions, has been implemented, with the action of community health agent teams. It is concluded that, in the city of São Paulo, the adoption of this health policy targeted at the homeless has promoted better access to primary health care services. Moreover, it has created a more focused approach to this population. Despite the success of this strategy, we should take into account that remaining challenges have to be tackled in future projects, such as the need of new strategies focusing on homeless people with mental disorders, as well as the guarantee of quality care characterized by comprehensiveness, longitudinality and coordination, among others.

  5. Cost-income analysis of oral health units of health care centers in Yazd city

    Directory of Open Access Journals (Sweden)

    Hosein Fallahzadeh

    2012-01-01

    Full Text Available Background and Aims: Increasing demands for health care's services on one hand and limited resources on the other hand brings about pressure over governments to find out a mechanism for fair and appropriate distribution of resources. Economic analysis is one of the appropriate tools for policy making on this priority. The aim of this study was to assess capital and consumption of oral health units of health care centers in Yazd city and comparing it with revenue of these centers and determining of cost effectiveness.Materials and Methods: In this descriptive cross sectional study, all health care centers of Yazd city with active dentistry department were evaluated. The data has been extracted from current documents in health care center of county based issued receipts and daily information registers.Results: Expended cost for providing of oral hygiene services in second half of 2008 in 13 medical health centers of Yazd included active dentistry section was 557.887.500 Rials and revenue to cost ratio was about 34%. The most provided service was related to tooth extraction and the average of tooth restoration in each working day was 0.48.Conclusion: With attention to low tariffs of dentistry services in medical health centers and paying subsidy to target groups, expenses of oral hygiene are always more than its revenue.

  6. UNDER-UTILIZATION OF COMMUNITY HEALTH CENTERS IN PURWOREJO REGENCY, CENTRAL JAVA

    OpenAIRE

    Atik Triratnawati

    2006-01-01

    The basic strategy of the Ministry of Health to achieve Health For All In Indonesia 2010 is through health paradigm, decentralization, professionalism and health service management. Community health centers play an important role to achieve the goal. Unfortunately, underutilization of community health centers is still a problem in Purworejo. The purpose of this study was to know the utilization of community health centers using a sociological health approach. Qualitative research by observati...

  7. The interplay between regulatory focus and temporal distance in the health context.

    Science.gov (United States)

    Berezowska, Aleksandra; Fischer, Arnout R H; van Trijp, Hans C M

    2018-02-01

    This study identifies how the interaction between temporal distance, regulatory focus, and framing of health outcomes affects individuals' intention to adopt a personalized nutrition service. A 2 (temporal distance: immediate health outcomes vs. delayed health outcomes) × 2 (regulatory focus: prevention vs. promotion) × 2 (health outcome framing: illness prevention vs. health promotion) full-factorial between-subjects design. In two experiments with samples of 236 and 242 students, regulatory focus was manipulated by asking participants to describe which academic outcomes they want to either achieve or prevent and how they aim to do this. Temporal distance and health outcome framing were manipulated by modifying descriptions of personalized nutrition services. To study the process through which temporal distance, regulatory focus, and health outcome framing affect adoption intention, measures of perceived privacy risk and perceived personalization benefit were included as mediators. The interaction between temporal distance and regulatory focus had a significant effect on adoption intention, perceived privacy risk, and perceived personalization benefit. For prevention-focused individuals' adoption intention was higher, perceived personalization benefit was higher, and perceived privacy risk was lower when health outcomes were immediate instead of delayed. These effects were not significant for promotion-focused individuals. Health outcome framing affected the interaction between temporal distance and regulatory focus, but only in Study 1. Only perceived personalization benefit served as a mediator. Tailoring temporal distance to individuals' regulatory focus increases adoption intention for personalized nutrition advice. Statement of contribution What is already known on this subject? Intention to adopt dietary recommendations results from a cognitive decision-making process. Regulatory focus and temporal distance are relevant for the adoption of dietary

  8. 76 FR 35683 - Medicare Program; Conditions of Participation (CoPs) for Community Mental Health Centers

    Science.gov (United States)

    2011-06-17

    ... Community Mental Health Centers; Proposed Rule #0;#0;Federal Register / Vol. 76 , No. 117 / Friday June 17... (CoPs) for Community Mental Health Centers AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS... participation (CoPs) that community mental health centers (CMHCs) would have to meet in order to participate in...

  9. The Breast Health Center at Women & Infants Hospital: origin, philosophy, and features.

    Science.gov (United States)

    Falkenberry, S S; Chung, M; Legare, R; Strenger, R; Wallace, D; Phillips, G; Morry, S; Marchant, D J; Cady, B

    2000-04-01

    The Breast Health Center, a component of the program in Women's Oncology at Women & Infants Hospital, is a multidisciplinary center devoted to the treatment and study of benign and malignant breast diseases. The philosophy, structure, and function of The Breast Health Center are described along with its specific components. The Breast Health Center's three fundamental missions of patient care, education, and research are discussed.

  10. Referral Practices Among U.S. Publicly Funded Health Centers That Offer Family Planning Services.

    Science.gov (United States)

    Carter, Marion W; Robbins, Cheryl L; Gavin, Loretta; Moskosky, Susan

    2018-01-29

    Referrals to other medical services are central to healthcare, including family planning service providers; however, little information exists on the nature of referral practices among health centers that offer family planning. We used a nationally representative survey of administrators from 1,615 publicly funded health centers that offered family planning in 2013-14 to describe the use of six referral practices. We focused on associations between various health center characteristics and frequent use of three active referral practices. In the prior 3 months, a majority of health centers (73%) frequently asked clients about referrals at clients' next visit. Under half (43%) reported frequently following up with referral sources to find out if their clients had been seen. A third (32%) of all health centers reported frequently using three active referral practices. In adjusted analysis, Planned Parenthood clinics (adjusted odds ratio 0.55) and hospital-based clinics (AOR 0.39) had lower odds of using the three active referral practices compared with health departments, and Title X funding status was not associated with the outcome. The outcome was positively associated with serving rural areas (AOR 1.39), having a larger client volume (AOR 3.16), being a part of an insurance network (AOR 1.42), and using electronic health records (AOR 1.62). Publicly funded family planning providers were heavily engaged in referrals. Specific referral practices varied widely and by type of care. More assessment of these and other aspects of referral systems and practices is needed to better characterize the quality of care.

  11. Nurse-midwives in federally funded health centers: understanding federal program requirements and benefits.

    Science.gov (United States)

    Carter, Martha

    2012-01-01

    Midwives are working in federally funded health centers in increasing numbers. Health centers provide primary and preventive health care to almost 20 million people and are located in every US state and territory. While health centers serve the entire community, they also serve as a safety net for low-income and uninsured individuals. In 2010, 93% of health center patients had incomes below 200% of the Federal Poverty Guidelines, and 38% were uninsured. Health centers, including community health centers, migrant health centers, health care for the homeless programs, and public housing primary care programs, receive grant funding and enjoy other benefits due to status as federal grantees and designation as federally qualified health centers. Clinicians working in health centers are also eligible for financial and professional benefits because of their willingness to serve vulnerable populations and work in underserved areas. Midwives, midwifery students, and faculty working in, or interacting with, health centers need to be aware of the regulations that health centers must comply with in order to qualify for and maintain federal funding. This article provides an overview of health center regulations and policies affecting midwives, including health center program requirements, scope of project policy, provider credentialing and privileging, Federal Tort Claims Act malpractice coverage, the 340B Drug Pricing Program, and National Health Service Corps scholarship and loan repayment programs. © 2012 by the American College of Nurse-Midwives.

  12. Workplace response of companies exposed to the 9/11 World Trade Center attack: a focus-group study

    Science.gov (United States)

    North, Carol S.; Pfefferbaum, Betty; Hong, Barry A.; Gordon, Mollie R.; Kim, You-Seung; Lind, Lisa; Pollio, David E.

    2014-01-01

    The terrorist attacks of 11 September 2001 (9/11) left workplaces in pressing need of a mental health response capability. Unaddressed emotional sequelae may be devastating to the productivity and economic stability of a company’s workforce. In the second year after the attacks, 85 employees of five highly affected agencies participated in 12 focus groups to discuss workplace mental health issues. Managers felt ill prepared to manage the magnitude and the intensity of employees’ emotional responses. Rapid return to work, provision of workplace mental health services, and peer support were viewed as contributory to emotional recovery. Formal mental health services provided were perceived as insufficient. Drawing on their post-9/11 workplace experience, members of these groups identified practical measures that they found helpful in promoting healing outside of professional mental health services. These measures, consistent with many principles of psychological first aid, may be applied by workplace leaders who are not mental health professionals. PMID:23066661

  13. Investigating Medication Errors in Educational Health Centers of Kermanshah

    Directory of Open Access Journals (Sweden)

    Mohsen Mohammadi

    2015-08-01

    Full Text Available Background and objectives : Medication errors can be a threat to the safety of patients. Preventing medication errors requires reporting and investigating such errors. The present study was conducted with the purpose of investigating medication errors in educational health centers of Kermanshah. Material and Methods: The present research is an applied, descriptive-analytical study and is done as a survey. Error Report of Ministry of Health and Medical Education was used for data collection. The population of the study included all the personnel (nurses, doctors, paramedics of educational health centers of Kermanshah. Among them, those who reported the committed errors were selected as the sample of the study. The data analysis was done using descriptive statistics and Chi 2 Test using SPSS version 18. Results: The findings of the study showed that most errors were related to not using medication properly, the least number of errors were related to improper dose, and the majority of errors occurred in the morning. The most frequent reason for errors was staff negligence and the least frequent was the lack of knowledge. Conclusion: The health care system should create an environment for detecting and reporting errors by the personnel, recognizing related factors causing errors, training the personnel and create a good working environment and standard workload.

  14. Patient Engagement in Community Health Center Leadership: How Does it Happen?

    Science.gov (United States)

    Sharma, Anjana E; Huang, Beatrice; Knox, Margae; Willard-Grace, Rachel; Potter, Michael B

    2018-05-18

    Patient engagement in primary care leadership is an important means to involve community voices at community health centers. Federally qualified health centers (FQHCs) are mandated to have patient representation within their governing boards, while practices seeking patient-centered medical home certification receive credit for implementing patient advisory councils (PACs). Our objective was to compare and contrast how community health centers engage patients in clinic management, decision-making and planning within governing boards versus PACs. Qualitative study conducted from August 2016 to June 2017 at community health centers in California, Arizona and Hawaii. We interviewed practice leaders of patient engagement programs at their site. Eligible clinics had patient representatives within their governing board, PAC, or both. We assessed patient demographics, roles and responsibilities of patients participating, and extent of involvement in quality improvement among governing boards versus PACs. We interviewed 19 sites, of which 17 were FQHCs that had governing boards. Of the 17 FQHCs, 11 had also implemented PACs. Two non-FQHC safety-net sites had PACs but did not have governing boards. Governing board members had formal, structured membership responsibilities such as finances and hiring personnel. PAC roles were more flexible, focusing on day-to-day clinic operations. Clinics tended to recruit governing board patient members for their skill set and professional experience; PAC member recruitment focused more on demographic representation of the clinic's patient population. Both groups worked on quality improvement, but governing boards tended to review clinic performance metrics, while PAC members were involved in specific project planning and implementation to improve clinical outcomes and patient experience. Patient involvement in clinic improvement in CHCs includes higher-level decision-making and governance through mechanisms such as governing boards, as

  15. A Multidimensional Data Warehouse for Community Health Centers.

    Science.gov (United States)

    Kunjan, Kislaya; Toscos, Tammy; Turkcan, Ayten; Doebbeling, Brad N

    2015-01-01

    Community health centers (CHCs) play a pivotal role in healthcare delivery to vulnerable populations, but have not yet benefited from a data warehouse that can support improvements in clinical and financial outcomes across the practice. We have developed a multidimensional clinic data warehouse (CDW) by working with 7 CHCs across the state of Indiana and integrating their operational, financial and electronic patient records to support ongoing delivery of care. We describe in detail the rationale for the project, the data architecture employed, the content of the data warehouse, along with a description of the challenges experienced and strategies used in the development of this repository that may help other researchers, managers and leaders in health informatics. The resulting multidimensional data warehouse is highly practical and is designed to provide a foundation for wide-ranging healthcare data analytics over time and across the community health research enterprise.

  16. Focus group interview: an underutilized research technique for improving theory and practice in health education.

    Science.gov (United States)

    Basch, C E

    1987-01-01

    The purpose of this article is to increase awareness about and stimulate interest in using focus group interviews, a qualitative research technique, to advance the state-of-the-art of education and learning about health. After a brief discussion of small group process in health education, features of focus group interviews are presented, and a theoretical framework for planning a focus group study is summarized. Then, literature describing traditional and health-related applications of focus group interviews is reviewed and a synthesis of methodological limitations and advantages of this technique is presented. Implications are discussed regarding: need for more inductive qualitative research in health education; utility of focus group interviews for research and for formative and summative evaluation of health education programs; applicability of marketing research to understanding and influencing consumer behavior, despite notable distinctions between educational initiatives and marketing; and need for professional preparation faculty to consider increasing emphasis on qualitative research methods.

  17. Effective implantation of light emitting centers by plasma immersion ion implantation and focused ion beam methods into nanosized diamond

    International Nuclear Information System (INIS)

    Himics, L.; Tóth, S.; Veres, M.; Tóth, A.; Koós, M.

    2015-01-01

    Highlights: • Characteristics of nitrogen implantation of nanodiamond using two low ion energy ion implantation methods were compared. • Formation of complex nitrogen-related defect centers was promoted by subsequent helium implantation and heat treatments. • Depth profiles of the implanted ions and the generated vacancies were determined using SRIM calculations. • The presence of nitrogen impurity was demonstrated by Fourier-transform infrared spectroscopic measurements. • A new nitrogen related band was detected in the photoluminescence spectrum of the implanted samples that was attributed to the N3 color center in nanodiamond. - Abstract: Two different implantation techniques, plasma immersion ion implantation and focused ion beam, were used to introduce nitrogen ions into detonation nanodiamond crystals with the aim to create nitrogen-vacancy related optically active centers of light emission in near UV region. Previously samples were subjected to a defect creation process by helium irradiation in both cases. Heat treatments at different temperatures (750 °C, 450 °C) were applied in order to initiate the formation of nitrogen-vacancy related complex centers and to decrease the sp 2 carbon content formed under different treatments. As a result, a relatively narrow and intensive emission band with fine structure at 2.98, 2.83 and 2.71 eV photon energies was observed in the light emission spectrum. It was assigned to the N3 complex defect center. The formation of this defect center can be expected by taking into account the relatively high dose of implanted nitrogen ions and the overlapped depth distribution of vacancies and nitrogen. The calculated depth profiles distribution for both implanted nitrogen and helium by SRIM simulation support this expectation

  18. Utilization of Mental Health Services in School-Based Health Centers.

    Science.gov (United States)

    Bains, Ranbir M; Cusson, Regina; White-Frese, Jesse; Walsh, Stephen

    2017-08-01

    We summarize utilization patterns for mental health services in school-based health centers. Administrative data on school-based health center visits in New Haven, Connecticut were examined for the 2007-2009 school years. Relative frequencies of mental health visits by age were calculated as a percentage of all visits and were stratified by sex, ethnicity/race, and insurance status. Mental health visits accounted for the highest proportion of visits (31.8%). The proportion of mental health visits was highest at 8 years (42.8%) and at 13 years (39.0%). The proportion of mental health visits among boys (38.4%) was higher than among girls (26.7%). Hispanic students had a lower proportion of mental health visits than black students (23.5% vs 35.8%) in all but 2 age groups. Students in the white/other ethnicity category had higher proportions of mental health visits than Hispanic and black students between ages 12 and 15. Students with no health insurance (22.5%) had lower proportions of mental health visits than students covered by Medicaid (34.3%) or private insurance (33.9%). The percentage of mental health visits by students with private insurance was highest (37.2%-49%) in the 13-15 age range. Usage patterns for mental health issues show pronounced, nonrandom variation relative to age and other demographic characteristics especially with 8-year-old boys. © 2017, American School Health Association.

  19. Oral health knowledge of health care workers in special children's center.

    Science.gov (United States)

    Wyne, Amjad; Hammad, Nouf; Splieth, Christian

    2015-01-01

    To determine the oral health knowledge of health care workers in special children's center. A self-administered questionnaire was used to collect following information: demographics, oral hygiene practices, importance of fluoride, dental visits, cause of tooth decay, gingival health, and sources of oral health information. The study was conducted at Riyadh Center for Special Children in Riyadh City from December 2013 to May 2014. All 60 health care workers in the center completed the questionnaire. A great majority (95%) of the workers brushed their teeth twice or more daily. More than two-third (71.7%) of the workers knew that fluoride helps in caries prevention. One in five (21.7%) workers thought that a dental visit only becomes necessary in case of a dental problem. Similarly, 13.3% of the workers thought to "wait till there is some pain in case of a dental cavity" before seeking dental treatment. The workers ranked soft drinks/soda (98.3%), flavored fizzy drinks (60%) and sweetened/flavored milks (43.3%) as top three cariogenic drinks. A great majority (95%) of the workers correctly responded that blood on toothbrush most probably is a sign of "gum disease". Dentists (50%) and media (45%) were the main source of their oral health information. There was no significant difference (p > 0.05) in workers' response in relation to their specific job. The special health care workers in the disabled children's center generally had satisfactory oral health knowledge and practices.

  20. The interplay between regulatory focus and temporal distance in the health context

    NARCIS (Netherlands)

    Berezowska, Aleksandra; Fischer, Arnout R.H.; Trijp, van Hans C.M.

    2018-01-01

    Objectives: This study identifies how the interaction between temporal distance, regulatory focus, and framing of health outcomes affects individuals' intention to adopt a personalized nutrition service. Design: A 2 (temporal distance: immediate health outcomes vs. delayed health outcomes) × 2

  1. Politics and the success of school-based health centers.

    Science.gov (United States)

    Rienzo, B A; Button, J W; Wald, K D

    2000-10-01

    School-based health centers (SBHCs) provide access to health services by bringing providers to children (and sometimes parents) and furnishing low cost services in an atmosphere of trust. While the number of SBHCs has continued to grow and some clinics have continued to expand their services, others have barely survived and some have even closed. This study investigated factors, particularly political forces, that affected the success of SBHCs. Using a national survey of clinic directors, this study assessed clinic success in terms both of longevity and service delivery. Findings indicate the factors most consistently and significantly associated with success include not only measures of "need" (school size and percent African-American enrollment or population) but of "politics" (citizen political ideology and Southern conservatism). Thus, politics matters more than previous studies suggested.

  2. Differences between Irish and Australian psychiatric nurses' family-focused practice in adult mental health services

    LENUS (Irish Health Repository)

    Grant, Anne

    2016-04-01

    Psychiatric nurses\\' practice with parents who have mental illness, their children and families is an important issue internationally. This study provides a comparison of Irish and Australian psychiatric nurses\\' family-focused practices in adult mental health services. Three hundred and forty three nurses across Ireland and 155 from Australia completed the Family Focused Mental Health Practice Questionnaire. Cross-country comparisons revealed significant differences, in terms of family-focused skill, knowledge, confidence and practice. Australian psychiatric nurses engaged in higher family-focused practice compared to Irish nurses. The comparative differences between countries may be attributable to differences in training, workplace support and policy.

  3. "Innovation" institutes in academic health centers: enhancing value through leadership, education, engagement, and scholarship.

    Science.gov (United States)

    Pines, Jesse M; Farmer, Steven A; Akman, Jeffrey S

    2014-09-01

    In the next decade, the biggest change in medicine in the United States will be the organizational transformation of the delivery system. Organizations-including academic health centers-able to achieve better outcomes for less will be the financial winners as new payment models become more prevalent. For medical educators, the question is how to prepare the next generation of physicians for these changes. One solution is the development of new "innovation" or "value" institutes. Around the nation, many of these new institutes are focused on surmounting barriers to value-based care in academic health centers, educating faculty, house staff, and medical students in discussions of cost-conscious care. Innovation institutes can also lead discussions about how value-based care may impact education in environments where there may be less autonomy and more standardization. Quality metrics will play a larger role at academic health centers as metrics focus more on outcomes than processes. Optimizing outcomes will require that medical educators both learn and teach the principles of patient safety and quality improvement. Innovation institutes can also facilitate cross-institutional discussions to compare data on utilization and outcomes, and share best practices that maximize value. Another barrier to cost-conscious care is defensive medicine, which is highly engrained in U.S. medicine and culture. Innovation institutes may not be able to overcome all the barriers to making medical care more cost-conscious, but they can be critical in enabling academic health centers to optimize their teaching and research missions while remaining financially competitive.

  4. 75 FR 55587 - Family-to-Family Health Information Center Program

    Science.gov (United States)

    2010-09-13

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Health Resources and Services Administration Family-to-Family Health Information Center Program AGENCY: Health Resources and Services Administration, HHS... Vermont Family-to-Family Health Information Center (F2F HIC) grant (H84MC00002) from the Parent to Parent...

  5. 77 FR 50519 - Center for Mental Health Services (CMHS); Amendment of Meeting

    Science.gov (United States)

    2012-08-21

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Mental Health Services (CMHS); Amendment of Meeting Pursuant to Public Law 92-463, notice is... Substance Abuse and Mental Health Services Administration's (SAMHSA), Center for Mental Health Services...

  6. Sexual Violence Screening Practices of Student Health Centers Located on Universities in Florida

    Science.gov (United States)

    Halstead, Valerie; Williams, Jessica R.; Gattamorta, Karina; Gonzalez-Guarda, Rosa

    2017-01-01

    Objective: The purpose of this study is to describe current sexual violence screening practices of student health centers located on universities in Florida. Participants: Institutional level data was collected from 33 student health centers from November 2015 through January 2016. The student health centers were located on public or private…

  7. 77 FR 59931 - Single Source Program Expansion Supplement Award to Area Health Education Centers (AHEC) Program...

    Science.gov (United States)

    2012-10-01

    ... Program Expansion Supplement Award to Area Health Education Centers (AHEC) Program Grantee; Exception to... Competition--Single Source Program Expansion Supplement Award to Area Health Education Centers (AHEC) Program... supplement award to the University of Guam School of Nursing, an Area Health Education Center (AHEC) Program...

  8. Indian public health standards in primary health centers and community health centers in Shimla District of Himachal Pradesh: A descriptive evaluation

    Directory of Open Access Journals (Sweden)

    Raman Chauhan

    2016-01-01

    Full Text Available Introduction: The health planners in India have visualized primary health centers (PHCs and community health centers (CHCs as the key healthcare delivery institutions in rural areas. These centers are supposed to have health manpower, infrastructure, and service delivery as per the Indian public health standards (IPHS guidelines (2010. Materials and Methods: A cross-sectional study was conducted in seven CHCs and 12 PHCs, randomly selected from eight blocks of Shimla District and evaluated in terms of health manpower, infrastructure, and services from September 2011 to August 2012. Data was collected from the selected units using structured data collection instruments designed by the IPHS. Results: The health centers were assessed according to IPHS guidelines. Outpatient department services and referral services were provided in all the centers studied. No specialist doctor was posted at any of CHCs against a sanctioned strength of at least four (surgeon, physician, obstetrician, and pediatrician per CHC. In 3 (42.8% CHCs and 8 (75% PHCs, no pharmacist was posted. Eight (75% PHCs did not have any staff nurse posted. Three (42.8% CHCs and 10 (83.3% PHCs did not have a laboratory technician. In CHCs, separate labor room was available in 6 (85.7% whereas a separate laboratory was available in all seven. Separate labor room and laboratory were available in four (25% PHCs. Conclusions: IPHS guidelines are not being followed at PHC and CHC levels of the district. Health manpower shortage is the key bottleneck in service delivery. Political advocacy is needed to ensure sufficient health manpower availability to deliver quality healthcare.

  9. The US CDC Centers for public health preparedness : building a nationwide exemplar network

    Energy Technology Data Exchange (ETDEWEB)

    Harris, D.A.; Paulson, G.; Perry, E. [New Jersey Univ. of Medicine and Dentistry, New Brunswick, NJ (United States). School of Public Health

    2005-07-01

    The network of Centers for Public Health Preparedness (CPHP) was created by the United States Centers for Disease Control and Prevention in response to the perception that public health professionals were inadequately prepared to respond to terrorism incidents, natural disasters and similar major events. The events of September 11, 2001 and the subsequent anthrax attacks confirmed the wisdom of a concerted approach to emergency preparedness. This paper provides an outline of the network's recent activities as well as a review of the rationale, history and progress of the network to date. In the most recent grant cycle, each center was required to allocate 20 per cent of its resources to network-wide activities, including contribution of CPHP-developed materials to a central resource center maintained by the Association of Schools of Public Health. The materials are publicly available and are to be used in the development of training programs; the establishment of 19 or more exemplar groups that focus on specific preparedness-related knowledge domains such as mental health, educational evaluation methods and field epidemiology, who are also expected to develop tool kits of validated and fully described training materials for use by any CPHP person or group. The outcome of the CPHP network activities is the development of a more comprehensive and robust core of preparedness training materials that aim to facilitate rapid and effective training, while at the same time eliminating redundancy and duplication of effort. It was concluded that the expenditure of 20 per cent of center funds on network development activities is forcing the academically based CPHPs to adopt a new collaborative paradigm in order to ensure effective nationwide preparedness. 3 refs.

  10. Integration of pharmacists into patient-centered medical homes in federally qualified health centers in Texas.

    Science.gov (United States)

    Wong, Shui Ling; Barner, Jamie C; Sucic, Kristina; Nguyen, Michelle; Rascati, Karen L

    To describe the integration and implementation of pharmacy services in patient-centered medical homes (PCMHs) as adopted by federally qualified health centers (FQHCs) and compare them with usual care (UC). Four FQHCs (3 PCMHs, 1 UC) in Austin, TX, that provide care to the underserved populations. Pharmacists have worked under a collaborative practice agreement with internal medicine physicians since 2005. All 4 FQHCs have pharmacists as an integral part of the health care team. Pharmacists have prescriptive authority to initiate and adjust diabetes medications. The PCMH FQHCs instituted co-visits, where patients see both the physician and the pharmacist on the same day. PCMH pharmacists are routinely proactive in collaborating with physicians regarding medication management, compared with UC in which pharmacists see patients only when referred by a physician. Four face-to-face, one-on-one semistructured interviews were conducted with pharmacists working in 3 PCMH FQHCs and 1 UC FQHC to compare the implementation of PCMH with emphasis on 1) structure and workflow, 2) pharmacists' roles, and 3) benefits and challenges. On co-visit days, the pharmacist may see the patient before or after physician consultation. Pharmacists in 2 of the PCMH facilities proactively screen to identify diabetes patients who may benefit from pharmacist services, although the UC clinic pharmacists see only referred patients. Strengths of the co-visit model include more collaboration with physicians and more patient convenience. Payment that recognizes the value of PCMH is one PCMH principle that is not fully implemented. PCMH pharmacists in FQHCs were integrated into the workflow to address specific patient needs. Specifically, full-time in-house pharmacists, flexible referral criteria, proactive screening, well defined collaborative practice agreement, and open scheduling were successful strategies for the underserved populations in this study. However, reimbursement plans and provider

  11. A literature review of record linkage procedures focusing on infant health outcomes

    Directory of Open Access Journals (Sweden)

    Carla Jorge Machado

    Full Text Available Record linkage is a powerful tool in assembling information from different data sources and has been used by a number of public health researchers. In this review, we provide an overview of the record linkage methodologies, focusing particularly on probabilistic record linkage. We then stress the purposes and research applications of linking records by focusing on studies of infant health outcomes based on large data sets, and provide a critical review of the studies in Brazil.

  12. Smoking Is So Ew!: College Smokers' Reactions to Health- Versus Social-Focused Antismoking Threat Messages.

    Science.gov (United States)

    Wong, Norman C H; Nisbett, Gwendelyn S; Harvell, Lindsey A

    2017-04-01

    This study utilizes Terror Management Theory (TMT) to examine differences between eliciting social death and physical death anxiety related to smoking, smoking attitudes, and quitting intent among college students. Moreover, an important TMT variable-self-esteem-was used as a moderator. A 2 × 3 between-subjects factorial design crossed smoking-based self-esteem (low, high) with mortality salience manipulation (health-focused, social-focused, control). Results suggest while both making health-focused salient and making social-focused mortality salient were effective at getting smokers to quit, there was less effect for health-focused mortality salience on those whose self-esteem is strongly tied to smoking. Effect of social-focused mortality salience was more pronounced among participants who highly linked self-esteem with smoking. For smokers with low smoking-based self-esteem, both health-focused and social-focused mortality salience were effective at motivating attitude change toward smoking and quitting intentions. Implications for smoking cessation ad design and TMT are discussed.

  13. Assessment of oral health attitudes and behavior among students of Kuwait University Health Sciences Center.

    Science.gov (United States)

    Ali, Dena A

    2016-01-01

    The aims of this study were to assess attitudes and behavior of oral health maintenance among students in four faculties (Medicine, Dentistry, Pharmacy, and Allied Health) and to compare oral health attitudes and behavior of all students at Kuwait University Health Sciences Center (KUHSC) based on their academic level. Students enrolled in the Faculties of Dentistry, Medicine, Pharmacy, and Allied Health at KUHSC were evaluated regarding their oral health attitudes and behavior by an e-mail invitation with a link to the Hiroshima University Dental Behavior Inventory survey that was sent to all 1802 students with Kuwait University Health Sciences Center e-mail addresses. The data were analyzed for frequency distributions, and differences among the groups were assessed using the Mann-Whitney U test, Chi-square test, and Kruskal-Wallis test. P values less than 0.05 were considered to be statistically significant ( P < 0.05). The results of this study indicated that dental students achieved better oral health attitudes and behavior than that of their nondental professional fellow students ( P < 0.05). Students in advanced academic levels and female students demonstrated better oral health attitudes and behavior. Dental students and students who were in advanced levels of their training along with female students demonstrated better oral health practices and perceptions than students in lower academic levels and male students, respectively. Additional studies for investigating the effectiveness and identifying areas requiring modification within the dental curriculum at KUHSC may be warranted.

  14. Behavioral Health and Health Care Reform Models: Patient-Centered Medical Home, Health Home, and Accountable Care Organization

    OpenAIRE

    Bao, Yuhua; Casalino, Lawrence P.; Pincus, Harold Alan

    2013-01-01

    Discussions of health care delivery and payment reforms have largely been silent about how behavioral health could be incorporated into reform initiatives. This paper draws attention to four patient populations defined by the severity of their behavioral health conditions and insurance status. It discusses the potentials and limitations of three prominent models promoted by the Affordable Care Act to serve populations with behavioral health conditions: the Patient Centered Medical Home, the H...

  15. Analysis of health in health centers area in Depok using correspondence analysis and scan statistic

    Science.gov (United States)

    Basir, C.; Widyaningsih, Y.; Lestari, D.

    2017-07-01

    Hotspots indicate area that has a higher case intensity than others. For example, in health problems of an area, the number of sickness of a region can be used as parameter and condition of area that determined severity of an area. If this condition is known soon, it can be overcome preventively. Many factors affect the severity level of area. Some health factors to be considered in this study are the number of infant with low birth weight, malnourished children under five years old, under five years old mortality, maternal deaths, births without the help of health personnel, infants without handling the baby's health, and infant without basic immunization. The number of cases is based on every public health center area in Depok. Correspondence analysis provides graphical information about two nominal variables relationship. It create plot based on row and column scores and show categories that have strong relation in a close distance. Scan Statistic method is used to examine hotspot based on some selected variables that occurred in the study area; and Correspondence Analysis is used to picturing association between the regions and variables. Apparently, using SaTScan software, Sukatani health center is obtained as a point hotspot; and Correspondence Analysis method shows health centers and the seven variables have a very significant relationship and the majority of health centers close to all variables, except Cipayung which is distantly related to the number of pregnant mother death. These results can be used as input for the government agencies to upgrade the health level in the area.

  16. Patient safety goals for the proposed Federal Health Information Technology Safety Center.

    Science.gov (United States)

    Sittig, Dean F; Classen, David C; Singh, Hardeep

    2015-03-01

    The Office of the National Coordinator for Health Information Technology is expected to oversee creation of a Health Information Technology (HIT) Safety Center. While its functions are still being defined, the center is envisioned as a public-private entity focusing on promotion of HIT related patient safety. We propose that the HIT Safety Center leverages its unique position to work with key administrative and policy stakeholders, healthcare organizations (HCOs), and HIT vendors to achieve four goals: (1) facilitate creation of a nationwide 'post-marketing' surveillance system to monitor HIT related safety events; (2) develop methods and governance structures to support investigation of major HIT related safety events; (3) create the infrastructure and methods needed to carry out random assessments of HIT related safety in complex HCOs; and (4) advocate for HIT safety with government and private entities. The convening ability of a federally supported HIT Safety Center could be critically important to our transformation to a safe and effective HIT enabled healthcare system. © The Author 2014. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  17. Parent-child health- and weight-focused conversations: Who is saying what and to whom?

    Science.gov (United States)

    Winkler, Megan R; Berge, Jerica M; Larson, Nicole; Loth, Katie A; Wall, Melanie; Neumark-Sztainer, Dianne

    2018-07-01

    The purpose of this study was to examine the prevalence of health-focused (healthy eating, physical activity) and weight-focused (weight, dieting) parent-child conversations, and to understand who is talking and who is listening, by exploring the associations these conversations have with parent and child characteristics. The study population included 546 parents (age 27-36 years) who participated in Project EAT (Eating and Activity in Teens and Young Adults)-IV (2015-2016) and had a child aged 2-17 years. Cross-sectional prevalence ratios were calculated to identify associations between parent and child characteristics and the parent-child conversations. Conversations about healthy eating (82%) and physical activity (75%) were more prevalent than those about the child's weight (30%), and dieting (25%). In adjusted models, parents meeting physical activity recommendations had a higher prevalence of health-focused conversations (healthy eating PR = 1.10, 95% CI = 1.01, 1.20; physical activity PR = 1.12, 95% CI = 1.02, 1.24); whereas, weight-focused conversations were more common among parents who had recently dieted and perceived their child to be overweight. Health-focused and weight-focused conversations were highly common among the oldest children aged 9-17 years (health-focused = 90-93% and weight-focused = 42-53%); though, a substantial prevalence of health- and weight-focused conversations (>50% and ≥10%, respectively) also occurred with the youngest children (2-4 years). Findings suggest that parent-child health- and weight-focused conversations are common and that characteristics, including child's age and parents' physical activity, dieting, and perceptions of child weight, may be useful to consider in public health messaging, interventions, and family education that address parent-child communication. Copyright © 2018 Elsevier Ltd. All rights reserved.

  18. Assessing the public health impact of using poison center data for public health surveillance.

    Science.gov (United States)

    Wang, Alice; Law, Royal; Lyons, Rebecca; Choudhary, Ekta; Wolkin, Amy; Schier, Joshua

    2017-12-13

    The National Poison Data System (NPDS) is a database and surveillance system for US poison centers (PCs) call data. The Centers for Disease Control and Prevention (CDC) and American Association of Poison Control Centers (AAPCC) use NPDS to identify incidents of potential public health significance. State health departments are notified by CDC of incidents identified by NPDS to be of potential public health significance. Our objective was to describe the public health impact of CDC's notifications and the use of NPDS data for surveillance. We described how NPDS data informed three public health responses: the Deepwater Horizon incident, national exposures to laundry detergent pods, and national exposures to e-cigarettes. Additionally, we extracted survey results of state epidemiologists regarding NPDS incident notification follow-up from 1 January 2015 to 31 December 2016 to assess current public health application of NPDS data using Epi Info 7.2 and analyzed data using SAS 9.3. We assessed whether state health departments were aware of incidents before notification, what actions were taken, and whether CDC notifications contributed to actions. NPDS data provided evidence for industry changes to improve laundry detergent pod containers safety and highlighted the need to regulate e-cigarette sale and manufacturing. NPDS data were used to improve situational awareness during the 2010 Deepwater Horizon oil spill. Of 59 health departments and PCs who responded to CDC notifications about anomalies (response rate = 49.2%), 27 (46%) reported no previous awareness of the incident, and 20 (34%) said that notifications contributed to public health action. Monitoring NPDS data for anomalies can identify emerging public health threats and provide evidence-based science to support public health action and policy changes.

  19. The Examination of The Outdoors of Family Health-Care Center: A Case Study In Çanakkale City Center

    OpenAIRE

    SAĞLIK, Alper; KELKİT, Abdullah

    2017-01-01

    The gardens of the health-care centers are areas of fear, anxiety and stress based. In the process of the treatment of patients, these areas have psychological, physical and social significance. For this reason, health-care center gardens should be designed to help treatment of patients. Well designed gardens are important for elimination of adverse effects of clinical environments on patients and helping patients to stay away from the stress by ensuring their socia...

  20. Leadership in Academic Health Centers: Transactional and Transformational Leadership.

    Science.gov (United States)

    Smith, Patrick O

    2015-12-01

    Leadership is a crucial component to the success of academic health science centers (AHCs) within the shifting U.S. healthcare environment. Leadership talent acquisition and development within AHCs is immature and approaches to leadership and its evolution will be inevitable to refine operations to accomplish the critical missions of clinical service delivery, the medical education continuum, and innovations toward discovery. To reach higher organizational outcomes in AHCs requires a reflection on what leadership approaches are in place and how they can better support these missions. Transactional leadership approaches are traditionally used in AHCs and this commentary suggests that movement toward a transformational approach is a performance improvement opportunity for AHC leaders. This commentary describes the transactional and transformational approaches, how they complement each other, and how to access the transformational approach. Drawing on behavioral sciences, suggestions are made on how a transactional leader can change her cognitions to align with the four dimensions of the transformational leadership approach.

  1. [Local planning: the speech of basic health care center manager].

    Science.gov (United States)

    Cubas, Márcia Regina

    2005-01-01

    As planning is understood as a management tool, this article offers an argument through the speech framework of Basic Health Care Center Managers in the city of Curitiba-PR, by means of the Collective Subject Speech Methodology on local planning aspects. Its purpose is to bring local managers to a reflection concerning their styles, practices and experiences, as well as to collaborate with central level leading teams towards building their planning processes in an upward, participatory, communicative and strategic way. Considerations of the speeches built from central ideas are presented: planning methodology; inter-sectoriality; territorial basis; team and community participation; training, autonomy and particular profile of local managers; the manager's agenda; and institutional culture.

  2. Rewards and challenges of community health center practice.

    Science.gov (United States)

    Cole, Allison M; Chen, Frederick M; Ford, Paul A; Phillips, William R; Stevens, Nancy G

    2014-04-01

    More than 1100 community health centers (CHCs) in the United States provide primary care to 20 million underserved patients annually. CHCs have struggled to recruit and retain qualified physicians. To understand physicians' work experiences in CHCs and identify major sources of satisfaction and dissatisfaction. Using purposeful sampling, we conducted semistructured interviews with 12 family physicians practicing in CHCs. Interview questions assessed physicians' experiences in CHCs and sources of satisfaction and dissatisfaction. Interview notes were coded and analyzed by 2 investigators using a grounded theory approach to identify key themes. Though family physicians feel tremendous satisfaction from care of underserved patients, they are frustrated with the overwhelming workload they experience. Family physicians also report poor administrative management while working in CHCs. Implementation of the Affordable Care Act, which relies on expansion of CHC services, may be adversely affected by family physicians' frustrations with CHC practice. Further research to explore and potentially improve the CHC work environment may be needed.

