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  1. LABORATORY SERVICES IN HEALTH CENTRES WITHIN ...

    African Journals Online (AJOL)

    1999-05-05

    May 5, 1999 ... the technicians aimed at improving the services in health centres within ... Settings: Twenty seven health centres in Amhara region, north .... man power in the laboratory .... service consumption in a teaching hospital in Gondar,.

  2. [The coordination of care in health centres].

    Science.gov (United States)

    Ribardière, Olivia

    2016-06-01

    Health centres are structurally designed to facilitate the coordination of care. However, evolutions in society have resulted in forms of consumption of health care which are not necessarily compatible with efficient care coordination. On a local level, teams are nevertheless organising and structuring themselves to offer the right form of care, to the right patient and at the right time.

  3. Assessing health centre systems for guiding improvement in diabetes care

    Directory of Open Access Journals (Sweden)

    Robinson Gary

    2005-08-01

    Full Text Available Abstract Background Aboriginal people in Australia experience the highest prevalence of diabetes in the country, an excess of preventable complications and early death. There is increasing evidence demonstrating the importance of healthcare systems for improvement of chronic illness care. The aims of this study were to assess the status of systems for chronic illness care in Aboriginal community health centres, and to explore whether more developed systems were associated with better quality of diabetes care. Methods This cross-sectional study was conducted in 12 Aboriginal community health centres in the Northern Territory of Australia. Assessment of Chronic Illness Care scale was adapted to measure system development in health centres, and administered by interview with health centre staff and managers. Based on a random sample of 295 clinical records from attending clients with diagnosed type 2 diabetes, processes of diabetes care were measured by rating of health service delivery against best-practice guidelines. Intermediate outcomes included the control of HbA1c, blood pressure, and total cholesterol. Results Health centre systems were in the low to mid-range of development and had distinct areas of strength and weakness. Four of the six system components were independently associated with quality of diabetes care: an increase of 1 unit of score for organisational influence, community linkages, and clinical information systems, respectively, was associated with 4.3%, 3.8%, and 4.5% improvement in adherence to process standards; likewise, organisational influence, delivery system design and clinical information systems were related to control of HbA1c, blood pressure, and total cholesterol. Conclusion The state of development of health centre systems is reflected in quality of care outcome measures for patients. The health centre systems assessment tool should be useful in assessing and guiding development of systems for improvement of

  4. Mental, physical and social health problems of call centre workers

    Directory of Open Access Journals (Sweden)

    P Bhuyar

    2008-01-01

    Full Text Available Background: Call centre workers in BPO face unique occupational hazards - mental, physical and psychosocial. Material & Method: A sample 100 call centre workers of both sexes and from two cities Pune and Mumbai were surveyed by both qualitative and quantitative methods for the above health problems. Results: A high proportion of workers faced sleep disturbances and associated mental stress and anxiety. Sleep disturbance and anxiety was significantly more in international call centres compared to domestic. There was also disturbance in circadian rhythms due to night shift. Physical problems such as musculoskeletal disorders, obesity, eye, and hearing problems were also present. Psychosocial problems included disruption in family life, use of tobacco and alcohol, and faulty eating habits. Conclusion: Better personal management, health education and more research is indicated to study the health problems in this emerging occupation.

  5. A relational conceptual framework for multidisciplinary health research centre infrastructure

    Directory of Open Access Journals (Sweden)

    Johnson Joy L

    2010-10-01

    Full Text Available Abstract Although multidisciplinary and team-based approaches are increasingly acknowledged as necessary to address some of the most pressing contemporary health challenges, many researchers struggle with a lack of infrastructure to facilitate and formalise the requisite collaborations. Specialised research centres have emerged as an important organisational solution, yet centre productivity and sustainability are frequently dictated by the availability and security of infrastructure funds. Despite being widely cited as a core component of research capacity building, infrastructure as a discrete concept has been rather analytically neglected, often treated as an implicit feature of research environments with little specification or relegated to a narrow category of physical or administrative inputs. The terms research infrastructure, capacity, and culture, among others, are deployed in overlapping and inconsistent ways, further obfuscating the crucial functions of infrastructure specifically and its relationships with associated concepts. The case is made for an expanded conceptualisation of research infrastructure, one that moves beyond conventional 'hardware' notions. Drawing on a case analysis of NEXUS, a multidisciplinary health research centre based at the University of British Columbia, Canada, a conceptual framework is proposed that integrates the tangible and intangible structures that interactively underlie research centre functioning. A relational approach holds potential to allow for more comprehensive accounting of the returns on infrastructure investment. For those developing new research centres or seeking to reinvigorate existing ones, this framework may be a useful guide for both centre design and evaluation.

  6. Mental and Physical health related problems of Call centre workers.

    Directory of Open Access Journals (Sweden)

    Dr. Vaibhavkumar Ramanuj

    2014-07-01

    Full Text Available Abstract: Background: The employees of a call centre in BPO may have certain occupational hazards which are unique for the industry. These may be mental, physical and psychosocial. Material & Method: A sample 100 call centre workers of both sexes and from day and night shifts were interviewed to find out about various health problems. Results: Mental stress was one of the main self reported health problem, reported by 44% and 54% of the respondents of day and night shift respectively. Sleep disturbance and disturbance in biological rhythm was mainly reported by the night shift workers.

  7. Service quality perceptions in primary health care centres in Greece.

    Science.gov (United States)

    Papanikolaou, Vicky; Zygiaris, Sotiris

    2014-04-01

    The paper refers to the increased competition between health care providers and the need for patient-centred services in Greece. Using service quality methodology, this paper investigates service quality perceptions of patients in Greek public primary health centres. To test the internal consistency and applicability of SERVQUAL in primary health care centres in Greece. SERVQUAL was used to examine whether patients have different expectations from health care providers and whether different groups of patients may consider some dimensions of care more important than others. The analysis showed that there were gaps in all dimensions measured by SERVQUAL. The largest gap was detected in empathy. Further analysis showed that there were also differences depending on gender, age and education levels. A separate analysis of expectations and perceptions revealed that this gap was because of differences in patients' perceptions rather than expectations. THIS paper raises a number of issues that concern the applicability of SERVQUAL in health care services and could enhance current discussions about SERVQUAL improvement. Quality of health care needs to be redefined by encompassing multiple dimensions. Beyond a simple expectations-perceptions gap, people may hold different understandings of health care that, in turn, influence their perception of the quality of services. © 2012 John Wiley & Sons Ltd.

  8. Service quality perceptions in primary health care centres in Greece

    Science.gov (United States)

    Papanikolaou, Vicky; Zygiaris, Sotiris

    2012-01-01

    Abstract Context  The paper refers to the increased competition between health care providers and the need for patient‐centred services in Greece. Using service quality methodology, this paper investigates service quality perceptions of patients in Greek public primary health centres. Objective  To test the internal consistency and applicability of SERVQUAL in primary health care centres in Greece. Strategy  SERVQUAL was used to examine whether patients have different expectations from health care providers and whether different groups of patients may consider some dimensions of care more important than others. Results  The analysis showed that there were gaps in all dimensions measured by SERVQUAL. The largest gap was detected in empathy. Further analysis showed that there were also differences depending on gender, age and education levels. A separate analysis of expectations and perceptions revealed that this gap was because of differences in patients’ perceptions rather than expectations. Discussion and conclusions  This paper raises a number of issues that concern the applicability of SERVQUAL in health care services and could enhance current discussions about SERVQUAL improvement. Quality of health care needs to be redefined by encompassing multiple dimensions. Beyond a simple expectations–perceptions gap, people may hold different understandings of health care that, in turn, influence their perception of the quality of services. PMID:22296402

  9. Integrated Marketing Communications Plan for Health Centre Rhein-Neckar

    OpenAIRE

    Stock, Katharina

    2017-01-01

    In today’s competitive environment, medical practices cannot do without advertising their services in order to attract and retain patients. Marketing in health care has become as essential as within any other industry. Therefore, this product-oriented thesis aims at creating an integrated marketing communications plan for the case company, Orthopaedic Health Centre Rhein-Neckar. The company’s objective is to increase sales generated by its diagnostic methods and treatment options for arthrosi...

  10. Quality of blood pressure measurement in community health centres.

    Science.gov (United States)

    Sandoya-Olivera, Edgardo; Ferreira-Umpiérrez, Augusto; Machado-González, Federico

    To determine the quality of the blood pressure measurements performed during routine care in community health centres. An observational, cross-sectional study was conducted in 5 private and public health centres in Maldonado, Uruguay, in July-August 2015. The observations were made during the measurements performed by health personnel, using the requirements established by the American Heart Association. An analysis was made on 36 variables that were grouped in categories related to environment, equipment, interrogation, patient, and observer. Statistical analysis was performed using Chi(2) test or Fisher test. Statistical significance was considered to be less than 5% (p<.05). The measurements were made by a registered nurse or nurse in 71% of cases, physician in 20%, and student nurse in 9%. An aneroid sphygmomanometer was used in 89%, and mercury 11%. Satisfactory results were found in variables related to environment (93%), equipment (99%), and patient attitude (82%), and intermediate in the attitudes of the operator (64%), and poor in relation to the interrogation (18%), with the mean of correct variables per measurement being 69%. The main flaws in the procedure were the operator. The measurement of blood pressure is a manoeuvre that healthcare professionals perform thousands of times a year. If the measurement is used for the diagnosis and/or chronic management of arterial hypertension, not systematically applying the established recommendations leads to an inappropriate care of a very significant number of patients. Copyright © 2017 Elsevier España, S.L.U. All rights reserved.

  11. Factors predicting drop-out in community mental health centres.

    Science.gov (United States)

    Reneses, Blanca; Muñoz, Elena; López-Ibor, Juan José

    2009-10-01

    This study aimed to identify treatment, therapist and patient factors associated with dropping out of treatment in four outpatient mental health services. The experimental group comprised all 789 individuals who attended for the first time the mental health services during one year and dropped out of treatment in the same year or during the two following ones. The control group consisted of the same number of individuals, chosen at random from patients who, in the same year, attended for the first time the services and did not subsequently drop out of treatment. The overall drop-out rate was 33.2%. According to logistic regression analysis, the predictive factors of dropping out were: being treated in a particular centre, the involvement of more than one therapist in treatment, having no previous history of psychiatric disorders, being young and being male.

  12. Community involvement in health services at Namayumba and Bobi health centres: A case study

    Directory of Open Access Journals (Sweden)

    Jane F. Namatovu

    2014-01-01

    Full Text Available Background: Community involvement has been employed in the development of both vertical and horizontal health programmes. In Uganda, there is no empirical evidence on whether and how communities are involved in their health services.Aim and Setting: The aim of this study was to establish the existence of community involvement in health services and to identify its support mechanisms in Namayumba and Bobi health centres in Wakiso and Gulu districts, respectively.Methods: Participants were selected with the help of a community mobiliser. Key informants were selected purposively depending on their expertise and the roles played in their respective communities. The focus group discussions and key informant interviews were audio-recorded and transcribed verbatim. The transcripts were analysed manually for emerging themes and sub-themes.Results: Several themes emerged from the transcripts and we categorised them broadly into those that promote community involvement in health services and those that jeopardise it. Easy community mobilisation and several forms of community and health centre efforts promote community involvement, whilst lack of trust for health workers and poor communication downplay community involvement in their health services.Conclusion: Community involvement is low in health services in both Namayumba and Bobi health centres.

  13. Evaluating quality of health services in health centres of Zanjan district of Iran.

    Science.gov (United States)

    Mohammadi, Ali; Mohammadi, Jamshid

    2012-01-01

    To assess quality of health services in Zanjan health centres based on clients' expectations and perceptions. The study was conducted by using service quality (SERVQUAL) scale on a sample of 300 females, clients of health care centres in the district of Zanjan, selected by cluster sampling. The results indicated that there were negative quality gaps at five SERVQUAL dimensions. The most and least negative quality gap mean scores were in reliability dimension (-2.1) and tangible (-1.13) respectively. There was statistically significant difference between clients' perceptions and expectations mean scores at all of the five service quality dimensions (P<0.001). The negative quality gap level in health service dimensions can be used as a guideline for redistribution of resources and managerial attempts to reduce quality gaps and improvement of health care quality.

  14. [The sainsbury centre for mental health: forensic mental health services in England and wales].

    Science.gov (United States)

    Rutherford, M; Duggan, S

    2008-06-01

    The Sainsbury Centre for Mental Health (SCMH) is a charity founded in 1985 by Gatsby Charitable Foundation. The SCMH works to improve the quality of life for people with mental health problems by influencing policy and practice in mental health and related services. Working to improve the quality of mental health care for people in prison is one of SCMH main work theme. This paper describes some epidemiological aspects of mental health situation of prisoners in England and Wales and the available forensic facilities to manage this kind of patients in prison.

  15. Delivery of eye and vision services in Aboriginal and Torres Strait Islander primary health care centres

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    Anthea M Burnett

    2016-12-01

    Full Text Available Background: Routine eye and vision assessments are vital for the detection and subsequent management of vision loss, which is particularly important for Aboriginal and Torres Strait Islander people, who face higher rates of vision loss than other Australians. In order to guide improvements, this paper will describe patterns, variations and gaps in these eye and vision assessments for Aboriginal and Torres Strait Islander people. Methods: Clinical audits from 124 primary health care centres (sample size 15,175 from five Australian States and Territories were conducted during 2005-2012. Main outcome measure was adherence to current guidelines for delivery of eye and vision assessments to adults with diabetes, those without a diagnosed major chronic disease and children attending primary health care centres. Results: Overall delivery of recommended eye and vision assessments varied widely between health centres. Of the adults with diabetes, 45% had a visual acuity assessment recorded within the previous 12 months (health centre range 0-88%, and 33% had a retinal examination recorded (health centre range 0-73%. Of the adults with no diagnosed major chronic disease, 31% had a visual acuity assessment recorded within the previous two years (health centre range 0-30%, and 13% had received an examination for trichiasis (health centre range 0-40%. In children, 49% had a record of a vision assessment (health centre range 0-97%, and 25% had a record of an examination for trachoma within the previous 12 months (health centre range 0-63%. Conclusions: There was considerable range, and variation in the recorded delivery of scheduled eye and vision assessments across health centres. Sharing the successful strategies of the better-performing health centres to support focused improvements in key areas of need may increase overall rates of eye examinations – important for the timely detection, referral and treatment of eye conditions affecting Aboriginal and

  16. Rapid health assessments of evacuation centres in areas affected by Typhoon Haiyan

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    Ruth Alma Ramos

    2015-11-01

    Full Text Available Introduction: Typhoon Haiyan caused thousands of deaths and catastrophic destruction, leaving many homeless in Region 8 of the Philippines. A team from the Philippine Field Epidemiology Training Program conducted a rapid health assessment survey of evacuation centres severely affected by Haiyan. Methods: A descriptive study was conducted whereby a convenience sample of evacuation centres were assessed on the number of toilets per evacuee, sanitation, drinking-water, food supply source and medical services. Results: Of the 20 evacuation centres assessed, none had a designated manager. Most were located in schools (70% with the estimated number of evacuees ranging from 15 to 5000 per centre. Only four (20% met the World Health Organization standard for number of toilets per evacuee; none of the large evacuation centres had even half the recommended number of toilets. All of the evacuation centres had available drinking-water. None of the evacuation centres had garbage collection, vector control activities or standby medical teams. Fourteen (70% evacuation centres had onsite vaccination activities for measles, tetanus and polio virus. Many evacuation centres were overcrowded. Conclusion: Evacuation centres are needed in almost every disaster. They should be safely located and equipped with the required amenities. In disaster-prone areas such as the Philippines, schools and community centres should not be designated as evacuation centres unless they are equipped with adequate sanitation services.

  17. Measuring information technology investment among Canadian academic health sciences centres.

    Science.gov (United States)

    Pederson, Lorraine; Leonard, Kevin

    2005-01-01

    Many recent studies have attempted to accurately measure the expenditure by hospitals in the area of new information technology (IT), for example see Leonard 1998 and Pink et al. 2001. This is usually done as an exercise to compare the healthcare sector with other industries that have had much more success in implementing and leveraging their IT investment (Willcocks 1992; Chan 2000). It is normally hoped that such investigation would help explain some of the differences among the various industries and provide insight into where (and how much) future IT spending should occur in healthcare (Leonard 2004). Herein, we present the results from a study of eight Canadian academic health sciences centres that contributed data in order to analyze the amount of information technology spending in their organizations. Specifically, we focus on one specific indicator: the IT spend ratio. This ratio is defined as the percentage of total IT net costs to total hospital net operating costs, and aims to provide a "relative (or percentage) measure of spending" so as to make the comparisons meaningful. One such comparison shows that hospitals spend only 55% of the amount the financial services sector spends.

  18. Understanding the dynamic interactions driving Zambian health centre performance: a case-based health systems analysis.

    Science.gov (United States)

    Topp, Stephanie M; Chipukuma, Julien M; Hanefeld, Johanna

    2015-05-01

    Despite being central to achieving improved population health outcomes, primary health centres in low- and middle-income settings continue to underperform. Little research exists to adequately explain how and why this is the case. This study aimed to test the relevance and usefulness of an adapted conceptual framework for improving our understanding of the mechanisms and causal pathways influencing primary health centre performance. A theory-driven, case-study approach was adopted. Four Zambian health centres were purposefully selected with case data including health-care worker interviews (n = 60); patient interviews (n = 180); direct observation of facility operations (2 weeks/centre) and key informant interviews (n = 14). Data were analysed to understand how the performance of each site was influenced by the dynamic interactions between system 'hardware' and 'software' acting on mechanisms of accountability. Structural constraints including limited resources created challenging service environments in which work overload and stockouts were common. Health workers' frustration with such conditions interacted with dissatisfaction with salary levels eroding service values and acting as a catalyst for different forms of absenteeism. Such behaviours exacerbated patient-provider ratios and increased the frequency of clinical and administrative shortcuts. Weak health information systems and lack of performance data undermined providers' answerability to their employer and clients, and a lack of effective sanctions undermined supervisors' ability to hold providers accountable for these transgressions. Weak answerability and enforceability contributed to a culture of impunity that masked and condoned weak service performance in all four sites. Health centre performance is influenced by mechanisms of accountability, which are in turn shaped by dynamic interactions between system hardware and system software. Our findings confirm the usefulness of combining Sheikh et al

  19. The structure and dynamics of health centres in the Netherlands: an institutional analysis.

    NARCIS (Netherlands)

    Batenburg, R.; Eyck, A.

    2011-01-01

    Context: Health centres are seen as a preferred organization of the modernized and integrated primary care. they are expected to facilitate an accessible contact point for medical care as close to people’s homes. Also, health centres are expected to deliver care in an efficient and effective way,

  20. The structure and dynamics of health centres in the Netherlands: an institutional analysis.

    NARCIS (Netherlands)

    Batenburg, R.; Eyck, A.

    2011-01-01

    Context: Health centres are seen as a preferred organization of the modernized and integrated primary care. they are expected to facilitate an accessible contact point for medical care as close to people’s homes. Also, health centres are expected to deliver care in an efficient and effective way, mi

  1. How to do a person-centred eye health consultation

    Directory of Open Access Journals (Sweden)

    Renée du Toit

    2015-09-01

    Full Text Available The care we give should focus on our patients – their needs, beliefs, and preferences – and not just on their disease. This is known as patient-centred care. We can take this idea further and talk about person-centred care, which reminds us that we should be concerned with the whole person – and their life – when they are outside of the clinic too, not just when they are in front of us.

  2. Prescription writing trends of antihistamines at the university health centre.

    Science.gov (United States)

    Kumar, Anil; Beenta

    2009-05-01

    The aim of the present study was to establish antihistamines drug prescribing pattern in order to improve the rational prescribing of antihistamines by physicians at Panjab University Health Centre. The study was performed in between the months of November 2005 to April 2006. Five hundred out patients were monitored and data was collected on WHO-based prescription-auditing performa. Demographic analysis of this prospective study revealed that out of the 500 patients, 293 (58.6 %) were male and 207 (41.4 %) were female and maximum patients were in the age group of 21-40 (34.8 %). Chlorpheniramine maleate (235 prescriptions) was the highest prescribed among antihistamine prescriptions (36.89 %) followed by diphenhydramine hydrochloride (186 prescriptions, 29.19%), cetirizine (175 prescriptions, 27.47 %) and promethazine (41 prescriptions, 6.4%). In comparison to generic drugs (169 prescriptions, 26.54%), branded were more prescribed at PUHC. Majority of antihistamines were in form of tablets (414 prescriptions, 64.99%) followed by liquid formulations (195 prescriptions, 30.61%) and injections (28 prescriptions, 4.40%). The average cost of different antihistamine drugs prescribed was as follows: diphenhydramine hydrochloride Rs. 34.74 followed by promethzine Rs. 22.46, chlorpheniramine maleate Rs. 15.30, and cetirizine Rs. 13.50. Average numbers of drugs prescribed per prescription were 1.27. The average consulting and dispensing time was 4.82 and 3.56 min, respectively. Out of the 500 university patients, 258 (51.6%) had the knowledge regarding the medication prescribed and 242 (48.4%) were unaware of the medication prescribed.

  3. Prescription writing trends of antihistamines at the university health centre

    Directory of Open Access Journals (Sweden)

    Kumar Anil

    2009-01-01

    Full Text Available The aim of the present study was to establish antihistamines drug prescribing pattern in order to improve the rational prescribing of antihistamines by physicians at Panjab University Health Centre. The study was performed in between the months of November 2005 to April 2006. Five hundred out patients were monitored and data was collected on WHO-based prescription-auditing performa. Demographic analysis of this prospective study revealed that out of the 500 patients, 293 (58.6 % were male and 207 (41.4 % were female and maximum patients were in the age group of 21-40 (34.8 %. Chlorpheniramine maleate (235 prescriptions was the highest prescribed among antihistamine prescriptions (36.89 % followed by diphenhydramine hydrochloride (186 prescriptions, 29.19%, cetirizine (175 prescriptions, 27.47 % and promethazine (41 prescriptions, 6.4%. In comparison to generic drugs (169 prescriptions, 26.54%, branded were more prescribed at PUHC. Majority of antihistamines were in form of tablets (414 prescriptions, 64.99% followed by liquid formulations (195 prescriptions, 30.61% and injections (28 prescriptions, 4.40%. The average cost of different antihistamine drugs prescribed was as follows: diphenhydramine hydrochloride Rs. 34.74 followed by promethzine Rs. 22.46, chlorpheniramine maleate Rs. 15.30, and cetirizine Rs. 13.50. Average numbers of drugs prescribed per prescription were 1.27. The average consulting and dispensing time was 4.82 and 3.56 min, respectively. Out of the 500 university patients, 258 (51.6% had the knowledge regarding the medication prescribed and 242 (48.4% were unaware of the medication prescribed.

  4. Contraceptive practices adopted by women attending an urban health centre.

    Science.gov (United States)

    Prateek, S S; Saurabh, R S

    2012-12-01

    India was the first country in world to launch - The National Family Welfare Programme in 1951 but even today the couple protection rate (CPR) is still not achieved as desired. To determine extent of awareness regarding contraception among married women. To estimate proportion of couples using contraceptive methods, identify reasons for their adoption & non adoption and to assess unmet needs for contraception. A cross sectional descriptive study of four months duration was conducted among married women in reproductive age group (15 - 49 years) attending general out-patient department in Urban Health Centre (UHC) employing universal sampling method. Participants not willing to respond and pregnant women were excluded. Total of 180 women were selected as study participants. Every woman was interviewed face to face with pre-tested questionnaire after taking informed consent. The data was analyzed by SPSS version 16. 94 (52.2%) were in age group of 20 - 24 years. 52.4% of women were aware about contraceptive practices, of which only 32.2% of subjects were using contraceptive methods. Out of these subjects, 89.66% used temporary methods and 10.34% used permanent methods. Cu-T (41.37%) was most preferred method. 93 subjects (51.6%) had unmet need for contraception. Religion, education status and age at marriage were significantly associated with contraceptive usage. The results suggest a significant Knowledge - Application Gap with regards to contraceptives knowledge and their actual usage in study participants. Almost fifty percent of the subjects had unmet need for contraception. This shows the need for more intense awareness campaigns for promoting contraceptive usage.

  5. Innovation in youth mental health services in Australia: common characteristics across the first headspace centres.

    Science.gov (United States)

    Rickwood, Debra; Van Dyke, Nina; Telford, Nic

    2015-02-01

    headspace centres comprise a significant innovation in community-based youth mental health service delivery in Australia. This paper examines the service activity of the first headspace centres to determine common and unique practice characteristics across headspace centres in this new approach to mental health service delivery. Data come from quarterly progress reports provided by the first 30 headspace centres during the 2010-2011 financial year. The information from 120 reports was analysed qualitatively using thematic analysis techniques to determine the types of activities reported by centres against key performance indicators. The main finding was the large number and wide range of centre activity. This heterogeneity may be explained in part by the diversity of communities across Australia and the importance that headspace places on addressing the specific needs of the local community as well as drawing upon the existing capacity that is available within a community. The most common activities were community engagement, building local partnerships and providing a youth friendly environment. There was a particularly strong focus by the majority of centres on establishing and supporting a Youth Reference Group to guide centre development and implementation. The progressive upscaling of headspace centres across Australia provides a unique opportunity to observe how a significant reorientation in health service delivery is implemented in practice to meet the needs of diverse communities. Further investigation of the headspace experience will provide critical lessons for other countries investing in new approaches to youth mental health. © 2013 Wiley Publishing Asia Pty Ltd.

  6. Length of stay in asylum centres and mental health in asylum seekers

    DEFF Research Database (Denmark)

    Hallas, Peter; Hansen, Anne R; Staehr, Mia A

    2007-01-01

    BACKGROUND: The length of stay in asylum centres is generally mentioned as a possible health risk to asylum seekers. Medical staff working with asylum seekers has claimed that long lengths of stay in asylum centres might cause or aggravate mental disorders. We used records from a large, multiethnic...

  7. The Pholela Health Centre - the origins of community-oriented ...

    African Journals Online (AJOL)

    government's purchase of land for a clinic, to the appointment of outsiders ... were play groups but also served as nutrition education and feeding centres. ... This process of annual extensions allowed .... and kwashiorkor; (ii/) high incidence of infectious diseases, .... (working class white community) ... Decision on evaluation.