  3. Oral health knowledge of health care workers in special children’s center

    Science.gov (United States)

    Wyne, Amjad; Hammad, Nouf; Splieth, Christian

    2015-01-01

    Objective: To determine the oral health knowledge of health care workers in special children’s center. Methods: A self-administered questionnaire was used to collect following information: demographics, oral hygiene practices, importance of fluoride, dental visits, cause of tooth decay, gingival health, and sources of oral health information. The study was conducted at Riyadh Center for Special Children in Riyadh City from December 2013 to May 2014. Results: All 60 health care workers in the center completed the questionnaire. A great majority (95%) of the workers brushed their teeth twice or more daily. More than two-third (71.7%) of the workers knew that fluoride helps in caries prevention. One in five (21.7%) workers thought that a dental visit only becomes necessary in case of a dental problem. Similarly, 13.3% of the workers thought to “wait till there is some pain in case of a dental cavity” before seeking dental treatment. The workers ranked soft drinks/soda (98.3%), flavored fizzy drinks (60%) and sweetened/flavored milks (43.3%) as top three cariogenic drinks. A great majority (95%) of the workers correctly responded that blood on toothbrush most probably is a sign of “gum disease”. Dentists (50%) and media (45%) were the main source of their oral health information. There was no significant difference (p > 0.05) in workers’ response in relation to their specific job. Conclusion: The special health care workers in the disabled children’s center generally had satisfactory oral health knowledge and practices. PMID:25878636

  4. Federally qualified health center dental clinics: financial information.

    Science.gov (United States)

    Bailit, Howard L; Devitto, Judy; Myne-Joslin, Ronnie; Beazoglou, Tryfon; McGowan, Taegan

    2013-01-01

    Federally Qualified Health Center (FQHC) dental clinics are a major component of the dental safety net system, providing care to 3.75 million patients annually. This study describes the financial and clinical operations of a sample of FQHCs. In cooperation with the National Network for Oral Health Access, FQHC dental clinics that could provide 12 months of electronic dental record information were asked to participate in the study. Based on data from 28 dental clinics (14 FQHCs), 50 percent of patients were under 21 years of age. The primary payers were Medicaid (72.4 percent) and sliding-scale/self-pay patients (17.5 percent). Sites averaged 3.1 operatories, 0.66 dental hygienists, and 1.9 other staff per dentist. Annually, each FTE dentist and hygienist provided 2,801 and 2,073 patient visits, respectively. Eighty percent of services were diagnostic, preventive, and restorative. Patient care accounted for 82 percent of revenues, and personnel (64.2 percent) and central administration (13.4 percent) accounted for most expenses. Based on a small convenience sample of FQHC dental clinics, this study presents descriptive data on their clinical and financial operations. Compared with data from the UDS (Uniform Data System) report, study FQHCs were larger in terms of space, staff, and patients served. However, there was substantial variation among clinics for almost all measures. As the number and size of FQHC dental clinics increase, the Health Resources and Services Administration needs to provide them access to comparative data that they can use to benchmark their operations. © 2013 American Association of Public Health Dentistry.

  5. 78 FR 45543 - Center for Mental Health Services; Notice of Meeting

    Science.gov (United States)

    2013-07-29

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Substance Abuse and Mental Health Services Administration Center for Mental Health Services; Notice of Meeting Pursuant to Public Law 92-463, notice is hereby given that the Substance Abuse and Mental Health Services Administration's (SAMHSA) Center for Mental...

  6. Profession differences in family focused practice in the adult mental health system.

    Science.gov (United States)

    Maybery, Darryl; Goodyear, Melinda; O'Hanlon, Brendan; Cuff, Rose; Reupert, Andrea

    2014-12-01

    There is a large gulf between what psychiatric services should (or could) provide and what they do in practice. This article sought to determine practice differences between the differing professions working in adult mental health services in terms of their family focused work. Three hundred and seven adult mental health professionals completed a cross-sectional survey of family focused practices in adult mental health services. Findings highlight that social workers engaged in more family focused practice compared to psychiatric nurses, who performed consistently the lowest on direct family care, compared to both social workers and psychologists. Clear skill, knowledge, and confidence differences are indicated between the professions. The article concludes by offering direction for future profession education and training in family focused practices. © 2014 Family Process Institute.

  7. The Oral Health Care Manager in a Patient-Centered Health Facility.

    Science.gov (United States)

    Theile, Cheryl Westphal; Strauss, Shiela M; Northridge, Mary Evelyn; Birenz, Shirley

    2016-06-01

    The dental hygienist team member has an opportunity to coordinate care within an interprofessional practice as an oral health care manager. Although dental hygienists are currently practicing within interprofessional teams in settings such as pediatric offices, hospitals, nursing homes, schools, and federally qualified health centers, they often still assume traditional responsibilities rather than practicing to the full extent of their training and licenses. This article explains the opportunity for the dental hygiene professional to embrace patient-centered care as an oral health care manager who can facilitate integration of oral and primary care in a variety of health care settings. Based on an innovative model of collaboration between a college of dentistry and a college of nursing, an idea emerged among several faculty members for a new management method for realizing continuity and coordination of comprehensive patient care. Involved faculty members began working on the development of an approach to interprofessional practice with the dental hygienist serving as an oral health care manager who would address both oral health care and a patient's related primary care issues through appropriate referrals and follow-up. This approach is explained in this article, along with the results of several pilot studies that begin to evaluate the feasibility of a dental hygienist as an oral health care manager. A health care provider with management skills and leadership qualities is required to coordinate the interprofessional provision of comprehensive health care. The dental hygienist has the opportunity to lead closer integration of oral and primary care as an oral health care manager, by coordinating the team of providers needed to implement comprehensive, patient-centered care. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. Restructuring within an academic health center to support quality and safety: the development of the Center for Quality and Safety at the Massachusetts General Hospital.

    Science.gov (United States)

    Bohmer, Richard M J; Bloom, Jonathan D; Mort, Elizabeth A; Demehin, Akinluwa A; Meyer, Gregg S

    2009-12-01

    Recent focus on the need to improve the quality and safety of health care has created new challenges for academic health centers (AHCs). Whereas previously quality was largely assumed, today it is increasingly quantifiable and requires organized systems for improvement. Traditional structures and cultures within AHCs, although well suited to the tripartite missions of teaching, research, and clinical care, are not easily adaptable to the tasks of measuring, reporting, and improving quality. Here, the authors use a case study of Massachusetts General Hospital's efforts to restructure quality and safety to illustrate the value of beginning with a focus on organizational culture, using a systematic process of engaging clinical leadership, developing an organizational framework dependent on proven business principles, leveraging focus events, and maintaining executive dedication to execution of the initiative. The case provides a generalizable example for AHCs of how applying explicit management design can foster robust organizational change with relatively modest incremental financial resources.

  9. Bringing Wellness to Schools: Opportunities and Challenges to Mental Health Integration in School Health Centers

    Science.gov (United States)

    Lai, Karen; Guo, Sisi; Ijadi-Maghsoodi, Roya; Puffer, Maryjane; Kataoka, Sheryl H.

    2016-01-01

    Objective School-based health centers (SBHCs) reduce mental health access-to-care barriers and improve educational outcomes for youth. This qualitative study evaluates the innovations and challenges of a unique network of SBHCs in a large, urban school district, as they attempt to integrate health, mental health, and educational services. Methods The 43 participants sampled included mental health providers, primary care providers, and care coordinators at 14 SBHCs. Semi-structured interviews with each participant were audio-recorded and transcribed. Themes were identified and coded using Atlas.ti 5.1, and collapsed into three domains: Operations, Partnership, and Engagement. Results Interviews revealed provider models ranging from single agencies offering both health and mental health services to co-located services. Sites with the Health Agency providing at least some mental health services reported more mental health screenings. Many sites utilized SBHC coordinators and coordination team meetings to facilitate relationships between schools and Health Agency and Community Mental Health Clinic providers. Partnership challenges included confidentiality policies and staff turnover. Participants also highlighted student and parent engagement, through culturally sensitive services, peer health advocates, and “drop-in” lunches. Conclusions Staffing and operational models are critical in the success of health-mental health-education integration. Among the provider models observed, the combined health and mental health provider model offered the most integrated services. Despite barriers, providers and schools have begun to implement novel solutions for operational problems and family engagement in mental health services. Implications for future SBHCs as an integrated model are described. PMID:27417895

  10. Mental health professionals' family-focused practice with families with dependent children: a survey study.

    Science.gov (United States)

    Tungpunkom, Patraporn; Maybery, Darryl; Reupert, Andrea; Kowalenko, Nick; Foster, Kim

    2017-12-08

    Many people with a mental illness are parents caring for dependent children. These children are at greater risk of developing their own mental health concerns compared to other children. Mental health services are opportune places for healthcare professionals to identify clients' parenting status and address the needs of their children. There is a knowledge gap regarding Thai mental health professionals' family-focused knowledge and practices when working with parents with mental illness and their children and families. This cross -sectional survey study examined the attitudes, knowledge and practices of a sample (n = 349) of the Thai mental health professional workforce (nurses, social workers, psychologists, psychiatrists) using a translated version of the Family-Focused Mental Health Practice Questionnaire (FFMHPQ). The majority of clinicians reported no training in family (76.8%) or child-focused practice (79.7%). Compared to other professional groups, psychiatric nurses reported lower scores on almost all aspects of family-focused practice except supporting clients in their parenting role within the context of their mental illness. Social workers scored highest overall including having more workplace support for family-focused practice as well as a higher awareness of family-focused policy and procedures than psychiatrists; social workers also scored higher than psychologists on providing support to families and parents. All mental health care professional groups reported a need for training and inter-professional practice when working with families. The findings indicate an important opportunity for the prevention of intergenerational mental illness in whose parents have mental illness by strengthening the professional development of nurses and other health professionals in child and family-focused knowledge and practice.

  11. Assessment of health community at the level of Health center Rakovica: Goals and opportunities

    Directory of Open Access Journals (Sweden)

    Šćepanović Aleksandar

    2017-01-01

    Full Text Available Assessment of the health status of the population is the foundation for troubleshooting health of the community. For this first step in solving the problems of health need to have adequate data. The basis for the registration of medical information is medical documentation. The aim is to assess the role and place of assessment of the health status of the community according to the literature in this field. We analyzed the available literature in the field of social medicine and health statistics, enlightened assessment of health in the community. The data necessary for determining the state of health can be related to many characteristics. The data can be accessed: review of available medical records and life statistics. Data analysis is performed with respect to the individual, family, group or the entire community. Based on the analysis and evaluation of health status can begin activities in the planning of preventive measures that should be implemented. To evaluate prevention plan is necessary to select and collect the appropriate data for the evaluation. The analysis and evaluation of individuals involved in cooperation with a team of health care health center for the level of Rakovica. Based on the good judgment of health condition can make appropriate plans of action to protect the health of the community.

  12. An ethnography of clinic "noise" in a community-based, promotora-centered mental health intervention.

    Science.gov (United States)

    Getrich, Christina; Heying, Shirley; Willging, Cathleen; Waitzkin, Howard

    2007-07-01

    Community-based health interventions have emerged as a growing focus for anthropological research. The application of ethnographic approaches in clinical practice settings reveals that community-based interventions must grapple with "noise," or unanticipated factors such as patients' own perceptions of illness and treatment, primary care providers' non-adherence to guidelines-based treatment, the social dynamics of the clinic site itself, and incomplete understanding and acceptance of an intervention by a clinic's staff members. Such noise can influence the implementation and quality of treatment. Thus, identifying clinic-based noise is critical in assessments of fidelity to intervention protocols as well as outcomes of community-based interventions. This paper highlights findings from an evaluation of a mental health intervention focusing on the role of promotoras (briefly trained, non-professional community health workers) as mental health practitioners in two urban New Mexico, USA, community health centers. Our research identified three areas of clinic-based noise: the clinics' physical ability to "absorb" the intervention, the challenges of co-worker instability and interpersonal relationships, and balancing extra workplace demands. The findings demonstrate the value of ethnographic approaches in community-based intervention research.

  13. Solid health care waste management status at health care centers in the West Bank - Palestinian Territory

    International Nuclear Information System (INIS)

    Al-Khatib, Issam A.; Sato, Chikashi

    2009-01-01

    Health care waste is considered a major public health hazard. The objective of this study was to assess health care waste management (HCWM) practices currently employed at health care centers (HCCs) in the West Bank - Palestinian Territory. Survey data on solid health care waste (SHCW) were analyzed for generated quantities, collection, separation, treatment, transportation, and final disposal. Estimated 4720.7 m 3 (288.1 tons) of SHCW are generated monthly by the HCCs in the West Bank. This study concluded that: (i) current HCWM practices do not meet HCWM standards recommended by the World Health Organization (WHO) or adapted by developed countries, and (ii) immediate attention should be directed towards improvement of HCWM facilities and development of effective legislation. To improve the HCWM in the West Bank, a national policy should be implemented, comprising a comprehensive plan of action and providing environmentally sound and reliable technological measures.

  14. Patient-Centered e-Health Record over the Cloud.

    Science.gov (United States)

    Koumaditis, Konstantinos; Themistocleous, Marinos; Vassilacopoulos, George; Prentza, Andrianna; Kyriazis, Dimosthenis; Malamateniou, Flora; Maglaveras, Nicos; Chouvarda, Ioanna; Mourouzis, Alexandros

    2014-01-01

    The purpose of this paper is to introduce the Patient-Centered e-Health (PCEH) conceptual aspects alongside a multidisciplinary project that combines state-of-the-art technologies like cloud computing. The project, by combining several aspects of PCEH, such as: (a) electronic Personal Healthcare Record (e-PHR), (b) homecare telemedicine technologies, (c) e-prescribing, e-referral, e-learning, with advanced technologies like cloud computing and Service Oriented Architecture (SOA), will lead to an innovative integrated e-health platform of many benefits to the society, the economy, the industry, and the research community. To achieve this, a consortium of experts, both from industry (two companies, one hospital and one healthcare organization) and academia (three universities), was set to investigate, analyse, design, build and test the new platform. This paper provides insights to the PCEH concept and to the current stage of the project. In doing so, we aim at increasing the awareness of this important endeavor and sharing the lessons learned so far throughout our work.

  15. Evaluating the Sustainability of School-Based Health Centers.

    Science.gov (United States)

    Navarro, Stephanie; Zirkle, Dorothy L; Barr, Donald A

    2017-01-01

    The United States is facing a surge in the number of school-based health centers (SBHCs) owing to their success in delivering positive health outcomes and increasing access to care. To preserve this success, experts have developed frameworks for creating sustainable SBHCs; however, little research has affirmed or added to these models. This research seeks to analyze elements of sustainability in a case study of three SBHCs in San Diego, California, with the purpose of creating a research-based framework of SBHC sustainability to supplement expertly derived models. Using a mixed methods study design, data were collected from interviews with SBHC stakeholders, observations in SBHCs, and SBHC budgets. A grounded theory qualitative analysis and a quantitative budget analysis were completed to develop a theoretical framework for the sustainability of SBHCs. Forty-one interviews were conducted, 6 hours of observations were completed, and 3 years of SBHC budgets were analyzed to identify care coordination, community buy-in, community awareness, and SBHC partner cooperation as key themes of sustainability promoting patient retention for sustainable billing and reimbursement levels. These findings highlight the unique ways in which SBHCs gain community buy-in and awareness by becoming trusted sources of comprehensive and coordinated care within communities and among vulnerable populations. Findings also support ideas from expert models of SBHC sustainability calling for well-defined and executed community partnerships and quality coordinated care in the procurement of sustainable SBHC funding.

  16. Holistic Health Care for the Medically Uninsured: The Church Health Center of Memphis.

    Science.gov (United States)

    Morris, G Scott

    2015-11-05

    The Church Health Center (CHC) in Memphis was founded in 1987 to provide quality, affordable health care for working, uninsured people and their families. With numerous, dedicated financial supporters and health care volunteers, CHC has become the largest faith-based health care organization of its type nationally, serving >61,000 patients. CHC embraces a holistic approach to health by promoting wellness in every dimension of life. It offers on-site services including medical care, dentistry, optometry, counseling, social work, and nutrition and fitness education, to promote wellness in every dimension of life. A 2012 economic analysis estimated that a $1 contribution to the CHC provided roughly $8 in health services. The CHC has trained >1200 Congregational Health Promoters to be health leaders and is conducting research on the effectiveness of faith community nurses partnering with congregations to assist in home care for patients recently discharged from Memphis hospitals. The MEMPHIS Plan, CHC's employer-sponsored health care plan for small business and the self-employed, offers uninsured people in lower-wage jobs access to quality, affordable health care. The CHC also conducts replications workshops several times a year to share their model with leaders in other communities. The Institute for Healthcare Improvement (IHI) recently completed a case study that concluded: "The CHC is one of a very few organizations successfully embodying all three components of the IHI Triple Aim by improving population health outcomes, enhancing the individual's health care experience, and controlling costs. All three have been part of the Center's DNA since its inception, and as a transforming force in the community, the model is well worth national attention."

  17. 77 FR 72868 - The Centers for Disease Control (CDC)/Health Resources and Services Administration (HRSA...

    Science.gov (United States)

    2012-12-06

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention The Centers for Disease Control (CDC)/Health Resources and Services Administration (HRSA) Advisory Committee on HIV, Viral... announcements of meetings and other committee management activities, for both the Centers for Disease Control...

  18. Using women's health research to develop women leaders in academic health sciences: the National Centers of Excellence in Women's Health.

    Science.gov (United States)

    Carnes, M; VandenBosche, G; Agatisa, P K; Hirshfield, A; Dan, A; Shaver, J L; Murasko, D; McLaughlin, M

    2001-01-01

    While the number of women entering U.S. medical schools has risen substantially in the past 25 years, the number of women in leadership positions in academic medicine is disproportionately small. The traditional pathway to academic leadership is through research. Women's health research is an ideal venue to fill the pipeline with talented women physicians and scientists who may become academic leaders in positions where they can promote positive change in women's health as well as mentor other women. The Office on Women's Health (OWH) in the U.S. Department of Health and Human Services has contracted with 18 academic medical centers to develop National Centers of Excellence in Women's Health. Emphasizing the integral link between women's health and women leaders, each of the Centers of Excellence must develop a leadership plan for women in academic medicine as part of the contract requirements. This paper describes the training programs in women's health research that have developed at five of the academic medical centers: the University of Wisconsin, Magee Women's Hospital, the University of Maryland, Medical College of Pennsylvania Hahnemann University, and the University of Illinois at Chicago. We discuss some of the challenges faced for both initiation and future viability of these programs as well as criteria by which these programs will be evaluated for success.

  19. Fostering Social Determinants of Health Transdisciplinary Research: The Collaborative Research Center for American Indian Health

    Directory of Open Access Journals (Sweden)

    Amy J. Elliott

    2015-12-01

    Full Text Available The Collaborative Research Center for American Indian Health (CRCAIH was established in September 2012 as a unifying structure to bring together tribal communities and health researchers across South Dakota, North Dakota and Minnesota to address American Indian/Alaska Native (AI/AN health disparities. CRCAIH is based on the core values of transdisciplinary research, sustainability and tribal sovereignty. All CRCAIH resources and activities revolve around the central aim of assisting tribes with establishing and advancing their own research infrastructures and agendas, as well as increasing AI/AN health research. CRCAIH is comprised of three divisions (administrative; community engagement and innovation; research projects, three technical cores (culture, science and bioethics; regulatory knowledge; and methodology, six tribal partners and supports numerous multi-year and one-year pilot research projects. Under the ultimate goal of improving health for AI/AN, this paper describes the overarching vision and structure of CRCAIH, highlighting lessons learned in the first three years.

  20. 'Could you please pass one of those health leaflets along?': exploring health, morality and resistance through focus groups.

    Science.gov (United States)

    Crossley, Michele L

    2002-10-01

    This paper derives from research in which focus groups were used as a preliminary method of eliciting peoples' perceptions, attitudes and opinions towards health and health promotion in a Northern British city. However, applying criticisms associated with social constructionist theories (e.g. discourse analysis and rhetorical analysis), some recently emerging work on focus groups (see The challenge and promise of focus groups, in: Barbour, Kitzinger (Eds.), Developing Focus Group Research: Politics, Theory and Practice, Sage, London, 1999, p. 1; Focus Groups in Social Research, Sage, London, 2001) has suggested that their traditional use, as a kind of 'window' onto peoples' attitudes and opinions, misses important dimensions of the way in which these phenomena are actively negotiated and constructed during the course of the focus group. Working on the premise that these observations are particularly pertinent to health issues, this paper draws on data from one focus group in order to provide a detailed working example of the way in which attitudes and opinions towards health issues are actively constructed during the course of interaction. In addition, in accordance with social constructionist theories, attention will be paid to the way in which such construction is inextricably linked to social and moral actions such as the negotiation of blame and allocation of responsibility. Through an analysis of six extracts, the paper ultimately identifies three 'positions' or 'stances', which develop over the course of the focus group, often in opposition to one another. These are: (1) 'positive mental attitude'; (2) 'genes and luck'; and (3) 'resistance'. Each of these positions becomes associated, not only with certain moral values, but also 'attached' to certain people within the group. One of the main aims of this analysis is to illustrate how, through the everyday nature of such debates, health remains an intrinsically moral phenomenon.

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

    Science.gov (United States)

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

    2016-06-01

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

  2. Quality of Prenatal Care Services in Karabuk Community Health Center

    Directory of Open Access Journals (Sweden)

    Binali Catak

    2012-04-01

    Full Text Available The aim of the study was to evaluate the quality and quantity of prenatal care services according to gestastional week in Karabuk Community Health Center (CHC. Methods: In this descriptive study 365 pregnant women was selected as sample among 753 pregnant women registered at Karabuk CHC in 18/01/2011. 93.0% of women in the selected sample has been visited in their homes and the face to face interviews were done. The questionnaire was prepared according to Prenatal Care Management Guidelines (PCMG of Ministry of Health. Findings The number of follow-ups was not complete in 23.7% of 15-24 month, 34.4% of 25-32 month, 52,1% of 33-42 month pregnant women. At least four follow-up visits were completed only in 66,7% of postpartum women. Timing of first visit was after 15th week in 15,6% of women. In follow up visits 62.5% of of women’s height were never measured, in 13,0% the women hearth sound of infants didn’t monitored at least once. Laboratory test numbers were under the level required by PCMG. The delivery conditions weren’t planned in 41,8% of last trimester and postpartum women and training about breastfeeding wasn’t given to 15,5 of the same group. Result In family medicine model in Karabuk CHC developments in number of prenatal follow-up visits were observed, but no substantial improvements were found in quality of prenatal visits. Regular in service trainings shoud be given to family doctors and midwives. The use of prenatal care guideline published by MoH should be increased. Keywords: Prenatal care, pregnancy, timing of first visit, qality of prenatal care [TAF Prev Med Bull 2012; 11(2.000: 153-162

  3. Behavioral health and health care reform models: patient-centered medical home, health home, and accountable care organization.

    Science.gov (United States)

    Bao, Yuhua; Casalino, Lawrence P; Pincus, Harold Alan

    2013-01-01

    Discussions of health care delivery and payment reforms have largely been silent about how behavioral health could be incorporated into reform initiatives. This paper draws attention to four patient populations defined by the severity of their behavioral health conditions and insurance status. It discusses the potentials and limitations of three prominent models promoted by the Affordable Care Act to serve populations with behavioral health conditions: the Patient-Centered Medical Home, the Health Home initiative within Medicaid, and the Accountable Care Organization. To incorporate behavioral health into health reform, policymakers and practitioners may consider embedding in the reform efforts explicit tools-accountability measures and payment designs-to improve access to and quality of care for patients with behavioral health needs.

  4. 78 FR 78966 - Board of Scientific Counselors, National Center for Health Statistics

    Science.gov (United States)

    2013-12-27

    ... Scientific Counselors, National Center for Health Statistics In accordance with section 10(a)(2) of the...), National Center for Health Statistics (NCHS) announces the following meeting of the aforementioned..., NCHS; discussion of vital statistics; future program reviews; National Health Interview Survey 2017...

  5. Intention and Usage of Computer Based Information Systems in Primary Health Centers

    Science.gov (United States)

    Hosizah; Kuntoro; Basuki N., Hari

    2016-01-01

    The computer-based information system (CBIS) is adopted by almost all of in health care setting, including the primary health center in East Java Province Indonesia. Some of softwares available were SIMPUS, SIMPUSTRONIK, SIKDA Generik, e-puskesmas. Unfortunately they were most of the primary health center did not successfully implemented. This…

  6. Redefining leadership education in graduate public health programs: prioritization, focus, and guiding principles.

    Science.gov (United States)

    Lachance, Jennifer A; Oxendine, Jeffrey S

    2015-03-01

    Public health program graduates need leadership skills to be effective in the complex, changing public health environment. We propose a new paradigm for schools of public health in which technical and leadership skills have equal priority as core competencies for graduate students. Leadership education should focus on the foundational skills necessary to effect change independent of formal authority, with activities offered at varying levels of intensity to engage different students. Leadership development initiatives should be practice based, process focused, interdisciplinary, diversity based, adaptive, experimental, innovative, and empowering, and they should encourage authenticity. Leadership training in graduate programs will help lay the groundwork for public health professionals to have an immediate impact in the workforce and to prioritize continuous leadership development throughout their careers.

  7. Redefining Leadership Education in Graduate Public Health Programs: Prioritization, Focus, and Guiding Principles

    Science.gov (United States)

    Oxendine, Jeffrey S.

    2015-01-01

    Public health program graduates need leadership skills to be effective in the complex, changing public health environment. We propose a new paradigm for schools of public health in which technical and leadership skills have equal priority as core competencies for graduate students. Leadership education should focus on the foundational skills necessary to effect change independent of formal authority, with activities offered at varying levels of intensity to engage different students. Leadership development initiatives should be practice based, process focused, interdisciplinary, diversity based, adaptive, experimental, innovative, and empowering, and they should encourage authenticity. Leadership training in graduate programs will help lay the groundwork for public health professionals to have an immediate impact in the workforce and to prioritize continuous leadership development throughout their careers. PMID:25706021

  8. Experience report: a training center for health response

    International Nuclear Information System (INIS)

    Maurmo, Alexandre M.; Leite, Teresa C.S.B.

    2009-01-01

    The Professor Nelson Valverde Training Center was created within FEAM (The ELETRONUCLEAR Medical Assistance Foundation) with the objective of capacitating Radio Nuclear Accident Responders for the Health Area in the Almirante Alvaro Alberto Nuclear Central (Angra dos Reis - RJ - Brazil). The first step was structuring the contents for this training using IAEA's Manuals as base (EPR Medical - 2005, EPR First Responders - 2006 and TMT - Handbook - 2009) and data from REAC/TS. The second step was to capacitate instructors. The third step was the integration with the Company's Radiological Protection Division, giving radiological assessment. Finally, the development of training applications, ending with Drills, Tests and Assessment, gathering data and suggestions, objectifying the constant improvement. Training Programs with pre and post evaluations have been started. Since 2004 training internal courses were ministered for 125 professionals with annual re-training and were ministered to 130 professionals from several external institutions. During the same period training courses were ministered to 140 trainees from the Radiological Protection Division of The Nuclear Power Plant of Angra dos Reis, as First Lay Responders, objectifying the improvement of the quality of the emergency response. (author)

  9. Health professionals' job satisfaction and associated factors at public health centers in West Ethiopia.

    Science.gov (United States)

    Deriba, Beyazin Kebede; Sinke, Shimele Ololo; Ereso, Berhane Megersa; Badacho, Abebe Sorsa

    2017-05-30

    Human resources are vital for delivering health services, and health systems cannot function effectively without sufficient numbers of skilled, motivated, and well-supported health workers. Job satisfaction of health workers is important for motivation and efficiency, as higher job satisfaction improves both employee performance and patient satisfaction. Even though several studies have addressed job satisfaction among healthcare professionals in different part of the world, there are relatively few studies on healthcare professionals' job satisfaction in Ethiopia. A facility-based cross-sectional study was conducted among health professionals working in health centers in April 2015 using self-administered structured questionnaires. All 322 health professionals working in 23 randomly selected public health centers were included. Factor scores were computed for the identified items by varimax rotation to represent satisfaction. Multivariate linear regression analysis was performed, and the effect of independent variables on the regression factor score quantified. Three hundred eight respondents participated with a response rate of 95.56%. The overall level of job satisfaction was 41.46%. Compensation (benefits) (beta 0.448 [95% CI 0.341 to 0.554]), recognition by management (beta 0.132 [95% CI 0.035 to 0.228]), and opportunity for development (beta 0.123 [95% CI 0.020 to 0.226]) were associated with job satisfaction. A unit increase in salary and incentives and recognition by management scores resulted in 0.459 (95% CI 0.356 to 0.561) and 0.156 (95% CI 0.065 to 0.247) unit increases in job satisfaction scores, respectively. The overall level of job satisfaction in health professionals was low. Salary and incentives, recognition by management, developmental opportunities, and patient appreciation were strong predictors of job satisfaction.

  10. A Required Online Course with a Public Health Focus for Third Professional Year Pharmacy Students.

    Science.gov (United States)

    King, Amber E; Egras, Amy M

    2015-06-25

    To design, deliver, and evaluate the impact of a required course on student knowledge acquisition and ability to evaluate contemporary public health issues. A 2-credit course was implemented using asynchronous, online delivery. Learning activities included literature retrieval and assessment, analytic writing, quizzes, and creation of a group wiki evaluating a current public health issue. Course topics included health care reform, social determinants of health, health disparities, evidence-based medicine, end-of-life care, patient safety, and research ethics. Strong student performance on assessments indicated an ability to use higher-order cognitive domains. Online delivery provided students with the flexibility to complete assignments at their convenience, allowed participation by all students, and encouraged self-directed learning. Completion of a required, online, asynchronous course with a public health focus allowed pharmacy students to increase their knowledge of and ability to evaluate contemporary ethical, social, cultural, and governmental issues affecting pharmacy practice.

  11. Development of an Inventory for Health-Care Office Staff to Self-Assess Their Patient-Centered Cultural Sensitivity

    Directory of Open Access Journals (Sweden)

    Carolyn M. Tucker

    2016-02-01

    Full Text Available Background: Patient-centered culturally sensitive health care (PC-CSHC is a best practice approach for improving health-care delivery to culturally diverse populations and reducing health disparities. Despite patients’ report that cultural sensitivity by health-care office staff is an important aspect of PC-CSHC, the majority of available research on PC-CSHC focuses exclusively on health-care providers. This may be due in part to the paucity of instruments available to assess the cultural sensitivity of health-care office staff. The objective of the present study is to determine the psychometric properties of the Tucker-Culturally Sensitive Health Care Office Staff Inventory-Self-Assessment Form (T-CSHCOSI-SAF. This instrument is designed to enable health-care office staff to self-assess their level of agreement that they display behaviors and attitudes that culturally diverse patients have identified as office staff cultural sensitivity indicators. Methods: A sample of 510 health-care office staff were recruited at 67 health-care sites across the United States. These health-care office staff anonymously completed the T-CSHCOSI-SAF and a demographic data questionnaire. Results and Level of Evidence: Confirmatory factor analyses of the T-CSHCOSI-SAF revealed that this inventory has 2 factors with high internal consistency reliability (Cronbach’s αs= .916 and .912. Conclusion and Implications: The T-CSHCOSI-SAF is a useful inventory for health-care office staff to assess their own level of patient-centered cultural sensitivity. Such self-assessment data can be used in the development and implementation of trainings to promote patient-centered cultural sensitivity of health-care office staff and to help draw the attention of these staff to displaying patient-centered cultural sensitivity.

  12. Leadership in academic health centers in the US: a review of the role and some recommendations.

    Science.gov (United States)

    Weil, Thomas P

    2014-01-01

    The leadership of the US's most complex academic health centers (AHCs)/medical centers requires individuals who possess a high level of clinical, organizational, managerial, and interpersonal skills. This paper first outlines the major attributes desired in a dean/vice president of health affairs before then summarizing the educational opportunities now generally available to train for such leadership and management roles. For the most part, the masters in health administration (MHA), the traditional MBA, and the numerous alternatives primarily available at universities are considered far too general and too lacking in emotional intelligence tutoring to be particularly relevant for those who aspire to these most senior leadership positions. More appropriate educational options for these roles are discussed: (a) the in-house leadership and management programs now underway at some AHCs for those selected early on in their career for future executive-type roles as well as for those who are appointed later on to a chair, directorship or similar position; and (b) a more controversial approach of potentially establishing at one or a few universities, a mid-career, professional program (a maximum of 12 months and therefore, being completed in less time than an MBA) leading to a masters degree in academic health center administration (MHCA) for those who aspire to fill a senior AHC leadership position. The proposed curriculum as outlined herein might be along the lines of some carefully designed masters level on-line, self-teaching modules for the more technical subjects, yet vigorously emphasizing integrate-type courses focused on enhancing personal and professional team building and leadership skills. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  13. Research on health equity in the SDG era: the urgent need for greater focus on implementation.

    Science.gov (United States)

    Rasanathan, Kumanan; Diaz, Theresa

    2016-12-09

    The tremendous increase in knowledge on inequities in health and their drivers in recent decades has not been matched by improvements in health inequities themselves, or by systematic evidence of what works to reduce health inequities. Within health equity research there is a skew towards diagnostic studies in comparison to intervention studies showing evidence of how interventions can reduce disparities. The lack of sufficient specific evidence on how to implement specific policies and interventions in specific contexts to reduce health inequities creates policy confusion and partly explains the lack of progress on health inequities. In the field of research on equity in health, the time has come to stop focusing so much energy on prevalence and pathways, and instead shift to proposing and testing solutions. Four promising approaches to do so are implementation research, natural experimental policy studies, research on buy-in by policy-makers to action on health inequities, and geospatial analysis. The case for action on social determinants and health inequities has well and truly been made. The community of researchers on health equity now need to turn their attention to supporting implementation efforts towards achievements of the Sustainable Development Goals and substantive reductions in health inequities.

  14. The occupational safety of health professionals working at community and family health centers.

    Science.gov (United States)

    Ozturk, Havva; Babacan, Elif

    2014-10-01

    Healthcare professionals encounter many medical risks while providing healthcare services to individuals and the community. Thus, occupational safety studies are very important in health care organizations. They involve studies performed to establish legal, technical, and medical measures that must be taken to prevent employees from sustaining physical or mental damage because of work hazards. This study was conducted to determine if the occupational safety of health personnel at community and family health centers (CHC and FHC) has been achieved. The population of this cross-sectional study comprised 507 nurses, 199 physicians, and 237 other medical personnel working at a total of 18 family health centers (FHC) and community health centers (CHC) in Trabzon, Turkey. The sample consisted of a total of 418 nurses, 156 physicians, and 123 other medical personnel. Sampling method was not used, and the researchers tried to reach the whole population. Data were gathered with the Occupational Safety Scale (OSS) and a questionnaire regarding demographic characteristics and occupational safety. According to the evaluations of all the medical personnel, the mean ± SD of total score of the OSS was 3.57 ± 0.98; of the OSS's subscales, the mean ± SD of the health screening and registry systems was 2.76 ± 1.44, of occupational diseases and problems was 3.04 ± 1.3 and critical fields control was 3.12 ± 1.62. In addition, occupational safety was found more insufficient by nurses (F = 14.18; P occupational safety to be insufficient as related to protective and supportive activities.

  15. A Record Linkage Protocol for a Diabetes Registry at Ethnically Diverse Community Health Centers

    OpenAIRE

    Maizlish, Neil A.; Herrera, Linda

    2005-01-01

    Community health centers serve ethnically diverse populations that may pose challenges for record linkage based on name and date of birth. The objective was to identify an optimal deterministic algorithm to link patient encounters and laboratory results for hemoglobin A1c testing and examine its variability by health center site, patient ethnicity, and other variables. Based on data elements of last name, first name, date of birth, gender, and health center site, matches with ≥50% to < 100% o...

  16. An interfaith workers' center approach to workplace rights: implications for workplace safety and health.

    Science.gov (United States)

    Cho, Chi C; Oliva, Jose; Sweitzer, Erica; Nevarez, Juan; Zanoni, Joseph; Sokas, Rosemary K

    2007-03-01

    Over the past decade, fatal occupational injury rates for immigrant workers have increased disproportionately, as have informal and precarious working arrangements. Workers' rights centers have emerged as a response. This descriptive report characterizes an innovative approach to encourage immigrant workers to access federal and state occupational safety and health programs through an interfaith workers' center. : Existing data obtained by volunteers at time of intake were redacted and imported into a SAS database for secondary analysis. Statistical methods used to evaluate associations between outcome of interest and various characteristics included the chi2 test of association, Fisher exact test of association, and multivariate logistic regression. A total of 934 individual records were reviewed, although for any given item, missing data was a limitation. Among 780 persons reporting their primary language, 75% spoke Spanish, 19% Polish, 4% English, and 1% Other. The following total numbers of formal complaints were filed with each of the following agencies: 110 referred to the state Department of Labor (DOL), 123 to the federal Equal Employment Opportunity Commission (EEOC), 65 concerning federal violations of wages and hours, and 47 complaints with the Occupational Safety and Health Administration (OSHA). Approximately 37% of the OSHA complaints resulted in a measurable outcome, exceeding the average for all complaints. Workers' most frequent concerns focus on pay and discrimination. Recasting occupational safety and health hazards as threats to income and as forms of discrimination may help identify hazards.

  17. The life cycles of six multi-center adaptive clinical trials focused on neurological emergencies developed for the Advancing Regulatory Science initiative of the National Institutes of Health and US Food and Drug Administration: Case studies from the Adaptive Designs Accelerating Promising Treatments Into Trials Project.

    Science.gov (United States)

    Guetterman, Timothy C; Fetters, Michael D; Mawocha, Samkeliso; Legocki, Laurie J; Barsan, William G; Lewis, Roger J; Berry, Donald A; Meurer, William J

    2017-01-01

    Clinical trials are complicated, expensive, time-consuming, and frequently do not lead to discoveries that improve the health of patients with disease. Adaptive clinical trials have emerged as a methodology to provide more flexibility in design elements to better answer scientific questions regarding whether new treatments are efficacious. Limited observational data exist that describe the complex process of designing adaptive clinical trials. To address these issues, the Adaptive Designs Accelerating Promising Treatments Into Trials project developed six, tailored, flexible, adaptive, phase-III clinical trials for neurological emergencies, and investigators prospectively monitored and observed the processes. The objective of this work is to describe the adaptive design development process, the final design, and the current status of the adaptive trial designs that were developed. To observe and reflect upon the trial development process, we employed a rich, mixed methods evaluation that combined quantitative data from visual analog scale to assess attitudes about adaptive trials, along with in-depth qualitative data about the development process gathered from observations. The Adaptive Designs Accelerating Promising Treatments Into Trials team developed six adaptive clinical trial designs. Across the six designs, 53 attitude surveys were completed at baseline and after the trial planning process completed. Compared to baseline, the participants believed significantly more strongly that the adaptive designs would be accepted by National Institutes of Health review panels and non-researcher clinicians. In addition, after the trial planning process, the participants more strongly believed that the adaptive design would meet the scientific and medical goals of the studies. Introducing the adaptive design at early conceptualization proved critical to successful adoption and implementation of that trial. Involving key stakeholders from several scientific domains early

  18. Barriers to Providing Health Education During Primary Care Visits at Community Health Centers: Clinical Staff Insights.

    Science.gov (United States)

    Alicea-Planas, Jessica; Pose, Alix; Smith, Linda

    2016-04-01

    The rapid increase of diverse patients living in the US has created a different set of needs in healthcare, with the persistence of health disparities continuing to challenge the current system. Chronic disease management has been discussed as a way to improve health outcomes, with quality patient education being a key component. Using a community based participatory research framework, this study utilized a web-based survey and explored clinical staff perceptions of barriers to providing patient education during primary care visits. With a response rate of nearly 42 %, appointment time allotment seemed to be one of the most critical factors related to the delivery of health education and should be considered key. The importance of team-based care and staff training were also significant. Various suggestions were made in order to improve the delivery of quality patient education at community health centers located in underserved areas.

  19. [The ''neighbourhood health'' strategy: actions focused on areas with special social and health needs].

    Science.gov (United States)

    Sierra, Isabel; Cabezas, Carmen; Brugulat, Pilar; Mompart, Anna

    2008-12-01

    Through the Law 2/2004 on improving neighbourhoods, urban areas and towns requiring special attention, the Government of Catalonia set up a fund for financing projects prepared by town/city councils for the integral improvement of neighbourhoods. The Ministry of Health signed on to the strategy with The Neighbourhood Health Programme, which was a healthcare policy priority. Healthcare and municipal structures cooperate at neighbourhood level in all of the phases of the community intervention project (analysis and detection of needs, prioritisation of the problems detected, definition and distribution of actions). Techniques such as the nominal group are used. Four vulnerable groups have been identified with higher levels of illness, co-morbidity, situations of risk, etc. (the young, the elderly, women and recent immigrants). The actions of all the agents involved, among them those from the Ministry of Health itself, are then intensified and prioritised and a specific portfolio of public health services is prepared.

  20. Strategies for the Integration of Medical and Health Representation within Law Enforcement Intelligence Fusion Centers

    National Research Council Canada - National Science Library

    Morrissey, James F

    2007-01-01

    Terrorism-related intelligence gathering, analysis and information dissemination would be improved and enhanced by including a medical and health element in law enforcement intelligence fusion centers...

  1. University of Illinois FRIENDS Children’s Environmental Health Center

    Data.gov (United States)

    Federal Laboratory Consortium — The FRIENDS Children's Environmental Health Center at the University of Illinois, Urbana-Champaign, was established in 2001 to investigate the interactive effects of...

  2. Community-centered family health history: a customized approach to increased health communication and awareness.

    Science.gov (United States)

    O'Leary, James; Edelson, Vaughn; Gardner, Nicora; Gepp, Alejandra; Kyler, Panelpha; Moore, Penelope; Petruccio, Claudia; Williams, Marc; Terry, Sharon; Bowen, Deborah

    2011-01-01

    There has been little study of whether family health history (FHH) tools used by individuals, families, and communities inspire measurable changes in communication and behavior. The Community-Centered Family Health History (CCFHH) project was a collaborative endeavor among national and community-based organizations with an interest in genetics education and health. Using community- based participatory research principles as a foundation, CCFHH examined whether the Does It Run In the Family? toolkit, a set of two customizable booklets on health and genetics, encourages discussion and collection of FHH information across diverse communities. Five communities across the country measured the utility of customized versions of the Does It Run In the Family? toolkit. Each community partner recruited families, consisting of two or more blood relatives, to use the toolkit for 3 months, discuss it among their family members, and consider the implications of the health information. Pre- and postintervention surveys measured family communication about family history and disease risk and the use of FHH information in health care provider interactions. After aggregate, cross-community analysis of individual responses, from pre- to post-toolkit use family members showed increases in communication about family history of disease risk (p < .05) and in awareness about FHH (p < .05). These findings indicate that diverse communities are receptive to FHH intervention, and tailored health educational materials can lead to increased conversations and awareness about health issues across communities.

  3. The identification and measurement of quality dimensions in health care: focus group interview results.

    Science.gov (United States)

    Jun, M; Peterson, R T; Zsidisin, G A

    1998-01-01

    The identification and measurement of service quality are critical factors that are responsible for customer satisfaction. This article identifies 11 attributes that define quality of care and patient satisfaction and reveals various gaps among the patient, physician, and administrator groups in the perceived importance of those dimensions. Managerial implications for patient-focused health care are discussed.

  4. Healthful Eating and Physical Activity in the Home Environment: Results from Multifamily Focus Groups

    Science.gov (United States)

    Berge, Jerica M.; Arikian, Aimee; Doherty, William J.; Neumark-Sztainer, Dianne

    2012-01-01

    Objective: To explore multiple family members' perceptions of risk and protective factors for healthful eating and physical activity in the home. Design: Ten multifamily focus groups were conducted with 26 families. Setting and Participants: Community setting with primarily black and white families. Family members (n = 103) were aged 8 to 61…

  5. Putting women at the center: a review of Indian policy to address person-centered care in maternal and newborn health, family planning and abortion

    Directory of Open Access Journals (Sweden)

    Aradhana Srivastava

    2017-07-01

    Full Text Available Abstract Background Person-centered care is a critical component of quality care, essential to enable treatment adherence, and maximize health outcomes. Improving the quality of health services is a key strategy to achieve the new global target of zero preventable maternal deaths by 2030. Recognizing this, the Government of India has in the last decade initiated a number of strategies to address quality of care in health and family welfare services. Methods We conducted a policy review of quality improvement strategies in India from 2005 to 15, covering three critical areas– maternal and newborn health, family planning, and abortion (MNHFP + A. Based on Walt and Gilson’s policy triangle framework, we analyzed the extent to which policies incorporated person-centered care, while identifying unaddressed issues. Data was sourced from Government of India websites, scientific and grey literature databases. Results Twenty-two national policy documents, comprising two policy statements and 20 implementation guidelines of specific schemes were included in the review. Quality improvement strategies span infrastructure, commodities, human resources, competencies, and accountability that are driving quality assurance in MNHFP + A services. However, several implementation challenges have affected compliance with person-centered care, thereby affecting utilization and outcomes. Conclusion Focus on person-centered care in Indian MNHFP + A policy has increased in recent years. Nevertheless, some aspects must still be strengthened, such as positive interpersonal behavior, information sharing and promptness of care. Implementation can be improved through better provider training, patient feedback and monitoring mechanisms. Moreover, unless persisting structural challenges are addressed implementation of person-centered care in facilities will not be effective.

  6. School-Based Health Centers and Childhood Obesity: "An Ideal Location to Address a Complex Issue"

    Science.gov (United States)

    National Assembly on School-Based Health Care, 2010

    2010-01-01

    One of today's most pressing public health problems is the rise in childhood overweight and obesity. School-based health centers (SBHCs)--the convergence of public health, primary care, and mental health in schools--represent an important element in the public health toolbox for combating the challenging epidemic. When working side-by-side in a…

  7. Trends in Mental Health and Substance Abuse Services at the Nation’s Community Health Centers: 1998–2003

    Science.gov (United States)

    Druss, Benjamin G.; Bornemann, Thomas; Fry-Johnson, Yvonne W.; McCombs, Harriet G.; Politzer, Robert M.; Rust, George

    2006-01-01

    Objective. We examined trends in delivery of mental health and substance abuse services at the nation’s community health centers. Methods. Analyses used data from the Health Resources and Services Administration (HRSA), Bureau of Primary Care’s (BPHC) 1998 and 2003 Uniform Data System, merged with county-level data. Results. Between 1998 and 2003, the number of patients diagnosed with a mental health/substance abuse disorder in community health centers increased from 210 000 to 800 000. There was an increase in the number of patients per specialty mental health/substance abuse treatment provider and a decline in the mean number of patient visits, from 7.3 visits per patient to 3.5 by 2003. Although most community health centers had some on-site mental health/substance abuse services, centers without on-site services were more likely to be located in counties with fewer mental health/substance abuse clinicians, psychiatric emergency rooms, and inpatient hospitals. Conclusions. Community health centers are playing an increasingly central role in providing mental health/substance abuse treatment services in the United States. It is critical both to ensure that these centers have adequate resources for providing mental health/substance abuse care and that they develop effective linkages with mental health/substance abuse clinicians in the communities they serve. PMID:17008573

  8. Beyond urban penalty and urban sprawl: back to living conditions as the focus of urban health.

    Science.gov (United States)

    Freudenberg, Nicholas; Galea, Sandro; Vlahov, David

    2005-02-01

    Researchers have long studied urban health, both to describe the consequences of urban living and to design interventions to promote the health of people living in cities. Two approaches to understanding the impact of cities on health have been dominant, namely, urban health penalty and urban sprawl. The urban penalty approach posits that cities concentrate poor people and expose them to unhealthy physical and social environments. Urban sprawl focuses on the adverse health and environmental effects of urban growth into outlying areas. We propose a model that integrates these approaches and emphasizes urban living conditions as the primary determinant of health. The aim of the model is to move beyond describing the health-related characteristics of various urban populations towards identifying opportunities for intervention. Such a shift in framework enables meaningful comparisons that can inform public health activities at the appropriate level and evaluate their effectiveness in improving the health of urban populations. The model is illustrated with two examples from current urban public health practice.

  9. Integrating a Nurse-Midwife-Led Oral Health Intervention Into CenteringPregnancy Prenatal Care: Results of a Pilot Study.

    Science.gov (United States)

    Adams, Sally H; Gregorich, Steven E; Rising, Sharon S; Hutchison, Margaret; Chung, Lisa H

    2017-07-01

    National and professional organizations recommend oral health promotion in prenatal care to improve women's oral health. However, few prenatal programs include education about oral health promotion. The objective of this study was to determine if women receiving a brief, low-cost, and sustainable educational intervention entitled CenteringPregnancy Oral Health Promotion had clinically improved oral health compared to women receiving standard CenteringPregnancy care. Women attending CenteringPregnancy, a group prenatal care model, at 4 health centers in the San Francisco Bay Area, participated in this nonrandomized controlled pilot study in 2010 to 2011. The intervention arm received the CenteringPregnancy Oral Health Promotion intervention consisting of two 15-minute skills-based educational modules addressing maternal and infant oral health, each module presented in a separate CenteringPregnancy prenatal care session. The present analysis focused on the maternal module that included facilitated discussions and skills-building activities including proper tooth brushing. The control arm received standard CenteringPregnancy prenatal care. Dental examinations and questionnaires were administered prior to and approximately 9 weeks postintervention. Primary outcomes included the Plaque Index, percent bleeding on probing, and percent of gingival pocket depths 4 mm or greater. Secondary outcomes were self-reported oral health knowledge, attitudes (importance and self-efficacy), and behaviors (tooth brushing and flossing). Regression models tested whether pre to post changes in outcomes differed between the intervention versus the control arms. One hundred and one women participated in the study; 49 were in the intervention arm, and 52 were in the control arm. The control and intervention arms did not vary significantly at baseline. Significant pre to post differences were noted between the arms with significant improvements in the intervention arm for the Plaque Index

  10. [Priorities for health policy and systems research focused on human resources in health].

    Science.gov (United States)

    Reveiz, Ludovic; Chapman, Evelina; Flórez, Carlos E Pinzón; Torres, Rubén

    2013-11-01

    Identify priorities for health policy and systems research related to human resources in Latin America and Caribbean countries. An online survey was designed based on a search in PubMed, Cochrane Library, and LILACS that contributed previously prioritized research questions. Respondents, mainly researchers and decision-makers, were identified through various sources. The first round, directed at researchers, aimed at refining and adding research questions and prioritizing questions that researchers regarded as relevant or very relevant. The second round was directed at researchers and decision-makers. A question was considered a priority when 50% (or more) of respondents described it as "relevant" or "very relevant." The first round included 20 questions on human resources and 33/66 researchers responded. Questions suggested by the researchers were added, resulting in 26 questions for the second round, which were sent to 121 researchers and decision-makers. Respondent representation by country was uniform in both rounds. In the second round, 14/26 (54%) questions were described as very relevant. Priority issues related to regulation of the market, integration of education and health care needs, and distribution of human resources. The response rate was 50% in the first round (33/66), and 34% in the second round (41/121). The results of this exercise provide a starting point for mobilization of resources for health policy and systems research. Identification of health systems research priorities is an effective and efficient strategy for reorienting political, financial, management, and social organization efforts for attaining universal health coverage.

  11. Evaluation of health resource utilization efficiency in community health centers of Jiangsu Province, China.

    Science.gov (United States)

    Xu, Xinglong; Zhou, Lulin; Antwi, Henry Asante; Chen, Xi

    2018-02-20

    While the demand for health services keep escalating at the grass roots or rural areas of China, a substantial portion of healthcare resources remain stagnant in the more developed cities and this has entrenched health inequity in many parts of China. At its conception, China's Deepen Medical Reform started in 2012 was intended to flush out possible disparities and promote a more equitable and efficient distribution of healthcare resources. Nearly half a decade of this reform, there are uncertainties as to whether the attainment of the objectives of the reform is in sight. Using a hybrid of panel data analysis and an augmented data envelopment analysis (DEA), we model human resources, material, finance to determine their technical and scale efficiency to comprehensively evaluate the transverse and longitudinal allocation efficiency of community health resources in Jiangsu Province. We observed that the Deepen Medical Reform in China has led to an increase concern to ensure efficient allocation of community health resources by health policy makers in the province. This has led to greater efficiency in health resource allocation in Jiangsu in general but serious regional or municipal disparities still exist. Using the DEA model, we note that the output from the Community Health Centers does not commensurate with the substantial resources (human resources, materials, and financial) invested in them. We further observe that the case is worst in less-developed Northern parts of Jiangsu Province. The government of Jiangsu Province could improve the efficiency of health resource allocation by improving the community health service system, rationalizing the allocation of health personnel, optimizing the allocation of material resources, and enhancing the level of health of financial resource allocation.

  12. [Sustainability focus in the health plans of the autonomous communities: sustainable development as an opportunity].

    Science.gov (United States)

    Moyano-Santiago, Miguel A; Rivera-Lirio, Juana M

    2016-01-01

    To determine the degree to which the health plans of the autonomous communities focus on the usual three dimensions of sustainability: economic, social and environmental, both in the general level of discourse and in the different areas of intervention. A qualitative study was conducted through content analysis of a large sample of documents. The specific methodology was analysis of symbolic and operational sensitivity in a sample of eleven health plans of the Spanish state. Social aspects, such as social determinants or vulnerable groups, are receiving increasing attention from the health planner, although there is room to strengthen attention to environmental issues and to provide specific interventions in economic terms. The analysis demonstrates the incipient state of health plans as strategic planning documents that integrate economic, social and environmental aspects and contribute to the sustainability of the different health systems of the country. Copyright © 2016 SESPAS. Published by Elsevier Espana. All rights reserved.

  13. [Patients and quality of primary health care services. Survey of practitioners at the Bahía de Cádiz and La Janda health centers].

    Science.gov (United States)

    Hernán García, M; Gutiérrez Cuadra, J L; Lineros González, C; Ruiz Barbosa, C; Rabadán Asensio, A

    2002-10-31

    To report the opinions of practitioners at health centers on dimensions of quality that affect user satisfaction. Cross-sectional study of focus groups (FG). Bahía de Cádiz and La Janda health centers in southwestern Spain. We studied 4 FG whose participants were staff members of the two health centers: FG1, physicians; FG2, user satisfaction service staff; FG3, social workers; FG4, nurses. The groups were based on the different functions of staff at the two centers. The analysis was based on variables in the SERCAL model (an adaptation of the SERVQUAL model for the Spanish health care system) of opinions regarding service quality: access, comfort (tangibles), personalized service (courtesy), competence, and loyalty. The data were analyzed with version N-Vivo of the NUDIST program. All dimensions of the theoretical model were identified by practitioners as constructs of users' perceptions of service quality. Users' and practitioners' views contrasted with and complemented each other to generate a model that could be validated. Access, personalized service and problem-solving (responsiveness) were key variables. Practitioners' opinions provided information of use in improving the quality model. Differences in opinion between users and practitioners merit further study based on an understanding of these groups' values and interests, and on the care provision context. Practitioners identified access, personalized service and problem-solving as features that influenced users' opinions of the quality of the health center.

  14. Educational Needs Assessment of Family Health Providers in Tabriz Health Care Centers in 2015

    Directory of Open Access Journals (Sweden)

    Faranak Ghoreyshyzadeh

    2017-06-01

    Full Text Available Background: This study intends to determine the educational needs of family health staff employed in health care centers in Tabriz, the provincial capital of east Azerbaijan, Iran in 2015. Methods: In this cross-sectional study 282 staff were enrolled, together with 22 managers, through census. The data collection tool was a researcher-designed questionnaire whose content validity were confirmed by 5 experts of health care and medical education centers. They self--evaluated their knowledge, skills and attitudes in 6 task processes including "integrated care for pregnant women", "women’s general and reproductive health", "child health care and breastfeeding", "vaccination skills", "teenagers’ and young adults’ health", and "common diseases prevention and control". Cronbach alpha coefficients were over 0.85. Data analysis was done using SPSS version 16 and descriptive statistics (mean and standard deviation and one-sample t tests were calculated to compare the mean of scores with midpoint criteria (=3. Results: Generally family health staff self-evaluated their knowledge, skills and attitudes in all task processes in higher than midpoint criteria level, which was consistent with the opinions of the managers, however, educational needs required by personnel in some processes or sub- process including "common diseases prevention and control" ( knowledge on referring thalassemia couples for genetic testing, mental health counseling, "vaccination skills" ( intradermal vaccination skills, "teenagers’ and young adults’ health" (Self-care training and parents education, "women’s general and reproductive health" (principles of family planning counseling and less needs stated in "integrated care for pregnant mothers" (except for diagnosis and management of ectopic pregnancy, placenta previa and abruption and "child health care" as compared to criteria (All P value <0.05. In contrast to self-assessment results, in interorganization evaluations

  15. Chronic Childhood Trauma, Mental Health, Academic Achievement, and School-Based Health Center Mental Health Services

    Science.gov (United States)

    Larson, Satu; Chapman, Susan; Spetz, Joanne; Brindis, Claire D.

    2017-01-01

    Background: Children and adolescents exposed to chronic trauma have a greater risk for mental health disorders and school failure. Children and adolescents of minority racial/ethnic groups and those living in poverty are at greater risk of exposure to trauma and less likely to have access to mental health services. School-based health centers…

  16. Advancing a conceptual model to improve maternal health quality: The Person-Centered Care Framework for Reproductive Health Equity.

    Science.gov (United States)

    Sudhinaraset, May; Afulani, Patience; Diamond-Smith, Nadia; Bhattacharyya, Sanghita; Donnay, France; Montagu, Dominic

    2017-11-06

    Background: Globally, substantial health inequities exist with regard to maternal, newborn and reproductive health. Lack of access to good quality care-across its many dimensions-is a key factor driving these inequities. Significant global efforts have been made towards improving the quality of care within facilities for maternal and reproductive health. However, one critically overlooked aspect of quality improvement activities is person-centered care. Main body: The objective of this paper is to review existing literature and theories related to person-centered reproductive health care to develop a framework for improving the quality of reproductive health, particularly in low and middle-income countries. This paper proposes the Person-Centered Care Framework for Reproductive Health Equity, which describes three levels of interdependent contexts for women's reproductive health: societal and community determinants of health equity, women's health-seeking behaviors, and the quality of care within the walls of the facility. It lays out eight domains of person-centered care for maternal and reproductive health. Conclusions: Person-centered care has been shown to improve outcomes; yet, there is no consensus on definitions and measures in the area of women's reproductive health care. The proposed Framework reviews essential aspects of person-centered reproductive health care.

  17. NIEHS/EPA Children’s Environmental Health Centers: Lifecourse Exposures & Diet: Epigenetics, Maturation & Metabolic Syndrome

    Science.gov (United States)

    The Columbia Center for Children’s Environmental Health (CCCEH) at Columbia University studies long-term health of urban pollutants on children raised in minority neighborhoods in inner-city communities.

  18. NIEHS/EPA CEHCs: Children's Environmental Health and Disease Prevention Center - Dartmouth College

    Science.gov (United States)

    The Columbia Center for Children’s Environmental Health (CCCEH) at Columbia University studies long-term health of urban pollutants on children raised in minority neighborhoods in inner-city communities.

  19. NHSC Jobs Center for Primary Care Medical, Dental and Mental Health Providers

    Data.gov (United States)

    U.S. Department of Health & Human Services — The National Health Service Corps (NHSC) Jobs Center helps doctors and nurses who are interested in working at areas where there is the highest need find out more...

  20. A focus group study on primary health care in Johannesburg Health ...

    African Journals Online (AJOL)

    nurse conflict and poor teamwork. This may threaten attempts to re-engineer primary health care in order to increase the presence of doctors at clinic level. The discipline of family medicine can make a difference, but reorganisation of the system ...

  1. Assessing Culture and Climate of Federally Qualified Health Centers: A Plan for Implementing Behavioral Health Interventions.

    Science.gov (United States)

    Kramer, Teresa L; Drummond, Karen L; Curran, Geoffrey M; Fortney, John C

    2017-01-01

    This study examines organizational factors relating to climate and culture that might facilitate or impede the implementation of evidence-based practices (EBP) targeting behavioral health in federally qualified health centers (FQHCs). Employees at six FQHCs participating in an evidence-based quality improvement (EBQI) initiative for mood disorders and alcohol abuse were interviewed (N=32) or surveyed using the Organizational Context Survey (OCS) assessing culture and climate (N=64). The FQHCs scored relatively well on proficiency, a previously established predictor of successful EBP implementation, but also logged high scores on scales assessing rigidity and resistance, which may hinder implementation. Qualitative data contextualized scores on FQHC culture and climate dimensions. Results suggest that the unique culture of FQHCs may influence implementation of evidence-based behavioral health interventions.

  2. Burnout of Physicians Working in Primary Health Care Centers under Ministry of Health Jeddah, Saudi Arabia.

    Science.gov (United States)

    Bawakid, Khalid; Abdulrashid, Ola; Mandoura, Najlaa; Shah, Hassan Bin Usman; Ibrahim, Adel; Akkad, Noura Mohammad; Mufti, Fauad

    2017-11-25

    Introduction The levels of physicians' job satisfaction and burnout directly affect their professionalism, punctuality, absenteeism, and ultimately, patients' care. Despite its crucial importance, little is known about professional burnout of the physicians in Saudi Arabia. The objectives of this research are two-fold: (1) To assess the prevalence of burnout in physicians working in primary health care centers under Ministry of Health; and (2) to find the modifiable factors which can decrease the burnout ratio. Methodology Through a cross-sectional study design, a representative sample of the physicians working in primary health care centers (PHCCs) Jeddah (n=246) was randomly selected. The overall burnout level was assessed using the validated abbreviated Maslach burnout inventory (aMBI) questionnaire. It measures the overall burnout prevalence based on three main domains i.e., emotional exhaustion, depersonalization, and personal accomplishment. Independent sample T-test, analysis of variance (ANOVA), and multivariate regression analysis were performed using Statistical Package for the Social Sciences (SPSS Version 22, IBM, Armonk, NY). Results Overall, moderate to high burnout was prevalent in 25.2% of the physicians. Emotional exhaustion was noted in 69.5%. Multivariate regression analysis showed that patient pressure/violence (p burnout. The patient's pressure/violence was the only significant independent predictor of overall burnout. Conclusion Emotional exhaustion is the most prominent feature of overall burnout in the physicians of primary health care centers. The main reasons include patient's pressure/violence, unorganized patient flow, less cooperative colleague doctors, fewer support services at the PHCCs, more paperwork, and less cooperative colleagues. Addressing these issues could lead to a decrease in physician's burnout.

  3. Establishing an Integrative Medicine Program Within an Academic Health Center: Essential Considerations.

    Science.gov (United States)

    Eisenberg, David M; Kaptchuk, Ted J; Post, Diana E; Hrbek, Andrea L; O'Connor, Bonnie B; Osypiuk, Kamila; Wayne, Peter M; Buring, Julie E; Levy, Donald B

    2016-09-01

    Integrative medicine (IM) refers to the combination of conventional and "complementary" medical services (e.g., chiropractic, acupuncture, massage, mindfulness training). More than half of all medical schools in the United States and Canada have programs in IM, and more than 30 academic health centers currently deliver multidisciplinary IM care. What remains unclear, however, is the ideal delivery model (or models) whereby individuals can responsibly access IM care safely, effectively, and reproducibly in a coordinated and cost-effective way.Current models of IM across existing clinical centers vary tremendously in their organizational settings, principal clinical focus, and services provided; practitioner team composition and training; incorporation of research activities and educational programs; and administrative organization (e.g., reporting structure, use of medical records, scope of clinical practice) and financial strategies (i.e., specific business plans and models for sustainability).In this article, the authors address these important strategic issues by sharing lessons learned from the design and implementation of an IM facility within an academic teaching hospital, the Brigham and Women's Hospital at Harvard Medical School; and review alternative options based on information about IM centers across the United States.The authors conclude that there is currently no consensus as to how integrative care models should be optimally organized, implemented, replicated, assessed, and funded. The time may be right for prospective research in "best practices" across emerging models of IM care nationally in an effort to standardize, refine, and replicate them in preparation for rigorous cost-effectiveness evaluations.

  4. Child welfare caseworkers as brokers of mental health services: a pilot evaluation of Project Focus Colorado.

    Science.gov (United States)

    Fitzgerald, Monica M; Torres, Marcela M; Shipman, Kimberly; Gorrono, Jessica; Kerns, Suzanne E U; Dorsey, Shannon

    2015-02-01

    Youth in the child welfare system (CWS) have substantially higher rates of mental health needs compared to the general population, yet they rarely receive targeted, evidence-based practices (EBPs). Caseworkers play the critically important role of "service broker" for CWS youth and families. This study examines preliminary caseworker-level outcomes of Project Focus Colorado (PF-C), a training and consultation program designed to improve access to EBPs for CWS youth. PF-C evaluation occurred in four child welfare offices (two intervention [n = 16 caseworkers] vs. two practice-as-usual, wait-list control [WLC; n = 12 caseworkers]). Receipt of PF-C was associated with significantly increased caseworker knowledge of (a) EBPs, (b) child mental health problems, (c) evidence-based treatment components targeting mental health problem areas, and (d) mental health screening instruments, compared to WLC. Dose of training and consultation was associated with greater ability to correctly classify mental health problems and match them to EBPs. These preliminary results suggest that targeted training and consultation help to improve caseworker knowledge of children's mental health needs, EBPs for mental health, and mental health screening instruments. © The Author(s) 2014.

  5. Introducing sexual orientation and gender identity into the electronic health record: one academic health center's experience.

    Science.gov (United States)

    Callahan, Edward J; Sitkin, Nicole; Ton, Hendry; Eidson-Ton, W Suzanne; Weckstein, Julie; Latimore, Darin

    2015-02-01

    Many U.S. populations experience significant health disparities. Increasing health care providers' awareness of and education about sexual orientation (SO) and gender identity (GI) diversity could help reduce health disparities among lesbian, gay, bisexual, and transgender (LGBT) patients. The authors share the University of California, Davis, Health System's (UCDHS's) experience as it became the first U.S. academic health center to formally introduce patient SO/GI demographic data into its electronic health record (EHR) as a step toward reducing LGBT health disparities. Adding these data to the EHR initially met with resistance. The authors, members of the UCDHS Task Force for Inclusion of SO/GI in the EHR, viewed this resistance as an invitation to educate leaders, providers, and staff about LGBT health disparities and to expose providers to techniques for discussing SO/GI with patients. They describe the strategies they employed to effect institutional culture change, including involvement of senior leadership, key informant interviews, educational outreach via grand rounds and resident workshops, and creation of a patient safety net through inviting providers to self-identify as welcoming LGBT patients. The ongoing cultural change process has inspired spin-off projects contributing to an improved climate for LGBT individuals at UCDHS, including an employee organization supporting SO/GI diversity, support for and among LGBT medical learners through events and listservs, development and implementation of an LGBT health curriculum, and creation of peer navigator programs for LGBT patients with cancer. The authors reflect on lessons learned and on institutional pride in and commitment to providing quality care for LGBT patients.

  6. Patient-centered communication in the era of electronic health records: What does the evidence say?

    Science.gov (United States)

    Rathert, Cheryl; Mittler, Jessica N; Banerjee, Sudeep; McDaniel, Jennifer

    2017-01-01

    Patient-physician communication is essential for patient-centered health care. Physicians are concerned that electronic health records (EHRs) negatively affect communication with patients. This study identified a framework for understanding communication functions that influence patient outcomes. We then conducted a systematic review of the literature and organized it within the framework to better understand what is known. A comprehensive search of three databases (CINAHL, Medline, PsycINFO) yielded 41 articles for analysis. Results indicated that EHR use improves capture and sharing of certain biomedical information. However, it may interfere with collection of psychosocial and emotional information, and therefore may interfere with development of supportive, healing relationships. Patient access to the EHR and messaging functions may improve communication, patient empowerment, engagement, and self-management. More rigorous examination of EHR impacts on communication functions and their influences on patient outcomes is imperative for achieving patient-centered care. By focusing on the role of communication functions on patient outcomes, future EHRs can be developed to facilitate care. Training alone is likely to be insufficient to address disruptions to communication processes. Processes must be improved, and EHRs must be developed to capture useful data without interfering with physicians' and patients' abilities to effectively communicate. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  7. Trends in academic health sciences libraries and their emergence as the "knowledge nexus" for their academic health centers.

    Science.gov (United States)

    Kronenfeld, Michael R

    2005-01-01

    The objective of this study was to identify trends in academic health sciences libraries (AHSLs) as they adapt to the shift from a print knowledgebase to an increasingly digital knowledgebase. This research was funded by the 2003 David A. Kronick Traveling Fellowship. The author spent a day and a half interviewing professional staff at each library. The questionnaire used was sent to the directors of each library in advance of the visit, and the directors picked the staff to be interviewed and set up the schedule. Seven significant trends were identified. These trends are part of the shift of AHSLs from being facility and print oriented with a primary focus on their role as repositories of a print-based knowledgebase to a new focus on their role as the center or "nexus" for the organization, access, and use of an increasingly digital-based knowledgebase. This paper calls for a national effort to develop a new model or structure for health sciences libraries to more effectively respond to the challenges of access and use of a digital knowledgebase, much the same way the National Library of Medicine did in the 1960s and 1970s in developing and implementing the National Network of Libraries of Medicine. The paper then concludes with some examples or ideas for research to assist in this process.

  8. Trends in academic health sciences libraries and their emergence as the “knowledge nexus” for their academic health centers*

    Science.gov (United States)

    Kronenfeld, Michael R.

    2005-01-01

    Objectives: The objective of this study was to identify trends in academic health sciences libraries (AHSLs) as they adapt to the shift from a print knowledgebase to an increasingly digital knowledgebase. This research was funded by the 2003 David A. Kronick Traveling Fellowship. Methods: The author spent a day and a half interviewing professional staff at each library. The questionnaire used was sent to the directors of each library in advance of the visit, and the directors picked the staff to be interviewed and set up the schedule. Results: Seven significant trends were identified. These trends are part of the shift of AHSLs from being facility and print oriented with a primary focus on their role as repositories of a print-based knowledgebase to a new focus on their role as the center or “nexus” for the organization, access, and use of an increasingly digital-based knowledgebase. Conclusion: This paper calls for a national effort to develop a new model or structure for health sciences libraries to more effectively respond to the challenges of access and use of a digital knowledgebase, much the same way the National Library of Medicine did in the 1960s and 1970s in developing and implementing the National Network of Libraries of Medicine. The paper then concludes with some examples or ideas for research to assist in this process. PMID:15685271

  9. Solution-Focused Strategies for Effective Sexual Health Communication among African American Parents and Their Adolescents.

    Science.gov (United States)

    Johnson, Sharon D; Williams, Sha-Lai

    2015-11-01

    The high rates of sexual risk behaviors, particularly among African American youths who may not be aware of their HIV status, provide indication that, unless prevention efforts are enhanced, this vulnerable group of youths will remain at greater risk for negative health status outcomes. Parents are important in efforts to reduce risk among youths and often have a willingness to be sexuality educators for their children; however, communication barriers often impede their ability to provide preventive sexual health knowledge to their youths. Social workers are often presented with opportunities to help parents develop effective sexual health communication skills in informal settings when formal interventions are not feasible. The present effort considers solution-focused strategies social workers can use to help parents overcome barriers and communicate more positively with their youths about sexual health.

  10. 77 FR 2548 - Board of Scientific Counselors, National Center for Health Statistics

    Science.gov (United States)

    2012-01-18

    ... Scientific Counselors, National Center for Health Statistics In accordance with section 10(a)(2) of the...), National Center for Health Statistics (NCHS) announces the following meeting of the aforementioned...; review of the ambulatory and hospital care statistics program; a discussion of the NHANES genetics...

  11. Opportunities for Increasing Human Papillomavirus Vaccine Provision in School Health Centers

    Science.gov (United States)

    Moss, Jennifer L.; Feld, Ashley L.; O'Malley, Brittany; Entzel, Pamela; Smith, Jennifer S.; Gilkey, Melissa B.; Brewer, Noel T.

    2014-01-01

    Background: Uptake of human papillomavirus (HPV) vaccine remains low among adolescents in the United States. We sought to assess barriers to HPV vaccine provision in school health centers to inform subsequent interventions. Methods: We conducted structured interviews in the fall of 2010 with staff from all 33 school health centers in North…

  12. 78 FR 74163 - Harrison Medical Center, a Subsidiary of Franciscan Health System Bremerton, Washington; Notice...

    Science.gov (United States)

    2013-12-10

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-83,070] Harrison Medical Center, a Subsidiary of Franciscan Health System Bremerton, Washington; Notice of Negative Determination... workers of Harrison Medical Center, a subsidiary of Franciscan Health System, Bremerton, Washington...

  13. National Resource Center for Health and Safety in Child Care and Early Education

    Science.gov (United States)

    ... National Resource Center for Health and Safety in Child Care and Early Education (NRC) at the University of Colorado College of ... National Resource Center for Health and Safety in Child Care and Early Education Email: info@NRCKids.org Please read our disclaimer ...

  14. Recruiting community health centers into pragmatic research: Findings from STOP CRC.

    Science.gov (United States)

    Coronado, Gloria D; Retecki, Sally; Schneider, Jennifer; Taplin, Stephen H; Burdick, Tim; Green, Beverly B

    2016-04-01

    Challenges of recruiting participants into pragmatic trials, particularly at the level of the health system, remain largely unexplored. As part of Strategies and Opportunities to STOP Colon Cancer in Priority Populations (STOP CRC), we recruited eight separate community health centers (consisting of 26 individual safety net clinics) into a large comparative effectiveness pragmatic study to evaluate methods of raising the rates of colorectal cancer screening. In partnership with STOP CRC's advisory board, we defined criteria to identify eligible health centers and applied these criteria to a list of health centers in Washington, Oregon, and California affiliated with Oregon Community Health Information Network, a 16-state practice-based research network of federally sponsored health centers. Project staff contacted centers that met eligibility criteria and arranged in-person meetings of key study investigators with health center leadership teams. We used the Consolidated Framework for Implementation Research to thematically analyze the content of discussions during these meetings to identify major facilitators of and barriers to health center participation. From an initial list of 41 health centers, 11 met the initial inclusion criteria. Of these, leaders at three centers declined and at eight centers (26 clinic sites) agreed to participate (73%). Participating and nonparticipating health centers were similar with respect to clinic size, percent Hispanic patients, and percent uninsured patients. Participating health centers had higher proportions of Medicaid patients and higher baseline colorectal cancer screening rates. Common facilitators of participation were perception by center leadership that the project was an opportunity to increase colorectal cancer screening rates and to use electronic health record tools for population management. Barriers to participation were concerns of center leaders about ability to provide fecal testing to and assure follow-up of

  15. Adult care transitioning for adolescents with special health care needs: a pivotal role for family centered care.

    Science.gov (United States)

    Duke, Naomi N; Scal, Peter B

    2011-01-01

    To examine the relationship between having a usual source of care, family centered care, and transition counseling for adolescents with special health care needs. Data are from 18,198 parents/guardians, of youth aged 12-17 years, who participated in the 2005-2006 National Survey of Children With Special Health Care Needs. Linear and logistic regression models were used to define relationships between parent report of identification of a usual place and provider of medical care for their child and counseling on four transition issues: transfer to adult providers, review of future health needs, maintaining health insurance in adulthood, and youth taking responsibility for care. The direct mediating effect of family centered care was evaluated. Youth having a usual source of care (vs. not) were more likely to receive counseling on future health needs (47.4 vs. 33.6%, P needs (56.3 vs. 39.6%, P needs and 94.9% of the effect of a usual source of care on encouragement to take responsibility for care. Study findings support the development of health care delivery models focusing on family centered care to the same degree as other health care access issues.

  16. Four aspects of the scope and quality of family planning services in US publicly funded health centers: Results from a survey of health center administrators.

    Science.gov (United States)

    Carter, Marion W; Gavin, Loretta; Zapata, Lauren B; Bornstein, Marta; Mautone-Smith, Nancy; Moskosky, Susan B

    2016-10-01

    This study aims to describe aspects of the scope and quality of family planning services provided by US publicly funded health centers before the release of relevant federal recommendations. Using nationally representative survey data (N=1615), we describe four aspects of service delivery: family planning services provided, contraceptive methods provided onsite, written contraceptive counseling protocols and youth-friendly services. We created a count index for each issue and used multivariable ordered logistic regression to identify health center characteristics associated with scoring higher on each. Half of the sample received Title X funding and about a third each were a community health center or health department clinic. The vast majority reported frequently providing contraceptive services (89%) and STD services (87%) for women in the past 3 months. Service provision to males was substantially lower except for STD screening. A total of 63% and 48% of health centers provided hormonal IUDs and implants onsite in the past 3 months, respectively. Forty percent of health centers included all five recommended contraceptive counseling practices in written protocols. Of youth-friendly services, active promotion of confidential services was among the most commonly reported (83%); offering weekend/evening hours was among the least (42%). In multivariable analyses, receiving Title X funding, having larger volumes of family planning clients and being a Planned Parenthood clinic were associated with higher scores on most indices. Many services were consistent with the recommendations for providing quality family planning services, but there was room for improvement across domains and health centers types. As assessed in this paper, the scope and quality of these family planning services was relatively high, particularly among Planned Parenthood clinics and Title X-funded centers. However, results point to important areas for improvement. Future studies should assess

  17. Biosecurity and Health Monitoring at the Zebrafish International Resource Center

    OpenAIRE

    Murray, Katrina N.; Varga, Zolt?n M.; Kent, Michael L.

    2016-01-01

    The Zebrafish International Resource Center (ZIRC) is a repository and distribution center for mutant, transgenic, and wild-type zebrafish. In recent years annual imports of new zebrafish lines to ZIRC have increased tremendously. In addition, after 15 years of research, we have identified some of the most virulent pathogens affecting zebrafish that should be avoided in large production facilities, such as ZIRC. Therefore, while importing a high volume of new lines we prioritize safeguarding ...

  18. Trends in the utilization of medical imaging from 2003 to 2011: clinical encounters offer a complementary patient-centered focus.

    Science.gov (United States)

    Dodoo, Martey S; Duszak, Richard; Hughes, Danny R

    2013-07-01

    The aim of this study was to investigate trends in utilization and spending for medical imaging, using medical visits resulting in imaging as a novel metric of utilization. Utilization and spending for medical imaging were examined using (1) Medicare Part B claims data from 2003 to 2011 to measure per-enrollee spending and (2) household component events data on the elderly Medicare-age population from the Medical Expenditure Panel Survey from 2003 to 2010 to measure utilization as a function of clinical encounters. Annual health spending and Medicare payments for imaging for the elderly population grew from $294 per enrollee in 2003 to $418 in 2006 and had declined to $390 by 2011. Over this entire time, however, annual medical visits by a similar Medicare-age (≥ 65 years old) population resulting in imaging trended consistently downward, from 12.8% in 2003 to 10.6% in 2011. Despite early growth and then more recent declines in average Medicare spending per enrollee since 2003, the percentage of patient encounters resulting in medical imaging has significantly and consistently declined nationwide. Spending alone is thus an incomplete measure of changes in the role and utilization of medical imaging in overall patient care. As policymakers focus on medical imaging, a thoughtful analysis of payment policy influencing imaging utilization, and its role in concurrent and downstream patient care, will be critical to ensure appropriate patient access. Copyright © 2013 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  19. Incidence and risk factors of urinary incontinence in women visiting Family Health Centers

    OpenAIRE

    K?l??, Meral

    2016-01-01

    Background The objective of this study is to determine the incidence and the risk factors of the urinary incontinence in women visiting the Health Family Center. Methods 430 women, who visited three Family Health Centers in the city center of Erzurum for any reason between 25 November and 20 January 2016, were included in this study without any sampling. The data were collected by using the face-to-face interview method. Percentage distribution, Chi square test, and logistic regression analys...

  20. Location Allocation of Health Care Centers Using Geographical Information System: region 11 of Tehran

    OpenAIRE

    Mohsen Ahadnejad; Hosein Ghaderi; Mohammad Hadian; Payam Haghighatfard; Banafsheh Darvishi; Elham Haghighatfard; Bitasadat Zegordi; Arash Bordbar

    2015-01-01

     Background & Objective: Location allocation of healthcare centers facilitates the accessibility of health services and the lack of proper distribution of these centers leads to increasing problems of citizens' access to these centers. The main objective of this study was to evaluate the distribution of healthcare centers in the region of the study and to determine deprived areas from this services. Materials & Methods: This research is a case study that has b...

  1. 75 FR 25273 - National Center on Minority and Health Disparities; Notice of Closed Meeting

    Science.gov (United States)

    2010-05-07

    ... and Health Disparities; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... and Health Disparities Special Emphasis Panel, Faith Based R21. Date: June 29-July 1, 2010. Time: 5 p..., Chief, Office of Scientific Review, National Center on Minority Health and Health Disparities, 6707...

  2. Sex Workers and HIV/AIDS: Analyzing Participatory Culture-Centered Health Communication Strategies

    Science.gov (United States)

    Basu, Ambar; Dutta, Mohan J.

    2009-01-01

    An emerging trend in health communication research advocates the need to foreground articulations of health by participants who are at the core of any health campaign. Scholarly work suggests that the culture-centered approach to health communication can provide a theoretical and practical framework to achieve this objective. The culture-centered…

  3. Health Worker Focused Distributed Simulation for Improving Capability of Health Systems in Liberia.

    Science.gov (United States)

    Gale, Thomas C E; Chatterjee, Arunangsu; Mellor, Nicholas E; Allan, Richard J

    2016-04-01

    The main goal of this study was to produce an adaptable learning platform using virtual learning and distributed simulation, which can be used to train health care workers, across a wide geographical area, key safety messages regarding infection prevention control (IPC). A situationally responsive agile methodology, Scrum, was used to develop a distributed simulation module using short 1-week iterations and continuous synchronous plus asynchronous communication including end users and IPC experts. The module contained content related to standard IPC precautions (including handwashing techniques) and was structured into 3 distinct sections related to donning, doffing, and hazard perception training. Using Scrum methodology, we were able to link concepts applied to best practices in simulation-based medical education (deliberate practice, continuous feedback, self-assessment, and exposure to uncommon events), pedagogic principles related to adult learning (clear goals, contextual awareness, motivational features), and key learning outcomes regarding IPC, as a rapid response initiative to the Ebola outbreak in West Africa. Gamification approach has been used to map learning mechanics to enhance user engagement. The developed IPC module demonstrates how high-frequency, low-fidelity simulations can be rapidly designed using scrum-based agile methodology. Analytics incorporated into the tool can help demonstrate improved confidence and competence of health care workers who are treating patients within an Ebola virus disease outbreak region. These concepts could be used in a range of evolving disasters where rapid development and communication of key learning messages are required.