  8. Evaluation of current care effectiveness: a survey of hypertension guideline implementation in Finnish health centres

    DEFF Research Database (Denmark)

    Alanen, Seija I; Johannala-Kemppainen, Riitta; Ijäs, Jarja J;

    2007-01-01

    OBJECTIVE: To assess the extent and style of implementation of the Hypertension Guideline (HT Guideline) in Finnish primary health centres, and to identify a scale of contrasting implementation styles in the health centres (with the two ends of the scale being referred to as information implement......OBJECTIVE: To assess the extent and style of implementation of the Hypertension Guideline (HT Guideline) in Finnish primary health centres, and to identify a scale of contrasting implementation styles in the health centres (with the two ends of the scale being referred to as information...... implementers or disseminators respectively). DESIGN: A cross-sectional study. Development of a questionnaire and criteria for assessing the extent and style of implementation of the HT Guideline. SETTING: Primary healthcare. SUBJECTS: All head physicians and senior nursing officers in Finnish health centres (n...... =290). MAIN OUTCOME MEASURES: The extent of adoption of the HT Guideline in health centres and the characteristics associated with the implementation style. RESULTS: Responses were received from 410 senior medical staff (246 senior nursing officers and 164 head physicians) representing altogether 264...

  9. How does a shortage of physicians impact on the job satisfaction of health centre staff?

    Science.gov (United States)

    Saxén, Ulla; Jaatinen, Pekka T; Kivelä, Sirkka-Liisa

    2008-01-01

    The aim was to determine how a shortage of physicians at Finnish health centres has affected the job satisfaction of the entire staff. A questionnaire was posted to 2848 employees working with patients at health centres in the Finnish provinces of Satakunta and Varsinais-Suomi. The information concerning the shortage of physicians at health centres was taken from research undertaken by the Finnish Medical Association in October 2003. The health centres were divided into four groups according to the severity of the shortage. The questionnaire was returned by 1447 employees. The staff at health centres with the most severe shortage of physicians were less satisfied with the management of the organization. Employees at health centres with a minor shortage of physicians were more satisfied with the quality of services in their operational unit. The shortage of physicians had no impact on staff satisfaction regarding the operation of their work unit, the strain of dealing with issues within their work environment, feelings of stress, the strain of working under pressure that they experienced, or interest in finding a new job. The majority of healthcare employees are satisfied and motivated in their work. The shortage of physicians has only a slightly negative impact on their satisfaction.

  10. Technical efficiency of public district hospitals and health centres in Ghana: a pilot study

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    Kirigia Joses M

    2005-09-01

    Full Text Available Abstract Background The Government of Ghana has been implementing various health sector reforms (e.g. user fees in public health facilities, decentralization, sector-wide approaches to donor coordination in a bid to improve efficiency in health care. However, to date, except for the pilot study reported in this paper, no attempt has been made to make an estimate of the efficiency of hospitals and/or health centres in Ghana. The objectives of this study, based on data collected in 2000, were: (i to estimate the relative technical efficiency (TE and scale efficiency (SE of a sample of public hospitals and health centres in Ghana; and (ii to demonstrate policy implications for health sector policy-makers. Methods The Data Envelopment Analysis (DEA approach was used to estimate the efficiency of 17 district hospitals and 17 health centres. This was an exploratory study. Results Eight (47% hospitals were technically inefficient, with an average TE score of 61% and a standard deviation (STD of 12%. Ten (59% hospitals were scale inefficient, manifesting an average SE of 81% (STD = 25%. Out of the 17 health centres, 3 (18% were technically inefficient, with a mean TE score of 49% (STD = 27%. Eight health centres (47% were scale inefficient, with an average SE score of 84% (STD = 16%. Conclusion This pilot study demonstrated to policy-makers the versatility of DEA in measuring inefficiencies among individual facilities and inputs. There is a need for the Planning and Budgeting Unit of the Ghana Health Services to continually monitor the productivity growth, allocative efficiency and technical efficiency of all its health facilities (hospitals and health centres in the course of the implementation of health sector reforms.

  11. Stabilisation of health as the centre point of a health psychology of ageing.

    Science.gov (United States)

    Scholz, Urte; König, Claudia; Eicher, Stefanie; Martin, Mike

    2015-01-01

    Current health psychological theories and research mainly cover improvement of health, recovery from illness or maintenance of health. With this theoretical manuscript, we argue that in ageing societies in which chronic illness and multimorbidity become the norm rather than the exception, this focus of health psychology is no longer sufficient. Instead, in line with a recent conceptualisation of health as "the ability to adapt and to self-manage", we suggest that the centre point of a health psychology of ageing needs to be the stabilisation of health. Current theories of lifespan development, such as the model of selection, optimisation and compensation, the motivational theory of life span development, the two-process model of assimilative and accommodative coping and the recently introduced functional quality of life model are described with regard to their assumptions and related research focussing on stabilisation. All of these models explicitly comprise stabilisation as an important process of successful, healthy ageing. So far, however, the empirical research examining these models does not take stabilisation into account. Implications for research methods and practise of health stabilisation are discussed.

  12. Satisfaction of clients with disabilities with services offered at primary health care centres in Ndola, Zambia

    Directory of Open Access Journals (Sweden)

    N. Mlenzana

    2012-12-01

    Full Text Available To establish satisfaction level of persons with disabilitiesregarding health services at primary health care centres in Ndola, Zambia.Key stakeholders views on satisfaction of services is an important componentof service rendering thus obtaining information is important in assistingwith the evaluation of health care service delivery. This will assist in improvingeffectiveness and availability of health care services to persons with physicaldisabilities.All persons with disabilities attending both rehabilitation centres andprimary health care centres in Ndola, Zambia, were targeted for this study. Willing participants were convenientlyselected to take part in the study.A cross sectional, descriptive study design using quantitative methods of data collection was used. The GeneralPractice Assessment Questionnaire was adjusted, piloted for Ndola population and used in this study to establishsatisfaction of participants. The study was ethically cleared at the University of the Western Cape and Zambia.Information and consent forms were signed by participants.Quantitative data was analysed descriptively and was reported in percentages.In the current study there were 191 participants of whom 56% were male and 44% were female with age rangefrom 18-65 years. Fifty-two percent of the participants presented with learning disabilities and 38% of persons withphysical disabilities. Majority of clients (54% were dissatisfied with availability of services and health care servicesat the health care centres. Areas that clients were dissatisfied with were accessibility, consultation with health professionals,waiting times and opening hours of the health care centres.Clients with disabilities who accessed health care services from selected health centres in Ndola were dissatisfiedwith aspects of health services. Accessibility, consultation with health professionals, waiting times and opening hoursof the health care centres were the origin of client dissatisfaction

  13. Variation in quality of preventive care for well adults in Indigenous community health centres in Australia

    Directory of Open Access Journals (Sweden)

    Hains Jenny

    2011-06-01

    Full Text Available Abstract Background Early onset and high prevalence of chronic disease among Indigenous Australians call for action on prevention. However, there is deficiency of information on the extent to which preventive services are delivered in Indigenous communities. This study examined the variation in quality of preventive care for well adults attending Indigenous community health centres in Australia. Methods During 2005-2009, clinical audits were conducted on a random sample (stratified by age and sex of records of adults with no known chronic disease in 62 Indigenous community health centres in four Australian States/Territories (sample size 1839. Main outcome measures: i adherence to delivery of guideline-scheduled services within the previous 24 months, including basic measurements, laboratory investigations, oral health checks, and brief intervention on lifestyle modification; and ii follow-up of abnormal findings. Results Overall delivery of guideline-scheduled preventive services varied widely between health centres (range 5-74%. Documentation of abnormal blood pressure reading ([greater than or equal to]140/90 mmHg, proteinuria and abnormal blood glucose ([greater than or equal to]5.5 mmol/L was found to range between 0 and > 90% at the health centre level. A similarly wide range was found between health centres for documented follow up check/test or management plan for people documented to have an abnormal clinical finding. Health centre level characteristics explained 13-47% of variation in documented preventive care, and the remaining variation was explained by client level characteristics. Conclusions There is substantial room to improve preventive care for well adults in Indigenous primary care settings. Understanding of health centre and client level factors affecting variation in the care should assist clinicians, managers and policy makers to develop strategies to improve quality of preventive care in Indigenous communities.

  14. A Study on Birth Asphyxia at Tertiary Health Centre

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    Ekta A Dalal

    2013-08-01

    Methodology: This was the cross sectional study conducted in the tertiary care centre of Ahmedabad on the full term babies with birth asphyxia. The maternal, fetal and newborn correlates were recorded according to predesigned proforma. Results: There were total 401 (6.6% babies born with apgar score of less than 7 at one minute and among them, 320 (79.8% were full term babies and 81 (20.2% were preterm babies. Among the babies 52.5% were male, 56.9% were primigravida, and only 41.9% had antenatal care present, 42.2% had MSL and 47.2% were small for date babies. Conclusion: Birth asphyxia is common the babies of the mother who had not received proper antenatal care. Maternal anaemia, primipara, meconium stained liquor babies have more chances of getting birth asphyxia. [Natl J Med Res 2013; 3(4.000: 374-376

  15. Co-designing person-centred mental health care

    DEFF Research Database (Denmark)

    2017-01-01

    Why should future mental health care be co-designed with users, and how do we do it? Based on our research we try yo answer these questions.......Why should future mental health care be co-designed with users, and how do we do it? Based on our research we try yo answer these questions....

  16. Towards evaluation of the quality of care in health centres.

    Science.gov (United States)

    Saturno, P J

    1995-01-01

    There is wide acknowledgement that quality assurance is desirable in primary health care. Considerable success has been achieved in this field by the Iberian Programme of Training and Implementation of Quality Assurance Activities in Primary Health Care, the basis for which is outlined below.

  17. The development of an intelligent laboratory information system for a community health promotion centre.

    Science.gov (United States)

    Chae, Young Moon; Lim, Hwan-Sub; Lee, Ju Hon; Bae, Mi Young; Kim, Gyu Hyung

    2002-01-01

    This study aimed to develop an Intelligent Laboratory Information System (ILIS) for the community health promotion centre in Kwachun city to help process an increasing amount of laboratory test data in an efficient manner, and to support the clinical decision-making of public health doctors. A sample of 170 cases was used for validation of the system. Overall, the system correctly predicted 92.5% of the cases. This paper also analysed the economic feasibility of the ILIS based on the Information Economics approach. The results showed that the ILIS not only helps screen more people by increasing the capacity of a health promotion centre, but also brings in more revenue to the centre.

  18. A survey of hypertensive practices at two community health centres ...

    African Journals Online (AJOL)

    Normally distributed data were analysed using the Student's t-test, and .... to the nearest zero, indicating uniform digital bias. This implies that BP is only .... insurance and rely on the public sector for their health care. Major deficiencies were ...

  19. [The Centre for Medical Research and Health in Niamey, Niger. The new CERMES].

    Science.gov (United States)

    Ouwe Missi Oukem-Boyer, O

    2014-01-01

    After 20 years under the umbrella of the Organisation de Coordination et de Coopération pour la lutte contre les Grandes Endémies (organization for coordination and cooperation against major endemic diseases), the Centre de Recherche sur les Méningites et les Schistosomoses (the meningitis and schistosomiasis research center) has been placed under the Niger Ministry of Public Health. It has become the Centre de Recherche Médicale et Sanitaire (medical and health research center) and thus keeps its acronym, CERMES. In 2008, CERMES became a full member of the Institut Pasteur International Network. Its main research interests include meningitis, malaria, and interactions between health, environment, and climate. CERMES also works in the areas of public health and health training. Here, 12 years after the creation of the new CERMES, we present its main research results, as well as the challenges and opportunities it faces.

  20. The impact of nutrition education at three health centres in Central Province, Kenya

    NARCIS (Netherlands)

    Hoorweg, J.C.; Niemeijer, R.

    1980-01-01

    This report contains an account of a study of the effects of nutrition education as given at three health centres in different ecological zones in Central Province, Kenya. Two groups of mothers in similar social and economic situations were selected for interviewing: frequent and infrequent visitors

  1. Role of the Poison Control Centre of Morocco in the Improvement of Public Health

    Directory of Open Access Journals (Sweden)

    Naima Rhalem

    2013-09-01

    How to cite this article: Rhalem N, Aghandous R, Chaoui H, Eloufir R, Badrane N, Windy M, et al. Role of the Poison Control Centre of Morocco in the Improvement of Public Health. Asia Pac J Med Toxicol 2013;2:82-6.

  2. Intimate partner violence among women of childbearing age in a primary health care centre in Nigeria.

    Science.gov (United States)

    Ilika, Amobi L; Okonkwo, Prosper I; Adogu, Prosper

    2002-12-01

    This study assessed the prevalence and characteristics of intimate partner violence among women of childbearing age in a primary health centre. With interviewer-administered questionnaire, information on partner violence was elicited from three hundred women of childbearing age selected by systematic sampling in a primary health care (PHC) centre. Over 40% had experienced violence within the last 12 months. Type of marriage and partner's education had effect on violence. Perceived reasons for violence were economic demand (56.1%), reproductive issues (42.5%), alcohol and drugs (61.2%). Forty eight per cent reported to family members. Only 1% reported to the Police. Intimate partner violence is a prevalent public health problem in eastern Nigeria. Health workers and social organisations should recognise the problem and offer necessary support, and women should be empowered to navigate through the problem.

  3. Faculty of Dentistry, Kuwait University, designated as a World Health Organization Collaborating Centre for Primary Oral Health Care.

    Science.gov (United States)

    Behbehani, J M

    2014-01-01

    The Faculty of Dentistry, Kuwait University, was designated as a World Health Organization (WHO) Collaborating Centre for Primary Oral Health Care (POHC) in 2011. This article aimed to describe the following: (1) the background for this nomination, (2) the WHO Collaborating Centre for POHC, its terms of reference and 5 activities, (3) the primary health care concept as it was established in Alma-Ata, (4) the oral health situation in Kuwait and in the Middle-East region and, finally, (5) how POHC policy should be implemented in Kuwait and this region. It can be concluded that, because the caries experience is very high in Kuwait and in the other countries of the Eastern Mediterranean region, good POHC programmes should be designed and implemented in this region. The Faculty of Dentistry will strengthen its research tradition and as a WHO Collaborating Centre for POHC will try to collect information and experience from POHC in this region and exchange ideas between POHC experts in this region on how these programmes could be further developed. This will happen according to the terms of reference and activity plans of the WHO Collaborating Centre for POHC approved by the WHO Global Oral Health Programme.

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

    Science.gov (United States)

    Martin, Carmel M; Félix-Bortolotti, Margot

    2014-12-01

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

  5. People-centred health systems: building more resilient health systems in the wake of the Ebola crisis.

    Science.gov (United States)

    Martineau, Fred P

    2016-09-01

    The 2014-2016 West African Ebola outbreak demonstrated the extent to which local social and political dynamics shape health system responses to crises such as epidemics. Many post-Ebola health system strengthening programmes are framed around a notion of health system 'resilience' that focuses on global rather than local priorities and fails to account for key local social dynamics that shape crisis responses. Post-crisis health system strengthening efforts require a shift towards a more 'people-centred' understanding of resilience that attends to the people, relationships and local contexts that constitute health systems and the practices that produce crisis responses.

  6. Closing the gender leadership gap: a multi-centre cross-country comparison of women in management and leadership in academic health centres in the European Union.

    Science.gov (United States)

    Kuhlmann, Ellen; Ovseiko, Pavel V; Kurmeyer, Christine; Gutiérrez-Lobos, Karin; Steinböck, Sandra; von Knorring, Mia; Buchan, Alastair M; Brommels, Mats

    2017-01-06

    Women's participation in medicine and the need for gender equality in healthcare are increasingly recognised, yet little attention is paid to leadership and management positions in large publicly funded academic health centres. This study illustrates such a need, taking the case of four large European centres: Charité - Universitätsmedizin Berlin (Germany), Karolinska Institutet (Sweden), Medizinische Universität Wien (Austria), and Oxford Academic Health Science Centre (United Kingdom). The percentage of female medical students and doctors in all four countries is now well within the 40-60% gender balance zone. Women are less well represented among specialists and remain significantly under-represented among senior doctors and full professors. All four centres have made progress in closing the gender leadership gap on boards and other top-level decision-making bodies, but a gender leadership gap remains relevant. The level of achieved gender balance varies significantly between the centres and largely mirrors country-specific welfare state models, with more equal gender relations in Sweden than in the other countries. Notably, there are also similar trends across countries and centres: gender inequality is stronger within academic enterprises than within hospital enterprises and stronger in middle management than at the top level. These novel findings reveal fissures in the 'glass ceiling' effects at top-level management, while the barriers for women shift to middle-level management and remain strong in academic positions. The uneven shifts in the leadership gap are highly relevant and have policy implications. Setting gender balance objectives exclusively for top-level decision-making bodies may not effectively promote a wider goal of gender equality. Academic health centres should pay greater attention to gender equality as an issue of organisational performance and good leadership at all levels of management, with particular attention to academic enterprises

  7. Service users' expectations of treatment and support at the Community Mental Health Centre in their recovery.

    Science.gov (United States)

    Biringer, Eva; Davidson, Larry; Sundfør, Bengt; Ruud, Torleif; Borg, Marit

    2016-08-03

    Focus on service users' needs, coping and empowerment, user involvement, and comprehensiveness are supposed to be key elements of the Community Mental Health Centres in Norway. Taking a user-oriented approach means acknowledging the individual's own expectations, aims and hopes. However, studies that have investigated service users' expectations of treatment and support at Community Mental Health Centres are hard to find. The aim of the study was therefore to explore service users' expectations at the start of treatment at a Community Mental Health Centre. Within a collaborative framework, taking a hermeneutic-phenomenological approach, ten service users participated in in-depth interviews about their expectations, hopes and aims for treatment and recovery. The participants sought help due to various mental health issues that had interfered with their lives and created disability and suffering. A data-driven stepwise approach in line with thematic analysis was used. The study was approved by the Norwegian Social Science Data Services. The following four main themes representing participants' expectations at the start of treatment were elicited: hope for recovery, developing understanding, finding tools for coping and receiving counselling and practical assistance. Participants' expectations about treatment were tightly interwoven with their personal aims and hopes for their future life, and expectations were often related to practical and financial problems, the solution of which being deemed necessary to gain a safe basis for recovery in the long run. The transferability of the results may be limited by the small number of participants. The study emphasises how important it is that service users' personal aims and expectations guide the collaborative treatment process. In addition to providing treatment aimed at improving symptoms, Community Mental Health Centres should take a more comprehensive approach than today by providing more support with family issues

  8. [Behaviour concerning smoking among the patients making use of advice in women health centres].

    Science.gov (United States)

    Kowalska, Alina; Szymański, Przemysław; Rzeźnicki, Adam; Stelmach, Włodzimierz

    2007-01-01

    The level of knowledge in the society about the harmful influence of smoking is increasing systematically. But there are still many people ignoring the warnings and prohibitions concerning smoking. The results of the research show that it is highly worrying that there are people for whom smoking is incredibly dangerous, e.g. children, youth, women, especially pregnant women. The aim of the work was to establish the percentage of smoking women among the patients of the women health centre, with the special focus on pregnant women. There were 120 women encompassed in this study in the health centre in Opoczno and 120 women using a similar health centre in Lodz between the 1st and the 15th March 2007, using a auditoria survey questionnaire. The collected data was worked out statistically. In the group of 240 tested people, 87 admitted to smoking, which is 36.3% of the respondents. Among the 185 women who were not pregnant, but were smoking, there were 75 (40.5%) and in the group of 55 pregnant women, there were 12 who smoked (f=0.22). Over 22% of the smoking women smoked over 10 cigarettes a day. From among 87 of the surveyed, 35.6% claimed they smoked everywhere they wanted. Majority of the respondents that is 52.9% lived with at least one other smoking person. Over 70% of them would like to quit smoking. Almost 48% stated their doctor has never talked with them about the influence of smoking on their health and almost 42% stated that no nurse or midwife has ever talked to them about this subject. Frequency of smoking among the tested people who were using the women health centre was high. Especially worrying was the percentage of the smoking pregnant women--every fifth of them smoked.

  9. Documentation of person-centred health plans for patients with acute coronary syndrome.

    Science.gov (United States)

    Jansson, Inger; Fors, Andreas; Ekman, Inger; Ulin, Kerstin

    2017-06-01

    Personalised care planning is argued for but there is a need to know more about what the plans actually contain. To describe the content of person-centred health, plans documented at three healthcare levels for patients with acute coronary syndrome. Patients with acute coronary syndrome aged under 75 years and admitted to two coronary care units at a university hospital were enrolled in the study. This retrospective descriptive study documented 89 person-centred health plans at three healthcare levels: hospital, outpatient and primary care. In total, 267 health plans were reviewed and a quantitative content analysis conducted. The health plans included commonly formulated goals, patients' own resources and support needed. The health plan goals were divided into three categories: lifestyle changes, illness management and relational activities. The most frequently reported goal for better health was increased physical activity, followed by social life/leisure activities and return to paid professional work. In order to reach the goals, patients identified three ways: own resources, family and social support and healthcare system, in total three categories. The most frequently reported own capability was self-motivation. Spouses and children were important sources of family and social support. The most frequently reported healthcare support was cardiac rehabilitation. In traditional care and treatment plans devised by health professionals, patient goals often comprise behavioural changes. When patients identify their own goals and resources with the help of professionals, they include maintaining social relations and being able to return to important activities such as work.

  10. 2016 INCAM Research Symposium: Expanding Person-Centred Care through Integrative Health Research.

    Science.gov (United States)

    Boon, Heather; Gaboury, Isabelle; Balneaves, Lynda G; Tsui, Teresa; Ng, Jeremy Y; Bozinovski, Natalie

    2016-12-01

    The following are abstracts of research presentations given at the 9th INCAM Research Symposium. The theme for this year's conference was "Expanding Person-Centred Care through Integrative Health Research", which was held on November 18 and 19, 2016 at the Toronto Marriott Bloor Yorkville Hotel in Ontario, Canada. The abstracts are grouped under the categories of oral or poster presentation based on their presentation at the Symposium. For more information, please visit: http://www.iscmr.org/content/canadian-chapter---public.

  11. Distribution of Malaria Case in Simpenan Public Health Centre Sukabumi District in 2011

    Directory of Open Access Journals (Sweden)

    Hubullah Fuadzy

    2012-12-01

    Full Text Available The number of malaria in Simpenan public health centre area needs a quick step in the patients finding by malaria microscopic officers, both by Active Case Detection (ACD and Passive Case Detection (PCD. The objective of th is article is to determine the distribution of malaria cases at Simpenan public health centre in Sukabumi during 2011. Data collection was carried out by malaria officersfrom Simpenan public health centre by identifying malaria parasite with microscope to any gold miners who just got home and was having a highfever. Malaria cases during the year 2011 experienced an increasing trend (R2 = 0.0175 from January (8.86% to December (15.18%, 79 cases of malaria was found and the peak of cases happened in December. Malaria was notfound in the age group of 0-14 years, but cases ofmalaria were found in productive age group (15-44 years old = 83%, 45-59 years old = 14%, 2: 60 years old = 3%, and also to all people working as gold miners in malaria-endemic areas i.e. Aceh, Bangka, Jambi, Kalimantan, Medan, Papua, Riau, and Sumbawa. This indicated that malaria in Simpenan was predicted as import cases.

  12. The rehabilitation of stroke patients at community health centres in the Western Cape

    Directory of Open Access Journals (Sweden)

    A. Rhoda

    2009-02-01

    Full Text Available The structure and process of rehabilitation of stroke patientsaffects the outcomes of the patients. The aim of this study was to determine thestructure and process of rehabilitation of stroke patients at Community HealthCentres  (CHCs in the Western Cape, South A frica. A  quantitative descriptive study was conducted. Questionnaires and archived records were used to collect the data. The study sample used to collect information related to the structure consisted of therapists (16 employed at the centres; while the study sample used to collect information related to the process consisted of 100 first time stroke patients. Descriptive statistics were conducted using Excel and SPSS. The results of the study revealed that there is a lack of occupational and speech therapy services at the centres forming partof the study sample. At centres where these services are provided the frequency and intensity with which the services are received by the patients is extremely low. Further research is needed to determine if the decreased intensity is onlyas a result of decreased availability of services or if inability of stroke clients to access the services also plays a role.

  13. Clinico-epidemiological profile of malaria: Analysis from a primary health centre in Karnataka, Southern India

    Directory of Open Access Journals (Sweden)

    Ramachandra Kamath

    2013-01-01

    Full Text Available Malaria continues to be a major public health problem in India and worldwide. The present study was based on records from a primary health centre in Karnataka. Morbidity patterns and important features of malaria transmission specific to Udupi district were investigated. The incidence of malaria and various morbidity patterns during 2010 and 2011 were compared and analyzed. Factors such as rapid urbanization, increased construction activities and influx of migratory workers were highlighted as the leading causes for the advent of malaria in the area. Recommendations have been provided for implementation in the near future.

  14. Human Centred Design Considerations for Connected Health Devices for the Older Adult

    Directory of Open Access Journals (Sweden)

    Richard P. Harte

    2014-06-01

    Full Text Available Connected health devices are generally designed for unsupervised use, by non-healthcare professionals, facilitating independent control of the individuals own healthcare. Older adults are major users of such devices and are a population significantly increasing in size. This group presents challenges due to the wide spectrum of capabilities and attitudes towards technology. The fit between capabilities of the user and demands of the device can be optimised in a process called Human Centred Design. Here we review examples of some connected health devices chosen by random selection, assess older adult known capabilities and attitudes and finally make analytical recommendations for design approaches and design specifications.

  15. Human-centred methods in the design of an e-health solution for patients undergoing weight loss treatment

    DEFF Research Database (Denmark)

    Das, Anita; Svanæs, Dag

    2013-01-01

    Background and objective Patients undergoing weight loss treatment require follow-up as part of the treatment process. E-health solutions may be used for this purpose. We have used an iterative design approach to develop a patient-centred e-health solution for patients undergoing weight loss...... in the design process. Our findings imply that involving stakeholders separately during specific human-centred activities is important in order to capture subtle, but critical aspects of the users’ requirements. Conclusion Applying human-centred methods in the design of e-health solutions requires...