  4. Relationship between organizational culture and commitment of employees in health care centers in west of Iran.

    Science.gov (United States)

    Hamidi, Yadollah; Mohammadibakhsh, Roghayeh; Soltanian, Alireza; Behzadifar, Masoud

    2017-01-01

    administrative units of health care centers (p organizational culture can lead to an escalation of organizational commitment among employees. Furthermore, focus on factors affecting the improvement of continuance commitment can promote organizational commitment of employees in administrative units of health care centers.

  5. Military Health System Utilization Management Program at Medical Centers

    National Research Council Canada - National Science Library

    1998-01-01

    .... This audit topic was the result of a coordinated effort by the Joint Audit Planning Group for Health Care and representatives from the Office of the Assistant Secretary of Defense (Health Affairs) (OASD(HA...

  6. Administrative Challenges to the Integration of Oral Health With Primary Care: A SWOT Analysis of Health Care Executives at Federally Qualified Health Centers.

    Science.gov (United States)

    Norwood, Connor W; Maxey, Hannah L; Randolph, Courtney; Gano, Laura; Kochhar, Komal

    Inadequate access to preventive oral health services contributes to oral health disparities and is a major public health concern in the United States. Federally Qualified Health Centers play a critical role in improving access to care for populations affected by oral health disparities but face a number of administrative challenges associated with implementation of oral health integration models. We conducted a SWOT (strengths, weaknesses, opportunities, and threats) analysis with health care executives to identify strengths, weaknesses, opportunities, and threats of successful oral health integration in Federally Qualified Health Centers. Four themes were identified: (1) culture of health care organizations; (2) operations and administration; (3) finance; and (4) workforce.

  7. Readiness of health centers and primary hospitals for the ...

    African Journals Online (AJOL)

    Background: In response to the 2005 World Health Assembly, many low income countries developed different healthcare financing mechanisms with risk pooling stategy to ensure universal coverage of health services. Accordingly, service availability and readiness of the health system to bear the responsibility of providing ...

  8. Patient-Centered Personal Health Record and Portal Implementation Toolkit for Ambulatory Clinics: A Feasibility Study.

    Science.gov (United States)

    Nahm, Eun-Shim; Diblasi, Catherine; Gonzales, Eva; Silver, Kristi; Zhu, Shijun; Sagherian, Knar; Kongs, Katherine

    2017-04-01

    Personal health records and patient portals have been shown to be effective in managing chronic illnesses. Despite recent nationwide implementation efforts, the personal health record and patient portal adoption rates among patients are low, and the lack of support for patients using the programs remains a critical gap in most implementation processes. In this study, we implemented the Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit in a large diabetes/endocrinology center and assessed its preliminary impact on personal health record and patient portal knowledge, self-efficacy, patient-provider communication, and adherence to treatment plans. Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit is composed of Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit-General, clinic-level resources for clinicians, staff, and patients, and Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit Plus, an optional 4-week online resource program for patients ("MyHealthPortal"). First, Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit-General was implemented, and all clinicians and staff were educated about the center's personal health record and patient portal. Then general patient education was initiated, while a randomized controlled trial was conducted to test the preliminary effects of "MyHealthPortal" using a small sample (n = 74) with three observations (baseline and 4 and 12 weeks). The intervention group showed significantly greater improvement than the control group in patient-provider communication at 4 weeks (t56 = 3.00, P = .004). For other variables, the intervention group tended to show greater improvement; however, the differences were not significant. In this preliminary study, Patient-Centered Personal Health Record and Patient Portal Implementation Toolkit showed potential for filling the gap in the current

  9. Barriers and facilitators to implementing a patient-centered model of contraceptive provision in community health centers.

    Science.gov (United States)

    Politi, Mary C; Estlund, Amy; Milne, Anne; Buckel, Christina M; Peipert, Jeffrey F; Madden, Tessa

    2016-01-01

    The Contraceptive CHOICE Project developed a patient-centered model for contraceptive provision including: (1) structured, evidence-based counseling; (2) staff and health care provider education; and (3) removal of barriers such as cost and multiple appointments to initiate contraception. In preparation for conducting a research study of the CHOICE model in three community health settings, we sought to identify potential barriers and facilitators to implementation. Using a semi-structured interview guide guided by a framework of implementation research, we conducted 31 qualitative interviews with female patients, staff, and health care providers assessing attitudes, beliefs, and barriers to receiving contraception. We also asked about current contraceptive provision and explored organizational practices relevant to implementing the CHOICE model. We used a grounded theory approach to identify major themes. Many participants felt that current contraceptive provision could be improved by the CHOICE model. Potential facilitators included agreement about the necessity for improved contraceptive knowledge among patients and staff; importance of patient-centered contraceptive counseling; and benefits to same-day insertion of long-acting reversible contraception (LARC). Potential barriers included misconceptions about contraception held by staff and providers; resistance to new practices; costs associated with LARC; and scheduling challenges required for same-day insertion of LARC. In addition to staff and provider training, implementing a patient-centered model of contraceptive provision needs to be supplemented by strategies to manage patient and system-level barriers. Community health center staff, providers, and patients support patient-centered contraceptive counseling to improve contraception provision if organizations can address these barriers.

  10. Culture-centered engagement with delivery of health services: co-constructing meanings of health in the Tzu Chi Foundation through Buddhist philosophy.

    Science.gov (United States)

    Dillard, Sydney J; Dutta, Mohan; Sun, Wei-San

    2014-01-01

    The shift in health communication scholarship from the narrow focus on curing to the complexly intertwined spaces of health, illness, healing, and curing attends to the dynamic cultural contexts within which meanings and practices are negotiated, directing scholarship toward alternative spaces of health care delivery. This study utilized the culture-centered approach as a theoretical lens for providing a discursive space for understanding meanings of health constituted in the practices of the Tzu Chi Foundation, an organization that offers biomedical services within the larger philosophical understandings of Buddhism with 10 million members in over 50 different countries. The emerging perspective promotes non-biomedical meanings of health through selfless giving and assistance founded in Buddhist principles, simultaneously seeking purity of the mind, body, and soul holistically. Through the negotiation of the principles driving Buddhist philosophy and the principles that shape biomedical health care delivery, this study seeks to understand the interpretive frames that circulate among foundation staff and care recipients.

  11. Reconsidering the popularity of primary health centers in India: a case study from rural Maharashtra.

    Science.gov (United States)

    Kamat, V R

    1995-07-01

    Most evaluations of India's primary health care (PHC) program have been critical of the ways government primary health centers have been functioning. It has been commonly noted that utilization of health services is poor and community participation in the PHC outreach program low. Additionally, medical officers and health center staff are often accused of being negligent in their duties. In this paper I argue that it is worthwhile examining how a popular primary health center functions in a context marked by a growing demand for Western medicines. Attention is drawn to the ingenious ways in which health personnel respond to client demands and government medicine shortages. The case of a popular primary health center in rural Maharashtra is presented. This health center is both the site of public and private health care. Discussed is the manner in which rural populations in India maximize available health care options given time, cash and transportation constraints. Current thinking about community health financing is considered in light of existing health care utilization patterns, community evaluation of free services, perceptions of entitlement and the likely response of practitioners to such schemes.

  12. Secure Cloud-Based Solutions for Different eHealth Services in Spanish Rural Health Centers

    Science.gov (United States)

    2015-01-01

    Background The combination of eHealth applications and/or services with cloud technology provides health care staff—with sufficient mobility and accessibility for them—to be able to transparently check any data they may need without having to worry about its physical location. Objective The main aim of this paper is to put forward secure cloud-based solutions for a range of eHealth services such as electronic health records (EHRs), telecardiology, teleconsultation, and telediagnosis. Methods The scenario chosen for introducing the services is a set of four rural health centers located within the same Spanish region. iCanCloud software was used to perform simulations in the proposed scenario. We chose online traffic and the cost per unit in terms of time as the parameters for choosing the secure solution on the most optimum cloud for each service. Results We suggest that load balancers always be fitted for all solutions in communication together with several Internet service providers and that smartcards be used to maintain identity to an appropriate extent. The solutions offered via private cloud for EHRs, teleconsultation, and telediagnosis services require a volume of online traffic calculated at being able to reach 2 Gbps per consultation. This may entail an average cost of €500/month. Conclusions The security solutions put forward for each eHealth service constitute an attempt to centralize all information on the cloud, thus offering greater accessibility to medical information in the case of EHRs alongside more reliable diagnoses and treatment for telecardiology, telediagnosis, and teleconsultation services. Therefore, better health care for the rural patient can be obtained at a reasonable cost. PMID:26215155

  13. Secure Cloud-Based Solutions for Different eHealth Services in Spanish Rural Health Centers.

    Science.gov (United States)

    de la Torre-Díez, Isabel; Lopez-Coronado, Miguel; Garcia-Zapirain Soto, Begonya; Mendez-Zorrilla, Amaia

    2015-07-27

    The combination of eHealth applications and/or services with cloud technology provides health care staff—with sufficient mobility and accessibility for them—to be able to transparently check any data they may need without having to worry about its physical location. The main aim of this paper is to put forward secure cloud-based solutions for a range of eHealth services such as electronic health records (EHRs), telecardiology, teleconsultation, and telediagnosis. The scenario chosen for introducing the services is a set of four rural health centers located within the same Spanish region. iCanCloud software was used to perform simulations in the proposed scenario. We chose online traffic and the cost per unit in terms of time as the parameters for choosing the secure solution on the most optimum cloud for each service. We suggest that load balancers always be fitted for all solutions in communication together with several Internet service providers and that smartcards be used to maintain identity to an appropriate extent. The solutions offered via private cloud for EHRs, teleconsultation, and telediagnosis services require a volume of online traffic calculated at being able to reach 2 Gbps per consultation. This may entail an average cost of €500/month. The security solutions put forward for each eHealth service constitute an attempt to centralize all information on the cloud, thus offering greater accessibility to medical information in the case of EHRs alongside more reliable diagnoses and treatment for telecardiology, telediagnosis, and teleconsultation services. Therefore, better health care for the rural patient can be obtained at a reasonable cost.

  14. Reducing the health disparities of Indigenous Australians: time to change focus.

    Science.gov (United States)

    Durey, Angela; Thompson, Sandra C

    2012-06-10

    Indigenous peoples have worse health than non-Indigenous, are over-represented amongst the poor and disadvantaged, have lower life expectancies, and success in improving disparities is limited. To address this, research usually focuses on disadvantaged and marginalised groups, offering only partial understanding of influences underpinning slow progress. Critical analysis is also required of those with the power to perpetuate or improve health inequities. In this paper, using Australia as a case example, we explore the effects of 'White', Anglo-Australian cultural dominance in health service delivery to Indigenous Australians. We address the issue using race as an organising principle, underpinned by relations of power. Interviews with non-Indigenous medical practitioners in Western Australia with extensive experience in Indigenous health encouraged reflection and articulation of their insights into factors promoting or impeding quality health care to Indigenous Australians. Interviews were audio-taped and transcribed. An inductive, exploratory analysis identified key themes that were reviewed and interrogated in light of existing literature on health care to Indigenous people, race and disadvantage. The researchers' past experience, knowledge and understanding of health care and Indigenous health assisted with data interpretation. Informal discussions were also held with colleagues working professionally in Indigenous policy, practice and community settings. Racism emerged as a key issue, leading us to more deeply interrogate the role 'Whiteness' plays in Indigenous health care. While Whiteness can refer to skin colour, it also represents a racialized social structure where Indigenous knowledge, beliefs and values are subjugated to the dominant western biomedical model in policy and practice. Racism towards Indigenous patients in health services was institutional and interpersonal. Internalised racism was manifest when Indigenous patients incorporated racist

  15. Reducing the health disparities of Indigenous Australians: time to change focus

    Directory of Open Access Journals (Sweden)

    Durey Angela

    2012-06-01

    Full Text Available Abstract Background Indigenous peoples have worse health than non-Indigenous, are over-represented amongst the poor and disadvantaged, have lower life expectancies, and success in improving disparities is limited. To address this, research usually focuses on disadvantaged and marginalised groups, offering only partial understanding of influences underpinning slow progress. Critical analysis is also required of those with the power to perpetuate or improve health inequities. In this paper, using Australia as a case example, we explore the effects of ‘White’, Anglo-Australian cultural dominance in health service delivery to Indigenous Australians. We address the issue using race as an organising principle, underpinned by relations of power. Methods Interviews with non-Indigenous medical practitioners in Western Australia with extensive experience in Indigenous health encouraged reflection and articulation of their insights into factors promoting or impeding quality health care to Indigenous Australians. Interviews were audio-taped and transcribed. An inductive, exploratory analysis identified key themes that were reviewed and interrogated in light of existing literature on health care to Indigenous people, race and disadvantage. The researchers’ past experience, knowledge and understanding of health care and Indigenous health assisted with data interpretation. Informal discussions were also held with colleagues working professionally in Indigenous policy, practice and community settings. Results Racism emerged as a key issue, leading us to more deeply interrogate the role ‘Whiteness’ plays in Indigenous health care. While Whiteness can refer to skin colour, it also represents a racialized social structure where Indigenous knowledge, beliefs and values are subjugated to the dominant western biomedical model in policy and practice. Racism towards Indigenous patients in health services was institutional and interpersonal. Internalised

  16. Influence of environmental factors on mental health within prisons: focus group study.

    Science.gov (United States)

    Nurse, Jo; Woodcock, Paul; Ormsby, Jim

    2003-08-30

    To increase understanding of how the prison environment influences the mental health of prisoners and prison staff. Qualitative study with focus groups. A local prison in southern England. Prisoners and prison staff. Prisoners reported that long periods of isolation with little mental stimulus contributed to poor mental health and led to intense feelings of anger, frustration, and anxiety. Prisoners said they misused drugs to relieve the long hours of tedium. Most focus groups identified negative relationships between staff and prisoners as an important issue affecting stress levels of staff and prisoners. Staff groups described a "circle of stress," whereby the prison culture, organisation, and staff shortages caused high staff stress levels, resulting in staff sickness, which in turn caused greater stress for remaining staff. Staff shortages also affected prisoners, who would be locked up for longer periods of time, the ensuing frustration would then be released on staff, aggravating the situation still further. Insufficient staff also affected control and monitoring of bullying and reduced the amount of time in which prisoners were able to maintain contact with their families. Greater consideration should be given to understanding the wider environmental and organisational factors that contribute to poor mental health in prisons. This information can be used to inform prison policy makers and managers, and the primary care trusts who are beginning to work in partnership with prisons to improve the mental health of prisoners.

  17. Influence of Human Factor Issues on Patient-Centered mHealth Apps' Impact; Where Do We Stand?

    Science.gov (United States)

    Wildenbos, G A; Peute, L W; Jaspers, M W M

    2016-01-01

    This paper discusses the preliminary results of a literature review on studies published in 2014-2015 concerning patient-centered mHealth applications' (apps) impact. Abstracts were included when they described a mHealth app targeted at patients and reported on the effects of this app on patient care. From a total of 559 potentially relevant articles, 17 papers were finally included. Nine studies reported a positive impact of the patient-centered mHealth app on patient care; 4 of these studies were randomized controlled trials. Measured impacts in the 17 studies focused on improving patients' physical activity, self-efficacy and medication adherence. Human factors issues potentially mediating these effects were discussed in all studies. Transitions in the interaction between healthcare providers and their patients were most often discussed as influencing the impact of the mHealth app. More research is needed, focussing on human issues mediating the effect of patient-centered mHealth apps to precipitate knowledge on the effectiveness of mHealth. This research should preferably be guided by socio-technical models.

  18. Mobile Health Technology in Late-Life Mental Illness: A Focused Literature Review.

    Science.gov (United States)

    Moussa, Yara; Mahdanian, Artin A; Yu, Ching; Segal, Marilyn; Looper, Karl J; Vahia, Ipsit V; Rej, Soham

    2017-08-01

    In an era of rising geriatric mental health care needs worldwide, technological advances can help address care needs in a cost-effective fashion. Our objective in this review was to assess whether mobile health technology, such as tablets and smartphones, are feasible to use in patients with late-life mental and cognitive disorders, as well as whether they were generally reliable modes of mental health/cognitive assessment. We performed a focused literature review of MEDLINE, PsychInfo, and Embase databases, including papers specifically assessing the implementation of mobile health technologies: electronic tablets (e.g., iPad), smartphones, and other mobile computerized equipment in older adults (age ≥65 years) diagnosed with or at risk of a mental and/or cognitive disorder. A total of 2,079 records were assessed, of which 7 papers were of direct relevance. Studies investigated a broad variety of mobile health technologies. Almost all examined samples with dementia/cognitive dysfunction or at risk for those disorders. All studies exclusively examined the use of mobile health technologies for the assessment of cognitive and or mental illness symptoms or disorders. None of the studies reported participants having any difficulties using the mobile health technology assessments and overall reliability was similar to paper-and-pencil modes of assessment. Overall, mobile health technologies were found to be feasible by patients and had promising reliability for the assessment of cognitive and mental illness domains in older adults. Future clinical trials will be necessary to assess whether portable communication interventions (e.g., symptom tracking) can improve geriatric mental health outcomes. Copyright © 2017 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

  19. International Health Regulations in practice: Focus on yellow fever and poliomyelitis.

    Science.gov (United States)

    Simons, H; Patel, D

    2016-10-02

    ASBTRACT The spread of infectious disease represents a global threat and therefore remains a priority on the international public health agenda. The International Health Regulations (IHR) (2005) came into effect in June 2007 and provide a legal framework to which the 196 member states of the World Health Assembly agree to abide. 1 These regulations include implementation of protective, control and response measures at points of entry to a country (i.e. land borders, sea and airports), and of notification measures, all of which aim to prevent or limit the spread of disease while minimising disruption to international trade. The World Health Organization can apply and enforce IHR (2005) to any disease considered to pose a significant threat to international public health. This short paper focuses on 2 diseases; yellow fever and poliomyelitis, both of which have the potential to spread internationally. It will discuss the measures applied under IHR (2005) to minimize the threat, and explore the implications for both travelers and travel health advisors.

  20. What young people want from health-related online resources: a focus group study.

    Science.gov (United States)

    Fergie, Gillian; Hunt, Kate; Hilton, Shona

    2013-08-01

    The growth of the Internet as an information source about health, particularly amongst young people, is well established. The aim of this study was to explore young people's perceptions and experiences of engaging with health-related online content, particularly through social media websites. Between February and July 2011 nine focus groups were facilitated across Scotland with young people aged between 14 and 18 years. Health-related user-generated content seems to be appreciated by young people as a useful, if not always trustworthy, source of accounts of other people's experiences. The reliability and quality of both user-generated content and official factual content about health appear to be concerns for young people, and they employ specialised strategies for negotiating both areas of the online environment. Young people's engagement with health online is a dynamic area for research. Their perceptions and experiences of health-related content seem based on their wider familiarity with the online environment and, as the online environment develops, so too do young people's strategies and conventions for accessing it.

  1. The possible worlds of global health research: An ethics-focused discourse analysis.

    Science.gov (United States)

    Brisbois, Ben; Plamondon, Katrina

    2018-01-01

    Representations of the world enable global health research (GHR), discursively constructing sites in which studies can legitimately take place. Depoliticized portrayals of the global South frequently obscure messy legacies of colonialism and motivate technical responses to health problems with political and economic root causes. Such problematic representations of the world have not yet been rigorously examined in relation to global health ethics, a major site of scholarly effort towards GHR that promotes justice and fairness. We carried out a discourse analysis of four guidance documents relevant to the ethical practice of GHR, purposively selecting texts covering different genres (UN documents and journal articles) and prominent GHR foci (HIV and clinical trials). In light of increasing acknowledgement of the lessons Indigenous health scholarship holds for global health ethics, the four analyzed texts also included a set of principles developed to support Indigenous nation-building. Three of four documents featured global disparities as reasons for ethical caution. These inequalities appeared without explanation or causes, with generation of new scientific knowledge following as a logical response to such disparities. The fourth - Indigenous health-focused - document clearly identified 'colonialism' as a reason for both inequities in society, and related harmful research practices. Solutions to disparities in this text did not necessarily involve cutting-edge research, but focused instead on empowerment and responsiveness to community priorities and needs. These contrasting representations of the world were accomplished in ways that depended on texts' 'participants', or the people they represented; specific vocabularies or language usages; intertextual relationships to prior texts; and overall objectives or intentions of the author(s). Our results illustrate how ethics and other guidance documents serve as an important terrain for constructing, naturalizing or

  2. Assessing the integration of health center and community emergency preparedness and response planning.

    Science.gov (United States)

    Wineman, Nicole V; Braun, Barbara I; Barbera, Joseph A; Loeb, Jerod M

    2007-11-01

    To assess the state of health center integration into community preparedness, we undertook a national study of linkages between health centers and the emergency preparedness and response planning initiatives in their communities. The key objectives of this project were to gain a better understanding of existing linkages in a nationally representative sample of health centers, and identify health center demographic and experience factors that were associated with strong linkages. The objectives of the study were to gain a baseline understanding of existing health center linkages to community emergency preparedness and response systems and to identify factors that were associated with strong linkages. A 60-item questionnaire was mailed to the population of health centers supported by the Health Resources and Services Administration's Bureau of Primary Health Care in February 2005. Results were aggregated and a chi square analysis identified factors associated with stronger linkages. Overall performance on study-defined indicators of strong linkages was low: 34% had completed a hazard vulnerability analysis in collaboration with the community emergency management agency, 30% had their role documented in the community plan, and 24% participated in community-wide exercises. Stronger linkages were associated with experience responding to a disaster and a perception of high risk for experiencing a disaster. The potential for health centers to participate in an integrated response is not fully realized, and their absence from community-based planning leaves an already vulnerable population at greater risk. Community planners should be encouraged to include health centers in planning and response and centers should receive more targeted resources for community integration.

  3. Barriers for domestic violence screening in primary health care centers

    African Journals Online (AJOL)

    Iman Y. Alotaby

    2012-08-09

    Aug 9, 2012 ... the field work of the study in the selected centers were the target population of this ... program; several methods were used to verify data entry. ..... asked about abuse.18 Based on the synthesis and interpretation of data from 25 ... in a primary care setting: the validity of ''feeling safe at home'' and prevalence ...

  4. Violence against health workers in Family Medicine Centers

    OpenAIRE

    Al-Turki, Nouf; Afify, Ayman AM; AlAteeq, Mohammed

    2016-01-01

    Nouf Al-Turki,1 Ayman AM Afify,1 Mohammed AlAteeq2 1Family Medicine Department, Prince Sultan Military Medical City, 2Department of Family Medicine and PHC, King Abdul-Aziz Medical City, National Guard Health Affairs, Riyadh, Kingdom of Saudi Arabia Background: Health care violence is a significant worldwide problem with negative consequences on both the safety and well-being of health care workers as well as workplace activities. Reports examining health care violence in Saudi Arabia are lim...

  5. Establishment of the South-Eastern Norway Regional Health Authority Resource Center for Children with Prenatal Alcohol/Drug Exposure

    Directory of Open Access Journals (Sweden)

    Gro C. C. Løhaugen

    2015-01-01

    Full Text Available This paper presents a new initiative in the South-Eastern Health Region of Norway to establish a regional resource center focusing on services for children and adolescents aged 2–18 years with prenatal exposure to alcohol or other drugs. In Norway, the prevalence of fetal alcohol spectrum (FAS is not known but has been estimated to be between 1 and 2 children per 1000 births, while the prevalence of prenatal exposure to illicit drugs is unknown. The resource center is the first of its kind in Scandinavia and will have three main objectives: (1 provide hospital staff, community health and child welfare personnel, and special educators with information, educational courses, and seminars focused on the identification, diagnosis, and treatment of children with a history of prenatal alcohol/drug exposure; (2 provide specialized health services, such as diagnostic services and intervention planning, for children referred from hospitals in the South-Eastern Health Region of Norway; and (3 initiate multicenter studies focusing on the diagnostic process and evaluation of interventions.

  6. Audit of a diabetic health education program at a large Primary Health Care Center in Asir region.

    Science.gov (United States)

    Al-Khaldi, Y M; Khan, M Y

    2000-09-01

    To evaluate the health education program in a large Primary Health Care Center, to find out the problems faced by the staff and to suggest the practical and relevant solutions. This study was carried out at Wasat Abha Primary Health Care Center, Asir region during 1997. The files of diabetics who attended the center were evaluated for health education topics by using a checklist. The essential structure of diabetic health education program was assessed by using another check list designed by the investigators. Data entry and analysis was carried out through SPSS package. Chi-square test was applied wherever necessary. The total number of diabetics who attended Wasat Abha Primary Health Care Center was 198. The duration of diabetes mellitus was 7.7+5.8 years. Ninety percent of these were married, 50.5% were educated and 79% were employed. Compliance to appointment was good in 60% and poor in 30% of diabetics. About 73% of the diabetics received at least one health education topic while 27% did not receive any health education at all. Only 33% of diabetic patients had adequate health education. Ninety one percent were provided with diabetic identification cards, 80% were explained about diabetes and 77% were educated about the role of diet. Essential structure for diabetes education program was found to be unsatisfactory. Effective diabetic health education program needs the availability of all essential structures, community participation and integration of the government and private sectors. The deficiencies in the structures and the process of health education programs in our practice are almost universal to other Primary Health Care Centers in the Asir region. Providing the Primary Health Care Centers with all essential structures and annual auditing are complimentary to a successful diabetic health education program.

  7. Relationship of Interpersonal Behaviors and Health-Related Control Appraisals to Patient Satisfaction and Compliance in a University Health Center

    Science.gov (United States)

    Campbell, Thomas A.; Auerbach, Stephen M.; Kiesler, Donald J.

    2007-01-01

    Objective: The authors' aim was to evaluate patient-provider relationships in a college health center. Participants: Eighty student patients and their health-care providers. Methods: Patients completed a measure of perceived health competence before a consultation and measures of provider participatory behavior and interpersonal behavior before…

  8. What constitutes an excellent allied health care professional? A multidisciplinary focus group study

    Directory of Open Access Journals (Sweden)

    Paans W

    2013-09-01

    Full Text Available Wolter Paans, Inge Wijkamp, Egbert Wiltens, Marca V Wolfensberger Research and Innovation Group Talent Development in Higher Education and Society, Hanze University of Applied Sciences, Groningen, The Netherlands. Background: Determining what constitutes an excellent allied health care professional (AHCP is important, since this is what will guide the development of curricula for training future physical therapists, oral hygienists, speech therapists, diagnostic radiographers, and dietitians. This also determines the quality of care. Aim: To describe perspectives of AHCPs on which characteristics are commonly associated with an excellent AHCP. Methods: AHCPs' perspectives were derived from three focus group discussions. Twenty-one health care professionals participated. The final analysis of the focus group discussions produced eight domains, in which content validity was obtained through a Delphi panel survey of 27 contributing experts. Results: According to the survey, a combination of the following characteristics defines an excellent AHCP: (1 cognizance, to obtain and to apply knowledge in a broad multidisciplinary health care field; (2 cooperativity, to effectively work with others in a multidisciplinary context; (3 communicative, to communicate effectively at different levels in complex situations; (4 initiative, to initiate new ideas, to act proactively, and to follow them through; (5 innovative, to devise new ideas and to implement alternatives beyond current practices; (6 introspective, to self-examine and to reflect; (7 broad perspective, to capture the big picture; and (8 evidence-driven, to find and to use scientific evidence to guide one's decisions. Conclusion: The AHCPs perspectives can be used as a reference for personal improvement for supervisors and professionals in clinical practice and for educational purposes. These perspectives may serve as a guide against which talented students can evaluate themselves. Keywords: clinical

  9. A Systematic Review of Knowledge Translation (KT) in Pediatric Pain: Focus on Health Care Providers.

    Science.gov (United States)

    Gagnon, Michelle M; Hadjistavropoulos, Thomas; Hampton, Amy J D; Stinson, Jennifer

    2016-11-01

    Pain is inadequately managed in pediatric populations across health care settings. Although training programs to improve health care provider knowledge and skills have been developed and evaluated, clinical practices have not always kept pace with advancing knowledge. Consequently, the goal of this review was to systematically examine the pediatric pain literature of knowledge translation (KT) programs targeting health care providers. Systematic searches of PubMed, Web of Science, CINAHL, and PsycINFO were undertaken. KT initiatives directed toward health care providers and in which the primary focus was on pediatric pain were included. Primary outcomes, intervention characteristics, and risk of bias were examined across studies. Study outcomes were conceptually organized and a narrative synthesis of results was conducted. A total of 15,191 abstracts were screened for inclusion with 98 articles retained on the basis of predetermined criteria. Across studies, KT approaches varied widely in format and focus. Knowledge-level changes and self-reported increases in comfort or confidence in skills/knowledge were consistently achieved. Practice-level changes were achieved in many areas with varying success. Design and reporting issues were identified in the majority of studies. Examination of patient-related outcomes and of the long-term impact of pediatric pain KT programs was limited across studies. KT programs vary in quality and impact. Although several successful programs have been developed, many studies include a high risk of bias due to study quality. Evidence-based KT program implementation and a focus on sustainability of outcomes must be given greater consideration in the field of pediatric pain.

  10. A review of zoonotic disease surveillance supported by the Armed Forces Health Surveillance Center.

    Science.gov (United States)

    Burke, R L; Kronmann, K C; Daniels, C C; Meyers, M; Byarugaba, D K; Dueger, E; Klein, T A; Evans, B P; Vest, K G

    2012-05-01

    The Armed Forces Health Surveillance Center (AFHSC), Division of Global Emerging Infections Surveillance and Response System conducts disease surveillance through a global network of US Department of Defense research laboratories and partnerships with foreign ministries of agriculture, health and livestock development in over 90 countries worldwide. In 2010, AFHSC supported zoonosis survey efforts were organized into four main categories: (i) development of field assays for animal disease surveillance during deployments and in resource limited environments, (ii) determining zoonotic disease prevalence in high-contact species which may serve as important reservoirs of diseases and sources of transmission, (iii) surveillance in high-risk human populations which are more likely to become exposed and subsequently infected with zoonotic pathogens and (iv) surveillance at the human-animal interface examining zoonotic disease prevalence and transmission within and between human and animal populations. These efforts have aided in the detection, identification and quantification of the burden of zoonotic diseases such as anthrax, brucellosis, Crimean Congo haemorrhagic fever, dengue fever, Hantaan virus, influenza, Lassa fever, leptospirosis, melioidosis, Q fever, Rift Valley fever, sandfly fever Sicilian virus, sandfly fever Naples virus, tuberculosis and West Nile virus, which are of military and public health importance. Future zoonotic surveillance efforts will seek to develop local capacity for zoonotic surveillance focusing on high risk populations at the human-animal interface. © 2011 Blackwell Verlag GmbH.

  11. Community health centers' impact on the political and economic environment: the Massachusetts example.

    Science.gov (United States)

    Hunt, James W

    2005-01-01

    Since their inception in 1965, community health centers have thrived against tough odds, including patchwork funding, an unpredictable public policy environment, and a volatile healthcare marketplace. Much of this long-term success has been attributed to the centers' ability to affect their economic and political environment. Massachusetts provides an excellent example of this outward orientation. It was here that the centers first took hold, grew rapidly as a result of grassroots activity, and came together as a group for advocacy and mutual assistance. This article examines the Massachusetts experience in light of the health centers' ability to survive and grow.

  12. Burnout of Physicians Working in Primary Health Care Centers under Ministry of Health Jeddah, Saudi Arabia

    Science.gov (United States)

    Bawakid, Khalid; Mandoura, Najlaa; Shah, Hassan Bin Usman; Ibrahim, Adel; Akkad, Noura Mohammad; Mufti, Fauad

    2017-01-01

    Introduction The levels of physicians' job satisfaction and burnout directly affect their professionalism, punctuality, absenteeism, and ultimately, patients' care. Despite its crucial importance, little is known about professional burnout of the physicians in Saudi Arabia. The objectives of this research are two-fold: (1) To assess the prevalence of burnout in physicians working in primary health care centers under Ministry of Health; and (2) to find the modifiable factors which can decrease the burnout ratio. Methodology Through a cross-sectional study design, a representative sample of the physicians working in primary health care centers (PHCCs) Jeddah (n=246) was randomly selected. The overall burnout level was assessed using the validated abbreviated Maslach burnout inventory (aMBI) questionnaire. It measures the overall burnout prevalence based on three main domains i.e., emotional exhaustion, depersonalization, and personal accomplishment. Independent sample T-test, analysis of variance (ANOVA), and multivariate regression analysis were performed using Statistical Package for the Social Sciences (SPSS Version 22, IBM, Armonk, NY). Results Overall, moderate to high burnout was prevalent in 25.2% of the physicians. Emotional exhaustion was noted in 69.5%. Multivariate regression analysis showed that patient pressure/violence (p <0.001), unorganized patients flow to clinics (p=0.021), more paperwork (p<0.001), and less co-operative colleague doctors (p=0.045) were the significant predictors for high emotional exhaustion. A positive correlation was noted between the number of patients per day and burnout. The patient’s pressure/violence was the only significant independent predictor of overall burnout. Conclusion Emotional exhaustion is the most prominent feature of overall burnout in the physicians of primary health care centers. The main reasons include patient’s pressure/violence, unorganized patient flow, less cooperative colleague doctors, fewer

  13. Climate change and environmental impacts on maternal and newborn health with focus on Arctic populations

    Directory of Open Access Journals (Sweden)

    Torkjel M. Sandanger

    2011-11-01

    Full Text Available In 2007, the Intergovernmental Panel on Climate Change (IPCC presented a report on global warming and the impact of human activities on global warming. Later the Lancet commission identified six ways human health could be affected. Among these were not environmental factors which are also believed to be important for human health. In this paper we therefore focus on environmental factors, climate change and the predicted effects on maternal and newborn health. Arctic issues are discussed specifically considering their exposure and sensitivity to long range transported contaminants.Considering that the different parts of pregnancy are particularly sensitive time periods for the effects of environmental exposure, this review focuses on the impacts on maternal and newborn health. Environmental stressors known to affects human health and how these will change with the predicted climate change are addressed. Air pollution and food security are crucial issues for the pregnant population in a changing climate, especially indoor climate and food security in Arctic areas.The total number of environmental factors is today responsible for a large number of the global deaths, especially in young children. Climate change will most likely lead to an increase in this number. Exposure to the different environmental stressors especially air pollution will in most parts of the world increase with climate change, even though some areas might face lower exposure. Populations at risk today are believed to be most heavily affected. As for the persistent organic pollutants a warming climate leads to a remobilisation and a possible increase in food chain exposure in the Arctic and thus increased risk for Arctic populations. This is especially the case for mercury. The perspective for the next generations will be closely connected to the expected temperature changes; changes in housing conditions; changes in exposure patterns; predicted increased exposure to Mercury

  14. Outcomes of antiretroviral treatment: a comparison between hospitals and health centers in Ethiopia.

    Science.gov (United States)

    Balcha, Taye T; Jeppsson, Anders

    2010-01-01

    the objective of this study was to compare the outcomes of antiretroviral therapy (ART) between hospital and health center levels in Ethiopia. medical records of 1709 ART patients followed for 24 months at 2 hospitals and 3 health centers in the Oromia region of Ethiopia were reviewed. Noted outcomes of ART were currently alive and on treatment; lost to follow-up (LTFU); transferred out (TO); and died (D). of 1709 HIV-positive patients started on ART between September 2006 and February 2007, 1044 (61%) remained alive and were on treatment after 24-month follow-up. In all, 835 (57%) of ART patients at hospitals and 209 (83%) at health centers were retained in the program. Of those who were alive and receiving ART, 79% of patients at health centers and 72% at hospitals were clinically or immunologically improving. In addition, 331 (23%) patients at hospitals were LFTU as compared to 24 (10%) of patients at health centers (relative risk [RR] at 95% confidence interval [CI]: .358 [.231-.555]). While 11% was the mortality rate at hospitals, 5% of patients at health centers also died (RR at 95% CI: .360 [.192-.673]). antiretroviral therapy at health centers was associated with more favorable outcomes than at hospitals.

  15. Academic health centers and care of undocumented immigrants in the United States: servant leaders or uncourageous followers?

    Science.gov (United States)

    Acosta, David A; Aguilar-Gaxiola, Sergio

    2014-04-01

    Public dialogue and debate about the health care overhaul in the United States is centered on one contentious question: Is there a moral obligation to ensure that all people (including undocumented immigrants) within its borders have access to affordable health care? For academic health centers (AHCs), which often provide safety-net care to the uninsured, this question has moral and social implications. An estimated 11 million undocumented immigrants living in the United States (80% of whom are Latino) are uninsured and currently prohibited from purchasing exchange coverage under the Patient Protection and Affordable Care Act, even at full cost. The authors attempt to dispel the many misconceptions and distorted assumptions surrounding the use of health services by this vulnerable population. The authors also suggest that AHCs need to recalibrate their mission to focus on social accountability as well as the ethical and humanistic practice of medicine for all people, recognizing the significance of inclusion over exclusion in making progress on population health and health care. AHCs play a crucial role, both in educational policy and as a safety-net provider, in reducing health disparities that negatively impact vulnerable populations. Better health for all is possible through better alignment, collaboration, and partnering with other AHCs and safety-net providers. Through servant leadership, AHCs can be the leaders that this change imperative demands.

  16. Ethical issues in genetics and public health in Latin America with a focus on Argentina.

    Science.gov (United States)

    Penchaszadeh, Victor B

    2015-07-01

    This paper reviews the health situation and developments in medical genetics and bioethics in Latin America, with a focus on Argentina. The region is the most inequitable in the world, with an average Gini Index of 52.5 and 25 % of the population living in poverty. Health expenditures are low and health systems are fragmented and privatised, with curtailed governmental responsibility and regulation. Health-care decision making is mostly in the hands of private insurance corporations and the medical-industrial complex, so that what is (or is not) covered by health plans is arbitrary and determined by the market and not by population health needs. This inequity and the lack of meaningful governmental intervention in the provision of health care, including genetic services, are at the heart of the bioethical dilemmas in Latin America. It is not surprising, therefore, that bioethics in the region has developed an approach grounded in social justice, equity and human rights as guiding principles, in contrast to the individualism espoused by Anglo-Saxon bioethics. The main ethical issues identified in genetics in Latin America are (1) inequity in access to genetic services, particularly in prenatal diagnosis, (2) genetic discrimination and (3) the lack of adherence to internationally accepted requisites of clinical validity and utility for diagnostic and predictive genetic testing. In this context, there is a risk that the impressive advances in genetics/genomics occurring in developed countries may fail to improve the public's health and deepen inequity, with the implementation of expensive genetic technologies of unproven validity.

  17. Relationship-centered health care as a Lean intervention.

    Science.gov (United States)

    Dunsford, Jennifer; Reimer, Laura E

    2017-12-01

    Continuous improvement efforts, recognized in much literature as Lean management techniques have been used in efforts to improve efficiency in democratic health care contexts for some time to varying degrees of success. The complexity of the health care system is magnified by the sheer number of processes and sub processes required to deliver value within a bureaucratic environment, while maintaining some level of compassionate and personalized care. There is inherent tension between what is required to be efficient and what is required to be caring and this conflict presses against Lean practice at the level of delivery.Administration and care intersect at the point of the patient's experience. In order to achieve the dual goals of improved value and lower costs, the application of Lean thinking for meaningful health care reform must acknowledge the fundamental dichotomy between the impersonal tasks required to provide health services, and human interactions. Meaningful health care reform requires an acknowledgement of this distinction, currently not recognized in literature. While administrative process improvements are necessary, they are insufficient to achieve a sustainable and caring health care system. Lean thinking must be applied differently for administrative processes and patient care encounters, because these are fundamentally different processes. In this way, Lean principles will effectively contribute to sustainable health system improvements. © The Author 2017. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  18. Use and records of child health handbook focused on growth and development.

    Science.gov (United States)

    Palombo, Claudia Nery Teixeira; Duarte, Luciane Simões; Fujimori, Elizabeth; Toriyama, Aurea Tamami Minagawa

    2014-08-01

    Objective To evaluate the use and records of the Child Health Handbook (CHH), especially growth and development. Method Cross-sectional study with 358 mother-child pairs registered in 12 Primary Health Centers (PHCs) of a small municipality. Mothers were interviewed at the PHC from February to April 2013 using a questionnaire. Data analysis was done using WHO Anthro software, Epi InfoTM and Stata. Results Fifty-three percent of the mothers were carrying the CHH at the time of the interview, similar to the proportion of mothers who were instructed to bring the CHH to health appointments. Annotations in the CHH during the visits were reported by 49%. The vaccination schedule was completed in 97% of the CHH, but only 9% and 8% of the CHH, respectively, contained growth charts and properly completed developmental milestones. Conclusion Low rates of use and unsatisfactory record-keeping in the CHH reinforce the need for investment in professional training and community awareness for the CHH to become an effective instrument of promotion of child health.