  16. Length of stay in asylum centres and mental health in asylum seekers: a retrospective study from Denmark

    DEFF Research Database (Denmark)

    Hallas, Peter; Hansen, Anne R; Staehr, Mia A

    2007-01-01

    The length of stay in asylum centres is generally mentioned as a possible health risk to asylum seekers. Medical staff working with asylum seekers has claimed that long lengths of stay in asylum centres might cause or aggravate mental disorders. We used records from a large, multiethnic group...... of asylum seekers to study if the incidence of mental disorders increased with length of stay....

  17. Guidelines to reduce sexually trasmitted infections at primary health care centres - Part 2

    Directory of Open Access Journals (Sweden)

    S.T.J. Molapo

    2007-09-01

    Full Text Available Sexually transmitted diseases are the second highest cause of death among women aged 15-44 years. The incidence and prevalence of sexually transmitted diseases is on the increase at many health care centres despite their dreadfulness and many preventative measures. According to the Scope of Practice of registered professional nurses working in a community health clinic, the registered professional nurse has a responsibility to prevent disease and promote health as well as do research. This paper aims to describe guidelines to reduce sexually transmitted infections at primary health care centres based on research done to investigate the community specific knowledge, attitudes and perceptions regarding sexually transmitted infections. Structured interviews were used to collect data from 1694 participants (males and females who were consulted at a primary health care clinic in Mamelodi, Gauteng province. Existing patients’ records were also utilised to calculate the incidence rate of sexually transmitted infections. Data were computerised and analysed quantitatively to reflect the results in frequencies and percentages as reported in Part 1 of this research. Guidelines to direct the practice of registered professional nurse were developed based on the findings of the results. These guidelines must underpin community specific interventions to reduce the incidence of sexually.

  18. [Implementation of good quality and safety practices. Descriptive study in a occupational mutual health centre].

    Science.gov (United States)

    Manzanera, R; Plana, M; Moya, D; Ortner, J; Mira, J J

    2016-01-01

    To describe the level of implementation of quality and safety good practice elements in a Mutual Society health centre. A Cross-sectional study was conducted to assess the level of implementation of good practices using a questionnaire. Some quality dimensions were also assessed (scale 0 to 10) by a set of 87 quality coordinators of health centres and a random sample of 54 healthcare professionals working in small centres. Seventy quality coordinators and 27 professionals replied (response rates 80% and 50%, respectively. There were no differences in the assessment of quality attributes between both groups. They identified as areas for improvement: use of practice guidelines (7.6/10), scientific and technical skills (7.5/10), and patient satisfaction (7.7/10). Availability and accessibility to clinical reports, informed consent, availability of hydro-alcoholic solution, and to record allergies, were considered of high importance to be implemented, with training and research, improvements in equipment and technology plans, adherence to clinical practice guidelines and the preparation of risk maps, being of less importance. The good practices related to equipment and resources have a higher likelihood to be implemented, meanwhile those related to quality and safety attitudes have more barriers before being implemented. The mutual has a similar behaviour than other healthcare institutions. Copyright © 2015 SECA. Published by Elsevier Espana. All rights reserved.

  19. Mind the gap: Person-centred delivery of mental health information to post-secondarystudents

    Directory of Open Access Journals (Sweden)

    Laura Lynne Armstrong

    2015-08-01

    Full Text Available Mental illnesses are rapidly escalating on university and college campuses. It is well known that postsecondary institutions are not doing enough to address mental health concerns: this represents a significant gap in our attempts to meet the mental health needs of young people. Deficits in mental health knowledge are now proposed as a major contributing factor to both stigma and low service access, but little research as explored this issue. There is also little research to date concerning what young people want to know about mental health and how best to disseminate mental health knowledge. Without such information, knowledge may not be shared in a person-centred, meaningful manner that youth will use. We explored these issues in the present study. First year postsecondary students (N = 271; n = 183 females; n = 85 males; n = 3 other from Ottawa, Ontario, Canada participated in the online survey. Almost half of the postsecondary youth participants, particularly males, had difficulty recognizing common mental illnesses, such as anxiety, eating disorders, and psychosis. Youth held inaccurate beliefs and stigma, as well as attitudes not in favour of help-seeking. They primarily wanted to know about symptoms of mental illnesses as well as how to cope with stress. Post-secondary students wanted to learn about mental health issues through public presentations, the Internet, and media. The present research suggests the need for an awareness and acknowledgement among policy-makers of first year post-secondary students' knowledge gaps and youth appropriate knowledge sharing. Assessing mental health knowledge, what post-secondary students want to know about mental health, and knowledge transfer preferences could aid in the development of a framework to address the significant gap in the mental health needs of post-secondary students in a person centred manner.

  20. Health status of children with cerebral palsy living in Europe: a multi-centre study

    DEFF Research Database (Denmark)

    Beckung, E; White-Koning, M; Marcelli, M

    2008-01-01

    AIM: The aim of this report is to describe the health status of 8-12-year-old children with cerebral palsy (CP) of all severities in Europe using the Child Health Questionnaire (CHQ). METHOD: A total of 818 children with CP from nine centres in defined geographical areas participated. CP type......, gross and fine motor function, additional impairments were classified and family data were obtained. The CHQ was used to measure the parent's perception of their child's physical (PHY) and psychosocial (PSY) health. RESULTS: PHY scores were lower than the reference samples with a median of 46......, parental education and employment revealed gross motor function, cognitive level and type of school attended were significant prognostic factors. CONCLUSION: This report is based on the largest sample to date of children with CP. Health status as measured using the CHQ was affected in all children...

  1. Public health action following an outbreak of toxigenic cutaneous diphtheria in an Auckland refugee resettlement centre.

    Science.gov (United States)

    Reynolds, Gary E; Saunders, Helen; Matson, Angela; O'Kane, Fiona; Roberts, Sally A; Singh, Salvin K; Voss, Lesley M; Kiedrzynski, Tomasz

    2016-12-24

    Global forced displacement has climbed to unprecedented levels due largely to regional conflict. Degraded public health services leave displaced people vulnerable to multiple environmental and infectious hazards including vaccine preventable disease. While diphtheria is rarely notified in New Zealand, a 2 person outbreak of cutaneous diphtheria occurred in refugees from Afghanistan in February 2015 at the refugee resettlement centre in Auckland. Both cases had uncertain immunisation status. The index case presented with a scalp lesion during routine health screen and toxigenic Corynebacterium diphtheriae was isolated. A secondary case of cutaneous diphtheria and an asymptomatic carrier were identified from skin and throat swabs. The 2 cases and 1 carrier were placed in consented restriction until antibiotic treatment and 2 clearance swabs were available. A total of 164 contacts were identified from within the same hostel accommodation as well as staff working in the refugee centre. All high risk contacts (n=101) were swabbed (throat, nasopharynx and open skin lesions) to assess C. diphtheriae carriage status. Chemoprophylaxis was administered (1 dose of intramuscular benzathine penicillin or 10 days of oral erythromycin) and diphtheria toxoid-containing vaccine offered regardless of immunisation status. Suspected cases were restricted on daily monitoring until swab clearance. A group of 49 low risk contacts were also offered vaccination. Results suggest a significant public health effort was required for a disease rarely seen in New Zealand. In light of increased worldwide forced displacement, similar outbreaks could occur and require a rigorous public health framework for management.

  2. A retrospective study of prescription pattern of antimicrobials in an Urban Health Centre run by a medical college

    National Research Council Canada - National Science Library

    Bala, Sharmin S; Chincholkar, Aparna S; Wagh, Ranjit J; Mutalik, Madhav M

    2014-01-01

    .... Materials and Methods: A retrospective prescription audit was done of all 655 prescriptions issued between 01/01/2012 and 31/12/2012 at the outpatient department of Urban Health Centre attached to a medical college...

  3. 20th ANNIVERSARY OF THE CHILDREN'S HEALTH AND EXERCISE CENTRE, UNIVERSITY OF EXETER, UK

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    Craig Sharp

    2007-09-01

    Full Text Available 20th ANNIVERSARY OF THE CHILDREN'S HEALTH AND EXERCISE CENTRE, UNIVERSITY OF EXETER, UK In recent years, partly because of the ever-younger exten-sion of high quality sport representation and partly, para-doxically, due to ever-increasing levels of obesity in the young, the discipline of paediatric physiology has moved from being an interesting curiosity to an extremely impor-tant area of practical knowledge. For example, children thermoregulate qualitatively and quantitatively differently from adults - before puberty their sweat rate per square metre of skin is less than half their adult level - and they may well have, proportionate to mass, 40% greater body surface area than an adult. On the musculo-skeletal side, they come late into 'kinetic-balance', into an appropriately economic mode of running or walking, so such effort is harder for them. In many other areas children, especially younger children, differ importantly from adults, and those involved in any aspects of their exercise, sport or medicine should be well aware of this. Hence the impor-tance of the discipline, and hence the reason for a very hearty celebration of the 20th anniversary of the Chil-dren's Health and Exercise Centre (CHERC, which, as is demonstrated here, has pioneered and expanded the entire discipline, as one of the world's leading paediatric labora-tories.To celebrate the 20th anniversary of the Children's Health and Exercise Centre (1987-2007 past and present mem-bers of the centre were invited to contribute a review article on paediatric exercise science. The collection of reviews, written by current and former PhD students, visiting research fellows and professors, visiting interns and current members of CHERC, discusses an array of topics, which have helped shaped the work of our centre. We would also like to take the opportunity to acknowl-edge all those associated with CHERC over the past 20 years, in particular the many children who have partici-pated in our

  4. Analysis of factors influencing the outpatient workload at Chinese health centres

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    Yin Ping

    2010-06-01

    Full Text Available Abstract Background Although the community health service system is now established in China, the utilisation of the community health service institutions is low due to the lack of a gate-keeping role of the primary health service providers and referrals among the three-tiered health service institutions. In addition to this, patients who can afford to pay, often seek best services in big hospitals to guarantee the quality of care. Thus, the need of guiding the patients to the community health services and increasing the utilisation of the community health service institutions is becoming an urgent problem, which hinders the future development of community health services. This study focuses on the question of how to increase the utilisation of Chinese community health centres (HCs. Methods A cross-sectional Base-line Survey of Chinese City Community Health Service System Building using the multi-staged cluster sampling was conducted to collect data from all HCs in 28 key contact cities. Relevant indicators of totally 1790 HCs were analysed. The statistical methods included ANONVA and logistic regression. Results and Conclusions The analysis suggested several key factors for increasing the outpatient workload (OW at the HCs: establishing an adequate referral system among the different levels of the health system; enhancing the qualification of health personnel and increasing the compensation by the health insurance for services provided at HCs. Other key factors with a positive effect on the OW included: the government ownership of the HCs, the scale of the institutions, the medical equipment used, the mix of health services provided, and the women in childbearing age in the residence.

  5. Less equal than others? Experiences of AYUSH medical officers in primary health centres in Andhra Pradesh.

    Science.gov (United States)

    Lakshmi, J K

    2012-01-01

    The National Rural Health Mission (NRHM) includes, inter alia, the establishment of an AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homoeopathy) component (practitioner, trained assistants, drugs and equipment) in every primary health centre (PHC). However, five years following the launch of the NRHM, the AYUSH mainstreaming scenario is below expectations, riddled with ethical and governance issues. Accounts from AYUSH practitioners at PHCs in various regions of the state of Andhra Pradesh reveal enormous lacunae in implementation: unfilled positions, inequitable emoluments, inadequate or absent infrastructure, assistance and supplies, unethical interpersonal arrangements, and limited support from non-AYUSH personnel. The widespread negative impact of these conditions undermines the value of AYUSH, demotivating both practitioners and patients, and failing to provide the intended support to the public health system.

  6. Who should decide how much and what information is important in person-centred health care?

    DEFF Research Database (Denmark)

    Kaltoft, Mette Kjer; Nielsen, Jesper Bo; Salkeld, Glenn

    2015-01-01

    implicitly segues into the patient having made a 'good decision'. In person-centred health care, whether, in what form, and with what weight, 'information' is included as a criterion of decision quality is a matter for the person involved, to decide in the light of their own values, preferences, and time......Most guidelines for clinical practice, and especially those for the construction of decision support tools, assume that the individual person (the patient) needs to be in possession of information of particular sorts and amount in order to qualify as having made an 'informed decision'. This often...

  7. Evaluating the effectiveness of IPTi on malaria using routine health information from sentinel health centres in southern Tanzania

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    Mshinda Hassan

    2011-02-01

    Full Text Available Abstract Background Intermittent preventive treatment of malaria in infants (IPTi consists of the administration of a treatment dose of sulphadoxine-pyrimethamine (SP at the time of routine vaccinations. The use of routine Health Management and Information Services (HMIS data to investigate the effect of IPTi on malaria, anaemia, and all-cause attendance in children aged 2-11 months presenting to 11 health centres in southern Tanzania is described. Methods Clinical diagnosis of malaria was confirmed with a positive blood slide reading from a quality assurance laboratory. Anaemia was defined using two thresholds (mild [Hb Results Seventy two per cent of infants presenting in intervention areas received at least one dose of IPTi- 22% received all three. During March 2006 - April 2007, the incidence of all cause attendance was two attendances per person, per year (pppy, including 0.2 episodes pppy of malaria, 0.7 episodes of mild and 0.13 episodes of severe anaemia. Point estimates for the effect of IPTi on malaria varied between 18% and 52%, depending on the scope of the analysis, although adjustment for clustering rendered these not statistically significant. Conclusions The point estimate of the effect of IPTi on malaria is consistent with that from a large pooled analysis of randomized control trials. As such, it is plausible that the difference seen in health centre data is due to IPTi, even thought the effect did not reach statistical significance. Findings draw attention to the challenges of robust inference of effects of interventions based on routine health centre data. Analysis of routine health information can reassure that interventions are being made available and having desired effects, but unanticipated effects should trigger data collection from representative samples of the target population.

  8. Mental health, sexual violence and the work of Sexual Assault Referral centres (SARCs) in England.

    Science.gov (United States)

    Brooker, Charlie; Durmaz, Emma

    2015-04-01

    There is a clear link between mental health status both before and after rape. It is known, for example, that approximately 40% of attendees to a Sexual Assault Referral centre (SARC) are already known to mental health services. Sexual Violence can also lead to the development of a mental illness. SARCs have been established, inter alia, to provide healthcare to the victims of rape where a mental health risk assessment should be undertaken. All 37 SARCs in England where asked to complete a short survey and a response rate of 68% was achieved. A high proportion (40%) of SACRs clients are already known to mental health services, however, only just under half of SARCs routinely assess mental health and when such an assessment is completed this is by an FME and substance misuse issues are not always included. Almost two-thirds of SARC services report problems in referring on to mental health services for a variety of reasons. More research is needed in this important area and NHS England should fully define the skills required to undertake a mental health risk assessment when someone has been the victim of rape.

  9. Implementation of Rogi Kalyan Samiti (RKS at Primary Health Centre Durvesh (2009 – 2010.

    Directory of Open Access Journals (Sweden)

    Saurabh RamBihariLal Shrivastava

    2012-06-01

    Full Text Available TITLE: - Implementation of Rogi Kalyan Samiti (RKS at Primary Health Centre Durvesh (2009 – 2010. BACKGROUND: - Rogi Kalyan Samiti (RKS was started under National Rural Health Mission (NRHM in year 2006 by Government of India to provide sustainable quality care with accountability and to ensure people’s participation with total transparency. This study was planned to assess the implementation of RKS at Primary Health Centre (PHC Durvesh in the year 2009-2010. METHODS: A Cross-sectional descriptive study was conducted at PHC Durvesh in a tribal area of Thane district. Permission of District Health Officer was taken prior to start of study. Study participants were members of governing & executive body, beneficiaries at PHC. Information was collected by in-depth interviews of members, exit interviews of the beneficiaries, assessment of audit reports & records and observation of physical infrastructure. Later on PHC staff was also interviewed to know their views regarding RKS. RESULTS: Members of the Governing and Executive body were not matching with the guidelines. They could not specify their individual roles. The signatories had better knowledge of fund expenditure in comparison to other members who solely depended on the directives of signatories. Most of the RKS meetings were irregular and were usually merged with other meetings. CONCLUSION: Assessment mechanism for the achievement of objectives of RKS was inadequate as it was done only annually, limited only up to scrutiny of bills, no assessment of quality of work, opinion of beneficiaries or health care workers was not considered. [TAF Prev Med Bull 2012; 11(3.000: 307-314

  10. Canada's International Development Research Centre's eco-health projects with Latin Americans: origins, development and challenges.

    Science.gov (United States)

    Cole, Donald C; Crissman, Charles C; Orozco, A Fadya

    2006-01-01

    Since its founding in 1970, Canada's International Development Research Centre (IDRC) has supported research by concerned Latin American researchers on environments and human health relationships. Framing of such relationships has changed through different periods. Participant observation, bibliographic searches, document review, and interviews with key IDRC staff. From the early years of multiple different projects, IDRC developed more focussed interest in tropical diseases, pesticides, agriculture and human health in the 1980s. The United Nations Conference on Sustainable Development in the early 1990s gave impetus to examination of links between ecosystems and human health or "EcoHealth". Projects in Latin America built on earlier work but extended it in methods (transdisciplinarity, community participation, gendered approach) and scope (broader land use and development paradigm issues tackled). A key IDRC-funded activity in Latin America was "EcoSalud", an Ecuadorian effort, which has worked with farming communities, agricultural researchers, health practitioners and local politicians to advance integrated pest management, better recognize and treat poisonings and improve pesticide-related policies. ONGOING CHALLENGES INCLUDE: mobilizing sufficient resources for the primary prevention focus of EcoHealth activities when primary care infrastructure remains stretched, promoting micro-level change in diverse communities and ecosystems, and addressing power structures at the global level that profoundly affect environmental change.

  11. Profile: Manhiça Health Research Centre (Manhiça HDSS).

    Science.gov (United States)

    Sacoor, Charfudin; Nhacolo, Ariel; Nhalungo, Delino; Aponte, John J; Bassat, Quique; Augusto, Orvalho; Mandomando, Inácio; Sacarlal, Jahit; Lauchande, Natu; Sigaúque, Betuel; Alonso, Pedro; Macete, Eusébio; Munguambe, Khátia; Guinovart, Caterina; Aide, Pedro; Menendez, Clara; Acácio, Sozinho; Quelhas, Diana; Sevene, Esperança; Nhampossa, Tacilta

    2013-10-01

    The Manhiça Health Research Centre, established in 1996 in a rural area of southern Mozambique, currently follows around 92 000 individuals living in approximately 20 000 enumerated and geo-positioned households. Its main strength is the possibility of linking demographic data and clinical data to promote and conduct biomedical research in priority health areas. Socio-demographic data are updated twice a year and clinical data are collected on a daily basis. The data collected in Manhiça HDSS comprises household and individual characteristics, household socio-economic assets, vital data, migration, individual health history and cause of death, among others. Studies conducted in this HDSS contributed to guide the health authorities and decision-making bodies to define or adjust health policies such as the introduction of Mozambique's expanded programme of immunization with different vaccines (Haemophilus influenzae type b, Pneumococcus) or the development of the concept of Intermittent Preventive Treatment for Infants (IPTi) that led to the World Health Organization recommendation of this method as best practice for the control of malaria among infants. Manhiça's data can be accessed through a formal request to Diana Quelhas (diana.quelhas@manhica.net) accompanied by a proposal that will be analysed by the Manhiça HDSS internal scientific and ethics committees.

  12. Creating a safety culture at the Children's and Women's Health Centre of British Columbia.

    Science.gov (United States)

    Verschoor, Katrina N; Taylor, Annemarie; Northway, Tracie L; Hudson, Denise G; Van Stolk, Dori E; Shearer, Kim J; McDougall, Debbie L; Miller, Georgene

    2007-02-01

    The Children's' and Women's Health Centre of British Columbia (C&W) is the largest hospital providing specialized care to women and children across the province of British Columbia in Canada. The values of quality and safety are threaded throughout the C&W strategic plan which emphasizes that safety is vital for better health. At C&W, a multifaceted approach is used to create and sustain a culture of safety. The Institute for Healthcare Improvement (IHI) has developed tools to facilitate the development of safety cultures within hospital settings. This article describes the implementation of some of these tools, such as the Safety Briefings Model and Patient Safety Leadership Walkrounds. We will discuss how we adapted these strategies to our pediatric settings; what we learned through the implementation process-our successes and challenges; and implications for future success.

  13. Effect of Health Services Quality to Inpatient Satisfaction in Health Centre of Jayapura Regency, Papua

    Directory of Open Access Journals (Sweden)

    Taufik A AWibowo

    2016-11-01

    Full Text Available To measure the quality of health care using five dimensions of service quality that is direct evidence (Tangibles responsiveness (responsiveness, reliability (realibility, security (assurance, and empathy. The purpose of this study is to determine the effect of the quality of inpatient health care with patient satisfaction in the health center Jayapura district. Survey method with cross sectional analytic study population in this study that all patients hospitalized at the health center during the month of August to September 2016. Sampling was conducted with a total sampling technique with a number of 106 respondents. Sources of primary data obtained from questionnaires and secondary data from six health centers in the county inpatient Jayapura. Analysis of data using multiple linear regression. The results showed that the most dominant variables linked to patient satisfaction compared with other variable is direct evidence (tangibles. The quality of health services at the health center Jayapura district has a significant relationship to the direct evidence (tangibles with patient satisfaction. Jayapura Regency Government through the Department of Health to maintain and continuously improve the quality of health care is the most basic health centers by strengthening institutions, infrastructure, and financing of adequate health centers so as to improve the quality of health centers and satisfaction to the patient.

  14. CLIENT SATISFACTION AND PERCEPTIONS ABOUT QUALITY OF HEALTH CARE AT A PRIMARY HEALTH CENTRE OF DELHI, INDIA

    Directory of Open Access Journals (Sweden)

    N Rasheed

    2012-10-01

    Full Text Available Background: Quality of services shows a variation between the client and the provider. Therefore, it needs to be explored whether the quality of care or the lack of quality can explain the utilization of government health care. Objectives:This paper attempts to assess the utilization of health services and client satisfaction for services provided by a Primary Health Centre (PHC at Delhi, India. Setting and design: The study was a facility based cross sectional study. Exit interviews were conducted among 400 patients seeking outdoor patient department (OPD services of thePHC Palam, New Delhi from May 2010 to November 2010. Material and Methods: Exit interviews were conducted among the patients at each of the service delivery points in the PHC to assess the utilization of services and the satisfaction of clients with the available services. Results: Most respondents rated the services to be of good quality on various parameters of health delivery. The PHC was the preferred health facility (98% for treatment seeking in comparison to other healthcare facilities in the area.The main factors affecting utilization of primary health care services provided by the government were easy accessibility, low cost, less waiting time, and presence of co-operative health personnel. Conclusion:Provision of quality primary healthcare services to clients can result in better utilization of services at the primary level, thereby reducing the unnecessary burden of secondary and tertiary level facilities in addition to improving the health status of the community.

  15. Gatekeepers of health: A qualitative assessment of child care centre staff's perspectives, practices and challenges to enteric illness prevention and management in child care centres

    Directory of Open Access Journals (Sweden)

    Adams Cindy L

    2008-06-01

    Full Text Available Abstract Background Enteric outbreaks associated with child care centres (CCC have been well documented internationally and in Canada. The current literature focuses on identifying potential risk factors for introduction and transmission of enteric disease, but does not examine why these risk factors happen, how the risk is understood and managed by the staff of CCCs, or what challenges they experience responding to enteric illness. The purpose of this study was to explore the understanding, knowledge and actions of CCC staff regarding enteric illness and outbreaks, and to identify challenges that staff encounter while managing them. Methods Focus groups were conducted with staff of regulated CCCs in Southern Ontario. Five focus groups were held with 40 participants. An open ended style of interviewing was used. Data were analyzed using content analysis. Results CCC staff play an important role in preventing and managing enteric illness. Staff used in-depth knowledge of the children, the centre and their personal experiences to assist in making decisions related to enteric illness. The decisions and actions may differ from guidance provided by public health officials, particularly when faced with challenges related to time, money, staffing and parents. Conclusion CCC staff relied on experience and judgment in coordination with public health information to assist decision-making in the management of enteric illness and outbreaks. Advice and guidance from public health officials to CCC staff needs to be consistent yet flexible so that it may be adapted in a variety of situations and meet regulatory and public health requirements.

  16. Portfolio of Outpatients Attending Centre for Urban Health, Madhya Pradesh, Central India

    Directory of Open Access Journals (Sweden)

    Arti Gupta

    2015-08-01

    Full Text Available Background: Knowledge on distribution and burden of diseases in a community is essential for planning of public health services. In the absence of information on morbidity profile through community-based surveys, facility-based data provide a good alternative. The aim of this study was to describe the morbidity profile of patients attending the Centre for Urban Health All India Institute of Medical Sciences (AIIMS Bhopal (CUHA. Methodology: A record-based descriptive study was carried out in the CUHA Bhopal, Madhya Pradesh, Central India. Information on age, gender, residence, new case, and principal diagnosis were extracted from the outpatient registers for the period between January 2014 and December 2014. Only newly registered patients for the study year (2014 were included. Descriptive analysis was done. Results: A total of 6685 new episodes of illnesses were treated. Adults (>15 years constituted about 85.0%. Overall, the respiratory disorders were the most common (27.2% followed by the digestive disorders (10.9%, circulatory disorders (9.9%, musculoskeletal disorders (8.8%, and infectious and parasitic disorders (7.4%. Conclusion: This study gives a brief description of the morbidity profile of patients attending a primary health care center over a period of 1 year. This knowledge would help in planning health services to meet the patients’ needs and help in training health staff.

  17. Primary Health Centre disaster preparedness after the earthquake in Padang Pariaman, West Sumatra, Indonesia

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    Mansyur Muchtaruddin

    2011-03-01

    Full Text Available Abstract Background The West Sumatra earthquake that occurred on September 30, 2009, caused severe damage in some districts, including Padang Pariaman. As Padang Pariaman is an earthquake-prone area, disaster and emergency management is necessary. Due to the limited health facilities, the health services completely rely on Puskesmas (Primary Health Centres, PHCs. This study is aimed at assessing the preparedness of PHCs to response to potential disasters in their surrounding area. Findings Padang Pariaman district was used in a case study setting to assess the readiness and preparedness of the PHCs there to face disasters. Self-administered questionnaire, key informant interview, and direct observation were used to obtain the data on human resources, facilities preparedness, and the procedures. The investigation focused on measuring four aspects, i.e. human resources, facilities preparedness, standard operating procedure (SOP, and policy. Due to the limited co-operation of the head of the PHCs, three PHCs were directly observed as a subsample. The evaluation was performed six months after the impact phase of the earthquake and three months after the PHCs' health staff training on improving the primary health care services. The number and quality of health staff in Padang Pariaman was far below ideal. Fewer than half of the PHCs had emergency facilities and only one considered the need for triage and fire management, whereas the transportation mode was still limited. An SOP and policy for facing disasters were not available in any of the PHCs. Therefore, promoting disaster preparedness, technical provision, including health staff training, is necessary. Conclusions Padang Pariaman district has not yet prepared its PHCs to face disaster, so it is apparent that PHCs' disaster preparedness in Padang Pariaman and also other earthquake-prone areas in Indonesia should be promoted. This should include increasing the number of doctors, providing training

  18. Dental Health Behavior in the Prevention of Pulmonary TB at Health Centre in Several Provinces

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    Indirawati Tjahja Notohartojo

    2016-02-01

    Full Text Available Background: Pulmonary TB is an infectious disease of the respiratory tract caused by bacteria. Dental health professionals such as dentists and dental nurses are in charge of health personnel to prevent, treat, cure, teeth the mouth, so as not to arise or aggravate toothache. In doing their job as dental health workers is expected to use gloves or masks, and always wash their hands to avoid the transmission of pulmonary TB disease. Methods: A cross sectional study was conducted involving 78 dental health professionals in 50 primary health centers that were chosen in six districts in three provinces of Banten, South Kalimantan and Gorontalo. Data were obtained by interviews and processed using SPSSResults: More than 90% dental health workers in work wore masks gloves and washed their hands after work. There was a signifi cant relationship between exercise with dental health professionals with a p value of 0.007, which means a signifi cant. Conclusion: In performing their duties, dental health workers have already used personal protective equipment such asmasks, gloves, and washed their hands and did enough exercise. Recommendation: need to increase knowledge about pulmonary TB in dental health professionals.

  19. Prescription monitoring of anti-hypertensive drug utilisation at the Panjab University Health Centre in India.

    Science.gov (United States)

    Tiwari, H; Kumar, A; Kulkarni, S K

    2004-03-01

    The present pilot study was conducted in order to establish the drug-prescribing trend of anti-hypertensive agents at the Panjab University Health Centre in India. A pilot study of six-month duration was conducted at the Panjab University Health Centre. The information was collected from the patients attending the outpatient department through a random sample method. World Health Organisation-based prescription-auditing proforma was used for data collection. This study revealed that most of the male patients were on monotherapy (60 percent). In the monotherapy category, four classes of drugs were used. These were calcium channel blockers (48.1 percent), beta-blockers (46.2 percent), ACE inhibitors (3.9 percent) and diuretics (1.9 percent). Among monotherapy drugs, calcium channel blockers were prescribed most whereas diuretics were least used. Among those who were treated with drug combinations, 92.1% received two drugs and 7.9 percent received three drugs. In combination therapy, a two-drug combination consisting of beta-blockers and calcium channel blockers was given to the majority of the patients. Overall, 57.8 percent patients were treated with a single anti-hypertensive drug and 42.2 percent were treated with anti-hypertensive drug combinations. The present study represents the current prescribing trend for anti-hypertensive agents and it highlights certain shortcomings in the existing prescribing practice. There is a considerable scope for improvement, particularly the under-utilisation of diuretics in the present prescribing pattern of anti-hypertensive drugs.

  20. Towards One Health Knowledge Networks: A Southern African Centre of Infectious Disease Surveillance case study

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    Eric Beda

    2012-06-01

    Full Text Available The dynamic nature of new information and/or knowledge is a big challenge for information systems. Early knowledge management systems focused entirely on technologies for storing, searching and retrieving data; these systems have proved a failure. Juirsica and Mylopoulos1 suggested that in order to build effective technologies for knowledge management, we need to further our understanding of how individuals, groups and organisations use knowledge. As the focus on knowledge management for organisations and consortia alike is moving towards a keen appreciation of how deeply knowledge is embedded in people’s experiences, there is a general realisation that knowledge cannot be stored or captured digitally. This puts more emphasis in creating enabling environments for interactions that stimulate knowledge sharing.Our work aims at developing an un-obtrusive intelligent system that glues together effective contemporary and traditional technologies to aid these interactions and manage the information captured. In addition this system will include tools to aid propagating a repository of scientific information relevant to surveillance of infectious diseases to complement knowledge shared and/or acts as a point of reference.This work is ongoing and based on experiences in developing a knowledge network management system for the Southern African Centre of Infectious Disease Surveillance (SACIDS, A One Health consortium of southern African academic and research institutions involved with infectious diseases of humans and animals in partnership with world-renowned centres of research in industrialised countries.

  1. A study of automated self-assessment in a primary care student health centre setting.

    Science.gov (United States)

    Poote, Aimee E; French, David P; Dale, Jeremy; Powell, John

    2014-04-01

    We evaluated the advice given by a prototype self-assessment triage system in a university student health centre. Students attending the health centre with a new problem used the automated self-assessment system prior to a face-to-face consultation with the general practitioner (GP). The system's rating of urgency was available to the GP, and following the consultation, the GP recorded their own rating of the urgency of the patient's presentation. Full data were available for 154 of the 207 consultations. Perfect agreement, where both the GP and the self-assessment system selected the same category of advice, occurred in 39% of consultations. The association between the GP assessment and the self-assessment rankings of urgency was low but significant (rho = 0.19, P = 0.016). The self-assessment system tended to be risk averse compared to the GP assessments, with advice for more urgent level of care seeking being recommended in 86 consultations (56%) and less urgent advice in only 8 (5%). This difference in assessment of urgency was significant (P self-assessed and GP-assessed urgency was not associated with symptom site or socio-demographic characteristics of the user. Although the self-assessment system was more risk averse than the GPs, which resulted in a high proportion of patients being triaged as needing emergency or immediate care, the self-assessment system successfully identified a proportion of patients who were felt by the GP to have a self-limiting condition that did not need a consultation. In its prototype form, the self-assessment system was not a replacement for clinician assessment and further refinement is necessary.

  2. Client-centred coaching in the paediatric health professions: a critical scoping review.

    Science.gov (United States)

    Schwellnus, Heidi; King, Gillian; Thompson, Laura

    2015-01-01

    Coaching is mainstream in business and is expanding into paediatric health care. With the focus on evidence-informed health practice, it is imperative to identify the key active components of interventions. Coaching is by definition a complex intervention with numerous components. The purpose of this critical review is to determine how coaching is currently defined, its prevalence in paediatric health care services and the frequency of the active components of coaching and to consider the findings of research to date. A critical review of the literature was conducted. Inclusion/exclusion criteria were based on the International Coach Federation, which stipulates that coaching is a collaborative process that involves client-centred goal setting, facilitation, self-discovery and capacity building. Seventeen studies were selected for thorough review. Throughout the literature, there was inconsistency in how coaching was defined. Studies included various components, but overall the literature lacked cohesion. To advance the field, a list of components that foster client engagement was developed along with a comprehensive definition of coaching involving affective, behavioural and cognitive components and a path of research necessary to evaluate this complex intervention. Implications for Rehabilitation A comprehensive approach to coaching involves consideration of multiple components. A coaching approach can enhance engagement in rehabilitation interventions. The operationalization of holistic ABC coaching that encapsulates the important components, which are affective, behavioural and cognitive in nature.

  3. Governance structure reform and antibiotics prescription in community health centres in Shenzhen, China.

    Science.gov (United States)

    Liang, Xiaoyun; Xia, Tingsong; Zhang, Xiulan; Jin, Chenggang

    2014-06-01

    It is unclear whether changing the governance structure of community health centres (CHCs) could affect antibiotic prescribing behaviour. To explore how changes in governance structure affect antibiotic prescription for children younger than 5 years of age with acute upper respiratory tract infections (AURI) in CHCs in Shenzhen, China. This study used an interrupted time series design with a comparison series. On 1 June 2009, the Health Bureau of Shenzhen's Baoan District transferred CHCs from a hospital-affiliated model to a self-managed independent model regarding finance, personnel and employee compensation. We collected 23481 electronic medical records of children younger than 5 years of age who were treated for AURI on an outpatient basis 1 year before and 1 year after governance structure reform. We used segmented regression analysis to evaluate the effect of reform on antibiotic prescription. After the reform, the proportion of patients receiving an antibiotic injection per month and the proportion of patients receiving two or more antibiotics conditional on receiving an antibiotic per month decreased 9.17% and 7.34%, respectively (P governance structure reform can have positive effects on behaviour for antibiotic prescribing. Moreover, this short-term effect might have important implications for further community health reforms in China. © The Author 2014. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  4. Length of stay in asylum centres and mental health in asylum seekers: a retrospective study from Denmark

    Science.gov (United States)

    Hallas, Peter; Hansen, Anne R; Stæhr, Mia A; Munk-Andersen, Ebbe; Jorgensen, Henrik L

    2007-01-01

    Background The length of stay in asylum centres is generally mentioned as a possible health risk to asylum seekers. Medical staff working with asylum seekers has claimed that long lengths of stay in asylum centres might cause or aggravate mental disorders. We used records from a large, multiethnic group of asylum seekers to study if the incidence of mental disorders increased with length of stay. Methods The study population was asylum seekers in Danish asylum centres run by the Danish Red Cross. General medical care was provided by Red Cross staff who could refer selected cases to medical specialists. If an asylum seeker needed more than three specialist consultations for mental illness or five consultations for physical illness the referrals had to be approved by The Danish Immigration Service. Between July 2001 – December 2002 the Red Cross prospectively registered health related data on all new applications (n = 4516) to the Immigration Service regarding referrals to medical specialists. We used these records to analyse the association between length of stay in the asylum centres and overall rate of referral for mental disorders. Data was analysed using weighted linear regression. Results We found that referrals for mental disorders increased with length of stay in asylum centres in a large, multiethnic population of asylum seekers. The association was found in all the categories of psychiatric illness studied and for a majority of the nationality groups studied. Conclusion Length of stay in asylum centres was associated with an increase in referrals for mental disorders in a large, multiethnic group of asylum seekers. The present study supports the view that prolonged length of stay in an asylum centre is a risk factor for mental health. The risk of psychiatric illness among asylum seekers should be addressed by political and humanitarian means, giving prevention of illness the highest priority. PMID:17931414

  5. A student-centred electronic health record system for clinical education.

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    Elliott, Kristine; Judd, Terry; McColl, Geoff

    2011-01-01

    Electronic Health Record (EHR) systems are an increasingly important feature of the national healthcare system [1]. However, little research has investigated the impact this will have on medical students' learning. As part of an innovative technology platform for a new masters level program in medicine, we are developing a student-centred EHR system for clinical education. A prototype was trialed with medical students over several weeks during 2010. This paper reports on the findings of the trial, which had the overall aim of assisting our understanding of how trainee doctors might use an EHR system for learning and communication in a clinical setting. In primary care and hospital settings, EHR systems offer potential benefits to medical students' learning: Longitudinal tracking of clinical progress towards established learning objectives [2]; Capacity to search across a substantial body of records [3]; Integration with online medical databases [3]; Development of expertise in creating, accessing and managing high quality EHRs [4]. While concerns have been raised that EHR systems may alter the interaction between teachers and students [3], and may negatively influence physician-patient communication [6], there is general consensus that the EHR is changing the current practice environment and teaching practice needs to respond. Final year medical students on clinical placement at a large university teaching hospital were recruited for the trial. Following a four-week period of use, semi-structured interviews were conducted with 10 participants. Audio-recorded interviews were transcribed and data analysed for emerging themes. Study participants were also surveyed about the importance of EHR systems in general, their familiarity with them, and general perceptions of sharing patient records. Medical students in this pilot study identified a number of educational, practical and administrative advantages that the student-centred EHR system offered over their existing ad

  6. Cost of Delivering Health Care Services in Public Sector Primary and Community Health Centres in North India

    Science.gov (United States)

    Gupta, Aditi; Verma, Ramesh; Bahuguna, Pankaj; Kumar, Dinesh; Kaur, Manmeet; Kumar, Rajesh

    2016-01-01

    Background With the commitment of the national government to provide universal healthcare at cheap and affordable prices in India, public healthcare services are being strengthened in India. However, there is dearth of cost data for provision of health services through public system like primary & community health centres. In this study, we aim to bridge this gap in evidence by assessing the total annual and per capita cost of delivering the package of health services at PHC and CHC level. Secondly, we determined the per capita cost of delivering specific health services like cost per antenatal care visit, per institutional delivery, per outpatient consultation, per bed-day hospitalization etc. Methods We undertook economic costing of fourteen public health facilities (seven PHCs and CHCs each) in three North-Indian states viz., Haryana, Himachal Pradesh and Punjab. Bottom-up costing method was adopted for collection of data on all resources spent on delivery of health services in selected health facilities. Analysis was undertaken using a health system perspective. The joint costs like human resource, capital, and equipment were apportioned as per the time value spent on a particular service. Capital costs were discounted and annualized over the estimated life of the item. Mean annual costs and unit costs were estimated along with their 95% confidence intervals using bootstrap methodology. Results The overall annual cost of delivering services through public sector primary and community health facilities in three states of north India were INR 8.8 million (95% CI: 7,365,630–10,294,065) and INR 26.9 million (95% CI: 22,225,159.3–32,290,099.6), respectively. Human resources accounted for more than 50% of the overall costs at both the level of PHCs and CHCs. Per capita per year costs for provision of complete package of preventive, curative and promotive services at PHC and CHC were INR 170.8 (95% CI: 131.6–208.3) and INR162.1 (95% CI: 112–219

  7. Psychosocial stressors and depression at a Swedish primary health care centre. A gender perspective study

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    Strömberg Ranja

    2011-11-01

    Full Text Available Abstract Background Psychosocial stress may account for the higher prevalence of depression in women and in individuals with a low educational background. The aim of this study was to analyse the association between depression and socio-demographic data, psychosocial stressors and lifestyle circumstances from a gender perspective in a relatively affluent primary care setting. Methods Patients, aged 18- 75 years, visiting a drop-in clinic at a primary care health centre were screened with Beck's Depression Inventory (BDI. The physicians used also targeted screening with BDI. A questionnaire on socio-demographic data, psychosocial stressors and use of alcohol and tobacco was distributed. Among patients, who scored BDI ≥10, DSM-IV-criteria were used to diagnose depression. Of the 404 participants, 48 men and 76 women were diagnosed with depression. The reference group consisted of patients with BDI score Results The same three psychosocial stressors: feeling very stressed, perceived poor physical health and being dissatisfied with one's family situation were associated with depression equally in men and women. The negative predictive values of the main effect models in men and women were 90.7% and 76.5%, respectively. Being dissatisfied with one's work situation had high ORs in both men and women. Unemployment and smoking were associated with depression in men only. Conclusions Three questions, frequently asked by physicians, which involve patient's family and working situation as well as perceived stress and physical health, could be used as depression indicators in early detection of depression in men and women in primary health care.

  8. PREVALENCE OF ANAEMIA IN PREGNANT WOMEN ATTENDING A PRIMARY HEALTH CENTRE IN BARPETA DISTRICT, ASSAM

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    Dhritishna

    2016-05-01

    Full Text Available BACKGROUND Anaemia in pregnancy has serious adverse effects on the health of the mother and the developing foetus. OBJECTIVES The study aims to estimate the prevalence of anaemia in pregnant woman attending the Nagaon Primary Health Centre (PHC in Barpeta district, Assam. METHODS A cross-sectional study was carried out from 1 April, 2014 to 1 May, 2014. 100 pregnant women attending Nagaon PHC were interviewed using a predesigned and pretested interview schedule followed by a short clinical examination for pallor and laboratory estimation of haemoglobin. Sahli’s (Acid Haematin method was used for haemoglobin estimation. Haemoglobin level below the cut-off 11 g/dL was used to label a pregnant woman as anaemic and further classified as mild (10-10.9 g/dL, moderate anaemia (7-9.9 g/dL and severe anaemia (<7 g/dL. RESULTS 77% women were suffering from anaemia. Out of these, 57 %were mildly anaemic and 20% were moderately anaemic. Women of younger age groups, greater parity, a gap less than 3 years between subsequent pregnancies, less education and practising Hinduism had a greater prevalence of anaemia. CONCLUSION Awareness about the serious consequences that anaemia can lead to and advocacy of a proper iron-rich diet, regular intake of IFA tablets and purification of water to prevent infestation by parasites can help in reduction of anaemia.

  9. Flexible work in call centres: Working hours, work-life conflict & health.

    Science.gov (United States)

    Bohle, Philip; Willaby, Harold; Quinlan, Michael; McNamara, Maria

    2011-01-01

    Call-centre workers encounter major psychosocial pressures, including high work intensity and undesirable working hours. Little is known, however, about whether these pressures vary with employment status and how they affect work-life conflict and health. Questionnaire data were collected from 179 telephone operators in Sydney, Australia, of whom 124 (69.3%) were female and 54 (30.2%) were male. Ninety-three (52%) were permanent full-time workers, 37 (20.7%) were permanent part-time, and 49 (27.4%) were casual employees. Hypothesised structural relationships between employment status, working hours and work organisation, work-life conflict and health were tested using partial least squares modelling in PLS (Chin, 1998). The final model demonstrated satisfactory fit. It supported important elements of the hypothesised structure, although four of the proposed paths failed to reach significance and the fit was enhanced by adding a path. The final model indicated that casual workers reported more variable working hours which were relatively weakly associated with greater dissatisfaction with hours. The interaction of schedule control and variability of hours also predicted dissatisfaction with hours. Conversely, permanent workers reported greater work intensity, which was associated with both lower work schedule control and greater work-life conflict. Greater work-life conflict was associated with more fatigue and psychological symptoms. Labour market factors and the undesirability of longer hours in a stressful, high-intensity work environment appear to have contributed to the results.

  10. A Worksite Health Education Workshop as Empowerment Intervention for Health Promotion in the National Research Centre of Egypt

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    Nagat Mohamed Amer

    2016-09-01

    Full Text Available AIM: The study aimed to assess worksite health education workshops as a successful tool for health promotion of employees. MATERIAL AND METHODS: A one day workshop was held for individuals engaged in research activities in the National research Centre of Egypt at the worksite. Its main objective was to highlight the nature, causes, symptoms and management of job stress. Participants were asked to fill a personality assessment sheet, a self-reported questionnaire for job satisfaction. Other questionnaires for assessment of falsification of type and some socio-demographic data were filled by the attendants. A concise survey was introduced at the end of the workshop for feedback collection. RESULTS: Attendants of the workshop were 36 subjects mainly females (94.4%. Mean age was 40.5 years with 63.9% of participants at their postdoctoral studies stage. Participants were at midway in the scale of job satisfaction (3.3 and did not suffer from falsification (0.3. The feedback survey score (11.5 showed great acceptance for the intervention. Special interest in the topic of stress was reported by 35.1% of attendants who found it the best item in the workshop and the interactive manipulation came next as declared by 18.9% of the participants. CONCLUSION: Worksite health education workshops seem to be a successful practice for empowerment in the Egyptian workplace.

  11. Knowledge and attitudes of nurses in community health centres about electronic medical records

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    Don O'Mahony

    2014-02-01

    Full Text Available Background: Nurses in primary healthcare record data for the monitoring and evaluation of diseases and services. Information and communications technology (ICT can improve quality in healthcare by providing quality medical records. However, worldwide, the majority of health ICT projects have failed. Individual user acceptance is a crucial factor in successful ICT implementation.Objectives: The aim of this study is to explore nurses’ knowledge, attitudes and perceptions regarding ICT so as to inform the future implementation of electronic medical record (EMR systems.Methods: A qualitative design was used. Semi-structured interviews were undertaken with nurses at three community health centres (CHCs in the King Sabata Dalyindyebo Local Municipality. The interview guide was informed by the literature on user acceptance of ICT. Interviews were recorded and analysed using content analysis.Results: Many nurses knew about health ICT and articulated clearly the potential benefits of an EMR such as fewer errors, more complete records, easier reporting and access to information. They thought that an EMR system would solve the challenges they identified with the current paper-based record system, including duplication of data, misfiling, lack of a chronological patient record, excessive time in recording and reduced time for patient care. For personal ICT needs, approximately half used cellphone Internet-based services and computers.Conclusions: In this study, nurses identified many challenges with the current recording methods. They thought that an EMR should be installed at CHCs. Their knowledge about EMR, positive attitudes to ICT and personal use of ICT devices increase the likelihood of successful EMR implementation at CHCs. 

  12. Risk of antenatal psychosocial distress in indigenous women and its management at primary health care centres in Australia.

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    Gausia, Kaniz; Thompson, Sandra C; Nagel, Tricia; Schierhout, Gill; Matthews, Veronica; Bailie, Ross

    2015-01-01

    This study explored the risk of antenatal psychosocial distress (APD) and associated potential factors and examined management aspects of risk of APD in women attending Aboriginal primary health care services in Australia. Audits of medical records of 797 pregnant women from 36 primary health centres in five jurisdictions (NSW, QLD, SA, WA and NT) were undertaken as part of a quality improvement programme. Information collected included mental health assessed by a standard screening tools, enquiry regarding social and emotional well-being (SEWB), depression management (including antidepressant medications) and referral. Around 18% (n=141) of women were at risk of APD based on assessment using a standard screening tool or by SEWB enquiry. There was a significant association between risk of distress and women's life style behaviours (e.g., alcohol, illicit drug use) and health centre characteristics. Of the 141 women, 16% (n= 22) were prescribed antidepressant drugs during pregnancy. A range of nonpharmaceutical mental health interventions were also recorded, including brief intervention of 61% (n=86), counselling of 57% (n=80) and cognitive behaviour therapy of 5% (n=7). About 39% (n=55) of women with APD were referred to external services for consultations with a psychiatrist, psychologist or social worker or to a women's refuge centre. The higher risk of APD associated with women's life style behaviour indicates that the better understanding of mental health in its cultural context is essential. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. A study of female genital swabs in primary health care centres in Jos, Nigeria

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    Samuel Nwadioha

    2011-03-01

    Full Text Available Objective: To detect some common microbial agents of female genital discharges in order to improve the current syndromic management of abnormal vaginal discharge. Methods: A prospective study of female genital swabs collected from Primary Health Care Centres, Jos, and analysed for microscopy, culture and sensitivity in Jos University Teaching Hospital, December 2006 to December 2007 was carried out. Results: Microbial agents were detected in 70% (700 of a total 1 000 female genital swabs studied. Candida species peaked with 42.0% (420 out of the 1000 samples, followed by Gardnerella vaginalis, an agent of bacterial vaginosis with 26.0%. The distribution of abnormal vaginal discharge was highest in young adults aged 21 to 30 years. Conclusions: It is concluded that abnormal vaginal discharge is most prevalent in the young sexually active age group with Candida species as the commonest agent. We recommend prevention, early diagnosis and prompt treatment of infective female genital discharge in order to reduce the menace of HIV transmission.

  14. Alcohol and drug use in students attending a student health centre.

    LENUS (Irish Health Repository)

    Cahill, E

    2010-09-01

    Alcohol and drug use amongst 3rd level students in Ireland is a concern and has been reported previously in the CLAN Survey. The aim of our study was to determine the alcohol and drug use and any alcohol associated adverse consequences amongst students attending the health centre of University College Cork (UCC). 178 (98.3%) of the 181 students who replied reported having ever drunk alcohol. 157 (91.3%) students drank spirits in the past year v 148 (86.5%) who drank beer\\/cider v 135 (78.5%) who drank wine. 81 (44.8%) students reported binge drinking at least once weekly. 48 (26.5%) students used cannabis in the past year v 12 (6.9%) who used cocaine and 7 (4%) who used ecstasy. All students who drink reported at least one adverse consequence. 114 (63%) of students report adverse consequences of other peoples drinking. The changing drinking behaviour of female students is of particular concern.

  15. Prescription patterns of antihypertensives in a community health centre in Mexico City: a drug utilization study.

    Science.gov (United States)

    Alba-Leonel, Adela; Carvajal, Alfonso; Fierro, Immaculada; Castillo-Nájera, Fernando; Campos-Ramos, Oscar; Villa-Romero, Antonio; Molina-Guarneros, Juan

    2016-06-01

    Hypertension is highly prevalent; in Mexico, the 2012 National Health and Nutrition Survey reported a prevalence of hypertension of 31.5% in the adult population. Pharmacological treatment is the commonest intervention and has been shown to reduce cardiovascular mortality and morbidity, and total mortality. Accordingly, the type and number of antihypertensives used and the outcome - in terms of blood pressure (BP) control - are important. Therefore, our purpose is to learn the pattern of antihypertensive drug prescription and explore the determinants of BP control in an urban population in Mexico. A retrospective cross-sectional drug utilization study was conducted. Medical records from a community health centre were searched to identify those corresponding to patients diagnosed with hypertension; information upon antihypertensives used and control of the disease was carefully retrieved. A logistic regression model was built to know the main determinants of BP control. A sample of 345 clinical records of interest was identified. Most patients received antihypertensives (86.4%); the leading medications used were angiotensin-converting enzyme inhibitors, 63.8%; beta-blockers (26.5%), diuretics (19.8%), angiotensin-receptor blockers (15.8%) and calcium-channel blockers (6.4%). Only the age (≥55 years) and BMI (>30) of the patients, and the age of the doctors (≥55 years), had an important influence on BP control. Obesity is a particular and important determinant of uncontrolled hypertension; it is worth to act on body weight, on an individual basis. As lack of control has been also tied to elderly doctors, an education programme could be envisaged. © 2016 The Authors Fundamental & Clinical Pharmacology published by John Wiley & Sons Ltd on behalf of Société Française de Pharmacologie et de Thérapeutique.

  16. Health status of internationally adopted children. The experience of an Italian “GLNBI” paediatric centre

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    Piero Valentini

    2012-09-01

    Full Text Available

    Background: according to ISTAT (National Institute of Statistics-Italy, in 2011 20.7% of the foreign population in Italy is composed by children, either coming along with their families or alone, like in international adoptions. Immigrant children have some peculiarities related to their previous living conditions, although there are no significant differences between immigrant and native children’ diseases.