  19. Use and records of child health handbook focused on growth and development

    Directory of Open Access Journals (Sweden)

    Claudia Nery Teixeira Palombo

    2014-08-01

    Full Text Available Objective To evaluate the use and records of the Child Health Handbook (CHH, especially growth and development. Method Cross-sectional study with 358 mother-child pairs registered in 12 Primary Health Centers (PHCs of a small municipality. Mothers were interviewed at the PHC from February to April 2013 using a questionnaire. Data analysis was done using WHO Anthro software, Epi InfoTM and Stata. Results Fifty-three percent of the mothers were carrying the CHH at the time of the interview, similar to the proportion of mothers who were instructed to bring the CHH to health appointments. Annotations in the CHH during the visits were reported by 49%. The vaccination schedule was completed in 97% of the CHH, but only 9% and 8% of the CHH, respectively, contained growth charts and properly completed developmental milestones. Conclusion Low rates of use and unsatisfactory record-keeping in the CHH reinforce the need for investment in professional training and community awareness for the CHH to become an effective instrument of promotion of child health.

  20. Using focus groups to design systems science models that promote oral health equity.

    Science.gov (United States)

    Kum, Susan S; Northridge, Mary E; Metcalf, Sara S

    2018-06-04

    While the US population overall has experienced improvements in oral health over the past 60 years, oral diseases remain among the most common chronic conditions across the life course. Further, lack of access to oral health care contributes to profound and enduring oral health inequities worldwide. Vulnerable and underserved populations who commonly lack access to oral health care include racial/ethnic minority older adults living in urban environments. The aim of this study was to use a systematic approach to explicate cause and effect relationships in creating a causal map, a type of concept map in which the links between nodes represent causality or influence. To improve our mental models of the real world and devise strategies to promote oral health equity, methods including system dynamics, agent-based modeling, geographic information science, and social network simulation have been leveraged by the research team. The practice of systems science modeling is situated amidst an ongoing modeling process of observing the real world, formulating mental models of how it works, setting decision rules to guide behavior, and from these heuristics, making decisions that in turn affect the state of the real world. Qualitative data were obtained from focus groups conducted with community-dwelling older adults who self-identify as African American, Dominican, or Puerto Rican to elicit their lived experiences in accessing oral health care in their northern Manhattan neighborhoods. The findings of this study support the multi-dimensional and multi-level perspective of access to oral health care and affirm a theorized discrepancy in fit between available dental providers and patients. The lack of information about oral health at the community level may be compromising the use and quality of oral health care among racial/ethnic minority older adults. Well-informed community members may fill critical roles in oral health promotion, as they are viewed as highly credible

  1. Qualitative findings from focus group discussions on hand hygiene compliance among health care workers in Vietnam.

    Science.gov (United States)

    Salmon, Sharon; McLaws, Mary-Louise

    2015-10-01

    It is accepted by hospital clinical governance that every clinician's "duty of care" includes hand hygiene, yet globally, health care workers (HCWs) continue to struggle with compliance. Focus group discussions were conducted to explore HCWs' barriers to hand hygiene in Vietnam. Twelve focus group discussions were conducted with HCWs from 6 public hospitals across Hanoi, Vietnam. Discussions included participants' experiences with and perceptions concerning hand hygiene. Tape recordings were transcribed verbatim and then translated into English. Thematic analysis was conducted by 2 investigators. Expressed frustration with high workload, limited access to hand hygiene solutions, and complicated guidelines that are difficult to interpret in overcrowded settings were considered by participants to be bona fide reasons for noncompliance. No participant acknowledged hand hygiene as a duty of care practice for her or his patients. Justification for noncompliance was the observation that visitors did not perform hand hygiene. HCWs did acknowledge a personal duty of care when hand hygiene was perceived to benefit her or his own health, and then neither workload or environmental challenges influenced compliance. Limited resources in Vietnam are amplified by overcrowded conditions and dual bed occupancy. Yet without a systematic systemic duty of care to patient safety, changes to guidelines and resources might not immediately improve compliance. Thus, introducing routine hand hygiene must start with education programs focusing on duty of care. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  2. Evaluation of Student Care Process in Urban and Rural Health Care Centers and Health House in Tabriz Using Tracer Methodology

    Directory of Open Access Journals (Sweden)

    Neda Kabiri

    2015-08-01

    Full Text Available Background and Objectives : Tracer methodology is a novel evaluation method which its purpose is to provide an accurate assessment of systems and processes for the delivery of care, treatment, and services at a health care organization. This study aimed to assess student care process in Tabriz using Tracer methodology. Material and Methods : This cross-sectional study was conducted in autumn 1391. Population study consisted of all the students who were covered by Tabriz health care center and study sample included an urban health care center, a rural health care center, a health house, and two schools in urban and rural areas which were selected by simple sampling method. Also, all the complicated and problematic processes were chosen to be assessed. Data were collected by interviewing, observing, and surveying documents and were compared with current standards. Results : The results of this study declared the percentage of points that each target group gained from tracer evaluation in student care process was 77% in health house, 90% in rural health care center and 83% in urban health care center. Findings indicated that documentation was the main weak point. Conclusion : According to the results of this study, student care process is sufficient; despite the fact that there are some deficiencies in caring process, as it may be improved through appropriate strategies. Furthermore, tracer methodology seems to be a proper method to evaluate various levels of health care system. ​

  3. Psychological health of military children: longitudinal evaluation of a family-centered prevention program to enhance family resilience.

    Science.gov (United States)

    Lester, Patricia; Stein, Judith A; Saltzman, William; Woodward, Kirsten; MacDermid, Shelley W; Milburn, Norweeta; Mogil, Catherine; Beardslee, William

    2013-08-01

    Family-centered preventive interventions have been proposed as relevant to mitigating psychological health risk and promoting resilience in military families facing wartime deployment and reintegration. This study evaluates the impact of a family-centered prevention program, Families OverComing Under Stress Family Resilience Training (FOCUS), on the psychological adjustment of military children. Two primary goals include (1) understanding the relationships of distress among family members using a longitudinal path model to assess relations at the child and family level and (2) determining pathways of program impact on child adjustment. Multilevel data analysis using structural equation modeling was conducted with deidentified service delivery data from 280 families (505 children aged 3-17) in two follow-up assessments. Standardized measures included service member and civilian parental distress (Brief Symptom Inventory, PTSD Checklist-Military), child adjustment (Strengths and Difficulties Questionnaire), and family functioning (McMaster Family Assessment Device). Distress was significantly related among the service member parent, civilian parent, and children. FOCUS improved family functioning, which in turn significantly reduced child distress at follow-up. Salient components of improved family functioning in reducing child distress mirrored resilience processes targeted by FOCUS. These findings underscore the public health potential of family-centered prevention for military families and suggest areas for future research. Reprint & Copyright © 2013 Association of Military Surgeons of the U.S.

  4. Use of qualitative methods and user-centered design to develop customized health information technology tools within federally qualified health centers to keep children insured.

    Science.gov (United States)

    DeVoe, Jennifer; Angier, Heather; Likumahuwa, Sonja; Hall, Jennifer; Nelson, Christine; Dickerson, Kay; Keller, Sara; Burdick, Tim; Cohen, Deborah

    2014-01-01

    Lack of health insurance negatively impacts children's health. Despite federal initiatives to expand children's coverage and accelerate state outreach efforts, millions of US children remain uninsured or experience frequent gaps in coverage. Most current efforts to enroll and retain eligible children in public insurance programs take place outside of the health care system. This study is a partnership between patients' families, medical informaticists, federally qualified health center (FQHC) staff, and researchers to build and test information technology tools to help FQHCs reach uninsured children and those at risk for losing coverage.

  5. School Health Connection Goes Electronic: Developing a Health Information Management System for New Orleans' School-Based Health Centers. Program Results Report

    Science.gov (United States)

    Rastorfer, Darl

    2011-01-01

    From February 2008 through April 2011, School Health Connection, a program of the Louisiana Public Health Institute, developed an electronic health information management system for newly established school-based health centers in Greater New Orleans. School Health Connection was established as part of a broader effort to restore community health…

  6. Focusing on psychiatric patients' strengths: A new vision on mental health care in Iran.

    Science.gov (United States)

    Zargham-Boroujeni, Ali; Maghsoudi, Jahangir; Oreyzi, Hamid Reza

    2015-01-01

    Identifying and using the strengths of patients, in practice, is a new territory. Today, the need to educate nurses and psychiatric patients about positive psychology in practice and the importance of understanding and focusing on strengths is clear. However, little is known about the strengths the psychiatric patients use and experience. Thus, this study has been designed and conducted in order to understand how people with psychiatric disorders demonstrate their strengths. In the present study, 13 semi-structured, qualitative interviews with patients and 2 focus groups with nurses were carried out. In addition, a qualitative content analysis was used to identify significant strengths. Based on the results, the four main strengths consisted of: Finding a meaning in daily living, work as enduring strength, entertaining activities, and positive relationship. Patients also reported that health care providers rarely focused on patients' strengths, and experts confirmed these findings. Our findings indicate that patients' own strengths are a pivotal factor in getting through their illness from their perspective. Despite the enduring legacy of pessimism regarding psychiatric patients, these people have a repertoire of strengths. Nurses should, therefore, have a greater focus on eliciting and nourishing psychiatric patients' strengths in their care. It is suggested that the theoretical and practical aspects of patients' strengths be incorporated in nursing school curricula.

  7. Focusing on psychiatric patients′ strengths: A new vision on mental health care in Iran

    Directory of Open Access Journals (Sweden)

    Ali Zargham-Boroujeni

    2015-01-01

    Full Text Available Background: Identifying and using the strengths of patients, in practice, is a new territory. Today, the need to educate nurses and psychiatric patients about positive psychology in practice and the importance of understanding and focusing on strengths is clear. However, little is known about the strengths the psychiatric patients use and experience. Thus, this study has been designed and conducted in order to understand how people with psychiatric disorders demonstrate their strengths. Materials and Methods: In the present study, 13 semi-structured, qualitative interviews with patients and 2 focus groups with nurses were carried out. In addition, a qualitative content analysis was used to identify significant strengths. Results: Based on the results, the four main strengths consisted of: Finding a meaning in daily living, work as enduring strength, entertaining activities, and positive relationship. Patients also reported that health care providers rarely focused on patients′ strengths, and experts confirmed these findings. Our findings indicate that patients′ own strengths are a pivotal factor in getting through their illness from their perspective. Conclusions: Despite the enduring legacy of pessimism regarding psychiatric patients, these people have a repertoire of strengths. Nurses should, therefore, have a greater focus on eliciting and nourishing psychiatric patients′ strengths in their care. It is suggested that the theoretical and practical aspects of patients′ strengths be incorporated in nursing school curricula.

  8. A Phenomenological Study: Community Mental Health Centers Leaders Influence on Clinician Effectiveness

    Science.gov (United States)

    Williams, Beth B.

    2011-01-01

    Some clinical leaders of community mental health centers are not aware of successful methods for supporting and empowering staff to be more effective, specifically when the staff is experiencing change because of new health information technology. Clinical leaders in community mental health face similar management issues as do other business,…

  9. Florida Public Health Training Center: Evidence-Based Online Mentor Program

    Science.gov (United States)

    Frahm, Kathryn A.; Alsac-Seitz, Biray; Mescia, Nadine; Brown, Lisa M.; Hyer, Kathy; Liburd, Desiree; Rogoff, David P.; Troutman, Adewale

    2013-01-01

    This article describes an Online Mentor Program (OMP) designed to support and facilitate mentorships among and between Florida Department of Health (FDOH) employees and USF College of Public Health students using a Web-based portal. The Florida Public Health Training Center (FPHTC) at the University of South Florida (USF) College of Public Health…

  10. 76 FR 21748 - Health Disparities Subcommittee (HDS), Advisory Committee to the Director, Centers for Disease...

    Science.gov (United States)

    2011-04-18

    ... Disparities Subcommittee (HDS), Advisory Committee to the Director, Centers for Disease Control and Prevention... through the ACD on strategic and other health disparities and health equity issues and provide guidance on... update including the CDC Health Disparities and Inequalities Report, U.S. 2011; the National Prevention...

  11. Methodological Reflections on the Use of Asynchronous Online Focus Groups in Health Research

    Directory of Open Access Journals (Sweden)

    Sarah Williams PhD

    2012-09-01

    Full Text Available The Internet is increasingly used as a tool in qualitative research. In particular, asynchronous online focus groups are used when factors such as cost, time, or access to participants can make conducting face-to-face research difficult. In this article we consider key methodological issues involved in using asynchronous online focus groups to explore experiences of health and illness. The written nature of Internet communication, the lack of physical presence, and the asynchronous, longitudinal aspects enable participants who might not normally contribute to research studies to reflect on their personal stories before disclosing them to the researcher. Implications for study design, recruitment strategies, and ethics should be considered when deciding whether to use this method.

  12. [Determinants of strategic management of a health center].

    Science.gov (United States)

    Huard, Pierre; Schaller, Philippe

    2014-01-01

    The article highlights the value of a strategic approach for the development of a primary care health centre. The method is adapted from corporate strategy: (i) analysis of the situation of the health centre and the obstacles to its development. (ii) selection of relations on which the strategy can be developed. (iii) elaboration of a system of interventions to create a cumulative development process. (iv) Illustration of the method by application to a case. The example illustrates the principles and method and highlights the importance of interpretations and choices in elaboration of a strategy, which is therefore always a unique construction. The strategic approach provides a framework that (i) provides a subject of discussion and negotiation between members of the health centre, (ii) strengthens the consistency of structural decisions, (iii) helps the health centre to overcome obstacles and initiate a development process.

  13. Defense Centers of Excellence for Psychological Health & Traumatic Brain Injury

    Science.gov (United States)

    ... Resources Deployments inTransition Support for Caregivers Support for Children Guard and Reserve Locating Health Care Media & Resources Media Relations News Room Social Media Graphics Videos and Podcasts External Links Continuing ...

  14. The quality of health care services provided in health care centers of Khorramabad using SERVQUAL model in 2010

    Directory of Open Access Journals (Sweden)

    mohammad javad tarrahi

    2012-06-01

    Conclusion: Expectations of the clients in all aspects of offering services are beyond than their perceptions, and needed to improve the quality of offering services in these centers in all the dimensions especially empathy dimension. It is recommended that the quality of the offering services be assessed periodically in these centers and intervene to improve the delivering of health services.

  15. Health care as perceived by persons with inflammatory bowel disease - a focus group study.

    Science.gov (United States)

    Lesnovska, Katarina Pihl; Hollman Frisman, Gunilla; Hjortswang, Henrik; Hjelm, Katarina; Börjeson, Sussanne

    2017-11-01

    The aim of this study was to explore the perceptions of health care among persons living with inflammatory bowel disease. The quality of care plays an important role in the life of persons with a chronic disease. To define what persons with inflammatory bowel disease perceive as high-quality care, greater focus must be placed on the individual's own perspective of living with the condition. A qualitative exploratory study was conducted based on focus groups. Five focus groups were conducted with adult persons living with inflammatory bowel disease, 14 men and 12 women aged 19-76 years. The interviews were performed between January-June 2014. The perceptions of health care from the perspective of persons living with inflammatory bowel disease were summarised in two categories: 'professional attitudes of healthcare staff' and 'structure of the healthcare organisation'. Persons with inflammatory bowel disease want to be encountered with respect, experience trust and obtain information at the right time. They also expect shared decision-making, communication and to encounter competent healthcare professionals. Furthermore, the expectations on and perceptions of the structure of the healthcare organisation comprise access to care, accommodation, continuity of care, as well as the pros and cons of specialised care. The findings show the importance of establishing a respectful and trusting relationship, facilitating healthcare staff and persons with inflammatory bowel disease to work as a team in fulfilling individual care needs - but there is room for improvement in terms of quality of care. A person-centred approach, which places the individual and her/his family at the centre, considering them experts on their own health and enabling them to collaborate with healthcare staff, seems important to reach a high-quality healthcare organisation for patients with Inflammatory bowel disease. © 2017 The Authors. Journal of Clinical Nursing Published by John Wiley & Sons Ltd.

  16. The significance of ethics reflection groups in mental health care: a focus group study among health care professionals.

    Science.gov (United States)

    Hem, Marit Helene; Molewijk, Bert; Gjerberg, Elisabeth; Lillemoen, Lillian; Pedersen, Reidar

    2018-06-05

    Professionals within the mental health services face many ethical dilemmas and challenging situations regarding the use of coercion. The purpose of this study was to evaluate the significance of participating in systematic ethics reflection groups focusing on ethical challenges related to coercion. In 2013 and 2014, 20 focus group interviews with 127 participants were conducted. The interviews were tape recorded and transcribed verbatim. The analysis is inspired by the concept of 'bricolage' which means our approach was inductive. Most participants report positive experiences with participating in ethics reflection groups: A systematic and well-structured approach to discuss ethical challenges, increased consciousness of formal and informal coercion, a possibility to challenge problematic concepts, attitudes and practices, improved professional competence and confidence, greater trust within the team, more constructive disagreement and room for internal critique, less judgmental reactions and more reasoned approaches, and identification of potential for improvement and alternative courses of action. On several wards, the participation of psychiatrists and psychologists in the reflection groups was missing. The impact of the perceived lack of safety in reflection groups should not be underestimated. Sometimes the method for ethics reflection was utilised in a rigid way. Direct involvement of patients and family was missing. This focus group study indicates the potential of ethics reflection groups to create a moral space in the workplace that promotes critical, reflective and collaborative moral deliberations. Future research, with other designs and methodologies, is needed to further investigate the impact of ethics reflection groups on improving health care practices.

  17. A comparison of health behaviors of women in centering pregnancy and traditional prenatal care.

    Science.gov (United States)

    Shakespear, Kaylynn; Waite, Phillip J; Gast, Julie

    2010-03-01

    Researchers sought to determine the difference in health behaviors between women who receive prenatal care via the Centering Pregnancy approach and those involved in traditional prenatal care. Using a cross-sectional design, adult pregnant women (n = 125) were surveyed from at least 28 weeks gestation to delivery. The sample was comprised of primarily white low income women. Using multiple linear regression it was determined that women in Centering Pregnancy had significantly lower index health behavior scores compared with the traditional care group showing that those in Centering Pregnancy reported engaging in fewer health promoting behaviors. Furthermore, no differences were observed for smoking or weight gain behaviors between groups. Additionally, those in Centering Pregnancy reported a lower perceived value of prenatal care. The results of this study suggest that Centering Pregnancy is not adequately aiding its patients in adopting healthy behaviors during pregnancy.

  18. Evaluation of the FOCUS (Feedback on Counseling Using Simulation) Instrument for Assessment of Client-Centered Nutrition Counseling Behaviors

    Science.gov (United States)

    Henry, Beverly W.; Smith, Thomas J.

    2010-01-01

    Objective: To develop an instrument to assess client-centered counseling behaviors (skills) of student-counselors in a standardized patient (SP) exercise. Methods: Descriptive study of the accuracy and utility of a newly developed counseling evaluation instrument. Study participants included 11 female student-counselors at a Midwestern…

  19. Maternal health issues and cardio-metabolic outcomes in the offspring: a focus on Indigenous populations.

    Science.gov (United States)

    Wicklow, Brandy A; Sellers, Elizabeth A C

    2015-01-01

    Non-communicable diseases (NCDs) including diabetes, obesity and cardiovascular disease are the leading causes of death worldwide. Indigenous populations are disproportionally affected. In an effort to halt the increasing disease burden, the mechanisms underlying the increasing rate of NCDs are an important area of study. Recent evidence has focused on the perinatal period as an influential period impacting the future cardio-metabolic health of the offspring. This concept has been defined as metabolic foetal programming and supports the importance of the developmental origins of health and disease in research and clinical practice, specifically in prevention efforts to protect future generations from NCDs. An understanding of the underlying mechanisms involved is not clear as of yet. However, an understanding of these mechanisms is imperative in order to plan effective intervention strategies. As much of the discussion below is gleaned from large epidemiological studies and animal studies, further research with prospective cohorts is necessary. Copyright © 2014. Published by Elsevier Ltd.

  20. Intensive Care Nurses’ Belief Systems Regarding the Health Economics: A Focused Ethnography

    Science.gov (United States)

    Heydari, Abbas; Vafaee-Najar, Ali; Bakhshi, Mahmoud

    2016-01-01

    Background: Health care beliefs can have an effect on the efficiency and effectiveness of nursing practices. Nevertheless, how belief systems impact on the economic performance of intensive care unit (ICU) nurses is not known. This study aimed to explore the ICU nurses’ beliefs and their effect on nurse’s: practices and behavior patterns regarding the health economics. Methods: In this study, a focused ethnography method was used. Twenty-four informants from ICU nurses and other professional individuals were purposively selected and interviewed. As well, 400 hours of ethnographic observations were used for data collection. Data analysis was performed using the methods described by Miles and Huberman (1994). Findings: Eight beliefs were found that gave meaning to ICU nurse’s practices regarding the health economics. 1. The registration of medications and supplies disrupt the nursing care; 2. Monitoring and auditing improve consumption; 3. There is a fear of possible shortage in the future; 4. Supply and replacement of equipment is difficult; 5. Higher prices lead to more accurate consumption; 6. The quality of care precedes the costs; 7. Clinical Guidelines are abundant but useful; and 8. Patient economy has priority over hospital economy. Maintaining the quality of patient care with least attention to hospital costs was the main focus of the beliefs formed up in the ICU regarding the health economics. Conclusions: ICU nurses’ belief systems have significantly shaped in relation to providing a high-quality care. Although high quality of care can lead to a rise in the effectiveness of nursing care, cost control perspective should also be considered in planning for improve the quality of care. Therefore, it is necessary to involve the ICU nurses in decision-making about unit cost management. They must become familiar with the principles of heath care economics and productivity by applying an effective cost management program. It may be optimal to implement the

  1. Intensive Care Nurses' Belief Systems Regarding the Health Economics: A Focused Ethnography.

    Science.gov (United States)

    Heydari, Abbas; Vafaee-Najar, Ali; Bakhshi, Mahmoud

    2016-09-01

    Health care beliefs can have an effect on the efficiency and effectiveness of nursing practices. Nevertheless, how belief systems impact on the economic performance of intensive care unit (ICU) nurses is not known. This study aimed to explore the ICU nurses' beliefs and their effect on nurse's practices and behavior patterns regarding the health economics. In this study, a focused ethnography method was used. Twenty-four informants from ICU nurses and other professional individuals were purposively selected and interviewed. As well, 400 hours of ethnographic observations were used for data collection. Data analysis was performed using the methods described by Miles and Huberman (1994). Eight beliefs were found that gave meaning to ICU nurse's practices regarding the health economics. 1. The registration of medications and supplies disrupt the nursing care; 2.Monitoring and auditing improve consumption; 3.There is a fear of possible shortage in the future; 4.Supply and replacement of equipment is difficult; 5.Higher prices lead to more accurate consumption; 6.The quality of care precedes the costs; 7. Clinical Guidelines are abundant but useful; and 8.Patient economy has priority over hospital economy. Maintaining the quality of patient care with least attention to hospital costs was the main focus of the beliefs formed up in the ICU regarding the health economics. ICU nurses' belief systems have significantly shaped in relation to providing a high-quality care. Although high quality of care can lead to a rise in the effectiveness of nursing care, cost control perspective should also be considered in planning for improve the quality of care. Therefore, it is necessary to involve the ICU nurses in decision-making about unit cost management. They must become familiar with the principles of heath care economics and productivity by applying an effective cost management program. It may be optimal to implement the reforms in various aspects, such as the hospital

  2. Environmental Stressors and Their Impact on Health and Disease with Focus on Oxidative Stress.

    Science.gov (United States)

    Münzel, Thomas; Daiber, Andreas

    2018-03-20

    Epidemiological, preclinical and interventional clinical studies have demonstrated that environmental stressors are associated with health problems, namely cardiovascular diseases. According to estimations of the World Health Organization (WHO), environmental risk factors account for an appreciable part of global deaths and life years spent with disability. This Forum addresses the impact of the environmental risk factors such as traffic noise exposure, air pollution by particulate matter (PM), mental stress/loneliness, and the life style risk factor (water-pipe) smoking on health and disease with focus on the cardiovascular system. We will critically discuss the use of observatory/modifiable biomarkers of oxidative stress and inflammation in environmental research on the aforementioned risk factors highlighting the need of exposome studies. Another focus will be on the epigenetic regulation via microRNAs in environmental stress upon exposure to noise and toxins/heavy metals as well as mental stress conditions, providing mechanistic insights into the modulation of microRNA signaling by oxidative stress, and vice versa the contribution of microRNAs to oxidative stress conditions. We will also provide an in-depth overview on the mechanistic pathways that lead to health problems (e.g., cardiovascular diseases) in response to environmental psychosocial stress, air pollution exposure in the form of ambient PM and diesel exhaust, traffic noise exposure, and the life style drug (water-pipe) smoking. Almost all stressors share the activation of the hypothalamic-pituitary-adrenocortical axis and of the sympathetic nervous system with subsequent onset of inflammation and oxidative stress, defining the here proposed therapeutic (antioxidant and exercise) strategies. Antioxid. Redox Signal. 28, 735-740.

  3. [Attendance at a health center by clandestine prostitutes in Djibouti].

    Science.gov (United States)

    Philippon, M; Saada, M; Kamil, M A; Houmed, H M

    1997-01-01

    The extent of clandestine prostitution in Djibouti is difficult to evaluate. Due to the secrecy of the prostitutes and often their low level of education, the follow-up of these patients is also difficult. A sexually transmitted disease clinic specialized in the treatment of prostitutes and their customers has been established in Djibouti since 1963. We tried to evaluate the available data on the clandestine prostitutes attendance at the center. The population was young with a mean age of 23 years. Fifty percent had children and 60% were divorced or separated. Ninety-one percent were Ethiopian and 73% lived in the same district of the city of Djibouti. Almost half of them were HIV positive. The duration of residence in Djibouti before the first visit to the clinic varied widely with a median of 12 months. However, the total duration of prostitution before the first visit was shorter with a median of 3 months. The complaint at the first visit was most often minor. Among the prostitutes who first came to the center in 1993, half of them came only once. The overall duration of follow-up was 8 months, for an average of 3.7 visits per patient. Alternatively, 20 patients had more than 10 consultations and this represented one third of the consultations given to previous patients. This last group is the only one which tended to respect the monthly visits proposed to each patient at the first consultation. The other patients seemed to come only when they felt ill. The routine statistical activities which separately counted the new and previous patients gave an optimistic but faulty impression: these showed an increase in the total number of patients and also an increase in the percentage of previous patients visiting (from 42 to 69% between 1988 and 1994). It is difficult to evaluate the follow-up of such a mobile population. The few patients known for their fidelity contrasted with the fact that half of the patients had visited the center only once. This low frequency of

  4. Decentralization and health system performance - a focused review of dimensions, difficulties, and derivatives in India.

    Science.gov (United States)

    Panda, Bhuputra; Thakur, Harshad P

    2016-10-31

    One of the principal goals of any health care system is to improve health through the provision of clinical and public health services. Decentralization as a reform measure aims to improve inputs, management processes and health outcomes, and has political, administrative and financial connotations. It is argued that the robustness of a health system in achieving desirable outcomes is contingent upon the width and depth of 'decision space' at the local level. Studies have used different approaches to examine one or more facets of decentralization and its effect on health system functioning; however, lack of consensus on an acceptable framework is a critical gap in determining its quantum and quality. Theorists have resorted to concepts of 'trust', 'convenience' and 'mutual benefits' to explain, define and measure components of governance in health. In the emerging 'continuum of health services' model, the challenge lies in identifying variables of performance (fiscal allocation, autonomy at local level, perception of key stakeholders, service delivery outputs, etc.) through the prism of decentralization in the first place, and in establishing directed relationships among them. This focused review paper conducted extensive web-based literature search, using PubMed and Google Scholar search engines. After screening of key words and study objectives, we retrieved 180 articles for next round of screening. One hundred and four full articles (three working papers and 101 published papers) were reviewed in totality. We attempted to summarize existing literature on decentralization and health systems performance, explain key concepts and essential variables, and develop a framework for further scientific scrutiny. Themes are presented in three separate segments of dimensions, difficulties and derivatives. Evaluation of local decision making and its effect on health system performance has been studied in a compartmentalized manner. There is sparse evidence about innovations

  5. Decentralization and health system performance – a focused review of dimensions, difficulties, and derivatives in India

    Directory of Open Access Journals (Sweden)

    Bhuputra Panda

    2016-10-01

    Full Text Available Abstract Introduction One of the principal goals of any health care system is to improve health through the provision of clinical and public health services. Decentralization as a reform measure aims to improve inputs, management processes and health outcomes, and has political, administrative and financial connotations. It is argued that the robustness of a health system in achieving desirable outcomes is contingent upon the width and depth of ‘decision space’ at the local level. Studies have used different approaches to examine one or more facets of decentralization and its effect on health system functioning; however, lack of consensus on an acceptable framework is a critical gap in determining its quantum and quality. Theorists have resorted to concepts of ‘trust’, ‘convenience’ and ‘mutual benefits’ to explain, define and measure components of governance in health. In the emerging ‘continuum of health services’ model, the challenge lies in identifying variables of performance (fiscal allocation, autonomy at local level, perception of key stakeholders, service delivery outputs, etc. through the prism of decentralization in the first place, and in establishing directed relationships among them. Methods This focused review paper conducted extensive web-based literature search, using PubMed and Google Scholar search engines. After screening of key words and study objectives, we retrieved 180 articles for next round of screening. One hundred and four full articles (three working papers and 101 published papers were reviewed in totality. We attempted to summarize existing literature on decentralization and health systems performance, explain key concepts and essential variables, and develop a framework for further scientific scrutiny. Themes are presented in three separate segments of dimensions, difficulties and derivatives. Results Evaluation of local decision making and its effect on health system performance has been

  6. Introduction of a child and adolescent mental health link worker: education and health staff focus group findings.

    Science.gov (United States)

    Hunter, A; Playle, J; Sanchez, P; Cahill, J; McGowan, L

    2008-10-01

    Policy guidance suggests that outcomes for adolescents with mental health problems can be improved by secondary education services (SES) and child and adolescent mental health services (CAMHS) working more closely. This study reports on staff experiences of the introduction of a mental health link worker (MHLW). The findings of two focus groups are presented, conducted with staff from CAMHS and SES. These focus groups formed part of the overall wider evaluation of the MHLW role. The groups explored staff perceptions and experiences following the introduction of the MHLW, and elicited their views on the effectiveness of this innovative role. Qualitative methods were employed, and analysis was conducted using the principles of grounded theory and the constant comparative method. The findings revealed that the MHLW was well received by both groups, despite the identification of potential barriers. A number of key themes emerged, which included the ability of the link worker to improve communication and to encourage mutual understanding between services. The issues raised by these themes are discussed and recommendations are made for future practice and research.

  7. Ethical considerations for conducting health disparities research in community health centers: a social-ecological perspective.

    Science.gov (United States)

    Boutin-Foster, Carla; Scott, Ebony; Melendez, Jennifer; Rodriguez, Anna; Ramos, Rosio; Kanna, Balavenkatesh; Michelen, Walid

    2013-12-01

    Community health centers (CHCs) provide optimal research settings. They serve a high-risk, medically underserved population in the greatest need of intervention. Low socioeconomic status renders this population particularly vulnerable to research misconduct. Traditional principles of research ethics are often applied to participants only. The social-ecological model offers a comprehensive framework for applying these principles across multiple levels (participants, providers, organizations, communities, and policy). Our experience with the Trial Using Motivational Interviewing, Positive Affect and Self-Affirmation in African-Americans with Hypertension, a randomized trial conducted in CHCs, led us to propose a new platform for discussing research ethics; examine the social, community, and political factors surrounding research conducted in CHCs; and recommend how future research should be conducted in such settings.

  8. Development of a work improvement checklist for occupational mental health focused on requests from workers.

    Science.gov (United States)

    Tahara, Hiroyuki; Yamada, Tatsuji; Nagafuchi, Keiko; Shirakawa, Chie; Suzuki, Kiyomi; Mafune, Kosuke; Kubota, Shinya; Hiro, Hisanori; Mishima, Norio; Nagata, Shoji

    2009-01-01

    To develop tools offering definite orientation for managers and employees to support their work improvement through occupational mental health. This research was a part of the Mental Health Improvement & Reinforcement Study (MIR study), conducted from October 2004 to March 2006. We developed a trial version named the Kaizen Check List (KCL) by referring to problem solving methods for quality management. Then we improved it for a formal version named MIR Research of Recognition (MIRROR). A feedback form named MIR Action Guidance (MIRAGe) was also developed. We analyzed data from 1,953 respondents at five manufacturing enterprises in Japan using MIRROR and the Brief Job Stress Questionnaire (BJSQ) to determine whether or not the workers requesting work improvement had more stress than other workers. The KCL had 47 items, which indicated desirable working conditions for mental health at work, and four answer categories. MIRROR has 45 selected items and improved answer categories. MIRAGe displays the results of MIRROR and step-by-step guidance for work improvement. Respondents with request had significantly higher scores in stressor and lower scores in buffer factors compared with respondents without request in many items of MIRROR. A combinational use of MIRROR and stress scales is useful for finding worksites with high risk factors for mental health and for directing focus on work improvement at these worksites according to workers' requests.

  9. Challenges and Opportunities to Improve Cervical Cancer Screening Rates in US Health Centers through Patient-Centered Medical Home Transformation

    Directory of Open Access Journals (Sweden)

    Olga Moshkovich

    2015-01-01

    Full Text Available Over the last 50 years, the incidence of cervical cancer has dramatically decreased. However, health disparities in cervical cancer screening (CCS persist for women from racial and ethnic minorities and those residing in rural and poor communities. For more than 45 years, federally funded health centers (HCs have been providing comprehensive, culturally competent, and quality primary health care services to medically underserved communities and vulnerable populations. To enhance the quality of care and to ensure more women served at HCs are screened for cervical cancer, over eight HCs received funding to support patient-centered medical home (PCMH transformation with goals to increase CCS rates. The study conducted a qualitative analysis using Atlas.ti software to describe the barriers and challenges to CCS and PCMH transformation, to identify potential solutions and opportunities, and to examine patterns in barriers and solutions proposed by HCs. Interrater reliability was assessed using Cohen’s Kappa. The findings indicated that HCs more frequently described patient-level barriers to CCS, including demographic, cultural, and health belief/behavior factors. System-level barriers were the next commonly cited, particularly failure to use the full capability of electronic medical records (EMRs and problems coordinating with external labs or providers. Provider-level barriers were least frequently cited.

  10. Health Care Employee Perceptions of Patient-Centered Care: A Photovoice Project

    Science.gov (United States)

    Balbale, Salva Najib; Turcios, Stephanie; LaVela, Sherri L.

    2015-01-01

    Given the importance of health care employees in the delivery of patient-centered care, understanding their unique perspective is essential for quality improvement. The purpose of this study was to use photovoice to evaluate perceptions and experiences around patient-centered care among Veterans Affairs (VA) health care employees. We asked participants to take photographs of salient features in their environment related to patient-centered care. We used the photographs to facilitate dialogue during follow-up interviews. Twelve VA health care employees across two VA sites participated in the project. Although most participants felt satisfied with their work environment and experiences at the VA, several areas for improvement were identified. These included a need for more employee health and wellness initiatives and a need for enhanced opportunities for training and professional growth. Application of photovoice enabled us to learn about employees' unique perspectives around patient-centered care while engaging them in an evaluation of care delivery. PMID:25274626

  11. Master's Level Graduate Training in Medical Physics at the University of Colorado Health Sciences Center.

    Science.gov (United States)

    Ibbott, Geoffrey S.; Hendee, William R.

    1980-01-01

    Describes the master's degree program in medical physics developed at the University of Colorado Health Sciences Center. Required courses for the program, and requirements for admission are included in the appendices. (HM)

  12. Programming and Process in Prisoner Rehabilitation: A Prison Mental Health Center.

    Science.gov (United States)

    Smith, James A., III; Faubert, Marie

    1990-01-01

    Reviews literature concerning men in prisons. Describes specific program at a prison mental health center which prepares men for reentry into society. Closes with reflections on one man's struggle to grow and prepare for the outside. (CM)

  13. UC Berkeley/Stanford Children’s Environment Health Center

    Data.gov (United States)

    Federal Laboratory Consortium — The overall goal of this Center is to better understand the effects of exposure in the womb to air pollutants and airborne bacteria on newborn health, immune system...

  14. 78 FR 14303 - Statement of Delegation of Authority; Health Resources and Services Administration and Centers...

    Science.gov (United States)

    2013-03-05

    ... Services Administration and Centers for Disease Control and Prevention I hereby delegate to the Administrator, Health Resources and Services Administration (HRSA), and the Director, Centers for Disease Control and Prevention (CDC), with authority to redelegate, the authority vested in the Secretary of the...

  15. A Learner-Centered Molecular Modeling Exercise for Allied Health Majors in a Biochemistry Class

    Science.gov (United States)

    Fletcher, Terace M.; Ershler, Jeff

    2014-01-01

    Learner-centered molecular modeling exercises in college science courses can be especially challenging for nonchemistry majors as students typically have a higher degree of anxiety and may not appreciate the relevance of the work. This article describes a learner-centered project given to allied health majors in a Biochemistry course. The project…

  16. 75 FR 82030 - Board of Scientific Counselors, National Center for Health Statistics (BSC, NCHS)

    Science.gov (United States)

    2010-12-29

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Board of...) of the Federal Advisory Committee Act (Pub. L. 92-463), the Centers for Disease Control and... below. All requests must contain the name, address, telephone number, and organizational affiliation of...

  17. 78 FR 48163 - Board of Scientific Counselors, National Center for Health Statistics

    Science.gov (United States)

    2013-08-07

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Board of... Federal Advisory Committee Act (Pub. L. 92-463), the Centers for Disease Control and Prevention (CDC... listed below. All requests must contain the name, address, telephone number, and organizational...

  18. 75 FR 17754 - Board of Scientific Counselors, National Center for Health Statistics, (BSC, NCHS)

    Science.gov (United States)

    2010-04-07

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Board of...) of the Federal Advisory Committee Act (Pub. L. 92-463), the Centers for Disease Control and... name, address, telephone number, and organizational affiliation of the presenter. Written comments...

  19. 78 FR 17411 - Board of Scientific Counselors, National Center for Health Statistics

    Science.gov (United States)

    2013-03-21

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Board of... Federal Advisory Committee Act (Pub. L. 92-463), the Centers for Disease Control and Prevention (CDC... contain the name, address, telephone number, and organizational affiliation of the presenter. Written...

  20. 78 FR 48438 - Board of Scientific Counselors, National Center for Health Statistics

    Science.gov (United States)

    2013-08-08

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Board of... Federal Advisory Committee Act (Pub. L. 92-463), the Centers for Disease Control and Prevention (CDC... listed below. All requests must contain the name, address, telephone number, and organizational...

  1. 77 FR 22326 - Board of Scientific Counselors, National Center for Health Statistics, (BSC, NCHS)

    Science.gov (United States)

    2012-04-13

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Board of...) of the Federal Advisory Committee Act (Pub. L. 92-463), the Centers for Disease Control and..., and organizational affiliation of the presenter. Written comments should not exceed five single-spaced...

  2. 78 FR 16471 - National Cybersecurity Center of Excellence (NCCoE) Secure Exchange of Electronic Health...

    Science.gov (United States)

    2013-03-15

    ...-02] National Cybersecurity Center of Excellence (NCCoE) Secure Exchange of Electronic Health...) National Cybersecurity Center of Excellence (NCCoE) invited organizations to provide products and technical.... companies to enter into ``National Cybersecurity Excellence Partnerships'' (NCEPs) in furtherance of the...

  3. 78 FR 32657 - Board of Scientific Counselors, National Center for Environmental Health/Agency for Toxic...

    Science.gov (United States)

    2013-05-31

    ..., diagnosis, treatment, control, and prevention of physical and mental diseases and other impairments; (2... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention (CDC) Board of.... L. 92-463), the Centers for Disease Control and Prevention (CDC), announces the following meeting of...