    Methods: in 3.5 years we evaluated every adoptee that reached our university centre, by using GLNBI (Gruppo di Lavoro Nazionale del Bambino Immigrato diagnostic – aiding protocol, in order to assess infectious diseases, nutritional deficiencies, immunization status, intestinal parasitosis or other pathologies; this protocol is actually applied only in research centres.

    Results: we evaluated 358 international adoptees from 4 different Zones of the world; average age at first visit was approximately 5 years. Health certifications concerning vaccination history records were considered “valid” in 59.2% (212/358, 49.5% (105/212 of which had a complete panel of immunization. QuantiFERON®_TB Gold In-Tube (QTF test resulted negative in 94.0% cases (313/333 and positive in 6.0% (20/333. HIV, HCV and Syphilis tests resulted in 0.3% positive test for each serology (1/358. Cysticercosis’ serology was positive in 8.9% (32/358 using immunoenzymatic assay (not confirmed by immunoblotting and Toxocariasis in 13.1% (47/358. Parasitological investigation of faeces were found positive on 42.7% (153/358 children, throat swabs in 11.5% (41/358 children. There were 82.4% (295/358 abnormal blood count, 41.9% (150/358 low ferritin, 89.9% (322/358 endocrine abnormalities and 20.4% (73/358 various pathologies evaluated by specialists.

    Conclusions: pathologies affecting our study group are the same affecting other categories of immigrant children, because they often

  17. EQ-5D Health Utility Scores: Data from a Comprehensive Canadian Cancer Centre.

    Science.gov (United States)

    Naik, Hiten; Howell, Doris; Su, Susie; Qiu, Xin; Brown, M Catherine; Vennettilli, Ashlee; Irwin, Margaret; Pat, Vivien; Solomon, Hannah; Wang, Tian; Hon, Henrique; Eng, Lawson; Mahler, Mary; Thai, Henry; Ho, Valerie; Xu, Wei; Seung, Soo Jin; Mittmann, Nicole; Liu, Geoffrey

    2017-02-01

    To improve the precision of health economics analyses in oncology, reference datasets of health utility (HU) scores are needed from cancer survivors across different disease sites. These data are particularly sparse amongst Canadian survivors. A survey was completed by 1759 ambulatory cancer survivors at the Princess Margaret Cancer Centre which contained demographic questions and the EuroQol-5D (EQ-5D) instrument. Clinical information was abstracted from electronic records and HU scores were calculated using Canadian health state valuations. Construct validity was assessed through correlation of HU and visual analog scale (VAS) scores (Spearman) and by comparing HU scores between performance status groups (effect size). The influence of socio-demographic clinical variables on HU was analyzed by non-parametric between-group comparisons and multiple linear regression. Mean EQ-5D HU scores were derived for 26 cancers. Among all survivors, the mean ± standard error of the mean EQ-5D utility score was 0.81 ± 0.004. Scores varied significantly by performance status (p < 0.0001) and correlated with VAS (Spearman r = 0.61). The cancer sites with the lowest mean HU scores were acute lymphoblastic leukemia (0.70 ± 0.03) and pancreatic cancer (0.76 ± 0.03); testicular cancer (0.89 ± 0.02) and chronic lymphocytic leukemia (0.90 ± 0.05) had the highest mean scores. A multiple regression model showed that scores were influenced by disease site (p < 0.001), education level (p < 0.001), partner status (p < 0.001), disease extent (p = 0.0029), and type of most recent treatment (p = 0.0061). This work represents the first set of HU scores for numerous cancer sites derived using Canadian preference weights. The dataset demonstrated construct validity and HU scores varied by general socio-demographic and clinical parameters.

  18. Determinants of patient enablement at primary health care centres in central Ethiopia: a cross-sectional study

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    Woldie, Mirkuzie K.; Assefa, Tsion; Morankar, Sudhakar

    2011-01-01

    Abstract Background Patient enablement is associated with behaviours like treatment adherence and self-care and is becoming a well-accepted indicator of quality of care. However, the concept of patient enablement has never been subjected to scientific inquiry in Ethiopia. Objectives The aim of this study was to determine the degree of patient enablement and its predictors after consultation at primary health care centres in central Ethiopia. Method Data were collected from 768 outpatients from six primary health care centres in central Ethiopia during a cross-sectional study designed to assess patient satisfaction. Consecutive patients, 15 years or older, were selected for the study from each health centre. Multinomial logistic regression was performed to identify predictors of patient enablement using SPSS (version 16.0). Results The study showed that 48.4% of patients expressed an intermediate level of enablement, while 25.4% and 26.2% of the patients expressed low and high levels of patient enablement, respectively. Four models were developed to identify predictors of patient enablement. The first model included socio-demographic variables, showing that residence, educational status and occupational status were significantly associated with patient enablement (p non-verbal communication, familiarity with the provider, information sharing about illness and arrangement for follow-up visits were strong predictors of patient enablement (p < 0.05). Conclusion The present study revealed specific predictors of patient enablement, which health care providers should consider in their practice to enhance patient enablement after consultation.

  19. The factors which have an impact on patients when they are choosing health care centres in Poland

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    A.M. Krukowska-Miler

    2015-09-01

    Full Text Available The aim of the article. The aim of this article is the presentation of factors, which have an impact on patients when they are choosing services in health care sector. The results of the analysis. In the article, factors, which have an impact on patients when they are choosing services in health care sector, are presented. The kinds of needs and the characteristic features of medical services, which influence directly on patients are shown in the paper. Presented research of appropriate group of health care centre respondents has shown that the main emphasis they put on the time of waiting for an appointment, doctors’ competences and the staff’s attitude towards patients. Good transport connections and the equipment of health centres are less important. This permits the management to improve the patient services by staff training, which makes the quality of services better, kind and full of empathy treating them. Also it is approved that it would be good if the practice in the health centre became the observation of patients’ and staff’s behaviour which could enable to distinguish appearing needs and possibilities of their fulfilling. The expectations of medical services purchasers are determined. It can be their earlier experience, friends’ opinions and heard information. It is proved that creating of too low level of expectations can make difficulties in encouraging large group of people to buy an offer. Too high level of expectations can make customers dissatisfied. At the same time when companies are concentrated on a customer, their goal of actions and basic success meter is purchaser’s satisfaction, but there should be the balance between the satisfaction level and company profitability. The research highlights also the aspect which is the most visible in the Polish health care system (it is common not only in Poland but in some European countries as well – the time of waiting for the appointments, mainly with specialists. It

  20. LIPID PROFILE OF TYPE 2 DIABETES PATIENTS ATTENDING AN URBAN HEALTH CENTRE IN GOA, INDIA

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    Nitin Y. Dhupdale

    2016-08-01

    Full Text Available The Global Diabetes Report 2016 states, “Globally, an estimated 422 million adults were living with diabetes in 2014 compared to 108 million in 1980. Diabetes is especially a significant secondary cause for the development of dyslipidaemia. Diabetes patients are prone to have an atherogenic mixture of high Triglycerides (TGs; high, small, dense Low-Density Lipoprotein (LDL fractions; and low High-Density Lipoprotein (HDL. This study is aimed at finding the prevalence of dyslipidaemia among type 2 diabetes patients residing in a suburban area of Goa. METHODOLOGY A record-based cross-sectional study design was employed to find the proportion of dyslipidaemia prevalent among the type 2 diabetes patients attending OPD of the Urban Health and Training Centre (UHTC at Santa Cruz in Goa. A sample of 100 type 2 DM patient records were randomly selected to capture the information of the type 2 DM patients. Patient records of fasting and postprandial blood sugars and fasting lipid parameters were utilised for this study. SPSS version 23 was utilised for statistical analysis; proportions, and chi-square test were used for analysis. RESULTS The overall prevalence of dyslipidaemia was 85% among the type 2 DM cases. Prevalence of hyperlipidaemia among females was high (88.7% as compared to males (78.9%. The mean level of total cholesterol was 188.78±38.25 mg/dL. Mean HDL-C level was 48.5±14.06 mg/dL. Mean value of LDL-C was 109.93±35.67 mg/dL. Mean level of LDL-C was 137.67±59.77 mg/dL. CONCLUSION The type 2 diabetes patients have very high prevalence of dyslipidaemia and should be monitored on regular basis to prevent cardiovascular events.

  1. Mentoring perception and academic performance: an Academic Health Science Centre survey.

    Science.gov (United States)

    Athanasiou, Thanos; Patel, Vanash; Garas, George; Ashrafian, Hutan; Shetty, Kunal; Sevdalis, Nick; Panzarasa, Pietro; Darzi, Ara; Paroutis, Sotirios

    2016-10-01

    To determine the association between professors' self-perception of mentoring skills and their academic performance. Two hundred and fifteen professors from Imperial College London, the first Academic Health Science Centre (AHSC) in the UK, were surveyed. The instrument adopted was the Mentorship Skills Self-Assessment Survey. Statement scores were aggregated to provide a score for each shared core, mentor-specific and mentee-specific skill. Univariate and multivariate regression analyses were used to evaluate their relationship with quantitative measures of academic performance (publications, citations and h-index). There were 104 professors that responded (response rate 48%). There were no statistically significant negative correlations between any mentoring statement and any performance measure. In contrast, several mentoring survey items were positively correlated with academic performance. The total survey score for frequency of application of mentoring skills had a statistically significant positive association with number of publications (B=0.012, SE=0.004, p=0.006), as did the frequency of acquiring mentors with number of citations (B=1.572, SE=0.702, p=0.030). Building trust and managing risks had a statistically significant positive association with h-index (B=0.941, SE=0.460, p=0.047 and B=0.613, SE=0.287, p=0.038, respectively). This study supports the view that mentoring is associated with high academic performance. Importantly, it suggests that frequent use of mentoring skills and quality of mentoring have positive effects on academic performance. Formal mentoring programmes should be considered a fundamental part of all AHSCs' configuration. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  2. Patient Centred Systems: Techno-Anthropological reflections on the challenges of 'meaningfully engaging' patients within health informatics research.

    Science.gov (United States)

    Wong, Ming-Chao; Almond, Helen; Cummings, Elizabeth; Roehrer, Erin; Showell, Chris; Turner, Paul

    2015-01-01

    This chapter explores how Techno-Anthropology can contribute to more explicitly professional and ethically responsible reflections on the socio-technical practices involved in meaningfully engaging patients in health informatics research. The chapter draws on insights from health informatics research projects focused on chronic disease and self-management conducted in Tasmania during the last 10 years. Through these projects the paper explores three topics of relevance to 'meaningful engagement' with patients: (i) Patient Self-Management and Chronic Disease (ii) Patients as Users in Health Informatics research, and, (iii) Evaluations of outcomes in Health and Health Informatics Interventions. Techno-Anthropological reflections are then discussed through the concepts of liminality, polyphony and power. This chapter argues that beyond its contribution to methodology, an important role for Techno-Anthropology in patient centred health informatics research may be its capacity to support new ways of conceptualising and critically reflecting on the construction and mediation of patients' needs, values and perspectives.

  3. Outcomes of antiretroviral treatment programmes in rural Lesotho: health centres and hospitals compared

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    Niklaus Daniel Labhardt

    2013-11-01

    Full Text Available Introduction: Lesotho was among the first countries to adopt decentralization of care from hospitals to nurse-led health centres (HCs to scale up the provision of antiretroviral therapy (ART. We compared outcomes between patients who started ART at HCs and hospitals in two rural catchment areas in Lesotho. Methods: The two catchment areas comprise two hospitals and 12 HCs. Patients ≥16 years starting ART at a hospital or HC between 2008 and 2011 were included. Loss to follow-up (LTFU was defined as not returning to the facility for ≥180 days after the last visit, no follow-up (no FUP as not returning after starting ART, and retention in care as alive and on ART at the facility. The data were analysed using logistic regression, competing risk regression and Kaplan-Meier methods. Multivariable analyses were adjusted for sex, age, CD4 cell count, World Health Organization stage, catchment area and type of ART. All analyses were stratified by gender. Results: Of 3747 patients, 2042 (54.5% started ART at HCs. Both women and men at hospitals had more advanced clinical and immunological stages of disease than those at HCs. Over 5445 patient-years, 420 died and 475 were LTFU. Kaplan-Meier estimates for three-year retention were 68.7 and 69.7% at HCs and hospitals, respectively, among women (p=0.81 and 68.8% at HCs versus 54.7% at hospitals among men (p<0.001. These findings persisted in adjusted analyses, with similar retention at HCs and hospitals among women (odds ratio (OR: 0.89, 95% confidence interval (CI: 0.73–1.09 and higher retention at HCs among men (OR: 1.53, 95% CI: 1.20–1.96. The latter result was mainly driven by a lower proportion of patients LTFU at HCs (OR: 0.68, 95% CI: 0.51–0.93. Conclusions: In rural Lesotho, overall retention in care did not differ significantly between nurse-led HCs and hospitals. However, men seemed to benefit most from starting ART at HCs, as they were more likely to remain in care in these facilities

  4. Building up careers in translational neuroscience and mental health research: Education and training in the Centre for Biomedical Research in Mental Health.

    Science.gov (United States)

    Rapado-Castro, Marta; Pazos, Ángel; Fañanás, Lourdes; Bernardo, Miquel; Ayuso-Mateos, Jose Luis; Leza, Juan Carlos; Berrocoso, Esther; de Arriba, Jose; Roldán, Laura; Sanjuán, Julio; Pérez, Victor; Haro, Josep M; Palomo, Tomás; Valdizan, Elsa M; Micó, Juan Antonio; Sánchez, Manuel; Arango, Celso

    2015-01-01

    The number of large collaborative research networks in mental health is increasing. Training programs are an essential part of them. We critically review the specific implementation of a research training program in a translational Centre for Biomedical Research in Mental Health in order to inform the strategic integration of basic research into clinical practice to have a positive impact in the mental health system and society. Description of training activities, specific educational programs developed by the research network, and challenges on its implementation are examined. The Centre for Biomedical Research in Mental Health has focused on training through different activities which have led to the development of an interuniversity master's degree postgraduate program in mental health research, certified by the National Spanish Agency for Quality Evaluation and Accreditation. Consolidation of training programs within the Centre for Biomedical Research in Mental Health has considerably advanced the training of researchers to meet competency standards on research. The master's degree constitutes a unique opportunity to accomplish neuroscience and mental health research career-building within the official framework of university programs in Spain.

  5. Practice what you preach: developing person-centred culture in inpatient mental health settings through strengths-based, transformational leadership.

    Science.gov (United States)

    Beckett, Paul; Field, John; Molloy, Luke; Yu, Nickolas; Holmes, Douglas; Pile, Emily

    2013-08-01

    The experience of nursing staff and consumers in inpatient mental health wards is often reported as being negative. Efforts to improve culture and practice have had limited success, with ineffective leadership, staff resistance, and unresponsive organisational culture identified as common barriers to change. Practice development has been promoted as an approach to developing person-centred culture that enables professional development through participation, learning and empowerment. For person-centred practice to flourish, organisational leadership at all levels must reflect the same principles. In preparation for the opening of a new integrated mental health service, an inpatient mental health team participated in a practice development project. An action research approach was used to facilitate a series of "away days," initially with the nursing team and then other members of the multidisciplinary team (MDT). Transformational leadership principles were adopted in the facilitation of team activities underpinned by strengths and solution-focused practices. Evaluation of the project by staff members was very positive and there was a high level of participation in practice development activities. The project resulted in the creation of a development plan for the ward, which prioritised five key themes: person-centred care, personal recovery, strengths-based principles, and evidence-based and values-based care. The project outcomes highlight the importance of leadership, which parallels the ideals promoted for clinical practice.

  6. [Drop-out from a mental health centre after the first contact].

    Science.gov (United States)

    Palmieri, Giovanni; D'Amore, Carlo; Cecchetti, Rita; Bonamoneta, Nadia; Gonnella, Maria Antonietta; Moio, Margherita; Paoletti, Stefania; Vendetti, Stefania; Schiavella, Rita; Picardi, Angelo

    2009-01-01

    Many patients drop-out from treatment after a single contact; however, characteristics have only rarely been investigated. We aimed at estimating the frequency of early drop-out and identifying possible risk factors. The study was performed at the Palestrina Mental Health Centre, located near Rome, Italy. The clinical charts of all first-time attenders who did not come back during a 7-year index period (2000-2006) were reviewed and information was collected on sociodemographic factors, psychiatric history, clinical presentation, and process of care. During the index period, 97 of 1.001 first-time attenders dropped out after the first contact. We excluded patients with symptoms of organic (N = 9) or severe mental disorders (N = 3). Of the remaining 85 patients, 49 presented with symptoms related to life events or situations ("reactive symptoms", RS), while 36 had "non-reactive symptoms" (NRS). Eighty-five randomly selected patients with comparable conditions (psychogenic reaction; anxiety, dysthymic or somatoform disorder; ICD-9 code 300.x, 308.x, 309.x) who came back to visit were included as controls. First-only contact patients tended to present with RS more often (58% vs. 43%) than controls. Therefore, the analyses were stratified for reactivity of symptoms. Among patients with NRS, first-only contact patients tended to be younger than controls. Among patients with RS, time until the next appointment tended to be longer in first-only contact patients than in controls. No other differences were observed between first-only contact patients and controls on sociodemographic variables, source of referral, and previous treatment history. The occurrence of early drop-out was relatively low. The higher prevalence of RS among first-only contact patients may suggest a greater disposition towards conflict or ambivalence in interpersonal situations. Patient-perceived service availability, in the form of shorter appointment delay, seems to promote maintenance of contact

  7. Calls to the British Columbia Drug and Poison Information Centre: A summary of differences by health service areas

    Science.gov (United States)

    Henderson, Sarah B; Kent, Debra; Kosatsky, Tom

    2014-01-01

    Objectives Poison control centres provide information on the management of poisoning incidents. The British Columbia (BC) Drug and Poison Information Centre recently implemented an electronic database system for recording case information, making it easier to use case data as a potential source of population-based information on health services usage and health status. This descriptive analysis maps poisoning case rates in BC, highlighting differences in patient age, substance type, medical outcome, and caller location. Methods There were 50,621 human exposure cases recorded during 2012 and 2013. Postal code or city name was used to assign each case to a Health Service Delivery Area (HSDA). Case rates per 1,000 person-years were calculated, including crude rates, age-standardized rates, age-specific rates, and rates by substance type, medical outcome, and caller location. Results The lowest case rate was observed in Richmond, a city where many residents do not speak English as a first language. The highest rate was observed in the Northwest region, where the economy is driven by resource extraction. Pharmaceutical exposures were elevated in the sparsely populated northern and eastern areas. Calls from health care facilities were highest in the Northwest region, where there are many remote Aboriginal communities. Conclusions Case rates were generally highest in the primarily rural northern and eastern areas of the province. Considering these results alongside contextual factors informs further investigation and action: addressing cultural and language barriers to accessing poison centre services, and developing a public health surveillance system for severe poisoning events in rural and remote communities. PMID:25379127

  8. Implementing people-centred health systems governance in 3 provinces and 11 districts of Afghanistan: a case study.

    Science.gov (United States)

    Anwari, Zelaikha; Shukla, Mahesh; Maseed, Basir Ahmad; Wardak, Ghulam Farooq Mukhlis; Sardar, Sakhi; Matin, Javid; Rashed, Ghulam Sayed; Hamedi, Sayed Amin; Sahak, Hedayatullah; Aziz, Abdul Hakim; Boyd-Boffa, Mariah; Trasi, Reshma

    2015-01-01

    Previous studies show that health systems governance influences health system performance and health outcomes. However, there are few examples of how to implement and monitor good governing practices in fragile and conflict affected environments. Good governance has the potential to make the health system people-centered. More research is needed on implementing a people-centered governance approach in these environments. We piloted an intervention that placed a people-centred health systems governance approach in the hands of multi-stakeholder committees that govern provincial and district health systems. We report the results of this intervention from three provinces and eleven districts in Afghanistan over a six month period. This mixed-methods exploratory case study uses analysis of governance self-assessment scores, health management information system data on health system performance, and focus group discussions. The outcomes of interest are governance scores and health system performance indicators. We document the application of a people-centred health systems governance conceptual model based on applying four effective governing practices: cultivating accountability, engaging with stakeholders, setting a shared strategic direction, and stewarding resources responsibly. We present a participatory approach where health system leaders identify and act on opportunities for making themselves and their health systems more accountable and responsive to the needs of the communities they serve. We found that health systems governance can be improved in fragile and conflict affected environments, and that consistent application of the effective governing practices is key to improving governance. Intervention was associated with a 20% increase in antenatal care visit rate in pilot provinces. Focus group discussions showed improvements across the four governing practices, including: establishment of new sub-committees that oversee financial transparency and governance

  9. Danish translation and validation of the Oslo Sports Trauma Research Centre questionnaires on overuse injuries and health problems

    DEFF Research Database (Denmark)

    Jorgensen, J. E.; Rathleff, C. R.; Rathleff, Michael Skovdal;

    2016-01-01

    The Oslo Sports Trauma Research Centre Overuse Injury Questionnaire (OSTRC-O) and the Oslo Sports Trauma Research Centre questionnaire on Health Problems (The OSTRC-H) make it possible to monitor illness and injury at regular intervals capturing prevalence and incidence of acute injury, overuse...... respondents; response rate was 89%. The OSTRC-H was distributed to 58 heterogenous respondents; response rate was 86%. No major disagreements were observed between the original and translated versions of the questionnaires. The OSTRC-O had high internal consistency (Cronbach's alpha 0.80-0.93). The primary...... reliability analyses including all participants, showed reliability ICC: 0.62 (95% CI: 0.42-0.77. The secondary reliability analyses that only included subjects who did not change injury region from the test to the retest showed an ICC of 0.86 (95% CI: 0.77-0.92).The questionnaires were found to be valid...

  10. Human Resources and Vaccine Management at Provincial Health Office, District/City Health Office and Primary Health Centre

    Directory of Open Access Journals (Sweden)

    Andi Leny Susyanty

    2015-03-01

    Full Text Available ABSTRAKlatar Belakang: Keputusan Menteri Kesehatan tentang Gerakan Akselerasi Imunisasi Nasional Universal Child Immunization 2010–2014 (GAIN UCI 2010–2014 menyatakan bahwa secara umum permasalahan penurunan cakupan maupun kualitas pelayanan imunisasi disebabkan oleh beberapa hal, di antaranya kekurangan jumlah, kualitas dan distribusi pengelola vaksin. Metode: Pengumpulan data dilakukan dengan kuesioner melalui wawancara mendalam, penelusuran data sekunder dan observasi. Analisis data dilakukan dengan melakukan skoring data pendidikan, lama kerja, pelatihan dan pengetahuan. Hasil:Jumlah petugas pengelola vaksin masih kurang, beberapa dinas kesehatan kabupaten/kota hanya memiliki satu pengelola Program Imunisasi yang merangkap sebagai pengelola vaksin, begitu juga dengan beberapa Puskesmas yang hanya memiliki satu pengelola program imunisasi yang merangkap pengelola vaksin dan juru imunisasi. Sementara dalam pedoman penyelenggaraan imunisasi dibutuhkan minimal dua tenaga pelaksana. Pengetahuan pengelola vaksin di puskesmas masih kurang, terutama dalam hal pengenalan vaksin dan pengenalan rantai vaksin (ILR. Pengelola vaksin di Dinkes Provinsi sudah mendapatkan pelatihan, namun pengelola vaksin Dinkes Kabupaten/Kota dan Puskesmas belum semua mendapat pelatihan. Pengetahuan pengelola vaksin di Puskesmas masih kurang, terutama dalam hal pengenalan vaksin dan pengenalan Coldchain (ILR.Saran:Diperlukan penambahan kuantitas dan kualitas pengelola vaksin, karena kualitas pengelola vaksin sangat berpengaruh terhadap kualitas vaksin, karena vaksin memerlukan penanganan yang khusus untuk menjaga kualitas vaksin tetap baik dan dapat memberikan kekebalan tubuh serta menghindarkan terjadinya penyakit yang dapat dicegah dengan imunisasi (PD3I.Kata kunci: vaksin, pengelola vaksin, pelatihan, pengetahuanABSTRACTBackground: In the Decree of the Minister of Health on the National Immunisation Movement Acceleration Universal Child Immunization 2010–2014

  11. Expansion of antiretroviral treatment to rural health centre level by a mobile service in Mumbwa district, Zambia

    Science.gov (United States)

    Dube, Christopher; Hayakawa, Tadao; Kakimoto, Kazuhiro; Yamada, Norio; Simpungwe, James B

    2010-01-01

    Abstract Problem Despite the Government’s effort to expand services to district level, it is still hard for people living with HIV to access antiretroviral treatment (ART) in rural Zambia. Strong demands for expanding ART services at the rural health centre level face challenges of resource shortages. Approach The Mumbwa district health management team introduced mobile ART services using human resources and technical support from district hospitals, and community involvement at four rural health centres in the first quarter of 2007. This paper discusses the uptake of the mobile ART services in rural Mumbwa. Local setting Mumbwa is a rural district with an area of 23 000 km2 and a population of 167 000. Before the introduction of mobile services, ART services were provided only at Mumbwa District Hospital. Relevant changes The mobile services improved accessibility to ART, especially for clients in better functional status, i.e. still able to work. In addition, these mobile services may reduce the number of cases “lost to follow-up”. This might be due to the closer involvement of the community and the better support offered by these services to rural clients. Lessons learnt These mobile ART services helped expand services to rural health facilities where resources are limited, bringing them as close as possible to where clients live. PMID:20931065

  12. Consultation on the Libyan health systems: towards patient-centred services

    Directory of Open Access Journals (Sweden)

    Reida M. El Oakley

    2013-01-01

    Full Text Available The extra demand imposed upon the Libyan health services during and after the Libyan revolution in 2011 led the ailing health systems to collapse. To start the planning process to re-engineer the health sector, the Libyan Ministry of Health in collaboration with the World Health Organisation (WHO and other international experts in the field sponsored the National Health Systems Conference in Tripoli, Libya, between the 26th and the 30th of August 2012. The aim of this conference was to study how health systems function at the international arena and to facilitate a consultative process between 500 Libyan health experts in order to identify the problems within the Libyan health system and propose potential solutions. The scientific programme adopted the WHO health care system framework and used its six system building blocks: i Health Governance; ii Health Care Finance; iii Health Service Delivery; iv Human Resources for Health; v Pharmaceuticals and Health Technology; and vi Health Information System. The experts used a structured approach starting with clarifying the concepts, evaluating the current status of that health system block in Libya, thereby identifying the strengths, weaknesses, and major deficiencies. This article summarises the 500 health expert recommendations that seized the opportunity to map a modern health systems to take the Libyan health sector into the 21st century.

  13. Teleaid -en ny form for samarbeid : en observasjonsstudie med evaluering av et telemedisinsk pilotprosjekt mellom Methodist Public Health Centre Mursan, India og Kvinneklinikken, Rikshospitalet.

    OpenAIRE

    Jacobsen, Silje Berild; Simensen, Susann

    2005-01-01

    Teleaid –a new way of cooperation. An observation study with evaluation of a pilot project between Methodist Public Health Centre Mursan, India and Kvinneklinikken, Rikshospitalet. Background: In September 2003 a pilot project were initiated between Kvinneklinikken, Rikshospitalet and Methodist Public Health Centre Mursan, India. The intention was to try a new way of providing medical assistance to rural areas through telecommunication. Our role in this project was to visit India to see ho...

  14. Nurse Managers' Perceptions Related to Their Leadership Styles, Knowledge, and Skills in These Areas—A Viewpoint: Case of Health Centre Wards in Finland

    OpenAIRE

    Soili Vesterinen; Marjo Suhonen; Arja Isola; Leena Paasivaara; Helena Laukkala

    2013-01-01

    The purpose of this study was to explore nurse managers' perceptions related to their leadership styles, knowledge, and their skills in these areas in health centre wards in Finland. The data were collected from nurse managers (n = 252) in health centre hospitals in Finland using a structured questionnaire (response rate 63%). Six leadership styles—visionary, coaching, affiliate, democratic, commanding, and isolating—were reflected on. Almost all respondents in every age group considered four...

  15. A comparison of death recording by health centres and civil registration in South Africans receiving antiretroviral treatment

    Directory of Open Access Journals (Sweden)

    Leigh F Johnson

    2015-12-01

    Full Text Available Introduction: There is uncertainty regarding the completeness of death recording by civil registration and by health centres in South Africa. This paper aims to compare death recording by the two systems, in cohorts of South African patients receiving antiretroviral treatment (ART. Methods: Completeness of death recording was estimated using a capture–recapture approach. Six ART programmes linked their patient record systems to the vital registration system using civil identity document (ID numbers and provided data comparing the outcomes recorded in patient files and in the vital registration. Patients were excluded if they had missing/invalid IDs or had transferred to other ART programmes. Results: After exclusions, 91,548 patient records were included. Of deaths recorded in patients files after 2003, 94.0% (95% CI: 93.3–94.6% were recorded by civil registration, with completeness being significantly higher in urban areas, older adults and females. Of deaths recorded by civil registration after 2003, only 35.0% (95% CI: 34.2–35.8% were recorded in patient files, with this proportion dropping from 60% in 2004–2005 to 30% in 2010 and subsequent years. Recording of deaths in patient files was significantly higher in children and in locations within 50 km of the health centre. When the information from the two systems was combined, an estimated 96.2% of all deaths were recorded (93.5% in children and 96.2% in adults. Conclusions: South Africa's civil registration system has achieved a high level of completeness in the recording of mortality. However, the fraction of deaths recorded by health centres is low and information from patient records is insufficient by itself to evaluate levels and predictors of ART patient mortality. Previously documented improvements in ART mortality over time may be biased if based only on data from patient records.

  16. Patient-centred interprofessional collaboration in primary care: challenges for clinical, educational and health services research. An EGPRN keynote paper.

    Science.gov (United States)

    Van Royen, Paul; Rees, Charlotte E; Groenewegen, Peter

    2014-12-01

    The theme 'patient-centred interprofessional collaboration' of the EGPRN conference in October 2012, captures in just three words important challenges for European primary care and its research agenda. Challenges for future research are formulated, in three domains: clinical, educational and health services research. Transferability of research, based upon advanced computational infrastructure, will facilitate a rapid learning health care system. In educational research, this includes the use of observational and reflexivity methods. Outcomes should be defined in terms of improvement of functional status and social participation rather than in terms of disease-specific outcomes. Partnership with all stakeholders, patients, GPs and their health care colleagues and students, can help in reducing avoidable waste in the production and reporting of research evidence.

  17. Profile of stroke patients treated at a community - based rehabilitation centre in a Cape Town health district

    Directory of Open Access Journals (Sweden)

    A. J. Rhoda

    2003-02-01

    Full Text Available Stroke is a leading cause of death and disability in both developed and developing countries. Limited information is available, in South Africa, on the epidemiological profile of stroke survivors requiring rehabilitation. A descriptive study was therefore undertaken to compile, amongst others the demographic and medical profile of stroke patients attending  rehabilitation at a primary health care facility (Bishop Lavis Rehabilitation Centre.  Both medical- and rehabilitation records were reviewed to ensure completeness of information and to minimize missing clinical data bias. Relevant data was  captured on a data capture sheet.  The latter was based on key findings from the literature and developed by the researcher. The mean age of the population of stroke patients studied was 59 years, which is markedly younger than what has been reported globally in the literature. As was expected, hypertension was found to be the most prevalent risk factor. The presence of a combination of risk factors in the  majority of the group (on average, 2.4 risk factors per person warrants the introduction of aggressive health  education and stroke prevention programmes at this primary health care centre.

  18. The Relationship between Paramedic Competency, Teamwork and Career Development with Quality of Service at Mengwi I Community Health Centre

    Directory of Open Access Journals (Sweden)

    Alit Naya

    2015-04-01

    Full Text Available Background and objective: Recent survey indicated that patient opinion of services at Mengwi I Community Health Centre was low and there was noticeable decline in patient visits. This study aimed to investigate the issues related to the quality of health services given by the paramedics. Methods: A crosssectional study was conducted with 38 paramedics on duty at the outpatient unit. They were interviewed to obtain the data on their opinions about the quality of their service, competence, teamwork and career development opportunities. Chi square test was used for bivariate analysis and logistic regression for multivariate analysis. Results: The results of bivariate analysis indicated there was significant association between the paramedics’quality of service with the competence, teamwork and career development (p<0,001. Multivariate analysis indicated that the paramedics’competence (OR=43,1; 95%CI: 1,3-1422,5 and development of career (OR=31,7; 95%CI: 1,1-829,7 were related to the paramedics’ quality of service. Conclusion: The quality of service of paramedics at Mengwi I Community Health Centre were significantly associated with the paramedics’competence and development of career. Keywords: competency, teamwork, career development, quality of service

  19. Oral health screening of elderly people attending a community care centre.

    Science.gov (United States)

    Diu, S; Gelbier, S

    1989-08-01

    A socio-dental survey was carried out to determine the level of dental disease and treatment requirement among elderly people attending a Community Care Centre. A screening programme involving 293 elderly people demonstrated a normative need of 82% and a felt need of 53%. Seventy-six per cent would have benefited from dental care. Many individuals who both needed and wanted dental care were not receiving it because they were discouraged from doing so predominantly because of poor mobility. It is recommended, therefore, that dentists be included in multi-disciplinary teams caring for elderly people so that they can be screened and given the opportunity to obtain dental care.

  20. From periphery to the centre: Towards repositioning churches for a meaningful contribution to public health care

    Directory of Open Access Journals (Sweden)

    Vhumani Magezi

    2012-02-01

    Full Text Available The role of communities in health care has gained prominence in the last few years. Churches as community structures have been identified as instrumental in health-care delivery. Whilst it is widely acknowledged that churches provide important health services, particularly in countries where there are poorly-developed health sectors, the role of churches in health care is poorly understood and often overlooked. This article discusses some causes of this lacuna and makes suggestions for repositioning churches for a meaningful contribution to health care. Firstly, the article provides a context by reviewing literature on the church and health care. Secondly, it clarifies the nature of interventions and the competencies of churches. Thirdly, it discusses the operational meaning of church and churches for assessing health-care contributions. Fourthly, it explores the health-care models that are discerned in church and health-care literature. Fifthly, it discusses the contribution of churches within a multidisciplinary health team. Sixthly, it proposes an appropriate motivation that should drive churches to be involved in health care and the ecclesiological design that underpins such health care interventions.

  1. Estimating average inpatient and outpatient costs and childhood pneumonia and diarrhoea treatment costs in an urban health centre in Zambia

    Directory of Open Access Journals (Sweden)

    Chola Lumbwe

    2009-10-01

    Full Text Available Abstract Background Millions of children die every year in developing countries, from preventable diseases such as pneumonia and diarrhoea, owing to low levels of investment in child health. Investment efforts are hampered by a general lack of adequate information that is necessary for priority setting in this sector. This paper measures the health system costs of providing inpatient and outpatient services, and also the costs associated with treating pneumonia and diarrhoea in under-five children at a health centre in Zambia. Methods Annual economic and financial cost data were collected in 2005-2006. Data were summarized in a Microsoft excel spreadsheet to obtain total department costs and average disease treatment costs. Results The total annual cost of operating the health centre was US$1,731,661 of which US$1 284 306 and US$447,355 were patient care and overhead departments costs, respectively. The average cost of providing out-patient services was US$3 per visit, while the cost of in-patient treatment was US$18 per bed day. The cost of providing dental services was highest at US$20 per visit, and the cost of VCT services was lowest, with US$1 per visit. The cost per out-patient visit for under-five pneumonia was US$48, while the cost per bed day was US$215. The cost per outpatient visit attributed to under-five diarrhoea was US$26, and the cost per bed day was US$78. Conclusion In the face of insufficient data, a cost analysis exercise is a difficult but feasible undertaking. The study findings are useful and applicable in similar settings, and can be used in cost effectiveness analyses of health interventions.

  2. Patient centred care in infertility health care: direct and indirect associations with wellbeing during treatment.

    Science.gov (United States)

    Gameiro, Sofia; Canavarro, Maria Cristina; Boivin, Jacky

    2013-12-01

    To investigate whether different dimensions of patient centred care (PCC) were directly associated with wellbeing or indirectly, via lower concerns about medical procedures and/or increased tolerability of treatment. Cross-sectional study with 322 women and 111 men undergoing fertility diagnosis or treatment recruited online and in clinical setting. Participants completed questionnaires that assess PCC (PCQ-Infertility), individual (BSI Anxiety and Depression subscales) and relational wellbeing (FertiQoL Relational Domain), treatment concerns (CART Procedural Concerns scale) and tolerability (FertiQoL Tolerability Domain) and they filled a socio-demographic and fertility data file. All dimensions of PCC were positively associated with better wellbeing except for organization of care. Information provision and continuity of care were indirectly associated with better individual wellbeing, the first via lower treatment concerns and the second via higher treatment tolerability. Competence, accessibility, continuity and communication were indirectly associated with better relational wellbeing via higher treatment tolerability. Patient centred care promotes wellbeing during treatment. PCC is directly associated to wellbeing but also indirectly. The mode of action of the different PCC dimensions on wellbeing varies. To promote patients' wellbeing during treatment clinics should provide treatment related information and allow patients to establish a stable clinical relationship with a trustworthy and competent physician. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  3. Relationship-centred care: antidote, guidepost or blind alley? The epistemology of 21st century health care.

    Science.gov (United States)

    Wyer, Peter C; Alves Silva, Suzana; Post, Stephen G; Quinlan, Patricia

    2014-12-01

    Contemporary health care is increasing in complexity and lacks a unifying understanding of epistemology, methodology and goals. Lack of conceptual consistency in concepts such as 'patient-centred care' (PCC) typifies system-wide discordance. We contrast the fragmented descriptions of PCC and related tools to its own origins in the writings of Balint and to a subsequent construct, relationship-centred care (RCC). We identify the explicit and elaborated connection between RCC and a defined epistemological foundation as a distinguishing feature of the construct and we demonstrate that this makes possible the recognition of alignments between RCC and independently developed constructs. Among these, we emphasize Schon's reflective practice, Nonaka's theory of organizational knowledge creation and the research methodology of realist synthesis. We highlight the relational principles common to these domains and to their common epistemologies and illustrate unsatisfying consequences of adherence to less adequate epistemological frameworks such as positivism. We offer RCC not as an 'antidote' to the dilemmas identified at the outset but as an example that illuminates the value and importance of explicit identification of the premises and assumptions underlying approaches to improvement of the health care system. We stress the potential value of identifying epistemological affinities across otherwise disparate fields and disciplines.

  4. Quality assurance of malaria case management in an urban and in sub-rural health centres in Goma, Congo

    Directory of Open Access Journals (Sweden)

    Prosper M. Lutala

    2011-02-01

    Full Text Available Background: Every year, up to three million deaths throughout the world occur as a result of malaria, 90% of which occur in Africa. Despite training providers in malaria case management and the availability of appropriate medical suppliers, there are still weaknesses in the management chain of malaria.Objectives: Our aim was to assess the quality of malaria case management in two primary health care centres in the Goma health district. Specific objectives were the assessment of quality accuracy in the dosage, the duration of treatment, the intervals between administrations, and the routes of administration of anti-malarial medication in two health centres, as well as the subsequent comparison of those two sites. Method: A descriptive retrospective study was conducted using the malaria register’s review to assess two health centres in the Goma health district. Socio-demographical and clinical data were recorded and the quality was assessed against the national guidelines. Descriptive statistics with percentages and Chi-square values were computed. Results: Under-dosage was more common in CCLK (Centre Chrétien du Lac Kivu [Lake Kivu Christian Centre] with 55 patients (62.5%; 95% CI, 52% – 71.8% patients, whilst the over-dosage was present in 64 patients (80%; 95% CI, 69.9% – 87.2% in CASOP (Caisse de Solidarité Ouvrière et Paysanne [Fund of Solidarity Workers and Peasants]. The duration of treatment was shorter in CCLK in 15 patients (93.7%; 95% CI, 71.6% – 98.8%; CASOP had a high rate of inappropriate intervals between the administration of drugs in 14 patients (82.3%; 95% CI, 58.9% – 93.8%. Intravenous administration rates were high in both sites with respectively 102 patients in CASOP (62.5%; 95% CI, 54.9% – 69.6% and 61 patients in CCLK (37.4%; 95% CI, 30.3% – 45.0%. Significant differences were found between the two sites with regard to intervals of administration (χ2 = 7.11, p = 0.007, duration of treatment (χ2 = 8.51, p

  5. Utilisation of the National Antiretroviral Therapy Guidelines among health care professionals working in Abuja treatment centres, Nigeria

    Directory of Open Access Journals (Sweden)

    Lindiwe I. Zungu

    2009-04-01

    Full Text Available Background: Access to and utilisations of the National Antiretroviral Treatment Guidelines (NATG are valuable factors for effective programme implementation. The objective of this study was to investigate the accessibility of the NATG and their utilisation by health care professionals from five treatment centres in Abuja, Nigeria.Method: A quantitative cross-sectional descriptive survey was conducted in 2007 using purposively sampled health care professionals. Questionnaires were self-administered to participants who consented in writing to participate in the survey.Results: 97 health care professionals participated in this study with about equal numbers of men and women: 48 (49.5% women and 49 (50.5% men. Of these, 21.6% were unaware of the existence of the NATG in their treatment centres. More than half (51.5% reported that they did not have access to the NATG as opposed to those (48.5% who had access to the guidelines. Furthermore, 16.5% of the participants confirmed that they had access to an institutional copy of the NATG while 14.4% indicated that they had individual copies and only 3.1% stated that they had individual copies and access to the hospital copy as well. Regarding utilisation of the NATG, 41.2% rarely used them, 32.9% never used them and only 25.7% often used them. The most frequent use of the NATG was among pharmacists (38.1% compared to the least frequent use among nurses (20.0%.Conclusion: Poor accessibility of the NATG may have a negative impact on guidelines utilisation among health care professionals in Nigeria.

  6. Towards generic online multicriteria decision support in patient-centred health care

    DEFF Research Database (Denmark)

    Dowie, Jack; Kaltoft, Mette Kjer; Salkeld, Glenn

    2015-01-01

    scored and ranked. The scores for each option combine, in a simple expected value calculation, the best estimates available now for the performance of those options on patient-determined criteria, with the individual patient's preferences, expressed as importance weightings for those criteria. The survey...... in pursuit of improved decision making and more informed choice within an overall philosophy of person- and patient-centred care. METHODS: The MCDA-based system generates patient-specific clinical guidance in the form of an opinion as to the merits of the alternative options in a decision, which are all...... software within which the Annalisa file is embedded (Elicia©) customizes and personalizes the presentation and inputs. Principles relevant to the development of such decision-specific MCDA-based aids are noted and comparisons with alternative implementations presented. The necessity to trade...

  7. A designated centre for people with disabilities operated by Health Service Executive, Westmeath

    LENUS (Irish Health Repository)

    Quinlan, Catherine

    2012-08-27

    Children on hemodialysis are at increased risk of thrombosis, especially when dialyzed via a central venous catheter (CVC); there are limited published data regarding the safety and efficacy of tinzaparin in this group. We conducted a retrospective chart review of all children in the National Pediatric Hemodialysis Centre for Ireland diagnosed with a CVC thrombus and treated with subcutaneous tinzaparin over a 10 year period. Seven children were treated with subcutaneous tinzaparin for 10 CVC thrombi. Tinzaparin was commenced at 175 IU\\/kg\\/day and the dose was titrated by measuring anti-factor Xa levels, aiming for levels of 0.3-1.0 IU\\/ml. Treatment was continued until resolution of the CVC thrombus. Restoration of normal flows during dialysis occurred within 3 days in all patients. There were no episodes of bleeding and all children tolerated the treatment well.

  8. The Gap between Tobacco Treatment Guidelines, Health Service Organization, and Clinical Practice in Comprehensive Cancer Centres

    Directory of Open Access Journals (Sweden)

    R. Mazza

    2011-01-01

    Full Text Available Smoking cessation is necessary to reach a higher quality of life, and, for a cancer patient, it represents an important step in improving the outcome of both prognosis and therapy. Being a cancer patient addicted to nicotine may be a critical situation. We conducted a survey to monitor how many comprehensive cancer centres in Italy have an outpatient smoker clinic and which kinds of resources are available. We also inquired about inpatient services offering psychological and pharmacological support for smoking cessation, reduction, or care of acute nicotine withdrawal symptoms. What we have witnessed is a significant gap between guidelines and services. Oncologists and cancer nurses are overscheduled, with insufficient time to engage in discussion on a problem that they do not consider directly related to cancer treatment. Furthermore, smoking habits and limited training in tobacco dependence and treatment act as an important barrier and lead to the undervaluation of smokers' needs.

  9. Health effects[1997 Scientific Report of the Belgian Nuclear Research Centre

    Energy Technology Data Exchange (ETDEWEB)

    Mahieu, L.

    1998-07-01

    The objectives of the research in the field of epidemiology , performed at the Belgian Nuclear Research Centre SCK-CEN are (1) to study cancer mortality and morbidity in nuclear workers in Belgium; (2) to document the feasibility of retrospective cohort studies in Belgium; (3) to participate in the IARC study. For radiobiology, the main objectives are: (1) to elucidate the mechanisms of the effects of ionizing radiation on the mammalian embryo during the early phase of its development, (2) to assess the genetic risks of maternal exposure to ionizing radiation, (3) to elucidate the mechanisms by which damage to the brain and mental retardation are caused in man after prenatal irradiation. The main achievements in these domains for 1997 are presented.

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

    Science.gov (United States)

    Lee, Eunji

    2016-01-01

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

  11. Health-promotion in the context of ageing and migration: a call for person-centred integrated practice

    Directory of Open Access Journals (Sweden)

    Qarin Lood

    2014-03-01

    Full Text Available Normal 0 false false false SV JA X-NONE Objective: For the aim of improving the implementation of a health-promoting intervention for older persons who are born abroad, this study aimed to explore health care professionals’ experiences of facilitators and barriers for their possibilities to support healthy ageing in the context of migration.Methods: Qualitative data were collected from four focus groups with health professionals who all had experience of working with older persons who are born abroad. Data were analysed with guidance from the method developed by Krueger and Casey, progressing from an empirical to an abstract level.Results: Five different conditions were found to influence supporting healthy ageing in the context of migration: sense of belonging through significant others; emotional bonds to a place called home; expectations on health and support during the ageing process; mutual understanding as a means for communication; and heterogeneity as a point of departure. The one comprehensive theme, complexity, describes how those aspects are interrelated in a complex and unpredictable way.Conclusions: The results point at the need for focusing on each person's experiences and health expectations, and the study provides a foundation for future research on the integration of whole-system and person-centred practice.

  12. Health-promotion in the context of ageing and migration: a call for person-centred integrated practice

    Directory of Open Access Journals (Sweden)

    Qarin Lood

    2014-03-01

    Full Text Available Normal 0 false false false SV JA X-NONE Objective: For the aim of improving the implementation of a health-promoting intervention for older persons who are born abroad, this study aimed to explore health care professionals’ experiences of facilitators and barriers for their possibilities to support healthy ageing in the context of migration. Methods: Qualitative data were collected from four focus groups with health professionals who all had experience of working with older persons who are born abroad. Data were analysed with guidance from the method developed by Krueger and Casey, progressing from an empirical to an abstract level. Results: Five different conditions were found to influence supporting healthy ageing in the context of migration: sense of belonging through significant others; emotional bonds to a place called home; expectations on health and support during the ageing process; mutual understanding as a means for communication; and heterogeneity as a point of departure. The one comprehensive theme, complexity, describes how those aspects are interrelated in a complex and unpredictable way. Conclusions: The results point at the need for focusing on each person's experiences and health expectations, and the study provides a foundation for future research on the integration of whole-system and person-centred practice.

  13. Holism, health and data - managing the person-centred digital haystack.

    Science.gov (United States)

    Rigby, Michael

    2010-01-01

    There is currently very legitimate pressure to change the function of health information systems to more explicitly serve and support the individual. Concurrently other support services to health, including condition monitoring, social care and intelligent housing, add to the complexity of patient health related data. A paradigm shift is needed, to recognize that many agencies and systems outside as well as within the health sector all work to support the citizen's health, yet the essential integrated view is not being provided, even though much needed not least by the citizen and their agents. Broker technologies can enable this new paradigm. Moreover, a move to identifying the patient's appointments and support services would enable a daily life dimension to be given due weight, and would recognize the patient's viewpoint in wanting to live an ordered life, not one subservient and reactive to the delivery of care by providers.

  14. Towards sustainable partnerships in global health: the case of the CRONICAS Centre of Excellence in Chronic Diseases in Peru.

    Science.gov (United States)

    Miranda, J Jaime; Bernabé-Ortiz, Antonio; Diez-Canseco, Francisco; Málaga, Germán; Cárdenas, María K; Carrillo-Larco, Rodrigo M; Lazo-Porras, María; Moscoso-Porras, Miguel; Pesantes, M Amalia; Ponce, Vilarmina; Araya, Ricardo; Beran, David; Busse, Peter; Boggio, Oscar; Checkley, William; García, Patricia J; Huicho, Luis; León-Velarde, Fabiola; Lescano, Andrés G; Mohr, David C; Pan, William; Peiris, David; Perel, Pablo; Rabadán-Diehl, Cristina; Rivera-Chira, Maria; Sacksteder, Katherine; Smeeth, Liam; Trujillo, Antonio J; Wells, Jonathan C K; Yan, Lijing L; García, Héctor H; Gilman, Robert H

    2016-06-02

    Human capital requires opportunities to develop and capacity to overcome challenges, together with an enabling environment that fosters critical and disruptive innovation. Exploring such features is necessary to establish the foundation of solid long-term partnerships. In this paper we describe the experience of the CRONICAS Centre of Excellence in Chronic Diseases, based at Universidad Peruana Cayetano Heredia in Lima, Peru, as a case study for fostering meaningful and sustainable partnerships for international collaborative research. The CRONICAS Centre of Excellence in Chronic Diseases was established in 2009 with the following Mission: "We support the development of young researchers and collaboration with national and international institutions. Our motivation is to improve population's health through high quality research." The Centre's identity is embedded in its core values - generosity, innovation, integrity, and quality- and its trajectory is a result of various interactions between multiple individuals, collaborators, teams, and institutions, which together with the challenges confronted, enables us to make an objective assessment of the partnership we would like to pursue, nurture and support. We do not intend to provide a single example of a successful partnership, but in contrast, to highlight what can be translated into opportunities to be faced by research groups based in low- and middle-income countries, and how these encounters can provide a strong platform for fruitful and sustainable partnerships. In defiant contexts, partnerships require to be nurtured and sustained. Acknowledging that all partnerships are not and should not be the same, we also need to learn from the evolution of such relationships, its key successes, hurdles and failures to contribute to the promotion of a culture of global solidarity where mutual goals, mutual gains, as well as mutual responsibilities are the norm. In so doing, we will all contribute to instil a new culture

  15. ASSESSMENT OF CLIENT’S SATISFACTION REGARDING SERVICE UTILIZATION IN AN URBAN HEALTH CENTRE IN NORTHERN INDIA

    Directory of Open Access Journals (Sweden)

    Pushapindra

    2015-07-01

    Full Text Available Modern healthcare systems are seeking to adopt a more client - oriented approach to the delivery of healthcare. Assessment of patient satisfaction is critical for efficient planning and monitoring of the healthcare system. Healthcare accessibility, quality of care provided, and its cost are the three domains of high priority which influence patients' health - related behavior. Patients' satisfaction is a powerful predictor of their health - related behavior which influences treatment outcomes in turn . There is a scarcity of information available on t his aspect of health care in this region of the country especially for the urban areas , therefore the present study is being undertaken . AIM: To assess the client’s satisfaction regarding service utilization at UHC. MATERIALS AND METHODS: Settings: Urban Health Centre, Dayanand Medical College and Hospital Ludhiana . STUDY DESIGN: Cross sectional study . A total of 422 willing patients who attended the Out Patient Department ( OPD of the Urban Health Centre from 1 st July 2014 to 30 th September 2014 were incl uded in the study. The patients didn’t agree to participate , who were previously interviewed in the study and the beneficiaries ( <18 years of age not accompanied by adult members or parents were excluded from the study. Informed written consent was taken from the patients and they were interviewed regarding the health services being provided at UHC. Statistical Analysis: Microsoft Excel , SPSS version 20. RESULTS : Major motivating factors for the patients to utilize the health services at UHC were the cost effectiveness, the proximity to their residence and their faith in the doctors. It was found that the patients were highly satisfied with the accessibility , services provided at waiting area , doctor - patient communication, and consultation and examination facilities. However, availability of the prescribed drugs and the waiting time for consultation came out to be the areas

  16. [The contribution of the Russian Research Centre of Medical Rehabilitation and Balneotherapeutics to the development of the health resort business in this country].