  4. User-centered Design Groups to Engage Patients and Caregivers with a Personalized Health IT Tool

    Science.gov (United States)

    Maher, Molly; Kaziunas, Elizabeth; Ackerman, Mark; Derry, Holly; Forringer, Rachel; Miller, Kristen; O’Reilly, Dennis; An, Larry C.; Tewari, Muneesh; Hanauer, David A.; Choi, Sung Won

    2015-01-01

    Health information technology (IT) has opened exciting avenues for capturing, delivering and sharing data, and offers the potential to develop cost-effective, patient-focused applications. In recent years, there has been a proliferation of health IT applications such as outpatient portals. Rigorous evaluation is fundamental to ensure effectiveness and sustainability, as resistance to more widespread adoption of outpatient portals may be due to lack of user friendliness. Health IT applications that integrate with the existing electronic health record and present information in a condensed, user-friendly format could improve coordination of care and communication. Importantly, these applications should be developed systematically with appropriate methodological design and testing to ensure usefulness, adoption, and sustainability. Based on our prior work that identified numerous information needs and challenges of HCT, we developed an experimental prototype of a health IT tool, the BMT Roadmap. Our goal was to develop a tool that could be used in the real-world, daily practice of HCT patients and caregivers (users) in the inpatient setting. In the current study, we examined the views, needs, and wants of patients and caregivers in the design and development process of the BMT Roadmap through two user-centered Design Groups, conducted in March 2015 and April 2015, respectively: Design Group I utilized a low-fidelity paper-based prototype and Design Group II utilized a high-fidelity prototype presented to users as a web-app on Apple® iPads. There were 11 caregivers (median age 44, range 34–69 years) and 8 patients (median age 18 years, range 11–24 years) in the study population. The qualitative analyses revealed a wide range of responses helpful in guiding the iterative development of the system. Three important themes emerged from the Design Groups: 1) perception of core features as beneficial (views), 2) alerting the design team to potential issues with the user

  5. Understanding Falls Risk and Impacts in Chinese American Older Patients at a Community Health Center.

    Science.gov (United States)

    Huang, Susan; Duong, Thomas; Ieong, Liss; Quach, Thu

    2017-08-01

    While falls are highly prevalent and costly for older adults, little is known about falls for Asian Americans. Using a custom, evidence-based, bilingual fall risk assessment and management tool, our study examined the prevalence of falls among older Chinese-speaking patients at a community health center. We identified the risks for falls and explored an association of fall risk with emergency room (ER) and hospital use in this population. The setting was at a community health center in Oakland, CA. Participants included 839 older Asian American adults (ages 65-80 years) who spoke Cantonese/Mandarin. Primary care clinic staff administered a fall risk assessment and management tool at the time of clinic visits to assess patients' risk factors for falls. Of the total, 173 (20.6%) reported having fallen in the past year, with women comprising a majority (71.7%). 362 patients in the cohort (43.1%) reported fear of falling. For the subset of Medicaid managed care patients (n = 455, 54.3% of total) for whom we were able to obtain ER and hospital utilization data, 31 patients (14.5%) who reported a fall risk had an ER/hospital episode compared to 15 (6.2%) of those who did not self-report fall risks (statistically significant, p cultural competence to focus on Asian American older adults, can help establish the prevalence of falls in this understudied population and effectively identify those at higher risk for falls and subsequent ER/hospital utilization. More research is needed to understand the risk and impacts of falls in understudied populations and identify ways to prevent these costly falls.

  6. State focus on health care-associated infection prevention in nursing homes.

    Science.gov (United States)

    Cohen, Catherine C; Herzig, Carolyn T A; Carter, Eileen J; Pogorzelska-Maziarz, Monika; Larson, Elaine L; Stone, Patricia W

    2014-04-01

    Despite increased focus on health care-associated infections (HAI), between 1.6 and 3.8 million HAI occur annually among the vulnerable population residing in US nursing homes (NH). This study characterized state department of health (DOH) activities and policies intended to improve quality and reduce HAI in NH. We created a 17-item standardized data collection tool informed by 20 state DOH Web sites, reviewed by experts in the field and piloted by 2 independent reviewers (Cohen's κ .45-.73). The tool and corresponding protocol were used to systematically evaluate state DOH Web sites and related links. Three categories of data were abstracted: (1) consumer-directed information intended to increase accountability of and competition between NH, including mandatory HAI reporting and NH inspection reports; (2) surveyor training for federally-mandated NH inspections; and (3) guidance for NH providers to prevent HAI and monitor incidence. Only 5 states included HAI reporting in NH with differing HAI types and reporting requirements. State DOH information and activities focused on NH quality and reducing HAI were inconsistent. Systematically characterizing state DOH efforts to reduce HAI in NH is important to interpret the effects of these activities. Copyright © 2014 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Mosby, Inc. All rights reserved.

  7. Cultural health capital and the interactional dynamics of patient-centered care

    OpenAIRE

    Dubbin, Leslie A.; Chang, Jamie Suki; Shim, Janet K.

    2013-01-01

    As intuitive and inviting as it may appear, the concept of patient-centered care has been difficult to conceptualize, institutionalize and operationalize. Informed by Bourdieu's concepts of cultural capital and habitus, we employ the framework of cultural health capital to uncover the ways in which both patients' and providers' cultural resources, assets, and interactional styles influence their abilities to mutually achieve patient-centered care. Cultural health capital is defined as a speci...

  8. Centering Pregnancy and Traditional Prenatal Care: A Comparison of Health Practices

    OpenAIRE

    Shakespear, Kaylynn

    2008-01-01

    Centering Pregnancy is an alternative method of providing prenatal care with increased education and social support with health assessment in a group setting. This study, a cross-sectional, correlational, convenience-sample design, sought to determine the difference between women who receive prenatal care in Centering Pregnancy prenatal care and those in traditional prenatal care in regards to health behaviors. Adult pregnant women (n = 125) were surveyed from at least 28 weeks gestation. The...

  9. Missed Opportunities for Chronic Diseases Prevention in a Primary Health Care Center in Istanbul

    OpenAIRE

    Ahmet Topuzoglu; Seyhan Hidiroglu; M.Fatih Onsuz; Gulsen Polat

    2011-01-01

    Aim: The aim of the study was to investigate missed opportunities about chronic diseases and related risk factors in a primary health care center in Istanbul. Method: This cross sectional study was held in a Primary Health Care Center in Istanbul with the study population consisted of 500 people which were applicated in one month period. Participants were asked; if they were questioned by their physician about major risk factors (smoking, obesity, diabetes mellitus, hypertension, coroner hear...

  10. The University of Texas Health Science Center at Houston

    African Journals Online (AJOL)

    Adebimpe Oyeyemi

    elucidates on the scholarship of discovery, the scholarship of application, the scholarship of integration and the scholarship of ... Science and professional education in medicine and health are .... approaches, modification of an existing approach that results in .... Their Teaching to Advance Practice and Improve Students.

  11. Quality of Family Planning Services in Primary Health Centers of ...

    African Journals Online (AJOL)

    Background: Good quality of care in family planning (FP) services help individuals and couples to meet their reproductive health needs safely and effectively. Therefore, assessment and improvement of the quality of family planning services could enhance family planning services utilization. This study was thus conducted ...

  12. Malaria microscopy in primary health care centers in Khartoum State ...

    African Journals Online (AJOL)

    Background: Adequate diagnosis of Malaria is achieved by detection and identification of malaria parasites through examination of Giemsa's stained blood films by competent personnel. Objective: To identify the competency of laboratory personnel of the clinical laboratories attached to primary health care centres at ...

  13. Bringing Wellness to Schools: Opportunities for and Challenges to Mental Health Integration in School-Based Health Centers.

    Science.gov (United States)

    Lai, Karen; Guo, Sisi; Ijadi-Maghsoodi, Roya; Puffer, Maryjane; Kataoka, Sheryl H

    2016-12-01

    School-based health centers (SBHCs) reduce access barriers to mental health care and improve educational outcomes for youths. This qualitative study evaluated the innovations and challenges of a unique network of SBHCs in a large, urban school district as the centers attempted to integrate health, mental health, and educational services. The 43 participants sampled included mental health providers, primary care providers, and care coordinators at 14 SBHCs. Semistructured interviews with each participant were audio recorded and transcribed. Themes were identified and coded by using Atlas.ti 5.1 and collapsed into three domains: operations, partnership, and engagement. Interviews revealed provider models ranging from single agencies offering both primary care and mental health services to colocated services. Sites where the health agency provided at least some mental health services reported more mental health screenings. Many sites used SBHC wellness coordinators and coordination team meetings to facilitate relationships between schools and health agency and community mental health clinic providers. Partnership challenges included confidentiality policies and staff turnover. Participants also highlighted student and parent engagement through culturally sensitive services, peer health advocates, and "drop-in" lunches. Staffing and operational models are critical in the success of integrating primary care, mental health care, and education. Among the provider models observed, the combined primary care and mental health provider model offered the most integrated services. Despite barriers, providers and schools have begun to implement novel solutions to operational problems and family engagement in mental health services.

  14. How Narrative Focus and a Statistical Map Shape Health Policy Support Among State Legislators.

    Science.gov (United States)

    Niederdeppe, Jeff; Roh, Sungjong; Dreisbach, Caitlin

    2016-01-01

    This study attempts to advance theorizing about health policy advocacy with combinations of narrative focus and a statistical map in an attempt to increase state legislators' support for policies to address the issue of obesity by reducing food deserts. Specifically, we examine state legislators' responses to variations in narrative focus (individual vs. community) about causes and solutions for food deserts in U.S. communities, and a statistical map (presence vs. absence) depicting the prevalence of food deserts across the United States. Using a Web-based randomized experiment (N=496), we show that narrative focus and the statistical map interact to produce different patterns of cognitive response and support for policies to reduce the prevalence of food deserts. The presence of a statistical map showing the prevalence of food deserts in the United States appeared to matter only when combined with an individual narrative, offsetting the fact that the individual narrative in isolation produced fewer thoughts consistent with the story's persuasive goal and more counterarguments in opposition to environmental causes and solutions for obesity than other message conditions. The image did not have an impact when combined with a story describing a community at large. Cognitive responses fully mediated message effects on intended persuasive outcomes. We conclude by discussing the study's contributions to communication theory and practice.

  15. Barriers and facilitators to implementing an evidence-based woman-focused intervention in South African health services.

    Science.gov (United States)

    Howard, Brittni N; Van Dorn, Richard; Myers, Bronwyn J; Zule, William A; Browne, Felicia A; Carney, Tara; Wechsberg, Wendee M

    2017-11-21

    Since the beginning of the HIV epidemic, numerous behavior change, risk-reduction, and biomedical interventions have been developed and tested. While some of these interventions have shown to be efficacious in randomized trials, it often takes almost two decades for an intervention to be translated into practice. Meanwhile, South Africa continues to have among the highest prevalence of HIV globally, with women of childbearing age bearing the burden of the epidemic. Given the urgency of the HIV epidemic among vulnerable women in South Africa, it is imperative that evidence-based interventions be implemented rapidly into practice. This study presents a first step toward examining the acceptability and feasibility of implementing the Women's Health CoOp (WHC) in clinics and substance abuse rehab settings in Cape Town, South Africa. We conducted focus group discussions with women who use substances and with service providers, we also conducted in-depth interviews with health service planners. Our goal was to examine implementation and clinical outcomes associated with delivery of the WHC across clinics and substance abuse rehab programs. All participants agreed on the need for the WHC. Perceived facilitators to implementing the WHC included the recognizable need for programs to empower women and to build the capacity of staff to address issues of substance use, sexual risk, and intimate partner violence. Participants also identified potential barriers to women engaging with this program, including the stigma women experience when seeking services and the lack of person-centered care at healthcare facilities. In a country with the largest number of women of childbearing age living with HIV, an evidence-based woman-focused intervention that comprehensively addresses women's risk for suboptimal antiretroviral adherence may be essential for reducing HIV incidence. However, potential barriers to implementing the WHC successfully must be addressed before the program can be

  16. Learning Curves: Making Quality Online Health Information Available at a Fitness Center

    OpenAIRE

    Dobbins, Montie T.; Tarver, Talicia; Adams, Mararia; Jones, Dixie A.

    2012-01-01

    Meeting consumer health information needs can be a challenge. Research suggests that women seek health information from a variety of resources, including the Internet. In an effort to make women aware of reliable health information sources, the Louisiana State University Health Sciences Center – Shreveport Medical Library engaged in a partnership with a franchise location of Curves International, Inc. This article will discuss the project, its goals and its challenges.

  17. Learning Curves: Making Quality Online Health Information Available at a Fitness Center.

    Science.gov (United States)

    Dobbins, Montie T; Tarver, Talicia; Adams, Mararia; Jones, Dixie A

    2012-01-01

    Meeting consumer health information needs can be a challenge. Research suggests that women seek health information from a variety of resources, including the Internet. In an effort to make women aware of reliable health information sources, the Louisiana State University Health Sciences Center - Shreveport Medical Library engaged in a partnership with a franchise location of Curves International, Inc. This article will discuss the project, its goals and its challenges.

  18. Comparison of the Performance of Health Volunteers in the Health Centers of Shahid Beheshti University of Medical Sciences

    Directory of Open Access Journals (Sweden)

    Ahmad-Reza Farsar

    2015-02-01

    Full Text Available Background and Objective: Health volunteers are the women who do charity work to prevent, protect and promote the health status of the covered neighbors and hereby cooperate with the health centers. The aim of this study was to compare the health volunteer's performance in the covered health centers by Shahid Beheshti University of Medical Sciences.Materials and Methods: This descriptive- analytical study was performed by the participation of 2060 Health volunteers, who were cooperating with 90 covered health centers by Shahid Beheshti University of Medical Sciences. These include Shomal, Shargh, Shemiranat, Pakdasht, Damavand and Firoozkooh. We used census sampling method. Demographic data was gathered through interviews with the health volunteers and their performance evaluated by the supervisor of the volunteers; through the evaluation forms and these data gathered together.Results: The mean (SD of the health volunteers performance was 30.9 (16.4 in all centers. They were 35.1 (22 in Shargh, 34 (14.5 in Shomal, 32 (11.3 in Firoozkooh, 28.3 (14 in Shemiranat, 7.9 (9.2 in Damavand and 23.6 (8.5 in Pakdasht respectively. The mean (SD of the efficacy of health volunteers was 8.6 (9.9 in all centers. They were 11.7 (5.6 in Firoozkooh, 10.7 (15.7 in Shargh, 9.4 (6.8 in Shomal, 7.9 (4.9 in Damavand, 7.9 (6.1 in Shemiranat and 4.6 (4.3 in Pakdasht respectively. Older and married volunteers with more experience performed better. There was no significant relationship between the efficacy of health volunteers with their literacy level, employment status and absorber of them.              Conclusion: The health volunteers of Shomal, Shargh and Firoozkooh had the best performances respectively. The performances of those in Shemiranat, Damavand and Pakdasht were less than the overall health centers’ mean score. The efficacy score of Firoozkooh, Shomal and Shargh health centers were above the overall health centers’ mean score respectively

  19. Association between proximity to a health center and early childhood mortality in Madagascar.

    Directory of Open Access Journals (Sweden)

    Saori Kashima

    Full Text Available OBJECTIVE: To evaluate the association between proximity to a health center and early childhood mortality in Madagascar, and to assess the influence of household wealth, maternal educational attainment, and maternal health on the effects of distance. METHODS: From birth records of subjects in the Demographic and Health Survey, we identified 12565 singleton births from January 2004 to August 2009. After excluding 220 births that lacked global positioning system information for exposure assessment, odds ratios (ORs and their 95% confidence intervals (CIs for neonatal mortality and infant mortality were estimated using multilevel logistic regression models, with 12345 subjects (level 1, nested within 584 village locations (level 2, and in turn nested within 22 regions (level 3. We additionally stratified the subjects by the birth order. We estimated predicted probabilities of each outcome by a three-level model including cross-level interactions between proximity to a health center and household wealth, maternal educational attainment, and maternal anemia. RESULTS: Compared with those who lived >1.5-3.0 km from a health center, the risks for neonatal mortality and infant mortality tended to increase among those who lived further than 5.0 km from a health center; the adjusted ORs for neonatal mortality and infant mortality for those who lived >5.0-10.0 km away from a health center were 1.36 (95% CI: 0.92-2.01 and 1.42 (95% CI: 1.06-1.90, respectively. The positive associations were more pronounced among the second or later child. The distance effects were not modified by household wealth status, maternal educational attainment, or maternal health status. CONCLUSIONS: Our study suggests that distance from a health center is a risk factor for early childhood mortality (primarily, infant mortality in Madagascar by using a large-scale nationally representative dataset. The accessibility to health care in remote areas would be a key factor to achieve

  20. Internal marketing strategy: Focusing on staff orientation in health care in South Africa

    Directory of Open Access Journals (Sweden)

    J. W. De Jager

    2008-12-01

    aims to present a comprehensive framework for Provincial Hospital Management to prioritise important staff related issues in order to satisfy their needs. The recommendations of this study need to be applied if acceptable health care is to be provided. Originality/Value: This study challenges existing internal marketing studies on health care services. Its significance lies in an attempt to establish the needs of diversified health care staff in a health care setting. It offers uniquely South African internal marketing framework that focuses on similarities and differences between medical and nursing staff in a Gauteng public hospital.

  1. A Review of Energy Drinks and Mental Health, with a Focus on Stress, Anxiety, and Depression

    Science.gov (United States)

    Smith, Andrew P.

    2016-01-01

    Background: Concerns have been expressed regarding the potential for caffeinated energy drinks to negatively affect mental health, and particularly so in young consumers at whom they are often targeted. The products are frequently marketed with declarations of increasing mental and physical energy, providing a short-term boost to mood and performance. Although a certain amount of evidence has accumulated to substantiate some of these claims, the chronic effects of energy drinks on mental health also need to be addressed. Methods: To review the relevant literature, PubMed and PsycINFO were searched for all peer-reviewed articles published in English that addressed associations between energy drink use and mental health outcomes. Case reports were also considered, though empirical studies investigating acute mood effects were excluded as a review of such articles had recently been published. Fifty-six articles were retrieved: 20 of these (along with eight more identified through other means) were included in the current review, and, because the majority addressed aspects of stress, anxiety, and depression, particular focus was placed on these outcomes. Results: Though a number of null findings (and one negative relationship) were observed, the majority of studies examined reported positive associations between energy drink consumption and symptoms of mental health problems. Conclusions: Though the findings imply that energy drink use may increase the risk of undesirable mental health outcomes, the majority of research examined utilized cross-sectional designs. In most cases, it was therefore not possible to determine causation or direction of effect. For this reason, longitudinal and intervention studies are required to increase our understanding of the nature of the relationships observed. PMID:27274415

  2. Beyond the physical examination: the nurse practitioner's role in adolescent risk reduction and resiliency building in a school-based health center.

    Science.gov (United States)

    Davis, Teresa K

    2005-12-01

    School-based health centers in high schools provide a unique setting in which to deliver risk-reduction and resilience-building services to adolescents. The traditional health care system operating in the United States focuses on the treatment of illness and disease rather than on preventing problems originating from health risk behaviors. Nurse practitioners can promote healthy behavior in adolescents through linkages to parents, schools, and community organizations; by conducting individual risk assessments; and by providing health education and access to creative health programs that build resilience and promote protective factors. With a focus on wellness, nurse practitioners as advanced practice nurses and specialists in disease prevention and health promotion can establish students' health priorities in the context of the primary health care they deliver on a daily basis.

  3. [A basic health care center. Care oriented at the community].

    Science.gov (United States)

    Marquilles Bonet, C; Quesada Santaulaira, L; Florensa Roca, C; Piñol Jové, M A; Cruz Esteve, I; Rodríguez Rosich, A

    1997-01-01

    Principle problems of a basic health care area (Lérida) are identified. This area, which has a patient case load of 22,244 people, was studied during the winter of 1993-94 by using information from various sources. Results indicate that the population of this community are basically young, urban, have a high cultural and social level, and are mostly employed. The principle causes of mortality are the same as in the rest of Cataluña. Diseases that cause the most working days lost to illness are: respiratory, mental and bone-joint problems. The most frequent diseases seen in the clinic are: hypertension, respiratory infections, endocrine and mental. An overall look at the state of health of these patients show that the principle problems are: tobacco use, high blood pressure, arthritis, lumbago, depression, stroke, diabetes and breast cancer.

  4. Genetic information: Special or not? Responses from focus groups with members of a health maintenance organization.

    Science.gov (United States)

    Diergaarde, Brenda; Bowen, Deborah J; Ludman, Evette J; Culver, Julie O; Press, Nancy; Burke, Wylie

    2007-03-15

    Genetic information is used increasingly in health care. Some experts have argued that genetic information is qualitatively different from other medical information and, therefore, raises unique social issues. This view, called "genetic exceptionalism," has importantly influenced recent policy efforts. Others have argued that genetic information is like other medical information and that treating it differently may actually result in unintended disparities. Little is known about how the general public views genetic information. To identify opinions about implications of genetic and other medical information among the general population, we conducted a series of focus groups in Seattle, WA. Participants were women and men between ages 18 and 74, living within 30 miles of Seattle and members of the Group Health Cooperative. A structured discussion guide was used to ensure coverage of all predetermined topics. Sessions lasted approximately 2 hr; were audio taped and transcribed. The transcripts formed the basis of the current analysis. Key findings included the theme that genetic information was much like other medical information and that all sensitive medical information should be well protected. Personal choice (i.e., the right to choose whether to know health risk information and to control who else knows) was reported to be of crucial importance. Participants had an understanding of the tensions involved in protecting privacy versus sharing medical information to help another person. These data may guide future research and policy concerning the use and protection of medical information, including genetic information. (c) 2007 Wiley-Liss, Inc.

  5. Prevalence of psychological disorders among patients attending community health centers, Perak, Malaysia

    Directory of Open Access Journals (Sweden)

    Asma Perveen

    2017-09-01

    Full Text Available Objective: The purpose of this study was to explore the prevalence of psychological disorders among community health centers in Batang Padang district Perak. Material & Methods: To conduct this study survey research method was used, seven community health centers in Batang Padang District, Perak were contacted to collect data from (N=216 respondents, who attended health facilities in Batang Padang District. There is no age limit, no education difference and no other requirement needed. Instrument and Materials: Depression, Anxiety and Stress Scale (DASS-21 PRIME Screen and PRIME MD Patient Health Questionnaire (PHQ. Results: Data collected from seven health community centers revealed that prevalence of Stress 86%, anxiety 124%, depression 67, psychotic symptoms 16%, somatoform symptoms 52%, panic symptoms 28%, and substance abuse 21%. the higher prevalence was stress and depression among people attending health centers. Conclusion: Results findings indicated that there is significant prevalence of psychological disorder among community health centers. Analysis of the results help us to determine that there is strong need to provide psychological services, awareness and education plan, management and prevention for psychological disorders

  6. Prevalence of psychological disorders among patients attending community health centers, Perak, Malaysia

    Directory of Open Access Journals (Sweden)

    Asma Perveen

    2017-09-01

    Full Text Available Objective: The purpose of this study was to explore the prevalence of psychological disorders among community health centers in Batang Padang district Perak. Material & Methods: To conduct this study survey research method was used, seven community health centers in Batang Padang District, Perak were contacted to collect data from (N=216 respondents, who attended health facilities in Batang Padang District. There is no age limit, no education difference and no other requirement needed. Instrument and Materials: Depression, Anxiety and Stress Scale (DASS-21 PRIME Screen and PRIME MD Patient Health Questionnaire (PHQ. Results: Data collected from seven health community centers revealed that prevalence of Stress 86%, anxiety 124%, depression 67, psychotic symptoms 16%, somatoform symptoms 52%, panic symptoms 28%, and substance abuse 21%. the higher prevalence was stress and depression among people attending health centers. Conclusion: Results findings indicated that there is significant prevalence of psychological disorder among community health centers. Analysis of the results help us to determine that there is strong need to provide psychological services, awareness and education plan, management and prevention for psychological disorders

  7. U.S. academic medical centers under the managed health care environment.

    Science.gov (United States)

    Guo, K

    1999-06-01

    This research investigates the impact of managed health care on academic medical centers in the United States. Academic medical centers hold a unique position in the U.S. health care system through their missions of conducting cutting-edge biomedical research, pursuing clinical and technological innovations, providing state-of-the-art medical care and producing highly qualified health professionals. However, policies to control costs through the use of managed care and limiting resources are detrimental to academic medical centers and impede the advancement of medical science. To survive the threats of managed care in the health care environment, academic medical centers must rely on their upper level managers to derive successful strategies. The methods used in this study include qualitative approaches in the form of key informants and case studies. In addition, a survey questionnaire was sent to 108 CEOs in all the academic medical centers in the U.S. The findings revealed that managers who perform the liaison, monitor, entrepreneur and resource allocator roles are crucial to ensure the survival of academic medical centers, so that academic medical centers can continue their missions to serve the general public and promote their well-being.

  8. Making it Work 2: using a virtual community to focus on rural health issues.

    Science.gov (United States)

    Godden, David J; Aaraas, Ivar J

    2006-01-01

    Between 21 and 23 September 2005, over 200 delegates from eight countries gathered in Tromsö, within the Arctic Circle, to discuss challenges and solutions to rural health issues. This conference was a sequel to a previous event entitled 'Making it Work', held in Scotland in 2003, in which it was identified that service delivery in remote and rural areas needed to be innovative to ensure equity. A major aim of this event was to move the debate forward to describe specific examples of practice that could be adopted in participating countries. The delegates included clinicians, managers and administrators, senior policymakers and educationalists, elected local and national politicians, patients and their representatives. In order to focus debate, the organisers provided an outline of a virtual remote community ('Hope'), including some geographic and demographic information, together with four case studies of individual health problems faced by residents of the community. During the introductory session, a short film was shown featuring the 'residents' of this community, introducing delegates to the specific problems they faced. Throughout the conference, delegates were asked to reflect back to how any recommendations made might apply to the citizens of Hope. The clinical scenarios presented included: (1) a 37 year old pregnant woman in labour during adverse weather conditions; (2) a 17 year old island resident with acute psychosis who attempts suicide; (3) an 80 year old woman living alone who suffers a stroke; and (4) a family of four with a complex range of chronic health issues including smoking, alcoholism, diabetes, teenage pregnancy, asthma and depression on a background of deprivation and unemployment. Parallel discussions and workshops focussed on a number of key themes linked to the examples highlighted in the 'Hope' scenario. These included: maternity services; mental health; chronic disease management; health improvement and illness prevention; supporting

  9. Developing population interventions with migrant women for maternal-child health: a focused ethnography.

    Science.gov (United States)

    Gagnon, Anita J; Carnevale, Franco; Mehta, Praem; Rousseau, Hélène; Stewart, Donna E

    2013-05-14

    Literature describing effective population interventions related to the pregnancy, birth, and post-birth care of international migrants, as defined by them, is scant. Hence, we sought to determine: 1) what processes are used by migrant women to respond to maternal-child health and psychosocial concerns during the early months and years after birth; 2) which of these enhance or impede their resiliency; and 3) which population interventions they suggest best respond to these concerns. Sixteen international migrant women living in Montreal or Toronto who had been identified in a previous study as having a high psychosocial-risk profile and subsequently classified as vulnerable or resilient based on indicators of mental health were recruited. Focused ethnography including in-depth interviews and participant observations were conducted. Data were analyzed thematically and as an integrated whole. Migrant women drew on a wide range of coping strategies and resources to respond to maternal-child health and psychosocial concerns. Resilient and vulnerable mothers differed in their use of certain coping strategies. Social inclusion was identified as an overarching factor for enhancing resiliency by all study participants. Social processes and corresponding facilitators relating to social inclusion were identified by participants, with more social processes identified by the vulnerable group. Several interventions related to services were described which varied in type and quality; these were generally found to be effective. Participants identified several categories of interventions which they had used or would have liked to use and recommended improvements for and creation of some programs. The social determinants of health categories within which their suggestions fell included: income and social status, social support network, education, personal health practices and coping skills, healthy child development, and health services. Within each of these, the most common

  10. Caries risk assessment tool and prevention protocol for public health nurses in mother and child health centers, Israel.

    Science.gov (United States)

    Natapov, Lena; Dekel-Markovich, Dan; Granit-Palmon, Hadas; Aflalo, Efrat; Zusman, Shlomo Paul

    2018-01-01

    Dental caries is the most prevalent chronic disease in children. Caries risk assessment tools enable the dentists, physicians, and nondental health care providers to assess the individual's risk. Intervention by nurses in primary care settings can contribute to the establishment of oral health habits and prevention of dental disease. In Israel, Mother and Child Health Centers provide free preventive services for pregnant women and children by public health nurses. A caries prevention program in health centers started in 2015. Nurses underwent special training regarding caries prevention. A customized Caries Risk Assessment tool and Prevention Protocol for nurses, based on the AAPD tool, was introduced. A two-step evaluation was conducted which included a questionnaire and in-depth phone interviews. Twenty-eight (out of 46) health centers returned a completed questionnaire. Most nurses believed that oral health preventive services should be incorporated into their daily work. In the in-depth phone interviews, nurses stated that the integration of the program into their busy daily schedule was realistic and appropriate. The lack of specific dental module for computer program was mentioned as an implementation difficulty. The wide use of our tool by nurses supports its simplicity and feasibility which enables quick calculation and informed decision making. The nurses readily embraced the tool and it became an integral part of their toolkit. We provide public health nurses with a caries risk assessment tool and prevention protocol thus integrating oral health into general health of infants and toddlers. © 2017 Wiley Periodicals, Inc.

  11. An Employee-Centered Care Model Responds to the Triple Aim: Improving Employee Health.

    Science.gov (United States)

    Fox, Kelly; McCorkle, Ruth

    2018-01-01

    Health care expenditures, patient satisfaction, and timely access to care will remain problematic if dramatic changes in health care delivery models are not developed and implemented. To combat this challenge, a Triple Aim approach is essential; Innovation in payment and health care delivery models is required. Using the Donabedian framework of structure, process, and outcome, this article describes a nurse-led employee-centered care model designed to improve consumers' health care experiences, improve employee health, and increase access to care while reducing health care costs for employees, age 18 and older, in a corporate environment.

  12. Determinants of puberty health among female adolescents residing in boarding welfare centers in Tehran: An application of health belief model.

    Science.gov (United States)

    Shirzadi, Shayesteh; Asghari Jafarabadi, Mohammad; Nadrian, Haidar; Mahmoodi, Hassan

    2016-01-01

    Background: Adolescence is a critical stage of growth and development. That is associated with changes in body shape and appearance. Issues such as irregular menstrual periods, amenorrhea, and menstrual cycle are major issues in women's health. The purpose of this study was to examine the determinants of physical puberty health based on the Health Belief Model (HBM) among female adolescents. Methods: This analytical cross sectional study was conducted in welfare boarding centers in Tehran, Iran. Data were collected in 2011 by a structured and valid questionnaire. Total 61 female adolescents (age range: 12-19 yrs) participated in this study from welfare boarding centers in Iran, Tehran, by using convenience sampling method. The questionnaire consisted of demographic characteristics, health belief model constructs and physical puberty health behaviors gathered by using interview. A series of univariate general linear models were used to assess the relationship between puberty health and health belief model constructs. Results: According to the results of this study there were positive significant relationships between perceived susceptibility, perceived benefits, perceived barriers, cues to action and increased puberty health in female adolescents (p<0.05). Perceived benefits, perceived barriers and cues to action were predictors of physical puberty health behaviors. Conclusion: Based on the results of the study to improve the physical Puberty health behaviors of female adolescents should make them aware of the benefits of health behaviors, and remove or reform the perceived barriers of health behaviors. Also, the appropriate information resources should be introduced for obtaining information about puberty health.

  13. Case studies in public-private-partnership in health with the focus of enhancing the accessibility of health interventions.

    Science.gov (United States)

    Njau, R J A; Mosha, F W; De Savigny, D

    2009-10-01

    Various definitions have been framed for public-private partnerships (PPPs) in health depending on the desired relationship and the characteristics of the respective sectors. These relationships span from a continuum of loose relationships with narrow objectives, lack of a legal status and an absence of a formalized membership or governing body to high level institutionalization. The latter includes concrete objectives, the presence of a legal status and permanent multi-sectoral membership. The study used qualitative research methods including case studies, literature review and interview with key informants. The research undertakes an extensive literature review of various PPP models in health in scale and in scope which are aimed at advancing public health goals in developing countries. The major emphasis is on a qualitative description of some of the PPPs in the planning and implementation phases, including the challenges encountered. This background is used to analyse in-depth two case studies which are both health oriented; the first one is a national level NGO consortium with a focus on malaria and the second one is an international advocacy group with an overarching goal of protecting children against malaria through an innovative mechanism. The case study approach is used to analyze why the PPP approach was used to address malaria control and how it was implemented. Both PPPs demonstrated that relationships between the public and private sector may begin from very humble and loose beginnings. However, with perseverance from committed individuals, a vision and trustworthiness may become powerful advocates for meeting prescribed health agendas. In conclusion, three key themes (trust, sacrifice and championship) run vividly through the case studies and are significant for developing countries to emulate.

  14. Public attitudes towards pricing policies to change health-related behaviours: a UK focus group study.

    Science.gov (United States)

    Somerville, Claire; Marteau, Theresa M; Kinmonth, Ann Louise; Cohn, Simon

    2015-12-01

    Evidence supports the use of pricing interventions in achieving healthier behaviour at population level. The public acceptability of this strategy continues to be debated throughout Europe, Australasia and USA. We examined public attitudes towards, and beliefs about the acceptability of pricing policies to change health-related behaviours in the UK. The study explores what underlies ideas of acceptability, and in particular those values and beliefs that potentially compete with the evidence presented by policy-makers. Twelve focus group discussions were held in the London area using a common protocol with visual and textual stimuli. Over 300,000 words of verbatim transcript were inductively coded and analyzed, and themes extracted using a constant comparative method. Attitudes towards pricing policies to change three behaviours (smoking, and excessive consumption of alcohol and food) to improve health outcomes, were unfavourable and acceptability was low. Three sets of beliefs appeared to underpin these attitudes: (i) pricing makes no difference to behaviour; (ii) government raises prices to generate income, not to achieve healthier behaviour and (iii) government is not trustworthy. These beliefs were evident in discussions of all types of health-related behaviour. The low acceptability of pricing interventions to achieve healthier behaviours in populations was linked among these responders to a set of beliefs indicating low trust in government. Acceptability might be increased if evidence regarding effectiveness came from trusted sources seen as independent of government and was supported by public involvement and hypothecated taxation. © The Author 2015. Published by Oxford University Press on behalf of the European Public Health Association.

  15. A Family-Centered Preventive Intervention within Pediatric Oncology: Adapting the FOCUS Intervention for Latino Youth and Their Families

    Science.gov (United States)

    Garcia, Ediza; Wijesekera, Kanchana; Lester, Patricia

    2017-01-01

    Pediatric cancer can disrupt the behavioral and emotional well-being of youth and their families, representing a potential psychological health risk for the entire family. Among ethnic minority families, cultural factors such as acculturation and language competency may affect the experience of this illness, which can, in turn, affect overall…

  16. Indicators of national focus of the research published by Public Health journals edited in Brazil.

    Science.gov (United States)

    Packer, Abel Laerte

    2015-07-01

    This report presents a set of bibliometric indicators and statistics which explain the high level of production of articles on research in public and collective health in Brazil which are published in the main nationally edited journals in the field. The predominance of publications in the Portuguese language by Brazilian authors results in a lower impact in terms of citations received as measured by the bibliometric indexes Scimago/Scopus and JCR/WoS. These bibliometric indexes are used to measure the production and performance of research and journals. Nevertheless, the performance of these same journals stands out in SciELO, and is competitive internationally in the broader context of Google Scholar Metrics. The challenge faced by journals in Brazil is developing and applying editorial policies for the valuation of research with a national focus, and its internationalization.

  17. The Complementary Roles of the School Nurse and School Based Health Centers. Position Statement

    Science.gov (United States)

    Ondeck, Lynnette; Combe, Laurie; Baszler, Rita; Wright, Janet

    2015-01-01

    It is the position of the National Association of School Nurses (NASN) that the unique combination of school nursing services and school-based health centers (SBHCs) facilitate positive health outcomes for students. The registered professional school nurse (hereinafter referred to as school nurse) is responsible for management of the daily health…

  18. 75 FR 384 - Event Problem Codes Web Site; Center for Devices and Radiological Health; Availability

    Science.gov (United States)

    2010-01-05

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2009-N-0576] Event Problem Codes Web Site; Center for Devices and Radiological Health; Availability AGENCY: Food and Drug Administration, HHS. ACTION: Notice. SUMMARY: The Food and Drug Administration (FDA) is announcing...

  19. Characteristics of Children with Autism Spectrum Disorders Who Received Services through Community Mental Health Centers

    Science.gov (United States)

    Bryson, Stephanie A.; Corrigan, Susan K.; McDonald, Thomas P.; Holmes, Cheryl

    2008-01-01

    Despite the presence of significant psychiatric comorbidity among children with autism spectrum disorders (ASDs), little research exists on those who receive community-based mental health services. This project examined one year (2004) of data from the database maintained by 26 community mental health centers (CMHCs) in the Midwestern US state of…

  20. Innovative Services Offered by School-Based Health Centers in New York City

    Science.gov (United States)

    Sisselman, Amanda; Strolin-Goltzman, Jessica; Auerbach, Charles; Sharon, Lisa

    2012-01-01

    School-based health centers (SBHCs) continue to provide essential health care services to children and families in underserved neighborhoods across the country. Preliminary studies show that students who use SBHCs have better attendance rates as well as higher rates of academic achievement and attachment to the learning environment. Few studies,…

  1. Center for Collegiate Mental Health (CCMH) 2015 Annual Report. Publication No. STA 15-108

    Science.gov (United States)

    Center for Collegiate Mental Health, 2015

    2015-01-01

    College student mental health received widespread attention during the 2014-2015 academic year with in depth commentary appearing in numerous major media outlets. These articles examined college student mental health from various perspectives including the experiences of students and parents, counseling centers, the rise of anxiety in higher…

  2. 76 FR 55078 - National Center on Minority and Health Disparities; Notice of Closed Meeting

    Science.gov (United States)

    2011-09-06

    ... and Health Disparities; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... and Health Disparities Special Emphasis Panel, ZMD1 RN (02) NIMHD Comprehensive Center of Excellence... Disparities, 6707 Democracy Boulevard, Suite 800, Bethesda, MD 20892, (301) 496-3996, [email protected

  3. 76 FR 57068 - National Center on Minority and Health Disparities Notice of Closed Meeting

    Science.gov (United States)

    2011-09-15

    ... and Health Disparities Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... and Health Disparities Special Emphasis Panel; ZMD1 RN 01 NIMHD Exploratory Centers of Excellence (P20... Disparities, 6707 Democracy Boulevard, Suite 800, Bethesda, MD 20892, (301) 496-3996, [email protected

  4. Quality Improvement Initiative in School-Based Health Centers across New Mexico

    Science.gov (United States)

    Booker, John M.; Schluter, Janette A.; Carrillo, Kris; McGrath, Jane

    2011-01-01

    Background: Quality improvement principles have been applied extensively to health care organizations, but implementation of quality improvement methods in school-based health centers (SBHCs) remains in a developmental stage with demonstration projects under way in individual states and nationally. Rural areas, such as New Mexico, benefit from the…

  5. NIEHS/EPA Children's Environmental Health and Disease Prevention Research Centers: 2017 Annual Meeting Proceedings

    Science.gov (United States)

    The 2017 Annual Meeting of the NIEHS/EPA Children’s Environmental Health and Disease Prevention Research Centers was hosted by EPA in collaboration with NIEHS and the Pediatric Environmental Health Specialty Units (PEHSUs). The meeting was held at the EPA Region 9 offices i...

  6. High School Students' Experiences of Bullying and Victimization and the Association with School Health Center Use

    Science.gov (United States)

    Lewis, Catherine; Deardorff, Julianna; Lahiff, Maureen; Soleimanpour, Samira; Sakashita, Kimi; Brindis, Claire D.

    2015-01-01

    Background: Bullying and victimization are ongoing concerns in schools. School health centers (SHCs) are well situated to support affected students because they provide crisis intervention, mental health care, and broader interventions to improve school climate. This study examined the association between urban adolescents' experiences of…

  7. Health beliefs and practices related to dengue fever: a focus group study.

    Science.gov (United States)

    Wong, Li Ping; AbuBakar, Sazaly

    2013-01-01

    This qualitative study aimed to provide an in-depth understanding of the meaning of dengue fever (DF) amongst people living in a dengue endemic region, dengue prevention and treatment-seeking behaviours. The Health Belief Model was used as a framework to explore and understand dengue prevention behaviours. A total of 14 focus group discussions were conducted with 84 Malaysian citizens of different socio-demographic backgrounds between 16(th) December, 2011 and 12(th) May, 2012. The study revealed that awareness about DF and prevention measures were high. The pathophysiology of dengue especially dengue haemorrhagic fever (DHF) and dengue shock syndrome (DSS) were rarely known; as a result, it was seen as deadly by some but was also perceived as easily curable by others without a basis of understanding. Young adults and elderly participants had a low perception of susceptibility to DF. In general, the low perceived susceptibility emerged as two themes, namely a perceived natural ability to withstand infection and a low risk of being in contact with the dengue virus vector, Aedes spp. mosquitoes. The barriers to sustained self-prevention against dengue prevention that emerged in focus groups were: i) lack of self-efficacy, ii) lack of perceived benefit, iii) low perceived susceptibility, and iv) unsure perceived susceptibility. Low perceived benefit of continued dengue prevention practices was a result of lack of concerted action against dengue in their neighborhood. Traditional medical practices and home remedies were widely perceived and experienced as efficacious in treating DF. Behavioural change towards attaining sustainability in dengue preventive practices may be enhanced by fostering comprehensive knowledge of dengue and a change in health beliefs. Wide use of unconventional therapy for DF warrants the need to enlighten the public to limit their reliance on unproven alternative treatments.