    Science.gov (United States)

    Povazhnaia, E A; Bobrovnitskiĭ, I P

    2013-01-01

    The definition of the notion of health resort business is proposed in the context of the legislation pertinent to the natural therapeutic resources, health and recreational localities, spa and resort facilities currently in force in this country. The main landmark events in the history of the Russian Research Centre of Rehabilitative Medicine and Balneotherapeutics are highlighted, its role in the development of balneotherapeutic science and health resort business is described. The major achievements of the Centre in the investigations of therapeutic properties of natural physical factors (climate, mineral waters, peloids, etc.), their action on the human organism, the possibilities of their application for the treatment and prevention of various pathological conditions in and outside health resort facilities are presented. The contribution of the specialists of the Centre to the search for and discovery of new resort resources is emphasized. Community needs in balneotheraputic treatment are estimated, scientific basis for its organization, principles and normatives of health resort business are discussed along with the problems of sanitary control and protection. The activities of the Centre as an organizer of the unique system of rehabilitative and balneotherapeutic aid to the population are overviewed. Scientifically substantiated indications and contraindications for the spa and resort-based treatment of various diseases are proposed in conjunction with the methods for the application of physiotherapeutic factors. The tasks currently facing the Centre and prospects for its future research activities in the fields of rehabilitative medicine and balneotherapeutics are discussed.

  17. Intestinal obstruction in children due to Ascariasis: A tertiary health centre experience

    Directory of Open Access Journals (Sweden)

    Mishra P

    2008-01-01

    Full Text Available Background: Ascariasis is the infestation by the largest intestinal nematode of man, a common problem in the tropics attributed to poor hygienic and low socioeconomic conditions. The aim of this research is to analyse the presentation, diagnosis and management of bowel obstruction caused by Ascaris lumbricoides, with special emphasis on the role of conservative management. Materials and Methods: This is a single centre, two consultant based 5 year retrospective study of childhood intestinal obstruction due to worms. Diagnosis in the suspected patients was based on history of passage of worms per mouth or rectum and on x-ray and ultrasonography findings. Only the patients of intestinal obstruction with documented evidence of roundworm infestation were included in the study and were followed for one year. Results: One hundred and three children with intestinal obstruction due to Ascaris lumbricoides were treated in the past five years at our centre. Abdominal pain was the most common presentation seen in 96 children followed by vomiting in 77 children. 20 children had history of vomiting worms and another 43 had history of passing worms in stool. Abdominal tenderness was present in 50 children, 48 had abdominal distension of varying degree, 50 had abdominal mass due to worm bolus, and 16 had or developed abdominal guarding or rigidity. All the children were managed as for acute intestinal obstruction along with hypertonic saline enema. The aim of management was "to starve the worm and hydrate the patient". 87 patients (84.47% responded favourably and were relieved of the obstruction by the conservative management, 16 children (15.53% had abdominal guarding or rigidity and underwent emergency exploration. Conclusion: Roundworm obstruction should be considered in the differential diagnoses of all cases of intestinal obstruction in children. Clinical history and examination along with X-ray and ultrasonography are very helpful for diagnosis of this

  18. Oral health of children with intractable epilepsy attending the UK National Centre for Young People with Epilepsy.

    Science.gov (United States)

    Percival, T; Aylett, S E; Pool, F; Bloch-Zupan, A; Roberts, G J; Lucas, V S

    2009-01-01

    To investigate the oral health of children with intractable epilepsy attending the UK National Centre for Young People with Epilepsy. 39 children and adolescents with intractable epilepsy at a residential school, the UK National Centre For Young People With Epilepsy (NCYPE) were age, gender and ethnicity matched with 39 healthy children from local schools in Surrey (England). Dental examinations were completed for indices for both the primary and permanent dentitions comprising decayed, missing and filled teeth and surfaces, plaque index, gingivitis index, developmental enamel defects, and incisor tooth trauma. There was no significant difference in the dmfs, dmft, DMFS or DMFT in the children with epilepsy compared with the controls. There was a significantly greater mean plaque score associated with permanent teeth in the children with epilepsy 68.0 SD+/- 31.5, compared with the control children, 142.9 SD+/- 23.2, pepilepsy 47.9+/-33.8, compared with the control children, 15.85+/-21.8, pepilepsy had experienced anterior tooth trauma, 54% in all, compared with the controls, 12.5% pepilepsy had greater mean plaque and gingivitis scores, the prevalence of dental caries was low. Children and teenagers with intractable epilepsy were more likely to have sustained dental trauma than controls. A dental service aimed at early attention to anterior tooth trauma is needed. In addition, there is an ongoing need for improving the oral hygiene of these individuals to prevent the development of periodontal disease in later life.

  19. LIS-lnterlink-connecting laboratory information systems to remote primary health-care centres via the Internet.

    Science.gov (United States)

    Clark, B; Wachowiak, B; Crawford, E W; Jakubowski, Z; Kabata, J

    1998-01-01

    A pilot study was performed to evaluate the feasibility of using the Internet to securely deliver patient laboratory results, and the system has subsequently gone into routine use in Poland. The system went from design to pilot and then to live implementation within a four-month period, resulting in the LIS-Interlink software product. Test results are retrieved at regular intervals from the BioLink(TM) LIS (Laboratory Information System), encrypted and transferred to a secure area on the Web server. The primary health-care centres dial into the Internet using a local-cell service provided by Polish Telecom (TP), obtain a TCP/IP address using the TP DHCP server, and perform HTTP 'get' and 'post' operations to obtain the files by secure handshaking. The data are then automatically inserted into a local SQL database (with optional printing of incoming reports)for cumulative reporting and searching functions. The local database is fully multi-user and can be accessed from different clinics within the centres by a variety of networking protocols.

  20. Quality, bias and service user experience in healthcare: 10 years of mental health guidelines at the UK National Collaborating Centre for Mental Health.

    Science.gov (United States)

    Kendall, Tim; Glover, Naomi; Taylor, Clare; Pilling, Stephen

    2011-08-01

    The guideline programme developed by the National Collaborating Centre for Mental Health (NCCMH) for the National Institute for Health and Clinical Excellence (NICE) is probably the most comprehensive and methodologically advanced mental health guideline programme in the world, covering most adults and children with mental health problems and addressing a broad range of pharmacological and psychological/psychosocial interventions. As the success of the NICE programme gains momentum, its influence in the National Health Service (NHS) grows. If guidelines contain systematic bias the effects will be widespread. Over the last 10 years the NCCMH has recognized imperfections and patterns of bias in the way that evidence is generated and included in guidelines, including psychological/psychosocial interventions and drug treatments. The pharmaceutical industry remains a major source of bias through selective reporting and publishing, and represents a threat to ensuring the evidence underpinning guidelines and clinical decision-making is as complete and reliable as possible. The inclusion of service users into guideline development at the NCCMH has developed in parallel to the identification and understanding of evidential bias, and is now becoming an important focus for high-quality guidelines which are becoming increasingly person-centred. For mental health this is as radical as the integration of psychological/psychosocial treatments into what has, for many years, been a largely medical domain. The future role of service users in monitoring their own experience of care and ensuring that trusts are accountable to them is now a real possibility and is likely to have an impact upon the traditional power relations in mental health and the stigma usually associated with psychiatric problems.

  1. A cross-sectional study of patients with and without substance use disorders in Community Mental Health Centres

    Directory of Open Access Journals (Sweden)

    Ruud Torleif

    2011-05-01

    Full Text Available Abstract Background Epidemiological studies have consistently established high comorbidity between psychiatric disorders and substance use disorders (SUD. This comorbidity is even more prominent when psychiatric populations are studied. Previous studies have focused on inpatient populations dominated by psychotic disorders, whereas this paper presents findings on patients in Community Mental Health Centres (CMHCs where affective and anxiety disorders are most prominent. The purpose of this study is to compare patients in CMHCs with and without SUD in regard to differences in socio-demographic characteristics, level of morbidity, prevalence of different diagnostic categories, health services provided and the level of improvement in psychiatric symptoms. Methods As part of the evaluation of the National Plan for Mental Health, all patients seen in eight CMHCs during a 4-week period in 2007 were studied (n = 2154. The CMHCs were located in rural and urban areas of Norway. The patients were diagnosed according to the ICD-10 diagnoses and assessed with the Health of the Nation Outcome Scales, the Alcohol Use Scale and the Drug Use Scale. Results Patients with SUD in CMHCs are more frequently male, single and living alone, have more severe morbidity, less anxiety and mood disorders, less outpatient treatment and less improvement in regard to recovery from psychological symptoms compared to patients with no SUD. Conclusion CMHCs need to implement systematic screening and diagnostic procedures in order to detect the special needs of these patients and improve their treatment.

  2. Morphological Spectrum of Orbitoocular Diseases in a Tertiary Health Centre in Keffi, North Central Nigeria

    Directory of Open Access Journals (Sweden)

    Ifeyinwa Mary Onwubuya

    2015-01-01

    Full Text Available Aim. The aim of this study was to carry out a retrospective clinicopathological analysis of the ocular lesions requiring biopsy seen in the Department of Histopathology, Federal Medical Centre (FMC, Keffi, in North Central Nigeria. Materials and Method. A retrospective review of the clinicopathologic profile of orbitoocular lesions diagnosed at the FMC, Keffi, was done. Clinical and pathological data were obtained from the patients’ clinical records and original biopsy reports, respectively. Results. Sixty-six cases of orbitoocular lesions were reviewed for this study. Of the 54 cases investigated, 28 were HIV negative while 26 were HIV positive (37.1% of all cases. There were 30 cases of Ocular Surface Squamous Neoplasia (OSSN with a male-to-female ratio of 0.9 : 1. Squamous cell carcinoma (SCC was the most frequent OSSN with 17 cases. The mean age of cases of SCC is 37.1 ± 7.6 SD (years. The mean age of carcinoma in situ is 35.8 ± 11.4 years. Conclusion. There was no significant difference in the sex distribution of patients with OSSN. It is probable that a diagnosis of squamous cell carcinoma may be encountered in about a year after diagnosis of a carcinoma in situ especially if the in situ carcinoma is left untreated or improperly treated.

  3. The Availability and Eligibility of Drug Warehouse at Health Centre Based on Geography and Topography in Indonesia (Rifaskes Data 2011

    Directory of Open Access Journals (Sweden)

    Rukmini Rukmini

    2015-03-01

    Full Text Available ABSTRAKLatar Belakang: Gudang obat Puskesmas merupakan salah satu sarana pelayanan kefarmasian yang perlu diperhatikan dalam upaya penyimpanan obat untuk menjamin mutu obat. Tulisan ini bertujuan untuk menganalisis ketersediaan dan kelayakan gudang obat Puskesmas di Indonesia, berdasarkan lokasi puskesmas secara geografi dan topografi. Metode: Penelitian ini merupakan analisis lanjut data sekunder Riset Fasilitas Kesehatan (Rifaskes tahun 2011 yang dilaksanakan di seluruh Puskesmas di 33 Propinsi di Indonesia. Hasil: Ketersediaan gudang obat pada Puskesmas di Indonesia berdasarkan geografi dan topografi sudah diatas 90%, kecuali Puskesmas pada daerah sangat terpencil (89,7%. Komponen fasilitas gudang obat di Indonesia, yang paling tinggi ketersediaannya adalah fasilitas pencatatan dan penataan obat yaitu catatan keluar masuk obat tahun 2010, dan paling rendah adalah fasilitas pendukung berupa lemari narkotika/psikotropik. Ketersediaan sarana tersebut semakin rendah pada daerah terpencil, perbatasan dan kepulauan. Kelayakan gudang obat Puskesmas di Indonesia, menunjukkan sebagian besar dalam kategori layak, dan proporsinya semakin rendah pada daerah terpencil, perbatasan dan kepulauan. Hasil uji statistik (Mann Whitney dan korelasi Spearman menunjukkan, kelayakan gudang obat berhubungan signifikan dengan geografi dan topografi kepulauan dan keterpencilan. Kesimpulan: Ketersediaan dan kelayakan gudang obat Puskesmas di Indonesia, sebagian besar sudah tersedia dalam kategori layak, dan proporsinya semakin rendah pada daerah terpencil, perbatasan dan kepulauan. Saran: Pemerintah Daerah dan Pusat wajib untuk meningkatkan sarana dan prasarana gudang obat melalui peningkatan anggaran kesehatan, untuk menjamin penyimpanan obat yang tepat dan sesuai dengan standar.Kata kunci: gudang obat, ketersediaan, kelayakan, geografi dan topografiABSTRACTBackground: Drug warehouse at health centres is one of pharmacy service that should be paid attention to store

  4. [Blood supply and demand at the Fifth District Health Centre in Bamako (Mali)].

    Science.gov (United States)

    Traore, Mamadou; Dumont, Alexandre; Kaya, Amadou Balobo; Traore, Soumana Oumar; Traore, Oumar Moussokoro; Dolo, Amadou

    2011-01-01

    An adequate uncontaminated blood supply is an essential element of an effective health care system. A regional blood transfusion policy was defined in 2004 by the Direction of Health in Bamako, Mali. The objective of this study is to analyse the coverage of transfusion needs at the Fifth District health Center in Bamako after the implementation of this policy. This prospective study, conducted from December 2006 through May 2007, included 134 patients for whom transfusion orders were recorded in the laboratory. The coverage rate of transfusion needs was estimated by dividing the number of units transfused by the number of units that health professionals requested. The blood supply was regular (46 units per month, on average) and consistent with demand (59 units per month on average). Overall, 75% of the transfusions were required for obstetric complications. All patients received at least one 450-mL unit of whole blood. The coverage of transfusion needs has reached 65% of the total number of units required (95% CI = 60-70%). The implementation of a functioning system of blood transfusion is complex. In Bamako, a system based on a centralized transfusion center met a high proportion of the needs in a reference hospital where demand was high while ensuring a high level of patient safety. Further studies are needed to guide the implementation of feasible and sustainable strategies for providing sufficient quantities of safe blood in other contexts and to assess the impact of these different strategies on global health, and on maternal health in particular.

  5. A qualitative study on barriers in the prevention of anaemia during pregnancy in public health centres: perceptions of Indonesian nurse-midwives.

    Science.gov (United States)

    Widyawati, Widyawati; Jans, Suze; Utomo, Sutarti; van Dillen, Jeroen; Janssen, A L M Lagro

    2015-02-26

    Anemia in pregnancy remains a major problem in Indonesia over the past decade. Early detection of anaemia in pregnancy is one of the components which is unsuccessfully implemented by nurse-midwives. This study aims to explore nurse-midwives' experiences in managing pregnant women with anaemia in Public Health Centres. We conducted a qualitative study with semi-structured face to face interviews from November 2011 to February 2012 with 23 nurse-midwives in five districts in Yogyakarta Special Province. Data analysis was thematic, using the constant comparison method, making comparison between participants and supported by ATLAS.ti software. Twelve nurse-midwives included in the interviews had less than or equal to 10 years' working experience (junior nurse-midwives) and 11 nurse-midwives had more than 10 years' working experience (senior nurse-midwives) in Public Health Centres. The senior nurse-midwives mostly worked as coordinators in Public Health Centres. Three main themes emerged: 1) the lack of competence and clinical skill; 2) cultural beliefs and low participation of family in antenatal care programme; 3) insufficient facilities and skilled support staff in Public Health Centres. The nurse-midwives realized that they need to improve their communication and clinical skills to manage pregnant women with anaemia. The husband and family involvement in antenatal care was constrained by the strength of cultural beliefs and lack of health information. Moreover, unfavourable work environment of the Public Health Centres made it difficult to apply antenatal care the pregnant womens' need. The availability of facilities and skilled staffs in Public Health Centre as well as pregnant women's husbands or family members contribute to the success of managing anaemia in pregnancy. Nurse-midwives and pregnant women need to be empowered to achieve the optimum result of anaemia management. We recommend a more comprehensive approach in managing pregnant women with anaemia

  6. Assessing health-care providers' readiness for reporting quality and patient safety indicators at primary health-care centres in Lebanon: a national cross-sectional survey.

    Science.gov (United States)

    Alameddine, Mohamad; Saleh, Shadi; Natafgi, Nabil

    2015-05-22

    Successful endorsement of quality indicators hinges on the readiness and acceptability of care providers for those measures. This paper aims to assess the readiness of care providers in the primary health-care sector in Lebanon for the implementation of quality and patient safety indicators. A cross-sectional survey methodology was utilized to gather information from 943 clinical care providers working at 123 primary health-care centres in Lebanon. The questionnaire included two sections: the first assessed four readiness dimensions (appropriateness, management support, efficacy, and personal valence) of clinical providers to use quality and safety indicators using the Readiness for Organization Change (ROC) scale, and the second section assessed the safety attitude at the primary care centre utilizing the Agency of Health Research and Quality (AHRQ) Safety Attitude Questionnaire (SAQ)-Ambulatory version. Although two thirds (66%) of respondents indicated readiness for implementation of quality and patient safety indicators in their centres, there appear to be differences by professional group. Physicians displayed the lowest scores on all readiness dimensions except for personal valence which was the lowest among nurses (60%). In contrast, allied health professionals displayed the highest scores across all readiness dimensions. Generally, respondents reflected a positive safety attitude climate in the centres. Yet, there remain a few areas of concern related to punitive culture (only 12.8% agree that staff should not be punished for reported errors/incidents), continuity of care (41.1% believe in the negative consequences of lack in continuity of care process), and resources (48.1% believe that the medical equipment they have are adequate). Providers with the highest SAQ score had 2.7, 1.7, 7 and 2.4 times the odds to report a higher readiness on the appropriateness, efficacy, management and personal valence ROC subscales, respectively (P value quality and patient

  7. The EU-project United4Health: User-centred design of an information system for a Norwegian telemedicine service.

    Science.gov (United States)

    Smaradottir, Berglind; Gerdes, Martin; Martinez, Santiago; Fensli, Rune

    2016-10-01

    Organizational changes of health care services in Norway brought to light a need for new clinical pathways. This study presents the design and evaluation of an information system for a new telemedicine service for chronic obstructive pulmonary disease patients after hospital discharge. A user-centred design approach was employed composed of a workshop with end-users, two user tests and a field trial. For data collection, qualitative methods such as observations, semi-structured interviews and a questionnaire were used. User workshop's outcome informed the implementation of the system initial prototype, evaluated by end-users in a usability laboratory. Several usability and functionality issues were identified and solved, such as the interface between the initial colour scheme and the triage colours. Iterative refinements were made and a second user evaluation showed that the main issues were solved. The responses to a questionnaire presented a high score of user satisfaction. In the final phase, a field trial showed satisfactory use of the system. This study showed how the target end-users groups were actively involved in identifying the needs, suggestions and preferences. These aspects were addressed in the development of an information system through a user-centred design process. The process efficiently enabled users to give feedback about design and functionality. Continuous refinement of the system was the key to full development and suitability for the telemedicine service. This research was a result of the international cooperation between partners within the project United4Health, a part of the Seventh Framework Programme for Research of the European Union. © The Author(s) 2015.

  8. Neurosurgery in Nigeria II - Evaluation of the perceptions of health personnel after the commencement of services in a new centre

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    Jude Kennedy C Emejulu

    2010-01-01

    Full Text Available Background: Prior to the commencement of neurosurgical services in our new centre, in 2006, the awareness of and perceptions about this specialty amongst the health workers were studied. One year after, having experienced first-hand the activities of the unit, these perceptions were again re-evaluated amongst the same workers to determine the impact of the unit on the opinions about the specialty. Methods and Materials: This study was carried out with a questionnaire designed with the 5-point Likert scale, and the respondents comprised of doctors, nurses, students, paramedics and administrators, randomly selected. The same questionnaire was used in the first study but was slightly modified for the present study. Results: Out of 400 questionnaires distributed randomly, 342 were completed and returned. Most of the respondents 282 (82.5% were aged 20 - 30years, mostly students 220 (64.3%, and majority 318 (93% have heard of neurosurgery prior to the establishment of our unit. The service need was rated very necessary by most 286(83.6%, availability of services in Nigeria rated inadequate by 177 (51.8%, and the quality of services rated fair 155(45.3%. The services in our centre were rated fair 138 (40.4% and lack of equipment/facilities was adjudged the greatest hindrance to practice 216 (63.2%, and majority 289 (84.5% strongly recommended that services continue. Conclusion: Neurosurgical services are still significantly inadequate in Nigeria, and though the establishment of new units has positively changed the perception of health workers about the specialty, provision of more manpower and modern facilities remains the major challenge.

  9. The association of drinking water treatment and distribution network disturbances with Health Call Centre contacts for gastrointestinal illness symptoms.

    Science.gov (United States)

    Malm, Annika; Axelsson, Gösta; Barregard, Lars; Ljungqvist, Jakob; Forsberg, Bertil; Bergstedt, Olof; Pettersson, Thomas J R

    2013-09-01

    There are relatively few studies on the association between disturbances in drinking water services and symptoms of gastrointestinal (GI) illness. Health Call Centres data concerning GI illness may be a useful source of information. This study investigates if there is an increased frequency of contacts with the Health Call Centre (HCC) concerning gastrointestinal symptoms at times when there is a risk of impaired water quality due to disturbances at water works or the distribution network. The study was conducted in Gothenburg, a Swedish city with 0.5 million inhabitants with a surface water source of drinking water and two water works. All HCC contacts due to GI symptoms (diarrhoea, vomiting or abdominal pain) were recorded for a three-year period, including also sex, age, and geocoded location of residence. The number of contacts with the HCC in the affected geographical areas were recorded during eight periods of disturbances in the water works (e.g. short stops of chlorine dosing), six periods of large disturbances in the distribution network (e.g. pumping station failure or pipe breaks with major consequences), and 818 pipe break and leak repairs over a three-year period. For each period of disturbance the observed number of calls was compared with the number of calls during a control period without disturbances in the same geographical area. In total about 55, 000 calls to the HCC due to GI symptoms were recorded over the three-year period, 35 per 1000 inhabitants and year, but much higher (>200) for children water works or in the distribution network. Our results indicate that GI symptoms due to disturbances in water works or the distribution network are rare. The number of serious failures was, however limited, and further studies are needed to be able to assess the risk of GI illness in such cases. The technique of using geocoded HCC data together with geocoded records of disturbances in the drinking water network was feasible.

  10. A designated centre for people with disabilities operated by Health Service Executive, Wexford

    LENUS (Irish Health Repository)

    Mikkers, Misja

    2014-09-01

    A persistent feature of international health policy debate is whether a single-payer or multiple-payer system can offer superior performance. In Ireland, a major reform proposal is the introduction of \\'managed competition\\' based on the recent reforms in the Netherlands, which would replace many functions of Ireland\\'s public payer with a system of competing health insurers from 2016. This article debates whether Ireland meets the preconditions for effective managed competition, and whether the government should implement the reform according to its stated timeline. We support our arguments by discussing the functioning of the Dutch and Irish systems.

  11. A designated centre for people with disabilities operated by Health Service Executive, Monaghan

    LENUS (Irish Health Repository)

    Day, Mary Rose

    2015-03-02

    Self-neglect is a worldwide and serious public health issue that can have serious adverse outcomes and is more common in older people. Cases can vary in presentation, but typically present as poor self-care, poor care of the environment and service refusal. Community nurses frequently encounter self-neglect cases and health and social care professionals play a key role in the identification, management and prevention of self-neglect. Self-neglect cases can give rise to ethical, personal and professional challenges. The aim of this article is to create a greater understanding of the concept of self-neglect among community nurses.

  12. A designated centre for people with disabilities operated by Health Service Executive, Tipperary

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    Xiao, Liang

    2011-02-01

    In this paper, we give an overview of methadone treatment in Ireland and outline the rationale for designing an electronic health record (EHR) with extensibility, interoperability and decision support functionality. Incorporating several international standards, a conceptual model applying a problem orientated approach in a hierarchical structure has been proposed for building the EHR.

  13. Het Dutch Wildlife Health Centre – kennis over wildziekten in Nederland

    NARCIS (Netherlands)

    Rijks, J.M.; Giessen, van der J.; Roest, H.I.J.; Kuiken, T.; Grone, A.

    2012-01-01

    Veel dierziekten inclusief zoönosen hebben wilde dieren als reservoir. Kennis over ziekten onder wilde dieren is van belang voor zowel de dier- en volksgezondheid, en vormt een essentieel onderdeel van het One health-concept. Een expertisecentrum wildziekten, waar dergelijke kennis vermeerderd en ge

  14. A designated centre for people with disabilities operated by Health Service Executive, Sligo

    LENUS (Irish Health Repository)

    Burke, Sara

    2014-09-01

    A new Irish government came to power in March 2011 with the most radical proposals for health system reform in the history of the state, including improving access to healthcare, free GP care for all by 2015 and the introduction of Universal Health Insurance after 2016. All this was to be achieved amidst the most severe economic crisis experienced by Ireland since the 1930s. The authors assess how well the system coped with a downsizing of resources by an analysis of coverage and health system activity indicators. These show a health system that managed \\'to do more with less\\' from 2008 to 2012. They also demonstrate a system that was \\'doing more with less\\' by transferring the cost of care onto people and by significant resource cuts. From 2013, the indicators show a system that has no choice but \\'to do less with less\\' with diminishing returns from crude cuts. This is evident in declining numbers with free care, of hospital cases and home care hours, alongside increased wait-times and expensive agency staffing. The results suggest a limited window of benefit from austerity beyond which cuts and rationing prevail which is costly, in both human and financial terms.

  15. A designated centre for people with disabilities operated by Health Service Executive, Cork

    LENUS (Irish Health Repository)

    O'Connor, Mairead

    2014-08-01

    Participation in organized cervical cancer screening has declined recently. While research has focussed on barriers to screening participation, less attention has been paid to what motivates women to attend. Moreover, little is known about health care provider\\/practitioner-level barriers and facilitators to participation. Better understanding of these issues could help inform strategies to improve participation.