  8. Patient-centered activity monitoring in the self-management of chronic health conditions.

    Science.gov (United States)

    Chiauzzi, Emil; Rodarte, Carlos; DasMahapatra, Pronabesh

    2015-04-09

    As activity tracking devices become smaller, cheaper, and more consumer-accessible, they will be used more extensively across a wide variety of contexts. The expansion of activity tracking and personal data collection offers the potential for patient engagement in the management of chronic diseases. Consumer wearable devices for activity tracking have shown promise in post-surgery recovery in cardiac patients, pulmonary rehabilitation, and activity counseling in diabetic patients, among others. Unfortunately, the data generated by wearable devices is seldom integrated into programmatic self-management chronic disease regimens. In addition, there is lack of evidence supporting sustained use or effects on health outcomes, as studies have primarily focused on establishing the feasibility of monitoring activity and the association of measured activity with short-term benefits. Monitoring devices can make a direct and real-time impact on self-management, but the validity and reliability of measurements need to be established. In order for patients to become engaged in wearable data gathering, key patient-centered issues relating to usefulness in care, motivation, the safety and privacy of information, and clinical integration need to be addressed. Because the successful usage of wearables requires an ability to comprehend and utilize personal health data, the user experience should account for individual differences in numeracy skills and apply evidence-based behavioral science principles to promote continued engagement. Activity monitoring has the potential to engage patients as advocates in their personalized care, as well as offer health care providers real world assessments of their patients' daily activity patterns. This potential will be realized as the voice of the chronic disease patients is accounted for in the design of devices, measurements are validated against existing clinical assessments, devices become part of the treatment 'prescription', behavior

  9. Physical environment and job satisfaction in a community mental health center.

    Science.gov (United States)

    Folkins, C; O'Reilly, C; Roberts, K; Miller, S

    1977-01-01

    Relocation of professional staff in a community mental health center provided a setting in which to evaluate the effects of physical environment on job satisfaction. Two mental health teams moved from an old, drab central clinic building to new satellite clinics while a third team remained in the old building. Relocated staff reported significant increase in satisfaction with physical surroundings as compared to staff that did not move. Furthermore, satisfaction with physical surroundings had some impact on overall satisfaction ratings. Physical surroundings in a community mental health center may be a mediating variable for staff morale and effectiveness.

  10. Distributed and grid computing projects with research focus in human health.

    Science.gov (United States)

    Diomidous, Marianna; Zikos, Dimitrios

    2012-01-01

    Distributed systems and grid computing systems are used to connect several computers to obtain a higher level of performance, in order to solve a problem. During the last decade, projects use the World Wide Web to aggregate individuals' CPU power for research purposes. This paper presents the existing active large scale distributed and grid computing projects with research focus in human health. There have been found and presented 11 active projects with more than 2000 Processing Units (PUs) each. The research focus for most of them is molecular biology and, specifically on understanding or predicting protein structure through simulation, comparing proteins, genomic analysis for disease provoking genes and drug design. Though not in all cases explicitly stated, common target diseases include research to find cure against HIV, dengue, Duchene dystrophy, Parkinson's disease, various types of cancer and influenza. Other diseases include malaria, anthrax, Alzheimer's disease. The need for national initiatives and European Collaboration for larger scale projects is stressed, to raise the awareness of citizens to participate in order to create a culture of internet volunteering altruism.

  11. Meeting baccalaureate public/community health nursing education competencies in nurse-managed wellness centers.

    Science.gov (United States)

    Thompson, Cheryl W; Bucher, Julia A

    2013-01-01

    The purpose of this article is to describe how community health competencies for baccalaureate nursing education have been met by locating clinical experiences in nurse-managed wellness centers. Such centers are an ideal setting for students to integrate theoretical concepts into clinical practice while building on previous learning. Students are able to develop skills in community health nursing practice at individual, family, and population level. In addition, the practice setting provides other advantages. Clients who represent a vulnerable population group receive valuable health services. Students gain learning opportunities that are broader than community health competencies, and faculty are provided clinical practice, research, and scholarship opportunities. The challenges to year-round sustainability of nurse-managed centers are burdensome; however, the benefits outweigh the difficulty of those challenges. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. Ensuring the success of women faculty at AMCs: lessons learned from the National Centers of Excellence in Women's Health.

    Science.gov (United States)

    Morahan, P S; Voytko, M L; Abbuhl, S; Means, L J; Wara, D W; Thorson, J; Cotsonas, C E

    2001-01-01

    Since the early 1970s, the numbers of women entering medical school and, subsequently, academic medicine have increased substantially. However, women faculty have not advanced at the expected rate to senior academic ranks or positions of leadership. In 1996, to counter this trend, the U.S. Department of Health and Human Services (DHHS) Office on Women's Health included women's leadership as a required component of the nationally funded Centers of Excellence in Women's Health to identify effective strategies and initiate model programs to advance women faculty in academic medicine. The authors describe the experience of Centers at seven U.S. medical schools in initiating and sustaining leadership programs for women. The processes used for program formation, the current programmatic content, and program evaluation approaches are explained. Areas of success (e.g., obtaining support from the institution's leaders) and difficulties faced in maintaining an established program (such as institutional fiscal constraints and the diminishing time available to women to participate in mentoring and leadership activities) are reviewed. Strategies to overcome these and other difficulties (e.g., prioritize and tightly focus the program with the help of an advisory group) are proposed. The authors conclude by reviewing issues that programs for women in academic medicine will increasingly need to focus on (e.g., development of new kinds of skills; issues of recruitment and retention of faculty; and increasing faculty diversity).

  13. The need for mental health services research focusing on poor young women.

    Science.gov (United States)

    Miranda, Jeanne; Green, Bonnie L.

    1999-06-01

    to be learned about the mental health status and needs of poor women, along with the impact of loss of public support on their physical and mental health. Access to mental health care within a managed care setting also needs to be addressed, and care taken to understand the particular needs of poor populations that will actually make these services accessible to them. Insufficient attention has thus far been paid to the cost implications of providing these services to the poor. While providing treatment is associated with significant costs, the costs of not providing care, especially the effects of depression on offspring, should not be overlooked. CHALLENGES TO EXAMINING MENTAL HEALTH IN POOR WOMEN: A number of suggestions were made for addressing practical and methodological challenges to providing mental health services. These include placing services for these individuals within their familiar medical settings, which requires close working relationships between psychiatric and medical personnel within these settings. Outreach is a necessary part of getting poor women into treatment, and should be a routine part of helping women become engaged with caregivers. Providing culturally sensitive treatments is an important focus too, through developing knowledge about the culturally based customs and expectations of target groups. Measurement issues need to be attended to, as most research instruments have been developed on middle class populations, and have not been examined for their psychometric properties and norms in less advantaged groups. Careful translation techniques are also required. Finally, working with institutions sponsoring research to educate them about special problems and challenges with these groups will help improve the quality and efficiency of the work accomplished.

  14. A Study of Children's Geographic Access to Health Services (Health Care Centers and Clinical Laboratories in Kermanshah City, Iran

    Directory of Open Access Journals (Sweden)

    Sohyla Reshadat

    2018-02-01

    Full Text Available Background Given that the protection of children's health is of special importance due to their special age and physical conditions, the present study aimed to investigate the condition of children's Geographic access to health services (Health Centers and Clinical Laboratories in Kermanshah city, Iran. Materials and Methods: In this applied study, the research approach was descriptive-analytic using quantitative models in Geographic information system (GIS environment. The statistical population was the whole population of young girls aged 0-14 years old in Kermanshah, Iran. Moreover, to evaluate the spatial deployment pattern of health services and the correct and true access of this groupto such services, all data and information were collected through the Iranian Statistics Center and evaluated using the Arc-GIS Software. The latest published population statistics on the Population and Housing Census in 2011 were considered the basis for the analyses. Results: The results of the present study demonstrated that more than 40% and 60% of the young girls aged 0-14 years old in Kermanshah were deprived of proper access to health centers and clinical laboratories, respectively. In terms of the status of children’s access in the Second Scenario (access to health services by vehicles and during 5, 10, and 15 minutes, about 5.53%, 93.1% and 15.1% lacked access to health centers, respectively. In addition, in terms of the status of children’s access to clinical laboratories during 5, 10, and 15 minutes, 17.26%, 65.4% and 51% lacked access to clinical laboratories, respectively. Conclusion: The access of young girls aged 0-14 years old to health services in Kermanshah was undesirable in the access to health services through walking. Additionally, the access of this groupto health services in the access to health services by vehicles was far better than the first one.

  15. The retention of health human resources in primary healthcare centers in Lebanon: a national survey.

    Science.gov (United States)

    Alameddine, Mohamad; Saleh, Shadi; El-Jardali, Fadi; Dimassi, Hani; Mourad, Yara

    2012-11-22

    Critical shortages of health human resources (HHR), associated with high turnover rates, have been a concern in many countries around the globe. Of particular interest is the effect of such a trend on the primary healthcare (PHC) sector; considered a cornerstone in any effective healthcare system. This study is a rare attempt to investigate PHC HHR work characteristics, level of burnout and likelihood to quit as well as the factors significantly associated with staff retention at PHC centers in Lebanon. A cross-sectional design was utilized to survey all health providers at 81 PHC centers dispersed in all districts of Lebanon. The questionnaire consisted of four sections: socio-demographic/ professional background, organizational/institutional characteristics, likelihood to quit and level of professional burnout (using the Maslach-Burnout Inventory). A total of 755 providers completed the questionnaire (60.5% response rate). Bivariate analyses and multinomial logistic regression were used to determine factors associated with likelihood to quit. Two out of five respondents indicated likelihood to quit their jobs within the next 1-3 years and an additional 13.4% were not sure about quitting. The top three reasons behind likelihood to quit were poor salary (54.4%), better job opportunities outside the country (35.1%) and lack of professional development (33.7%). A U-shaped relationship was observed between age and likelihood to quit. Regression analysis revealed that high levels of burnout, lower level of education and low tenure were all associated with increased likelihood to quit. The study findings reflect an unstable workforce and are not conducive to supporting an expanded role for PHC in the Lebanese healthcare system. While strategies aiming at improving staff retention would be important to develop and implement for all PHC HHR; targeted retention initiatives should focus on the young-new recruits and allied health professionals. Particular attention should

  16. The retention of health human resources in primary healthcare centers in Lebanon: a national survey

    Directory of Open Access Journals (Sweden)

    Alameddine Mohamad

    2012-11-01

    Full Text Available Abstract Background Critical shortages of health human resources (HHR, associated with high turnover rates, have been a concern in many countries around the globe. Of particular interest is the effect of such a trend on the primary healthcare (PHC sector; considered a cornerstone in any effective healthcare system. This study is a rare attempt to investigate PHC HHR work characteristics, level of burnout and likelihood to quit as well as the factors significantly associated with staff retention at PHC centers in Lebanon. Methods A cross-sectional design was utilized to survey all health providers at 81 PHC centers dispersed in all districts of Lebanon. The questionnaire consisted of four sections: socio-demographic/ professional background, organizational/institutional characteristics, likelihood to quit and level of professional burnout (using the Maslach-Burnout Inventory. A total of 755 providers completed the questionnaire (60.5% response rate. Bivariate analyses and multinomial logistic regression were used to determine factors associated with likelihood to quit. Results Two out of five respondents indicated likelihood to quit their jobs within the next 1–3 years and an additional 13.4% were not sure about quitting. The top three reasons behind likelihood to quit were poor salary (54.4%, better job opportunities outside the country (35.1% and lack of professional development (33.7%. A U-shaped relationship was observed between age and likelihood to quit. Regression analysis revealed that high levels of burnout, lower level of education and low tenure were all associated with increased likelihood to quit. Conclusions The study findings reflect an unstable workforce and are not conducive to supporting an expanded role for PHC in the Lebanese healthcare system. While strategies aiming at improving staff retention would be important to develop and implement for all PHC HHR; targeted retention initiatives should focus on the young-new recruits

  17. Sustainable Model for Public Health Emergency Operations Centers for Global Settings

    OpenAIRE

    Balajee, S. Arunmozhi; Pasi, Omer G.; Etoundi, Alain Georges M.; Rzeszotarski, Peter; Do, Trang T.; Hennessee, Ian; Merali, Sharifa; Alroy, Karen A.; Phu, Tran Dac; Mounts, Anthony W.

    2017-01-01

    Capacity to receive, verify, analyze, assess, and investigate public health events is essential for epidemic intelligence. Public health Emergency Operations Centers (PHEOCs) can be epidemic intelligence hubs by 1) having the capacity to receive, analyze, and visualize multiple data streams, including surveillance and 2) maintaining a trained workforce that can analyze and interpret data from real-time emerging events. Such PHEOCs could be physically located within a ministry of health epidem...

  18. Implementing the Obesity Care Model at a Community Health Center in Hawaii to Address Childhood Obesity

    OpenAIRE

    Okihiro, May; Pillen, Michelle; Ancog, Cristeta; Inda, Christy; Sehgal, Vija

    2013-01-01

    Obesity, the most common chronic disease of childhood, is prevalent among economically disadvantaged children. The Chronic Care and Obesity Care Models are comprehensive health care strategies to improve outcomes by linking primary care best practices and community-based programs. Pediatric providers and community health centers are well positioned to design and implement coordinated and synergistic programs to address childhood health disparities. This article describes a comprehensive proje...

  19. Building a Culture of Authentic Partnership: One Academic Health Center Model for Nursing Leadership.

    Science.gov (United States)

    Heath, Janie; Swartz, Colleen

    2017-09-01

    Senior nursing leaders from the University of Kentucky (UK) College of Nursing and UK HealthCare have explored the meaning of an authentic partnership. This article quantifies the tangible benefits and outcomes from this maturing academic nursing and clinical practice partnership. Benefits include inaugural academic nursing participation in health system governance, expanded integration of nursing research programs both in the college and in the health science center, and the development of collaborative strategies to address nursing workforce needs.

  20. Hazardous alcohol use among doctors in a Tertiary Health Center

    Directory of Open Access Journals (Sweden)

    Adetunji Obadeji

    2015-01-01

    Full Text Available Background: Doctors have been identified as one of the key agents in the prevention of alcohol-related harm, however, their level of use and attitudes toward alcohol will affect such role. Aim: This study is aimed at describing the pattern of alcohol use and the predictors of hazardous drinking among hospital doctors. Setting: Study was conducted at the Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria. Design: A cross-sectional survey involving all the doctors in the teaching hospital. Materials and Methods: All the consenting clinicians completed a sociodemographic questionnaire and alcohol use was measured using the 10-item alcohol use disorder identification test (AUDIT and psychological well-being was measured by the 12-item General Health Questionnaire (GHQ-12. Statistical Analysis Used: Statistical analyses were done using the Statistical Package for Social Sciences version 16. Chi-square tests with Yates correction were used to describe the relationship between respondent′s characteristics and AUDIT scores as appropriate. Results: There were a total of 122 participants. Eighty-five (69.7% of them were abstainers, 28 (23% were moderate drinkers, and 9 (7.3% hazardous drinkers. With the exception of age, there was no significant relationship between sociodemographic status, years of practice, specialty of practice, and hazardous alcohol use. Experiencing stress or GHQ score above average is significantly associated with hazardous drinking. Conclusion: Hazardous drinking among hospital doctors appears to be essentially a problem of the male gender, especially among those older than 40 years. Stress and other form of psychological distress seem to play a significant role in predicting hazardous drinking among doctors.

  1. US Centers for Disease Control and Prevention and Its Partners' Contributions to Global Health Security.

    Science.gov (United States)

    Tappero, Jordan W; Cassell, Cynthia H; Bunnell, Rebecca E; Angulo, Frederick J; Craig, Allen; Pesik, Nicki; Dahl, Benjamin A; Ijaz, Kashef; Jafari, Hamid; Martin, Rebecca

    2017-12-01

    To achieve compliance with the revised World Health Organization International Health Regulations (IHR 2005), countries must be able to rapidly prevent, detect, and respond to public health threats. Most nations, however, remain unprepared to manage and control complex health emergencies, whether due to natural disasters, emerging infectious disease outbreaks, or the inadvertent or intentional release of highly pathogenic organisms. The US Centers for Disease Control and Prevention (CDC) works with countries and partners to build and strengthen global health security preparedness so they can quickly respond to public health crises. This report highlights selected CDC global health protection platform accomplishments that help mitigate global health threats and build core, cross-cutting capacity to identify and contain disease outbreaks at their source. CDC contributions support country efforts to achieve IHR 2005 compliance, contribute to the international framework for countering infectious disease crises, and enhance health security for Americans and populations around the world.

  2. 76 FR 31618 - National Center on Minority Health and Health Disparities; Notice of Meeting

    Science.gov (United States)

    2011-06-01

    ... Health and Health Disparities; Notice of Meeting Pursuant to section 10(d) of the Federal Advisory... Council on Minority Health and Health Disparities. The meeting will be open to the public as indicated... on Minority Health and Health Disparities. Date: June 14, 2011. Closed: 8 a.m. to 9:30 a.m. Agenda...

  3. 76 FR 6808 - National Center on Minority Health and Health Disparities; Notice of Meeting

    Science.gov (United States)

    2011-02-08

    ... Health and Health Disparities; Notice of Meeting Pursuant to section 10(d) of the Federal Advisory... Council on Minority Health and Health Disparities. The meeting will be open to the public as indicated... on Minority Health and Health Disparities. Date: February 22, 2011. Closed: 8 a.m. to 9:30 a.m...

  4. 75 FR 66114 - National Center on Minority Health and Health Disparities; Notice of Closed Meeting

    Science.gov (United States)

    2010-10-27

    ... Health and Health Disparities; Notice of Closed Meeting Pursuant to section 10(d) of the Federal Advisory... and Health Disparities Special Emphasis Panel; NCMHD Health Disparities Research on Minority and... Review Officer, National Institute on Minority Health and Health Disparities, 6707 Democracy Boulevard...

  5. 75 FR 28262 - National Center on Minority Health and Health Disparities; Notice of Meeting

    Science.gov (United States)

    2010-05-20

    ... Health and Health Disparities; Notice of Meeting Pursuant to section 10(d) of the Federal Advisory... Council on Minority Health and Health Disparities. The meeting will be open to the public as indicated... Advisory Council on Minority Health and Health Disparities. Date: June 8, 2010. Closed: 8 a.m. to 9 a.m...

  6. 76 FR 55075 - National Center on Minority Health and Health Disparities; Notice of Meeting

    Science.gov (United States)

    2011-09-06

    ... Health and Health Disparities; Notice of Meeting Pursuant to section 10(d) of the Federal Advisory... Council on Minority Health and Health Disparities. The meeting will be open to the public as indicated... on Minority Health and Health Disparities. Date: September 13, 2011. Closed: 8 to 9:30 a.m. Agenda...

  7. 75 FR 53975 - National Center on Minority Health and Health Disparities; Notice of Meeting

    Science.gov (United States)

    2010-09-02

    ... Health and Health Disparities; Notice of Meeting Pursuant to section 10(a) of the Federal Advisory... Council on Minority Health and Health Disparities. The meeting will be open to the public as indicated... on Minority Health and Health Disparities. Date: September 14, 2010. Closed: 8 a.m. to 9:30 a.m...

  8. Could Values and Social Structures in Singapore Facilitate Attainment of Patient-Focused, Cultural, and Linguistic Competency Standards in a Patient-Centered Medical Home Pilot?

    Science.gov (United States)

    Shih, Jenny A; Shiow, Sue-Anne Toh Ee; Wee, Hwee-Lin

    2015-01-01

    Primary care practices in the United States are transforming into patient-centered medical homes (PCMHs) at a rapid pace. Newer PCMH standards have emphasized culturally and linguistically appropriate services (CLAS), but at this time, only some states in the United States have proposed or passed cultural competency training for health care professionals. Other countries are moving to PCMH models. Singapore, a small, ethnically diverse island nation, has national values and social structures that emphasize cultural and linguistic cohesion. In this piece, we examine Singapore’s first PCMH pilot with a national academic center and primary care practice group. Features such as common shared values, self-reliance, racial and religious harmony, patient experience surveillance, and incorporation of CLAS standards in routine health care transactions may predict success for the PCMH in Singapore, with some implications for the United States. PMID:28725822

  9. Establishment of a Community-Based Mental Health Center in Yazd: A Short Report

    Directory of Open Access Journals (Sweden)

    Golrasteh Kholasehzadeh

    2016-10-01

    Full Text Available About 40 years ago, the mental health services providing strategies have been dramatically changed worldwide. As well as, it is considered as a new revolution in mental health and named as community-based mental health movement. Moreover, mental health centers in Iran have been established in order to make a change in urban community-based mental health (CMHC. The first CMHC was founded in Tehran 16th district in 2010. In Yazd, it was established in 2010. In this article, the steps for establishment of the first CMHC were described.

  10. Use of Stakeholder Focus Groups to Define the Mission and Scope of a new Department of Population Health.

    Science.gov (United States)

    Tierney, William M

    2018-04-09

    The focus and funding of US healthcare is evolving from volume to value-based, and healthcare leaders, managers, payers, and researchers are increasingly focusing on managing populations of patients. Simultaneously, there is increasing interest in getting "upstream" from disease management to promote health and prevent disease. Hence, the term "population health" has both clinical and community-based connotations relevant to the tripartite mission of US medical schools. To seek broad input for the strategic development of the Department of Population Health in a new medical school at a tier 1 research university. Focus groups with facilitated consensus development. Eighty-one persons representing the Dell Medical School and other schools at the University of Texas at Austin, city/county government, community nonprofit organizations, and faculty from other local university schools along with selected national academic leaders. Focus groups with subsequent consensus development of emphases identified premeeting by participants by e-mail exchanges. The resulting departmental strategic plan included scope of work, desired characteristics of leaders, and early impact activities in seven areas of interest: community engagement and health equity, primary care and value-based health, occupational and environment medicine, medical education, health services and community-based research, health informatics and data analysis, and global health. Medical schools should have a primary focus in population, most effectively at the departmental level. Engaging relevant academic and community stakeholders is an effective model for developing this emerging discipline in US medical schools.

  11. Understanding and Predicting Social Media Use Among Community Health Center Patients: A Cross-Sectional Survey

    Science.gov (United States)

    2014-01-01

    Background The use of social media by health care organizations is growing and provides Web-based tools to connect patients, caregivers, and providers. Objective The aim was to determine the use and factors predicting the use of social media for health care–related purposes among medically underserved primary care patients. Methods A cross-sectional survey was administered to 444 patients of a federally qualified community health center. Results Community health center patients preferred that their providers use email, cell phones for texting, and Facebook and cell phone apps for sharing health information. Significantly more Hispanic than white patients believed their providers should use Facebook (P=.001), YouTube (P=.01), and Twitter (P=.04) for sharing health information. Use and intentions to use social media for health-related purposes were significantly higher for those patients with higher subjective norm scores. Conclusions Understanding use and factors predicting use can increase adoption and utilization of social media for health care–related purposes among underserved patients in community health centers. PMID:25427823

  12. Medicaid Expansion And Grant Funding Increases Helped Improve Community Health Center Capacity.

    Science.gov (United States)

    Han, Xinxin; Luo, Qian; Ku, Leighton

    2017-01-01

    Through the expansion of Medicaid eligibility and increases in core federal grant funding, the Affordable Care Act (ACA) sought to increase the capacity of community health centers to provide primary care to low-income populations. We examined the effects of the ACA Medicaid expansion and changes in federal grant levels on the centers' numbers of patients, percentages of patients by type of insurance, and numbers of visits from 2012 to 2015. In the period after expansion (2014-15), health centers in expansion states had a 5 percent higher total patient volume, larger shares of Medicaid patients, smaller shares of uninsured patients, and increases in overall visits and mental health visits, compared to centers in nonexpansion states. Increases in federal grant funding levels were associated with increases in numbers of patients and of overall, medical, and preventive service visits. If federal grant levels are not sustained after 2017, there could be marked reductions in health center capacity in both expansion and nonexpansion states. Project HOPE—The People-to-People Health Foundation, Inc.

  13. Sustaining the edge: factors influencing strategy selection in academic health centers.

    Science.gov (United States)

    Walsh, Anne M; Szabat, Kathryn

    2002-01-01

    Competition within the acute care sector as well as increased penetration by managed care organizations has influenced the structure and role of academic health centers during the past decade. The market factors confronting academic health centers are not dissimilar from conditions that confront other organizations competing in mature industries characterized by declining profitability and intense rivalry for market share. When confronted with intense competition or adverse external events, organizations in other industries have responded to potential threats by forming alliances, developing joint ventures, or merging with another firm to maintain their competitive advantage. Although mergers and acquisitions dominated the strategic landscape in the healthcare industry during the past decade, recent evidence suggests that other types of strategic ventures may offer similar economic and contracting benefits to member organizations. Academic health centers have traditionally been involved in network relationships with multiple partners via their shared technology, collaborative research, and joint educational endeavors. These quasi-organizational relationships appear to have provided a framework for strategic decisions and allowed executives of academic health centers to select strategies that were competitive yet closely aligned with their organizational mission. The analysis of factors that influenced strategy selection by executives of academic health centers suggests a deliberate and methodical approach to achieving market share objectives, expanding managed care contracts, and developing physician networks.

  14. Health Disparities in Pediatric Asthma: Comprehensive Tertiary Care Center Experience.

    Science.gov (United States)

    Holmes, Laurens; Kalle, Fanta; Grinstead, Laura; Jimenez, Maritza; Murphy, Meghan; Oceanic, Pat; Fitzgerald, Diane; Dabney, Kirk

    2015-03-01

    Study conducted at Nemours /Alfred I. duPont Hospital for Children, Wilmington, DE 19803 BACKGROUND: Although the treatment and management of asthma hasimproved over time, incidence and prevalence among children continues to rise in the United States. Asthma prevalence, health services utilization, and mortality rate demonstrate remarkable disparities. The underlying causes of these disparities are not fully understood. We aimed to examine racial/ethnic variances in pediatric asthma prevalence/admission. We retrospectively reviewed data on 1070 patients and applied a cross-sectional design to assess asthma admission between 2010 and 2011. Information was available on race/ethnicity, sex, insurance status, severity of illness (SOI), and length of stay/hospitalization (LOS).Chi-square statistic was used for the association between race and other variables in an attempt to explain the racial/ethnic variance. The proportionate morbidity of asthma was highest amongCaucasians (40.92%) and African Americans (40.54%), intermediate among others (16.57%), and lowest among Asian (0.56%), American Indian/Alaska Native (0.28%), and Hawaiian Native/Pacific Islander (0.28%). Overall there were disparities by sex, with more boys (61.80%) diagnosed with asthma than girls (38.20%), χ2(7)=20.1, p=0.005. Insurance status, and SOI varied by race/ethnicity, but not LOS. Caucasian children were more likely to have private insurance, while African Americans and Hispanics were more likely to have public insurance (p<0.005). Asthma was more severe among non-Hispanic children, χ2(14)=154.6, p<0.001. While the overall readmission proportion was 2.8%, readmission significantly varied by race/ethnicity. Racial/ethnic disparities in asthma admission exist among children in the Delaware Valley. There were racial/ethnic disparities in insurance status, asthma severity, and sex differed by race/ethnicity, but not in length of hospitalization. © 2015 National Medical Association. Published by

  15. Integration of Latino/a cultural values into palliative health care: a culture centered model.

    Science.gov (United States)

    Adames, Hector Y; Chavez-Dueñas, Nayeli Y; Fuentes, Milton A; Salas, Silvia P; Perez-Chavez, Jessica G

    2014-04-01

    Culture helps us grapple with, understand, and navigate the dying process. Although often overlooked, cultural values play a critical and influential role in palliative care. The purpose of the present study was two-fold: one, to review whether Latino/a cultural values have been integrated into the palliative care literature for Latinos/as; two, identify publications that provide recommendations on how palliative care providers can integrate Latino/a cultural values into the end-of-life care. A comprehensive systematic review on the area of Latino/a cultural values in palliative care was conducted via an electronic literature search of publications between 1930-2013. Five articles were identified for reviewing, discussing, or mentioning Latino/a cultural values and palliative care. Only one article specifically addressed Latino/a cultural values in palliative care. The four remaining articles discuss or mention cultural values; however, the cultural values were not the main focus of each article's thesis. The results of the current study highlight the lack of literature specifically addressing the importance of integrating Latino/a cultural values into the delivery of palliative care. As a result, this article introduces the Culture-Centered Palliative Care Model (CCPC). The article defines five key traditional Latino/a cultural values (i.e., familismo, personalismo, respeto, confianza, and dignidad), discusses the influence of each value on palliative health care, and ends with practical recommendations for service providers. Special attention is given to the stages of acculturation and ethnic identity.

  16. Attitudes, barriers and facilitators for health promotion in the elderly in primary care. A qualitative focus group study.

    Science.gov (United States)

    Badertscher, Nina; Rossi, Pascal Olivier; Rieder, Arabelle; Herter-Clavel, Catherine; Rosemann, Thomas; Zoller, Marco

    2012-07-11

    Effective health promotion is of great importance from clinical as well as from public health perspectives and therefore should be encouraged. Especially regarding health promotion in the elderly, general practitioners (GPs) have a key role. Nevertheless, evidence suggests a lack of health promotion by GPs, especially in this age group. The aim of our study was to assess self-perceived attitudes, barriers and facilitators of GPs to provide health promotion in the elderly. We performed a qualitative focus group study with 37 general practitioners. The focus group interviews were recorded digitally, transcribed literally and analysed with ATLAS.ti, a software program for qualitative text analysis. Among the participating GPs, definitions of health promotion varied widely and the opinions regarding its effectiveness were very heterogeneous. The two most important self-perceived barriers for GPs to provide health promotion in the elderly were lack of time and insufficient reimbursement for preventive and health promotion advice. As intervention to increase health promotion in the elderly, GPs suggested, for example, integration of health promotion into under and postgraduate training. Changes at the practice level such as involving the practice nurse in health promotion and counselling were discussed very controversially. Health promotion, especially in the elderly, is crucial but in the opinion of the GPs we involved in our study, there is a gap between public health requirements and the reimbursement system. Integration of health promotion in medical education may be needed to increase knowledge as well as attitudes of GPs regarding this issue.

  17. [Study of the work and of working in Family Health Care Support Center].

    Science.gov (United States)

    Lancman, Selma; Gonçalves, Rita Maria de Abreu; Cordone, Nicole Guimarães; Barros, Juliana de Oliveira

    2013-10-01

    To understand the organization of and the working conditions in family health care support centers, as well as subjective experiences related to work in two of these centers. This was a case study carried out during 2011 and 2012 in two family health care support centers in Sao Paulo, Southeastern Brazil. Data were collected and analyzed using two theoretical-methodological references from ergonomics and work psychodynamics influenced, respectively, by ergonomic work analysis, developed based on open observations of a variety of tasks and on interviews and in practice in work psychodynamics, carried out using think tanks about the work. The work of the Family Health Care Support Centers in question is constituted on the bases of complex, diversified actions to be shared among the various professionals and teams involved. Innovative technological tools, which are not often adopted by primary health care professionals, are used and the parameters and productivity measures do not encompass the specificity and the complexity of the work performed. These situations require constant organizational rearrangement, especially between the Family Health Care Support Centers and the Family Health Care Teams, causing difficulties in carrying out the work as well as in constituting the identity of the professionals studied. The study attempts to lend greater visibility to the work processes at the Family Health Care Support Centers in order to contribute to advances in public policy on primary healthcare. It is important to stress that introducing changes at work, which affect both its organization and work conditions, is above all a commitment, which to be effective, must be permanent and must involve the different levels of hierarchy.

  18. Creating a center for global health at the University of Wisconsin-Madison.

    Science.gov (United States)

    Haq, Cynthia; Baumann, Linda; Olsen, Christopher W; Brown, Lori DiPrete; Kraus, Connie; Bousquet, Gilles; Conway, James; Easterday, B C

    2008-02-01

    Globalization, migration, and widespread health disparities call for interdisciplinary approaches to improve health care at home and abroad. Health professions students are pursuing study abroad in increasing numbers, and universities are responding with programs to address these needs. The University of Wisconsin (UW)-Madison schools of medicine and public health, nursing, pharmacy, veterinary medicine, and the division of international studies have created an interdisciplinary center for global health (CGH). The CGH provides health professions and graduate students with courses, field experiences, and a new Certificate in Global Health. Educational programs have catalyzed a network of enthusiastic UW global health scholars. Partnerships with colleagues in less economically developed countries provide the foundation for education, research, and service programs. Participants have collaborated to improve the education of health professionals and nutrition in Uganda; explore the interplay between culture, community development, and health in Ecuador; improve animal health and address domestic violence in Mexico; and examine successful public health efforts in Thailand. These programs supply students with opportunities to understand the complex determinants of health and structure of health systems, develop adaptability and cross-cultural communication skills, experience learning and working in interdisciplinary teams, and promote equity and reduce health disparities at home and abroad. Based on the principles of equity, sustainability, and reciprocity, the CGH provides a strong foundation to address global health challenges through networking and collaboration among students, staff, and faculty within the UW and beyond.

  19. Evacuation of a mental health center during a forest fire in Israel.

    Science.gov (United States)

    Kreinin, Anatoly; Shakera, Tatiana; Sheinkman, Ayala; Levi, Tamar; Tal, Vered; Polakiewicz, Jacob

    2014-08-01

    Tirat Carmel Mental Health Center was successfully evacuated in December 2010 during a ravaging forest fire in the nearby Carmel Mountains. A total of 228 patients were successfully evacuated from the center within 45 minutes. No fatalities or injuries associated with the evacuation occurred. We believe that the efficient functioning of the administrative and medical staff provides a replicable model that can contribute to the level of awareness and readiness of hospital staff members for natural and manmade disasters.

  20. Effects of a randomized intervention to improve workplace social capital in community health centers in China.

    Science.gov (United States)

    Sun, Xiaojie; Zhang, Nan; Liu, Kun; Li, Wen; Oksanen, Tuula; Shi, Lizheng

    2014-01-01

    To examine whether workplace social capital improved after implementing a workplace social capital intervention in community health centers in China. This study was conducted in 20 community health centers of similar size in Jinan of China during 2012-2013. Using the stratified site randomization, 10 centers were randomized into the intervention group; one center was excluded due to leadership change in final analyses. The baseline survey including 447 staff (response rate: 93.1%) was conducted in 2012, and followed by a six-month workplace social capital intervention, including team building courses for directors of community health centers, voluntarily public services, group psychological consultation, and outdoor training. The follow-up survey in July 2013 was responded to by 390 staff members (response rate: 86.9%). Workplace social capital was assessed with the translated and culturally adapted scale, divided into vertical and horizontal dimensions. The facility-level intervention effects were based on all baseline (n = 427) and follow-up (n = 377) respondents, except for Weibei respondents. We conducted a bivariate Difference-in-Difference analysis to estimate the facility-level intervention effects. No statistically significant intervention effects were observed at the center level; the intervention increased the facility-level workplace social capital, and its horizontal and vertical dimensions by 1.0 (p = 0.24), 0.4 (p = 0.46) and 0.8 (p = 0.16), respectively. The comprehensive intervention seemed to slightly improve workplace social capital in community health centers of urban China at the center level. High attrition rate limits any causal interpretation of the results. Further studies are warranted to test these findings.

  1. Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury, Annual Report 2009

    Science.gov (United States)

    2009-01-01

    applications for recovering from disaster and trauma Defense and Veterans Brain Injury Center Develops and delivers advanced TBI-specifi c treatment...specifically aimed at developing cognitive and motor therapy tools using videogame technology, game-based PH outreach tools and support tools for children of...Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury Annual Report 2009 Report Documentation Page Form ApprovedOMB No

  2. Evaluation of the organizational cultural competence of a community health center: a multimethod approach.

    Science.gov (United States)

    Cherner, Rebecca; Olavarria, Marcela; Young, Marta; Aubry, Tim; Marchant, Christina

    2014-09-01

    Cultural competence is an important component of client-centered care in health promotion and community health services, especially considering the changing demographics of North America. Although a number of tools for evaluating cultural competence have been developed, few studies have reported on the results of organizational cultural competence evaluations in health care or social services settings. This article aims to fill this gap by providing a description of a cultural competence evaluation of a community health center serving a diverse population. Data collection included reviewing documents, and surveying staff, management, and the Board of Directors. The organization fully met 28 of 53 standards of cultural competence, partially met 21 standards, and did not meet 2 standards, and 2 standards could not be assessed due to missing information. The advantages and lessons learned from this organizational cultural competence evaluation are discussed. © 2014 Society for Public Health Education.

  3. Zebrafish Health Conditions in the China Zebrafish Resource Center and 20 Major Chinese Zebrafish Laboratories.

    Science.gov (United States)

    Liu, Liyue; Pan, Luyuan; Li, Kuoyu; Zhang, Yun; Zhu, Zuoyan; Sun, Yonghua

    2016-07-01

    In China, the use of zebrafish as an experimental animal in the past 15 years has widely expanded. The China Zebrafish Resource Center (CZRC), which was established in 2012, is becoming one of the major resource centers in the global zebrafish community. Large-scale use and regular exchange of zebrafish resources have put forward higher requirements on zebrafish health issues in China. This article reports the current aquatic infrastructure design, animal husbandry, and health-monitoring programs in the CZRC. Meanwhile, through a survey of 20 Chinese zebrafish laboratories, we also describe the current health status of major zebrafish facilities in China. We conclude that it is of great importance to establish a widely accepted health standard and health-monitoring strategy in the Chinese zebrafish research community.

  4. Implementing the obesity care model at a community health center in Hawaii to address childhood obesity.

    Science.gov (United States)

    Okihiro, May; Pillen, Michelle; Ancog, Cristeta; Inda, Christy; Sehgal, Vija

    2013-01-01

    Obesity, the most common chronic disease of childhood, is prevalent among economically disadvantaged children. The Chronic Care and Obesity Care Models are comprehensive health care strategies to improve outcomes by linking primary care best practices and community-based programs. Pediatric providers and community health centers are well positioned to design and implement coordinated and synergistic programs to address childhood health disparities. This article describes a comprehensive project based on the Obesity Care Model initiated at a rural community health center in Hawaii to address childhood obesity including: (1) the health care delivery changes constituting the quality improvement project; (2) capacity and team-building activities; (3) use of the project community level data to strengthen community engagement and investment; and (4) the academic-community partnership providing the project framework. We anticipate that these efforts will contribute to the long-term goal of reducing the prevalence of obesity and obesity associated morbidity in the community.

  5. Spaceflight Radiation Health program at the Lyndon B. Johnson Space Center

    Energy Technology Data Exchange (ETDEWEB)

    Johnson, A.S.; Badhwar, G.D.; Golightly, M.J.; Hardy, A.C.; Konradi, A.; Yang, T.C.

    1993-12-01

    The Johnson Space Center leads the research and development activities that address the health effects of space radiation exposure to astronaut crews. Increased knowledge of the composition of the environment and of the biological effects of space radiation is required to assess health risks to astronaut crews. The activities at the Johnson Space Center range from quantification of astronaut exposures to fundamental research into the biological effects resulting from exposure to high energy particle radiation. The Spaceflight Radiation Health Program seeks to balance the requirements for operational flexibility with the requirement to minimize crew radiation exposures. The components of the space radiation environment are characterized. Current and future radiation monitoring instrumentation is described. Radiation health risk activities are described for current Shuttle operations and for research development program activities to shape future analysis of health risk.

  6. Spaceflight Radiation Health program at the Lyndon B. Johnson Space Center

    International Nuclear Information System (INIS)

    Johnson, A.S.; Badhwar, G.D.; Golightly, M.J.; Hardy, A.C.; Konradi, A.; Yang, T.C.

    1993-12-01

    The Johnson Space Center leads the research and development activities that address the health effects of space radiation exposure to astronaut crews. Increased knowledge of the composition of the environment and of the biological effects of space radiation is required to assess health risks to astronaut crews. The activities at the Johnson Space Center range from quantification of astronaut exposures to fundamental research into the biological effects resulting from exposure to high energy particle radiation. The Spaceflight Radiation Health Program seeks to balance the requirements for operational flexibility with the requirement to minimize crew radiation exposures. The components of the space radiation environment are characterized. Current and future radiation monitoring instrumentation is described. Radiation health risk activities are described for current Shuttle operations and for research development program activities to shape future analysis of health risk

  7. 75 FR 78997 - Centers for Disease Control and Prevention/Health Resources and Services Administration (CDC/HRSA...

    Science.gov (United States)

    2010-12-17

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention Centers for Disease Control and Prevention/Health Resources and Services Administration (CDC/HRSA) Advisory Committee... and other committee management activities, for both the Centers for Disease Control and Prevention and...

  8. Trauma-Focused Smoking Cessation for Smokers Exposed to the World Trade Center Disaster: A Randomized Clinical Trial.

    Science.gov (United States)

    Gonzalez, Adam; Friedberg, Fred; Li, Xiaotong; Zvolensky, Michael J; Bromet, Evelyn J; Mahaffey, Brittain L; Vujanovic, Anka A; Luft, Benjamin J; Kotov, Roman

    2017-08-01

    The main objective was to evaluate the efficacy of an 8-session, group-based comprehensive smoking cessation and trauma management (CSC-T) treatment among daily smokers (≥5 cigarettes/day) exposed to the World Trade Center (WTC) disaster with elevated WTC-related post-traumatic stress disorder (PTSD) symptoms. Participants (N = 90) were randomly assigned to CSC-T (N = 44; 63.6% white; 27.3% female; mean age = 51.32 ± 7.87) or comprehensive smoking cessation (CSC) alone (N = 46; 71.7% white; 28.3% female; mean age = 48.74 ± 10.66), which was comparable in length and time. Assessments included a diagnostic clinical interview and self-report measures of PTSD and respiratory symptoms, and smoking behavior, and biologically confirmed smoking abstinence. Evaluations occurred at a baseline visit, each treatment session, and at 1-, 2-, 4-, 12-, and 26-weeks post-treatment. The two treatments did not differ in regard to PTSD symptom improvement. After quit day (week 6), the two groups had similar 7-day (~15%) and 6-month (~20%) abstinence rates as well as average number of cigarettes smoked, and PTSD and respiratory symptoms. It is possible that the Cognitive Behavioral Therapy skills specific to quitting smoking, group-based support, and degree of therapist contact, that were available in both treatments may have played a role in equalizing the abstinence rates between the two conditions. Although the current study found no evidence that the CSC-T was superior to the CSC alone treatment, the abstinence rates observed were high relative to previous trials of smokers with diagnosed PTSD. Further development of smoking cessation programs tailored to the needs of smokers with PTSD symptoms continues to be needed. This study suggests that a CSC program aids in smoking abstinence for smokers with PTSD symptoms and that incorporating trauma management skills, may not add additional benefits for abstinence and PTSD and respiratory symptom relief. Further work is needed to

  9. Evaluation of Environmental Health Indicators of Halva and Tahini Production Centers in Ardakan, Yazd

    Directory of Open Access Journals (Sweden)

    Mohammad Taghi Ghaneian

    2014-03-01

    Results: Generally, 75% production centers had favorable hygienic status and 25% had slightly favorable hygienic status. According to obtained results, hygienic status of production centers had relatively favorable and favorable conditions and only in January and February in 31.3% and 18.8% processing hall and 12.5% product store was in a very favorable hygienic status. The results showed that in terms of environmental health status, 62.5% production centers in raw materials store part, 66.66% in production processing hall, 20.83% in packaging hall, 60.41% in product store and 37.5% in bathrooms had favorable status. Based on the results, hygienic status of bathrooms and processing hall achieved lowest and highest score, respectively. Statistical analysis showed that between hygienic status and production rate (p=0.411 there is no significant relationship. Conclusion: The results of this study indicate that the halva and tahini production centers of Ardakan city in terms of environmental health indicators had slightly favorable status to favorable and none of the production centers had not very favorable conditions. The results of this study can be used to improve health status of halva and tahini production centers.

  10. Nursing schools and academic health centers: toward improved alignment and a synergistic partnership

    Directory of Open Access Journals (Sweden)

    Emami A

    2017-08-01

    Full Text Available Azita Emami,1 Darcy Jaffe,2 Paula Minton-Foltz,3 Grace Parker,4 Susan Manfredi,5 Theresa Braungardt,6 Kelly W Marley,1 Laura Cooley,1 Staishy Bostick Siem7 1University of Washington School of Nursing, Seattle, WA, USA; 2Harborview Medical Center, University of Washington Medicine, Seattle, WA, USA; 3Patient Care Services, Harborview Medical Center, University of Washington Medicine, Seattle, WA, USA; 4University of Washington Medical Center, Seattle, WA, USA; 5Patient Care Services, Northwest Hospital and Medical Center, Seattle, WA, USA; 6Valley Medical Center, Seattle, WA, USA; 7Marketing and Communications, University of Washington School of Nursing, Seattle, WA, USA Abstract: This paper presents the findings from a national survey which the University of Washington conducted among leaders of 32 US academic nursing institutions that are part of academic health centers (AHCs and complements these findings with results from a separate report by the American Association of Colleges of Nursing. While expressing overall satisfaction with their AHC relationships, these leaders find that nursing is often given greater parity in matters of education and research than in mission setting, financial, and governance matters. AHCs are being asked to meet new health care challenges in new ways, starting with the education of health care professionals. AHCs need to be restructured to give nursing full parity if the nation’s and world’s needs for preventive and clinical care are to be best met.Keywords: nursing parity, academic nursing institutions, nurse leaders, institutional alignment

  11. Compliance of child care centers in Pennsylvania with national health and safety performance standards for emergency and disaster preparedness.

    Science.gov (United States)

    Olympia, Robert P; Brady, Jodi; Kapoor, Shawn; Mahmood, Qasim; Way, Emily; Avner, Jeffrey R

    2010-04-01

    To determine the preparedness of child care centers in Pennsylvania to respond to emergencies and disasters based on compliance with National Health and Safety Performance Standards for Out-of-Home Child Care Programs. A questionnaire focusing on the presence of a written evacuation plan, the presence of a written plan for urgent medical care, the immediate availability of equipment and supplies, and the training of staff in first aid/cardiopulmonary resuscitation (CPR) as delineated in Caring for Our Children: National Health and Safety Performance Standards for Out-of-Home Child Care Programs, 2nd Edition, was mailed to 1000 randomly selected child care center administrators located in Pennsylvania. Of the 1000 questionnaires sent, 496 questionnaires were available for analysis (54% usable response rate). Approximately 99% (95% confidence interval [CI], 99%-100%) of child care centers surveyed were compliant with recommendations to have a comprehensive written emergency plan (WEP) for urgent medical care and evacuation, and 85% (95% CI, 82%-88%) practice their WEP periodically throughout the year. More than 20% of centers did not have specific written procedures for floods, earthquakes, hurricanes, blizzards, or bomb threats, and approximately half of the centers did not have specific written procedures for urgent medical emergencies such as severe bleeding, unresponsiveness, poisoning, shock/heart or circulation failure, seizures, head injuries, anaphylaxis or allergic reactions, or severe dehydration. A minority of centers reported having medications available to treat an acute asthma attack or anaphylaxis. Also, 77% (95% CI, 73%-80%) of child care centers require first aid training for each one of its staff members, and 33% (95% CI, 29%-37%) require CPR training. Although many of the child care centers we surveyed are in compliance with the recommendations for emergency and disaster preparedness, specific areas for improvement include increasing the frequency

  12. Evaluation of input and process components of quality of child health services provided at 24 × 7 primary health centers of a district in Central Gujarat

    Directory of Open Access Journals (Sweden)

    Paragkumar Chavda

    2015-01-01

    Full Text Available Context: With the critical Indian challenge on child survival and health, time is ripe to initiate focus on quality of services apart from measuring coverage, to bring about improvements. Aims: To assess the quality of child health services provided at 24 × 7 Primary Health Centers of Vadodara District in Gujarat in terms of Input and Process Indicators. Settings and Design: The study was carried out in 12 randomly chosen 24 × 7 Primary Health Centers (PHCs of Vadodara district using a modified quality assessment checklist of the Program on District Quality Assurance for Reproductive and Child Health (RCH services with use of scores from May 2010 to June 2011. Subjects and Methods: Inputs assessment was done by facility survey. Process assessment for the four child health service components used actual observation of service, review of records and interview of service providers and clients. Results: The mean obtained score for facilities in Input section was 65%. Highest score was obtained for Drugs and Consumables (86% followed by Equipments and Supplies (74%. The score obtained for Infrastructure facility was 65%, Personnel and training was 56% and Essential protocols and guidelines scored 43%. The mean obtained score in the process section was 55%. Highest scores were obtained for immunization at 76%. This was followed by newborn care (52%, growth monitoring (52%. management of sick child (41%. Conclusion: Quality improvement efforts should focus not only on resource-intensive structural improvements, but also on cost-effective measures at improving service delivery process, especially adherence to service guidelines by providers.

  13. Service line structure and decision-maker attention in three health systems: Implications for patient-centered care.

    Science.gov (United States)

    Louis, Christopher J; Clark, Jonathan R; Gray, Barbara; Brannon, Diane; Parker, Victoria

    2017-06-15

    Scholars have noted a disconnect between the level at which structure is typically examined (the organization) and the level at which the relevant coordination takes place (service delivery). Accordingly, our understanding of the role structure plays in care coordination is limited. In this article, we explore service line structure, with an aim of advancing our understanding of the role service line structure plays in producing coordinated, patient-centered care. We do so by giving special attention to the cognitive roots of patient-centeredness. Our exploratory study relied on comparative case studies of the breast cancer service lines in three health systems. Nonprobability discriminative snowball sampling was used to identify the final sample of key informants. We employed a grounded approach to analyzing and interpreting the data. We found substantial variation across the three service lines in terms of their structure. We also found corresponding variation across the three case sites in terms of where informant attention was primarily focused in the process of coordinating care. Drawing on the attention-based view of the firm, our results draw a clear connection between structural characteristics and the dominant focus of attention (operational tactics, provider roles and relationships, or patient needs and engagement) in health care service lines. Our exploratory results suggest that service line structures influence attention in two ways: (a) by regulating the type and intensity of the problems facing service line participants and (b) by encouraging (or discouraging) a shared purpose around patient needs. Patient-centered attention-a precursor to coordinated, patient-centered care-depends on the internal choices organizations make around service line structure. Moreover, a key task for organizational and service line leaders is to structure service lines to create a context that minimizes distractions and enables care providers to focus their attention on

  14. Preliminary safety and efficacy results with robotic high-intensity focused ultrasound : A single center Indian experience

    Directory of Open Access Journals (Sweden)

    Shashikant Mishra

    2011-01-01

    Full Text Available Background : There are no Indian data of high-intensity focused ultrasound (HIFU. Being an alternative, still experimental modality, reporting short-term safety outcome is paramount. Aims : This study was aimed at to assess the safety and short-term outcome in patients with prostate cancer treated by HIFU. Settings and Design : A retrospective study of case records of 30 patients undergoing HIFU between January 2008 to September 2010 was designed and conducted. Materials and Methods : The procedural safety was analyzed at 3 months. Follow-up consisted of 3 monthly prostate-specific antigen (PSA levels and transrectal biopsy if indicated. All the patients had a minimum follow-up of 6 months. Results : A mean prostate volume of 26.9 ± 8.5 cm 3 was treated in a mean time of 115 ± 37.4 min. There was no intraoperative complication. The postoperative pain visual analogue score at day 0 was 2.1 ± 1.9 and at day 1 was 0.4 ± 0.8 on a scale of 1-10. Mean duration of perurethral catheter removal was 3.9 days. The complications after treatment were: LUTS in seven patients, stress incontinence in two, stricture in two, and symptomatic urinary tract infection in five. Average follow-up duration was 10.4 months (range, 6-20 months. Mean time to obtain PSA nadir was 6 ± 3 months with a median PSA nadir value of 0.3 ng/ml. Two patients had positive prostatic biopsy in the localized (high risk group. Conclusions : HIFU was safe in carcinoma prostate patients. The short-term results were efficacious in localized disease. The low complication rates and favorable functional outcome support the planning of further larger studies.

  15. Tetanus Seroprevalence among Pregnant Women in Ben-U Sen Health Center in Diyarbakir

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    Ali Ceylan

    2011-08-01

    Full Text Available Aim: At the aim of this study was to determine the tetanus seroprevalence among pregnant women and childbearing aged woman living in the Ben-u Sen Health Center region that is in lower socio-economical level. Materials and methods: In this descriptive study, a team including the staff of health center and several volunteers visited the houses of pregnant women living in the health center coverage region and questionnaires were completed through face to face interviews. The study group included 214 pregnant women. Among them, serum samples of 197 subjects’ were studied for anti-toxic antibody for tetanus. For control, serum samples from 200 women living in the same health center region were collected. It was evaluated as partially protective, protective and longterm protection when tetanus antibody level was 0,01-<0,1 IU/ml, 0,1-<1.0 IU/ml and 1,0 IU/ml and over, respectively. Results: The mean age of the women was 26,4, mean marriage and first pregnancy ages were 17,9 and 18,9, respectively, and 40% of the subjects had never been examined or received follow up by a health center. It was revealed that 25.8% of the subjects were not protected and 74.2% had a full protection level of antibody. Within the control group, the same levels of antibodies were detected in 40.0% and 60.0% of the women, respectively. Conclusion: The study indicates that the immunity levels against tetanus are not satisfactory and every childbearing aged woman should be included in a vaccination program whenever they receive any examination in a health center. [TAF Prev Med Bull 2011; 10(4.000: 481-486

  16. Outpatient prescription practices in rural township health centers in Sichuan Province, China

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    Jiang Qian

    2012-09-01

    Full Text Available Abstract Background Sichuan Province is an agricultural and economically developing province in western China. To understand practices of prescribing medications for outpatients in rural township health centers is important for the development of the rural medical and health services in this province and western China. Methods This is an observational study based on data from the 4th National Health Services Survey of China. A total of 3,059 prescriptions from 30 township health centers in Sichuan Province were collected and analyzed. Seven indicators were employed in the analyses to characterize the prescription practices. They are disease distribution, average cost per encounter, number of medications per encounter, percentage of encounters with antibiotics, percentage of encounters with glucocorticoids, percentage of encounters with combined glucocorticoids and antibiotics, and percentage of encounters with injections. Results The average medication cost per encounter was 16.30 Yuan ($2.59. About 60% of the prescriptions contained Chinese patent medicine (CPM, and almost all prescriptions (98.07% contained western medicine. 85.18% of the prescriptions contained antibiotics, of which, 24.98% contained two or more types of antibiotics; the percentage of prescriptions with glucocorticoids was 19.99%; the percentage of prescriptions with both glucocorticoids and antibiotics was 16.67%; 51.40% of the prescriptions included injections, of which, 39.90% included two or more injections. Conclusions The findings from this study demonstrated irrational medication uses of antibiotics, glucocorticoids and injections prescribed for outpatients in the rural township health centers in Sichuan Province. The reasons for irrational medication uses are not only solely due to the pursuit of maximizing benefits in the township health centers, but also more likely attributable to the lack of medical knowledge of rational medication uses among rural doctors and the

  17. Digital health and the need to develop centers of expertise in sub-Saharan Africa : two examples in Mali and Cameroon.

    Science.gov (United States)

    Bagayoko, C-O; Bediang, G; Anne, A; Niang, M; Traoré, A-K; Geissbuhler, A

    2017-11-01

    It is generally agreed today that digital technology provides a lever for improving access to health care, care processes, and public health planning and activities such as education and prevention. Its use in countries that have reached a given level of development has taken place in a somewhat fragmented manner that raises important interoperability problems and sometimes makes synergy impossible between the different projects of digital health. This may be linked to several factors, principally the lack of a global vision of digital health, and inadequate methodological knowledge that prevents the development and implementation of this vision. The countries of Africa should be able to profit from these errors from the beginnings of digital health, by moving toward systemic approaches, known standards, and tools appropriate to the realities on the ground. The aim of this work is to present the methodological approaches as well as the principal results of two relatively new centers of expertise in Mali and Cameroon intended to cultivate this vision of digital governance in the domain of health and to train professionals to implement the projects. Both centers were created due to initiatives of organizations of civil society. The center in Mali developed toward an economic interest group and then to collaboration with healthcare and university organizations. The same process is underway at the Cameroon center. The principal results from these centers can be enumerated under different aspects linked to research, development, training, and implementation of digital health tools. They have produced dozens of scientific publications, doctoral dissertations, theses, and papers focused especially on subjects such as the medicoeconomic evaluation tools of e-health and health information technology systems. In light of these results, we can conclude that these two centers of expertise have well and truly been established. Their role may be decisive in the local training of

  18. [Health Centers: science and ideology in the re-organization of public health in the twentieth century].

    Science.gov (United States)

    Mello, Guilherme Arantes; Viana, Ana Luiza d'Ávila

    2011-12-01

    Health Centers appeared in the United States around 1910. They provided social assistance in conjunction with some type of medical care. Their original separation between preventive and curative medicine was superseded by the concept of whole health in the 1940s, when Health Center discourse became part of medical education. In the 1960s, the notion of community medicine arose out of the war on poverty. These ideas spread through Brazil in the 1920s and were strengthened under the Vargas policy of national construction, but it was the Serviço Especial de Saúde Pública (Special Public Health Service) that was primarily responsible for lending them their practical and conceptual shape in this country.

  19. Focus on sex differences in grant applications submitted to the Netherlands Organization for Health Research and Development

    NARCIS (Netherlands)

    Keuken, Debby G.; Haafkens, Joke A.; Klazinga, Niek S.

    2007-01-01

    ABSTRACT: BACKGROUND: Several measures have been implemented at international level to ensure that there is a greater focus on sex differences in health research. This study evaluates the effect of various formal incentives that were introduced by a Dutch financer of health research to encourage

  20. [Evaluation of special GP-centered health care contracts in Germany by the participating GPs. present situation and future perspectives].

    Science.gov (United States)

    Klingenberg, Anja; Broge, Björn; Herholz, Harald; Szecsenyi, Joachim; Ose, Dominik

    2010-02-01

    In 2004, German statutory health care funds were given the possibility to offer their insured a special general practitioner-( GP-)centered health care contract (HZV), since 2007 they are obliged to do so. The aim of these contracts is to strengthen the role of the GP as a coordinator in the health care system. Until now, the evidence regarding the GPs' view on these contracts is poor. A written survey was conducted in Hesse in order to learn how the participating GPs evaluate the regional HZV. In Apri 2008, a questionnaire was developed, tested and mailed to 2,815 GPs who were participating in the GP-centered health care contract at that time. All analyses where conducted with SPSS (version 15.0). A total of 686 questionnaires were returned (response rate 24.4%). Altogether, the GPs' feedback ranged from great approval to clear disapproval of the contract. However, 70.0% of the survey's participants evaluated the HZV in general to be positive, 60.1% felt it strengthens their role as a GP. Quality circles on good prescribing and GP-specific education, obligatory parts of the HZV, were evaluated to be especially positive (70.3% and 69.4%, respectively). Positive effects were also seen concerning coordination of care (53.3%) and cooperation with patients (36.3%). Improvements concerning cooperation with specialists and hospitals were reported less often (24.9% and 13.0%, respectively). Workload because of additional administration for the HZV was criticized. In future, special GP-centered health care contracts should focus on improvement of cooperation between GPs and other caregivers. Workload for additional administration should be reduced.

  1. Barriers and facilitators to implementing an evidence-based woman-focused intervention in South African health services

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    Brittni N. Howard

    2017-11-01

    Full Text Available Abstract Background Since the beginning of the HIV epidemic, numerous behavior change, risk-reduction, and biomedical interventions have been developed and tested. While some of these interventions have shown to be efficacious in randomized trials, it often takes almost two decades for an intervention to be translated into practice. Meanwhile, South Africa continues to have among the highest prevalence of HIV globally, with women of childbearing age bearing the burden of the epidemic. Given the urgency of the HIV epidemic among vulnerable women in South Africa, it is imperative that evidence-based interventions be implemented rapidly into practice. This study presents a first step toward examining the acceptability and feasibility of implementing the Women’s Health CoOp (WHC in clinics and substance abuse rehab settings in Cape Town, South Africa. Methods We conducted focus group discussions with women who use substances and with service providers, we also conducted in-depth interviews with health service planners. Our goal was to examine implementation and clinical outcomes associated with delivery of the WHC across clinics and substance abuse rehab programs. Results All participants agreed on the need for the WHC. Perceived facilitators to implementing the WHC included the recognizable need for programs to empower women and to build the capacity of staff to address issues of substance use, sexual risk, and intimate partner violence. Participants also identified potential barriers to women engaging with this program, including the stigma women experience when seeking services and the lack of person-centered care at healthcare facilities. Conclusions In a country with the largest number of women of childbearing age living with HIV, an evidence-based woman-focused intervention that comprehensively addresses women’s risk for suboptimal antiretroviral adherence may be essential for reducing HIV incidence. However, potential barriers to

  2. Assessment of maternal and child health (MCH practices with a focus on Janani Suraksh Yojana (JSY

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    Sandeep Sachdeva

    2013-01-01

    Full Text Available Background Janani Suraksha Yojana (JSY is a safe motherhood intervention encompassing conditional cash transfer scheme initiated under National Rural Health Mission (NRHM.Objective A rapid appraisal was conducted to assess selected maternal and child health (MCH practices among rural mothers in a block of Haryana with a focus on JSY. Methodology Using stratified random sampling, 6 health subcentre area in a rural block of Haryana were selected and all available JSY (n=72 mothers with their child in age-group of 6-11 months were covered. Similar numbers of non-JSY (n=76 mother were also contacted by the investigators using pre-designed, pre-tested semi-structure interview schedule. Results Out of 148 mothers, majority (77.02% were in the age-group of 20-24 years; overall 52.02% [45.83% (JSY vs. 57.89% (non-JSY] had completed atleast 9 years of schooling; all (100% JSY beneficiaries belonged to affirmative group (OBC/SC but only 38.89% of them possessed BPL-card; a total of 68 (45.94%, 62 (41.89% and 18 (12.16% mothers had one, two & three living children respectively and 93% women were home-maker. Higher proportion of non-JSY (72.36% viz. JSY (54.16% mothers had institutional delivery (p<0.05. Pre-lacteal feed was administered to 60% of newborn while 95% received colostrum; however only 32.43% were initiated on breast-milk within first hour of birth inspite of all being normal vaginal deliveries. Nearly 91.66% of JSY and 22.36% of non-JSY mothers were aware of the financial scheme (p<0.05; only 20.83% JSY mothers received money within one-month of delivery; 47.22% of mothers spent money either on themselves or child care while amongst rest it got utilized within general family pool.

  3. Developing Collaborative Maternal and Child Health Leaders: A Descriptive Study of the National Maternal and Child Health Workforce Development Center.

    Science.gov (United States)

    Clarke, Alina Nadira; Cilenti, Dorothy

    2018-01-01

    Purpose An assessment of the National Maternal and Child Health Workforce Development Center (the Center) was conducted to describe (1) effects of the Center's training on the use of collaborative leadership practices by MCH leaders, and (2) perceived barriers to collaboration for MCH leaders. The Center provides services to strengthen MCH professionals' skills in three core areas: Change Management/Adaptive Leadership, Evidence-Based Decision Making, and Systems Integration. Description This descriptive qualitative study compares eight interview responses from a sample of the Center's participants and findings from a document review of the training curriculum against an existing framework of collaborative leadership themes. Assessment Systems thinking tools and related training were highly referenced, and the interviewees often related process-based leadership practices with their applied learning health transformation projects. Perceived barriers to sustaining collaborative work included: (1) a tendency for state agencies to have siloed priorities, (2) difficulty achieving a consensus to move a project forward without individual partners disengaging, (3) strained organizational partnerships when the individual representative leaves that partnering organization, and (4) difficulty in sustaining project-based partnerships past the short term. Conclusion The findings in this study suggest that investments in leadership development training for MCH professionals, such as the Center, can provide opportunities for participants to utilize collaborative leadership practices.

  4. Focus Groups Investigating Mental Health Attitudes and Beliefs of Parents and Teachers in South Lebanon: Are They Culturally Determined?

    Science.gov (United States)

    Doumit, Myrna A A; Farhood, Laila F; Hamady, Carmen

    2018-05-01

    The wars that Lebanon had endured led to a devastating number of deaths, injuries, and displacements. Such tragedies have detrimentally affected its civilians psychologically. To identify knowledge, attitudes, and practices of teachers and parents concerning child/adolescent mental health. Using purposeful sampling, five focus groups were conducted with teachers and parents of students from elementary, middle, and secondary levels in two private hub schools in South Lebanon. A total of 27 teachers and 18 parents participated separately in focus groups. Three themes emerged: (a) Mental health care is a priority for overall health, (b) Mental illness is a cultural taboo, and (c) There is a need for better education and cultural understanding about mental health. This is the first study in Lebanon directly targeted at parents' and teachers' mental health concerns. Such findings will add to transcultural nursing knowledge about the importance of mental health care.

  5. Focus on CSIR research in water resources: CSIR’S environmental human health risk assessment

    CSIR Research Space (South Africa)

    Genthe, Bettina

    2007-08-01

    Full Text Available Environmental health risk assessment deals with risks associated with manmade and natural environmental hazards. Environmental health risk assessment provides a means of estimating the probability of adverse health effects associated with hazards...

  6. Assessment of the Relationship between Spiritual and Social Health and the Self-Care Ability of Elderly People Referred to Community Health Centers.

    Science.gov (United States)

    Mohammadi, Mahboobeh; Alavi, Mousa; Bahrami, Masoud; Zandieh, Zahra

    2017-01-01

    Promotion of self-care ability among older people is an essential means to help maintain and improve their health. However, the role of spiritual and social health has not yet been considered in detail in the context of self-care ability among elderly. The aim of this study was to assess the relationship between spiritual and social health and self-care ability of older people referred to community health centers in Isfahan. In this cross-sectional correlation study, 200 people, aged 60 years and older, referred to healthcare centers in 2016 were recruited through convenience sampling method. Data were collected by four-part tool comprising of: (a) demographics, (b) Ellison and Palotzin's spiritual well-being scale, (c) Kees's "social health" scale, and (d) self-care ability scale for the elderly by Soderhamn's; data were analyzed by descriptive and inferential (independent t -test, analysis of variance - ANOVA, Pearson's coefficient tests, and multiple regression analysis) statistics by SPSS16 software. Findings showed that the entered predictor variables were accounted for 41% of total variance ( R 2 ) of the two self-care ability in the model ( p well-being and social health, significantly predicted the self-care ability of older people. The results of this study emphasized on the relationship between spiritual and social health of the elderly people and their ability to self-care. Therefore, it would be recommended to keep the focus of the service resources towards improving social and spiritual health to improve self-care ability in elderly people.

  7. [The Psychosocial Adaptation Process of Psychiatric Nurses Working in Community Mental Health Centers].

    Science.gov (United States)

    Min, So Young

    2015-12-01

    The aim of this study was to verify psychosocial issues faced by psychiatric and community mental health nurse practitioners (PCMHNP) working in community mental health centers, and to identify the adaptation processes used to resolve the issues. Data were collected through in-depth interviews between December 2013 and August 2014. Participants were 11 PCMHNP working in community mental health centers. Analysis was done using the grounded theory methodology. The first question was "How did you start working at a community mental health center; what were the difficulties you faced during your employment and how did you resolve them?" The core category was 'regulating within relationships.' The adaptation process was categorized into three sequential stages: 'nesting,' 'hanging around the nest,' and 'settling into the nest.' Various action/interaction strategies were employed in these stages. The adaptation results from using these strategies were 'psychiatric nursing within life' and 'a long way to go.' The results of this study are significant as they aid in understanding the psychosocial adaptation processes of PCMHNP working in community mental health centers, and indicate areas to be addressed in the future in order for PCMHNP to fulfill their professional role in the local community.

  8. Insuring the uninsured: potential impact of Health Care Reform Act of 2010 on trauma centers.

    Science.gov (United States)

    Shafi, Shahid; Ogola, Gerald; Fleming, Neil; Rayan, Nadine; Kudyakov, Rustam; Barnes, Sunni A; Ballard, David J

    2012-11-01

    Viability of trauma centers is threatened by cost of care provided to patients without health insurance. The health care reform of 2010 is likely to benefit trauma centers by mandating universal health insurance by 2014. However, the financial benefit of this mandate will depend on the reimbursement provided. The study hypothesis was that compensation for the care of uninsured trauma patients at Medicare or Medicaid rates will lead to continuing losses for trauma centers. Financial data for first hospitalization were obtained from an urban Level I trauma center for 3 years (n = 6,630; 2006-2008) and linked with clinical information. Patients were grouped into five payments categories: commercial (29%), Medicaid (8%), Medicare (20%), workers' compensation (6%), and uninsured (37%). Prediction models for costs and payments were developed for each category using multiple regression models, adjusting for patient demographics, injury characteristics, complications, and survival. These models were used to predict payments that could be expected if uninsured patients were covered by different insurance types. Results are reported as net margin per patient (payments minus total costs) for each insurance type, with 95% confidence intervals, discounted to 2008 dollar values. Patients were typical for an urban trauma center (median age of 43 years, 66% men, 82% blunt, 5% mortality, and median length of stay 4 days). Overall, the trauma center lost $5,655 per patient, totaling $37.5 million over 3 years. These losses were encountered for patients without insurance ($14,343), Medicare ($4,838), and Medicaid ($15,740). Patients with commercial insurance were profitable ($5,295) as were those with workers' compensation ($6,860). Payments for the care of the uninsured at Medicare/Medicaid levels would lead to continued losses at $2,267 to $4,143 per patient. The health care reforms of 2010 would lead to continued losses for trauma centers if uninsured are covered with Medicare

  9. Analysis of the main activities of the city center of Alexander's psychosomatic hospital of St. Petersburg, focused on the choice of priorities in perfection of treatment and prophylaxis

    Directory of Open Access Journals (Sweden)

    N. P. Vanchakova

    2014-01-01

    Full Text Available The authors have analyzed the results of the City Psychosomatic Centre (CPSC activity in 2009-2011 ys in order to find out the most important trends in the clinical work that may be helpful in planning of management and prophylaxis. The methods applied were statistical and clinico-statistical analyses of the results of of the Center work in 2009-2011 ys. There were changes in the structure by increasing the incidence of diseases associated with stress and organic damage brain with mental disorders, showed an increase in the flow of male patients. Found that the average length of stay in bed in the center of psychosomatic inpatient unit was 9.2-9.7 days, which creates barriers to good practice the use of antidepressants. Overcoming of these challenges can be achieved through the formation of new forms of continuity between the departments of the psychosomatic center, the health center and the offices of St. Petersburg SHCI «Alexander's Hospital,» and other medical institutions of the city.

  10. [Qualitative evaluation of TAMARPP, the relapse prevention program for substance abusers at the Mental Health and Welfare Center].

    Science.gov (United States)

    Taniai, Tomoko; Yottsuji, Naomi; Okuda, Hidemi; Karibe, Haruo; Miura, Kasumi; Hiraga, Masasi; Kondo, Ayumi; Matsumoto, Toshihiko

    2014-12-01

    The development of an effective treatment system for patients with addiction-related problems like substance abuse or pathological gambling is urgently needed. The purpose of this study was to clarify the therapeutic factors of the Tama Mental Health and Welfare Center Relapse Prevention Program (TAMARPP). The program is provided at the Tama Comprehensive Center for Mental Health and Welfare, which is operated publicly by the Tokyo Metropolitan Government. Seven personnel (3 clinical psychologists, 2 public health nurses, and 2 recovering counselors) searched the consultation records of 31 participants who had continued treatment longer than 1 year, and made a list of qualitative factors that may positively impact participant outcome. The following six factors were extracted: 1) a "no-blame" atmosphere that makes participants feel safe and free; 2) a mutual helping process that enables participants to empathize with one another; 3) an individual-centered approach that focuses on a participant's motivation to recover; 4) a psycho-educational process that establishes treatment goals; 5) a treatment goal that involves some type of social role; and 6) the referral of graduates to another long-term treatment program such as Narcotics Anonymous. Our results suggest the need of personnel to provide treatment as follows: 1) keep the circumstances safe; 2) use a method that matches the participant's motivation; 3) refer graduates to another in-depth treatment program; 4) emphasize the relationship between thinking, emotion, and behavior; and 5) improve the quality of life of the participant. The missions of our center, an official institution that runs such a program, are as follows: 1) to be the first place at which addicts seek aid during the early stage; 2) to cooperate with other facilities in order to provide social resources that support recovery; and 3) to support patients suffering from both addiction and comorbid psychiatric diseases.

  11. Hypertension care at primary health care centers: a report from Abha, Saudi Arabia.

    Science.gov (United States)

    Al-Homrany, Mohammed A; Khan, Mohd Yunus; Al-Khaldi, Yahia Mater; Al-Gelban, Khalid S; Al-Amri, Hasan Saed

    2008-11-01

    It is well known that effective management of hypertension reduces the incidence of myo-cardial infarction, stroke and vascular complications. The Ministry of Health, Kingdom of Saudi Arabia, introduced the Quality Assurance Guidelines with the hope to improve the management of hypertension in its centers. We conducted an audit of two Primary Health Care Centers namely, Al-Manhal (MPHCC) and Al-Numais (NPHCC), to evaluate how well hypertension was managened at these centers. A check list was derived from the Quality Assurance Manual to audit the process and to assess the health outcome. A retrospective study on a chosen sample of 120 files of hypertensive patients, out of 256 from both the Primary Health Care Centers was performed, during the last three months of the year 2000. Results showed that 61% of the patients were between 45-64 years of age, 56% were females, 85% were married, 54% were illiterate and 7.5% were smokers. A total of 92% of the patients had primary hypertension and 25% had a positive family history of hypertension. Beta-blockers were the most commonly used drugs in both the centers. Although the recording of the information was not perfect, there was no statistical difference in the socio-demongraphic data and also the means of the total score in both the centres. On the other hand, carrying out the important procedures for hypertensive patients was found to be better at MPHCC in comparison to NPHCC (p compliance to appointment in both the centers. Our study reveals that the process of hypertension care at the two Primary Health Care Centres in Aseer region was not in accordance with the recommended national standards. The reasons include lack of updating systems, recall system and provision of laboratory services and all these factors need to be addressed to improve care.

  12. Improving patient-centered communication while using an electronic health record: Report from a curriculum evaluation.

    Science.gov (United States)

    Fogarty, Colleen T; Winters, Paul; Farah, Subrina

    2016-05-01

    Researchers and clinicians are concerned about the impact of electronic health record use and patient-centered communication. Training about patient-centered clinical communication skills with the electronic health record may help clinicians adapt and remain patient-centered. We developed an interactive workshop eliciting challenges and opportunities of working with the electronic health record in clinical practice, introduction of specific patient-centered behaviors and mindful practice techniques, and video demonstrating contrasts in common behavior and "better practices." One hundred thirty-nine resident physicians and faculty supervisors in five residency training programs at the University of Rochester Medical Center participated in the workshops. Participants were asked to complete an 11-item survey of behaviors related to their use of the electronic health record prior to training and after attending training. We used paired t-tests to assess changes in self-reported behavior from pre-intervention to post-intervention. We trained 139 clinicians in the workshops; 110 participants completed the baseline assessment and 39 completed both the baseline and post-intervention assessment. Data from post-curriculum respondents found a statistically significant increase in "I told the patient when turning my attention from the patient to the computer," from 60% of the time prior to the training to 70% of the time after. Data from our program evaluation demonstrated improvement in one communication behavior. Sample size limited the detection of other changes; further research should investigate effective training techniques for patient-centered communication while using the electronic health record. © The Author(s) 2016.

  13. Are Health Centers in Thailand Ready for Health Information Technology? : A National Survey

    OpenAIRE

    Kijsanayotin, Boonchai; Speedie, Stuart

    2006-01-01

    The Thailand universal health care coverage scheme was instituted in 2001 and The Thailand Ministry of Public Health (MOPH) is restructuring its information systems to support this reform. The MOPH anticipates developing computerized health information systems which can provide information for administration tasks and can improve both healthcare delivery and public health services. To achieve these target goals, knowledge about users and organizations is vital. The knowledge of how health cen...

  14. Mobile Health Insurance System and Associated Costs: A Cross-Sectional Survey of Primary Health Centers in Abuja, Nigeria.

    Science.gov (United States)

    Chukwu, Emeka; Garg, Lalit; Eze, Godson

    2016-05-17

    Nigeria contributes only 2% to the world's population, accounts for 10% of the global maternal death burden. Health care at primary health centers, the lowest level of public health care, is far below optimal in quality and grossly inadequate in coverage. Private primary health facilities attempt to fill this gap but at additional costs to the client. More than 65% Nigerians still pay out of pocket for health services. Meanwhile, the use of mobile phones and related services has risen geometrically in recent years in Nigeria, and their adoption into health care is an enterprise worth exploring. The purpose of this study was to document costs associated with a mobile technology-supported, community-based health insurance scheme. This analytic cross-sectional survey used a hybrid of mixed methods stakeholder interviews coupled with prototype throw-away software development to gather data from 50 public primary health facilities and 50 private primary care centers in Abuja, Nigeria. Data gathered documents costs relevant for a reliable and sustainable mobile-supported health insurance system. Clients and health workers were interviewed using structured questionnaires on services provided and cost of those services. Trained interviewers conducted the structured interviews, and 1 client and 1 health worker were interviewed per health facility. Clinic expenditure was analyzed to include personnel, fixed equipment, medical consumables, and operation costs. Key informant interviews included a midmanagement staff of a health-management organization, an officer-level staff member of a mobile network operator, and a mobile money agent. All the 200 respondents indicated willingness to use the proposed system. Differences in the cost of services between public and private facilities were analyzed at 95% confidence level (Phealth care facilities is significantly higher than at public primary health care facilities. Key informant interviews with a health management organizations

  15. Interprofessional academic health center leadership development: the case of the University of Alabama at Birmingham's Healthcare Leadership Academy.

    Science.gov (United States)

    Savage, Grant T; Duncan, W Jack; Knowles, Kathy L; Nelson, Kathleen; Rogers, David A; Kennedy, Karen N

    2014-05-01

    The study describes the genesis of the University of Alabama at Birmingham's Healthcare Leadership Academy (HLA), highlights the HLA's outcomes, discloses how the HLA has changed, and delineates future directions for academic health center (AHC) interprofessional leadership training. While interprofessional training is recognized as an important component of the professional education for health professionals, AHCs have not focused on interprofessional leadership training to prepare future AHC leaders. As professional bureaucracies, AHCs require leadership distributed across different professions; these leaders not only should be technical experts, but also skilled at interprofessional teamwork and collaborative governance. The HLA is examined using the case method, which is supplemented with a descriptive analysis of program evaluation data and outcomes. The HLA has created a networked community of AHC leaders; the HLA's interprofessional team projects foster innovative problem solving. Interprofessional leadership training expands individuals' networks and has multiple organizational benefits. © 2014.

  16. Analysis of premature births for the period from 2009. to 2013. in Health Center Kosovska Mitrovica

    OpenAIRE

    Adžić V.; Galjak S.; Radojević G.; Relić G.

    2015-01-01

    Delivery before 37th week of gestation is defined as preterm, independently of body mass of babies, according to the World Health Organization. Premature birth is the current problem in the world due to the high risk of neonatal morbidity and mortality and incompletely clear etiology. In our country the frequency of preterm delivery is 6%. We have retrospectively analyzed early deliveries in Health Center Kosovska Mitrovica in the period from 2009 to 2013. In this five-year period, there were...

  17. Socio-demographic and Lifestyle Factors in Breastfeeding Mothers, Referring to Isfahan Health Centers

    OpenAIRE

    Zahra Sohrabi; Fatemeh Momenzadeh; Seyedeh Zahra Aemmi; Malihe Tabibi; Zahra Musavi; Mitra Savabi

    2016-01-01

    Background The feeding importance of child in first two years of life and mental damage caused by malnutrition during this period is obvious. However the mother's lifestyle and long-term effects on the health of the mother and infant during breastfeeding period should not be neglected. Therefore, this study aimed to determine the relationship between the demographic characteristics and lifestyle of breastfeeding mothers referring to health centers in Isfahan. Materials and Methods In this cro...

  18. Focus on People: Rethinking the Power and Potential of Personal Health Records - Q and A

    Centers for Disease Control (CDC) Podcasts

    Dr. Patricia Brennan discusses how Project HealthDesign is working to enhance the utility and flexibility of personal health records as a critical tool to help people take action to improve their health and improve the health care of all Americans.

  19. Focus on People: Rethinking the Power and Potential of Personal Health Records - Part 2

    Centers for Disease Control (CDC) Podcasts

    Dr. Patricia Brennan discusses how Project HealthDesign is working to enhance the utility and flexibility of personal health records as a critical tool to help people take action to improve their health and improve the health care of all Americans.

  20. Focus on People: Rethinking the Power and Potential of Personal Health Records - Part 1

    Centers for Disease Control (CDC) Podcasts

    Dr. Patricia Brennan discusses how Project HealthDesign is working to enhance the utility and flexibility of personal health records as a critical tool to help people take action to improve their health and improve the health care of all Americans.