  16. Operational Efficiency of an Immunization Clinic Attached to Rural Health Training Centre in Delhi, India: A Time and Motion Study

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    Varun Kumar

    2014-01-01

    Full Text Available Background. Obtaining baseline data about current patterns of work is important for assessing the effects of interventions designed to improve care delivery. Time and motion studies allow for the most accurate measurement of structured components. Therefore, the present study was conducted to study the operational efficiency of an immunization clinic in Delhi, India. Methods. An observational cross-sectional study was conducted at the immunization clinic of Rural Health Training Centre in Delhi, India, from January 2014 to March 2014. The study composed two stage evaluations, a passive observation and a time and motion study. Systemic random sampling method was used to select 863 mothers/caregivers attending the immunization clinic. Results. At the immunization clinic, the study participants spent 64.1% of their total time in waiting. For new cases, the mean time taken for initial registration and receiving postvaccination advice was found to be significantly longer than old cases. Delivering health care services took more time during Mondays and also during the first hour of the day. Conclusion. Results of this study will guide public health decision-makers at all government levels in planning and implementation of immunization programs in developing countries.

  17. Innovation and the English National Health Service: a qualitative study of the independent sector treatment centre programme.

    Science.gov (United States)

    Turner, Simon; Allen, Pauline; Bartlett, Will; Pérotin, Virginie

    2011-08-01

    Over the past two decades, an international trend of exposing public health services to different forms of economic organisation has emerged. In the English National Health Service (NHS), care is currently provided through a quasi-market including 'diverse' providers from the private and third sector. The predominant scheme through which private sector companies have been awarded NHS contracts is the Independent Sector Treatment Centre (ISTC) programme. ISTCs were designed to produce innovative models of service delivery for elective care and stimulate innovation among incumbent NHS providers. This paper investigates these claims using qualitative data on the impact of an ISTC upon a local health economy (LHE) composed of NHS organisations in England. Using the case of elective orthopaedic surgery, we conducted semi-structured interviews with senior managers from incumbent NHS providers and an ISTC in 2009. We show that ISTCs exhibit a different relationship with frontline clinicians because they counteract the power of professional communities associated with the NHS. This has positive and negative consequences for innovation. ISTCs have introduced new routines unencumbered by the extant norms of professional communities, but they appear to represent weaker learning environments and do not reproduce cooperation across organisational boundaries to the same extent as incumbent NHS providers. Copyright © 2011 Elsevier Ltd. All rights reserved.

  18. A designated centre for people with disabilities operated by Health Service Executive, Donegal

    LENUS (Irish Health Repository)

    Murphy, Deirdre J

    2009-01-01

    BACKGROUND: Caesarean section is one of the most commonly performed major operations in women throughout the world. Rates are escalating, with studies from the United States of America, the United Kingdom, China and the Republic of Ireland reporting rates between 20% and 25%. Operative morbidity includes haemorrhage, anaemia, blood transfusion and in severe cases, maternal death. The value of routine oxytocics in the third stage of vaginal birth has been well established and it has been assumed that these benefits apply to caesarean delivery as well. A slow bolus dose of oxytocin is recommended following delivery of the baby at caesarean section. Some clinicians use an additional infusion of oxytocin for a further period following the procedure. Intravenous oxytocin has a very short half-life (4-10 minutes) therefore the potential advantage of an oxytocin infusion is that it maintains uterine contractility throughout the surgical procedure and immediate postpartum period, when most primary haemorrhages occur. The few trials to date addressing the optimal approach to preventing haemorrhage at caesarean section have been under-powered to evaluate clinically important outcomes. There has been no trial to date comparing the use of an intravenous slow bolus of oxytocin versus an oxytocin bolus and infusion. METHODS AND DESIGN: A multi-centre randomised controlled trial is proposed. The study will take place in five large maternity units in Ireland with collaboration between academics and clinicians in the disciplines of obstetrics and anaesthetics. It will involve 2000 women undergoing elective caesarean section after 36 weeks gestation. The main outcome measure will be major haemorrhage (blood loss >1000 ml). A study involving 2000 women will have 80% power to detect a 36% relative change in the risk of major haemorrhage with two-sided 5% alpha. DISCUSSION: It is both important and timely that we evaluate the optimal approach to the management of the third stage at

  19. Topical xylitol administration by parents for the promotion of oral health in infants: a caries prevention experiment at a Finnish Public Health Centre.

    Science.gov (United States)

    Mäkinen, Kauko K; Järvinen, Kirsti L; Anttila, Carita H; Luntamo, Leena M; Vahlberg, Tero

    2013-08-01

    This demonstration programme tested topical use of xylitol as a possible oral health promoting regimen in infants at a Finnish Public Health Centre in 2002-2011. Parents (usually mothers) began once- or twice-daily administration of a 45% solution of xylitol (2.96 m) onto all available deciduous teeth of their children at the age of approximately 6-8 months. The treatment (xylitol swabbing), which continued till the age of approximately 36 months (total duration 26-28 months), was carried out using cotton swabs or a children's toothbrush; the approximate daily xylitol usage was 13.5 mg per each deciduous tooth. At the age of 7 years, caries data on the deciduous dentition of 80 children were compared with those obtained from similar, untreated children (n = 90). Xylitol swabbing resulted in a significant (P caries compared with the comparison subjects (relative risk 2.1 and 4.0, respectively; 95% confidence intervals 1.42-3.09 and 2.01-7.98, respectively). Similar findings were obtained when the children were 5 or 6 years old. The treatment reduced the need of tooth filling relative risk and 95% confidence intervals at 7 years: 11.86 and 6.36-22.10, respectively; P dental health was accomplished in infants participating in a topical at-home xylitol administration experiment, which was offered to families in the area by the Public Health Centre as a supplement to standard oral health care. Caregiver assessment of the programme was mostly rated as high or satisfactory. © 2013 FDI World Dental Federation.

  20. Cross-sectional study of factors associated with community health centre use in a recently urbanised community in Chengdu, China.

    Science.gov (United States)

    Liu, Danping; Meng, Hongdao; Dobbs, Debra; Conner, Kyaien O; Hyer, Kathryn; Li, Ningxiu; Ren, Xiaohui; Gao, Bo

    2017-06-08

    Public investment in community health centres (CHCs) has been increasing as a response to rapid urbanisation in China. The objectives of this study were: (1) to examine factors associated with CHC use among residents from a recently urbanised community in western China and (2) to describe satisfaction with CHC among users. Cross-sectional design. A community recently converted to urban status with a newly constructed CHC in Southwest China. A random sample of 2259 adults in the Hezuo community in Chengdu, China, completed the survey in 2013. Trained staff interviewed study participants in their homes using structured questionnaires. The survey included questions regarding sociodemographics, health status, access to and usage of healthcare, health behaviours and CHC use. The Andersen's behavioural model of health service use was used to guide multivariable logistic regression modelling in identifying predisposing, enabling and need factors associated with the likelihood of using CHC. Descriptive statistics were used to describe residents' satisfaction with the CHC. A total of 71.8% of the respondents reported using the CHC during the past year. Factors influencing adults' CHC use included: gender, marital status, education level and knowledge of one's blood pressure (predisposing factors); annual household per capita income and walking time to the CHC (enabling factors) and self-rated health as well as physical activities (need factors). CHC users reported modest satisfaction across various aspects of the CHC. Neighbourhood CHC in urban areas provides important services to these residents living in a recently urbanised community. All three categories of factors in the Andersen model help explain the likelihood of CHC use. There is much room for improvement in CHC to enhance customer satisfaction. Future research is needed to improve access to CHCs and promote their use in urbanised populations with low to modest education. © Article author(s) (or their employer

  1. A designated centre for people with disabilities operated by Health Service Executive, Sligo

    LENUS (Irish Health Repository)

    McNicholas, F

    2011-04-01

    Children in care in Ireland have increased by 27% in the last decade. This population is recognized to be among the most vulnerable. This study aims to describe their placement histories, service use and mental health needs. Data was obtained on 174 children (56.5% of eligible sample) with a mean age of 10.83 (SD = 5.04). 114 (65.5%) were in care for three years or more. 29 (16.7%) did not have a SW and 49 (37.7%) had no GP 50 (28.7%) were attending CAMHS. Long term care, frequent placement changes and residential setting were significantly related with poorer outcomes and increased MH contact. Given the increase in numbers in care and the overall decrease in resource allocation to health and social care, individual care planning and prioritizing of resources are essential.

  2. The ethics of allocation of scarce health care resources: a view from the centre.

    Science.gov (United States)

    Calman, K C

    1994-06-01

    Resource allocation is a central part of the decision-making process in any health care system. Resources have always been finite, thus the ethical issues raised are not new. The debate is now more open, and there is greater public awareness of the issues. It is increasingly recognised that it is the technology which determines resources. The ethical issues involved are often conflicting and relate to issues of individual rights and community benefits. One central feature of resource allocation is the basing of decisions on the outcomes of health care and on their subsequent economic evaluation. The knowledge base is therefore of great importance as is the audit of results of clinical treatment. Public involvement is seen as an integral part of this process. For all parts of the process, better methodologies are required.

  3. Visual inspection with acetic acid for cervical cancer screening in a tertiary health care centre

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    Shaily Agarwal

    2016-03-01

    Conclusions: VIA is useful for detection of precursor lesions of cervical cancer not only in low-resource settings but also in well-equipped health centers and cancer centers. In these non low-resource settings, VIA has a positive predictive value comparable to the conventional Pap smear, but it is more likely to achieve earlier diagnosis, follow-up, and treatment than cytology based screening. [Int J Reprod Contracept Obstet Gynecol 2016; 5(3.000: 752-756

  4. SEQUenCE: a service user-centred quality of care instrument for mental health services.

    Science.gov (United States)

    Hester, Lorraine; O'Doherty, Lorna Jane; Schnittger, Rebecca; Skelly, Niamh; O'Donnell, Muireann; Butterly, Lisa; Browne, Robert; Frorath, Charlotte; Morgan, Craig; McLoughlin, Declan M; Fearon, Paul

    2015-08-01

    To develop a quality of care instrument that is grounded in the service user perspective and validate it in a mental health service. The instrument (SEQUenCE (SErvice user QUality of CarE)) was developed through analysis of focus group data and clinical practice guidelines, and refined through field-testing and psychometric analyses. All participants were attending an independent mental health service in Ireland. Participants had a diagnosis of bipolar affective disorder (BPAD) or a psychotic disorder. Twenty-nine service users participated in six focus group interviews. Seventy-one service users participated in field-testing: 10 judged the face validity of an initial 61-item instrument; 28 completed a revised 52-item instrument from which 12 items were removed following test-retest and convergent validity analyses; 33 completed the resulting 40-item instrument. Test-retest reliability, internal consistency and convergent validity of the instrument. The final instrument showed acceptable test-retest reliability at 5-7 days (r = 0.65; P Service Satisfaction Scale (r = 0.84, P service user perspective and suitable for routine use. It may serve as a useful tool in individual care planning, service evaluation and research. The instrument was developed and validated with service users with a diagnosis of either BPAD or a psychotic disorder; it does not yet have established external validity for other diagnostic groups. © The Author 2015. Published by Oxford University Press in association with the International Society for Quality in Health Care; all rights reserved.

  5. Multi-centred mixed-methods PEPFAR HIV care & support public health evaluation: study protocol

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    Fayers Peter

    2010-09-01

    Full Text Available Abstract Background A public health response is essential to meet the multidimensional needs of patients and families affected by HIV disease in sub-Saharan Africa. In order to appraise curret provision of HIV care and support in East Africa, and to provide evidence-based direction to future care programming, and Public Health Evaluation was commissioned by the PEPFAR programme of the US Government. Methods/Design This paper described the 2-Phase international mixed methods study protocol utilising longitudinal outcome measurement, surveys, patient and family qualitative interviews and focus groups, staff qualitative interviews, health economics and document analysis. Aim 1 To describe the nature and scope of HIV care and support in two African countries, including the types of facilities available, clients seen, and availability of specific components of care [Study Phase 1]. Aim 2 To determine patient health outcomes over time and principle cost drivers [Study Phase 2]. The study objectives are as follows. 1 To undertake a cross-sectional survey of service configuration and activity by sampling 10% of the facilities being funded by PEPFAR to provide HIV care and support in Kenya and Uganda (Phase 1 in order to describe care currently provided, including pharmacy drug reviews to determine availability and supply of essential drugs in HIV management. 2 To conduct patient focus group discussions at each of these (Phase 1 to determine care received. 3 To undertake a longitudinal prospective study of 1200 patients who are newly diagnosed with HIV or patients with HIV who present with a new problem attending PEPFAR care and support services. Data collection includes self-reported quality of life, core palliative outcomes and components of care received (Phase 2. 4 To conduct qualitative interviews with staff, patients and carers in order to explore and understand service issues and care provision in more depth (Phase 2. 5 To undertake document

  6. Towards One Health disease surveillance: The Southern African Centre for Infectious Disease Surveillance approach

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    Esron D. Karimuribo

    2012-06-01

    Full Text Available Africa has the highest burden of infectious diseases in the world and yet the least capacity for its risk management. It has therefore become increasingly important to search for ‘fit-for- purpose’ approaches to infectious disease surveillance and thereby targeted disease control. The fact that the majority of human infectious diseases are originally of animal origin means we have to consider One Health (OH approaches which require inter-sectoral collaboration for custom-made infectious disease surveillance in the endemic settings of Africa. A baseline survey was conducted to assess the current status and performance of human and animal health surveillance systems and subsequently a strategy towards OH surveillance system was developed. The strategy focused on assessing the combination of participatory epidemiological approaches and the deployment of mobile technologies to enhance the effectiveness of disease alerts and surveillance at the point of occurrence, which often lies in remote areas. We selected three study sites, namely the Ngorongoro, Kagera River basin and Zambezi River basin ecosystems. We have piloted and introduced the next-generation Android mobile phones running the EpiCollect application developed by Imperial College to aid geo-spatial and clinical data capture and transmission of this data from the field to the remote Information Technology (IT servers at the research hubs for storage, analysis, feedback and reporting. We expect that the combination of participatory epidemiology and technology will significantly improve OH disease surveillance in southern Africa.

  7. Determinants Associated with Syphilis among the Youth in Health Centre Wamena City, Jayawijaya Regency

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    Oliphina Rumbekwan

    2016-08-01

    Full Text Available Abstract Sexually transmitted infections (STI cases in province of Papua in 2013 were 1,213 cases, then in 2014 the number of visits to STI services were 19 945 cases with the number of STI patients of 10,995 cases and the number of syphilis patients was 2,150 cases, while cases of syphilis in adolescent at the health center Wamena City District Jayawijaya in 2015 were 91 cases. The method used in this research is quantitative correlation type with cross sectional study. The population in this study was all teenagers who visited the health center Jayawijaya Wamena town, with 578 teenagers. The sampling technique used was purposive sampling, obtained a sample of 236 respondents. The data collection is done by distributing questionnaires to the respondents. Analysis of the data in this study is analysis of univariate and bivariate. The results showed a correlation between free association with syphilis in adolescence (p-value = 0.000, there is a relationship between the use of condoms with syphilis in adolescence (p-value = 0.000, there is no relationship between early sex education with disease syphilis in adolescence (p-value = 0.151, there is no relationship between the supervision of parents with syphilis in adolescence (p-value = 0.265, there is a relationship between personal hygiene with syphilis in adolescence (p-value = 0.001 , there is no relationship between the mass media with syphilis in adolescence (p-value = 0.569.

  8. Awareness and Practice of Biomedical Waste Management Among Different Health Care Personnel at Tertiary Care Centre, Rajkot, India

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    Rajesh K Chudasama

    2014-05-01

    Full Text Available Background: Bio medical waste collection and proper disposal has become a significant concern for both the medical and general community. Objective: To know the awareness and practice of biomedical waste management (BMW among health care personnel working at a tertiary care centre. Methods: The study was conducted from January 2013 to June 2013. It was a descriptive observational hospital based cross sectional study. Study participants included the resident and intern doctors, nursing staff, laboratory technicians, sanitary staff (ward boys, aaya and sweepers working in the P D U Government Medical College and Civil Hospital, Rajkot who are dealing with BMW. The study was conducted by using pretested, semi-structured pro forma. Results: Total 282 health care personnel participated, including 123 resident and intern doctors, 92 nursing personnel, 13 laboratory technicians and 54 sanitary staff. Only 44.3% study participants received training for bio medical waste management. Except for doctors (98.4%, awareness regarding identification and use of color coded bags as per BMW act, was very poor among health care personnel. Record keeping for injuries related to biomedical waste was very poor for all health care personnel. Significant number of paramedics maintained record of BMW at work place, practiced disinfection and segregation of BMW at work place, used personal protective measures while handling BMW. Significant number of resident and intern doctors practiced correct method for collecting sharps and needles than paramedical staff. Conclusion: Intensive training program at regular time interval and a system of monitoring and surveillance about practice of day to day BMW management should be evolved.

  9. A designated centre for people with disabilities operated by Health Service Executive, Cork

    LENUS (Irish Health Repository)

    Spicer, Neil

    2011-07-13

    Abstract Background Despite massive scale up of funds from global health initiatives including the Global Fund to Fight AIDS, Tuberculosis and Malaria (Global Fund) and other donors, the ambitious target agreed by G8 leaders in 2005 in Gleneagles to achieve universal access to HIV\\/AIDS treatment by 2010 has not been reached. Significant barriers to access remain in former Soviet Union (FSU) countries, a region now recognised as a priority area by policymakers. There have been few empirical studies of access to HIV\\/AIDS services in FSU countries, resulting in limited understanding and implementation of accessible HIV\\/AIDS interventions. This paper explores the multiple access barriers to HIV\\/AIDS services experienced by a key risk group-injecting drug users (IDUs). Methods Semi-structured interviews were conducted in two FSU countries-Ukraine and Kyrgyzstan-with clients receiving Global Fund-supported services (Ukraine n = 118, Kyrgyzstan n = 84), service providers (Ukraine n = 138, Kyrgyzstan n = 58) and a purposive sample of national and subnational stakeholders (Ukraine n = 135, Kyrgyzstan n = 86). Systematic thematic analysis of these qualitative data was conducted by country teams, and a comparative synthesis of findings undertaken by the authors. Results Stigmatisation of HIV\\/AIDS and drug use was an important barrier to IDUs accessing HIV\\/AIDS services in both countries. Other connected barriers included: criminalisation of drug use; discriminatory practices among government service providers; limited knowledge of HIV\\/AIDS, services and entitlements; shortages of commodities and human resources; and organisational, economic and geographical barriers. Conclusions Approaches to thinking about universal access frequently assume increased availability of services means increased accessibility of services. Our study demonstrates that while there is greater availability of HIV\\/AIDS services in Ukraine and Kyrgyzstan, this does not equate with

  10. Assessing the Queuing Process Using Data Envelopment Analysis: an Application in Health Centres.

    Science.gov (United States)

    Safdar, Komal A; Emrouznejad, Ali; Dey, Prasanta K

    2016-01-01

    Queuing is one of the very important criteria for assessing the performance and efficiency of any service industry, including healthcare. Data Envelopment Analysis (DEA) is one of the most widely-used techniques for performance measurement in healthcare. However, no queue management application has been reported in the health-related DEA literature. Most of the studies regarding patient flow systems had the objective of improving an already existing Appointment System. The current study presents a novel application of DEA for assessing the queuing process at an Outpatients' department of a large public hospital in a developing country where appointment systems do not exist. The main aim of the current study is to demonstrate the usefulness of DEA modelling in the evaluation of a queue system. The patient flow pathway considered for this study consists of two stages; consultation with a doctor and pharmacy. The DEA results indicated that waiting times and other related queuing variables included need considerable minimisation at both stages.

  11. Leptospira Seroprevalence and Risk Factors in Health Centre Patients in Hoima District, Western Uganda.

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    Anou Dreyfus

    2016-08-01

    Full Text Available The burden of human leptospirosis in Uganda is unknown. We estimated the seroprevalence of Leptospira antibodies, probable acute/recent leptospirosis, and risk factors for seropositivity in humans in rural Western Uganda.359 non-pregnant adults visiting the Kikuube and Kigorobya Health Centers were sequentially recruited during March and April 2014. A health history survey and serum were collected from consented participants. Overall, 69% reported having fever in the past year, with 49% reporting malaria, 14% malaria relapse, 6% typhoid fever, 3% brucellosis, and 0% leptospirosis. We tested sera by microscopic agglutination test (MAT against eight Leptospira serovars representing seven serogroups. Leptospira seroprevalence was 35% (126/359; 95%CI 30.2-40.3% defined as MAT titer ≥ 1:100 for any serovar. The highest prevalence was against L. borgpetersenii Nigeria (serogroup Pyrogenes at 19.8% (71/359; 95%CI 15.9-24.4%. The prevalence of probable recent leptospirosis (MAT titer ≥1:800 was 1.9% (95%CI 0.9-4.2% and uniquely related to serovar Nigeria (serogroup Pyrogenes. Probable recent leptospirosis was associated with having self-reported malaria within the past year (p = 0.048. Higher risk activities included skinning cattle (n = 6 with 12.3 higher odds (95%CI 1.4-108.6; p = 0.024 of Leptospira seropositivity compared with those who had not. Participants living in close proximity to monkeys (n = 229 had 1.92 higher odds (95%CI 1.2-3.1; p = 0.009 of seropositivity compared with participants without monkeys nearby.The 35% prevalence of Leptospira antibodies suggests that exposure to leptospirosis is common in rural Uganda, in particular the Nigeria serovar (Pyrogenes serogroup. Leptospirosis should be a diagnostic consideration in febrile illness and "smear-negative malaria" in rural East Africa.

  12. Leptospira Seroprevalence and Risk Factors in Health Centre Patients in Hoima District, Western Uganda

    Science.gov (United States)

    Pearson, Raewynne; Kankya, Clovice; Kajura, Charles; Alinaitwe, Lordrick; Kakooza, Steven; Pelican, Katharine M.; Travis, Dominic A.; Mahero, Michael; Boulware, David R.; Mugisha, Lawrence

    2016-01-01

    Background The burden of human leptospirosis in Uganda is unknown. We estimated the seroprevalence of Leptospira antibodies, probable acute/recent leptospirosis, and risk factors for seropositivity in humans in rural Western Uganda. Methodology and Principal Findings 359 non-pregnant adults visiting the Kikuube and Kigorobya Health Centers were sequentially recruited during March and April 2014. A health history survey and serum were collected from consented participants. Overall, 69% reported having fever in the past year, with 49% reporting malaria, 14% malaria relapse, 6% typhoid fever, 3% brucellosis, and 0% leptospirosis. We tested sera by microscopic agglutination test (MAT) against eight Leptospira serovars representing seven serogroups. Leptospira seroprevalence was 35% (126/359; 95%CI 30.2–40.3%) defined as MAT titer ≥ 1:100 for any serovar. The highest prevalence was against L. borgpetersenii Nigeria (serogroup Pyrogenes) at 19.8% (71/359; 95%CI 15.9–24.4%). The prevalence of probable recent leptospirosis (MAT titer ≥1:800) was 1.9% (95%CI 0.9–4.2%) and uniquely related to serovar Nigeria (serogroup Pyrogenes). Probable recent leptospirosis was associated with having self-reported malaria within the past year (p = 0.048). Higher risk activities included skinning cattle (n = 6) with 12.3 higher odds (95%CI 1.4–108.6; p = 0.024) of Leptospira seropositivity compared with those who had not. Participants living in close proximity to monkeys (n = 229) had 1.92 higher odds (95%CI 1.2–3.1; p = 0.009) of seropositivity compared with participants without monkeys nearby. Conclusions/Significance The 35% prevalence of Leptospira antibodies suggests that exposure to leptospirosis is common in rural Uganda, in particular the Nigeria serovar (Pyrogenes serogroup). Leptospirosis should be a diagnostic consideration in febrile illness and “smear-negative malaria” in rural East Africa. PMID:27487398

  13. A model for extending antiretroviral care beyond the rural health centre

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    Wools-Kaloustian Kara K

    2009-09-01

    Full Text Available Abstract Background A major obstacle facing many lower-income countries in establishing and maintaining HIV treatment programmes is the scarcity of trained health care providers. To address this shortage, the World Health Organization has recommend task shifting to HIV-infected peers. Methods We designed a model of HIV care that utilizes HIV-infected patients, community care coordinators (CCCs, to care for their clinically stable peers with the assistance of preprogrammed personal digital assistants (PDAs. Rather than presenting for the standard of care, monthly clinic visits, in this model, patients were seen every three months in clinics and monthly by their CCCs in the community during the interim two months. This study was conducted in Kosirai Division, western Kenya, where eight of the 24 sub-locations (defined geographic areas within the division were randomly assigned to the intervention with the remainder used as controls. Prior to entering the field, CCCs underwent intensive didactic training and mentoring related to the assessment and support of HIV patients, as well as the use of PDAs. PDAs were programmed with specific questions and to issue alerts if responses fell outside of pre-established parameters. CCCs were regularly evaluated in six performance areas. An impressionistic analysis on the transcripts from the monthly group meetings that formed the basis of the continuous feedback and quality improvement programme was used to assess this model. Results All eight of the assigned CCCs successfully passed their training and mentoring, entered the field and remained active for the two years of the study. On evaluation of the CCCs, 89% of their summary scores were documented as superior during Year 1 and 94% as superior during Year 2. Six themes emerged from the impressionistic analysis in Year 1: confidentiality and "community" disclosure; roles and responsibilities; logistics; clinical care partnership; antiretroviral adherence; and

  14. The Analysis Of Antibiotic Consumption And Bacterial Resistance As An Indicator Of Their Proper Use At The Urology Department In The Health Centre “Studenica” Kraljevo

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    Bukonjić Andriana

    2015-06-01

    Full Text Available The objective of the study was to analyze antibiotic consumption and determine bacterial resistance rates as an indicator of the rational utilization of this drug group at the urology department in the Health Centre “Studenica” Kraljevo.

  15. Rationality, practice variation and person-centred health policy: a threshold hypothesis.

    Science.gov (United States)

    Djulbegovic, Benjamin; Hamm, Robert M; Mayrhofer, Thomas; Hozo, Iztok; Van den Ende, Jef

    2015-12-01

    Variation in practice of medicine is one of the major health policy issues of today. Ultimately, it is related to physicians' decision making. Similar patients with similar likelihood of having disease are often managed by different doctors differently: some doctors may elect to observe the patient, others decide to act based on diagnostic testing and yet others may elect to treat without testing. We explain these differences in practice by differences in disease probability thresholds at which physicians decide to act: contextual social and clinical factors and emotions such as regret affect the threshold by influencing the way doctors integrate objective data related to treatment and testing. However, depending on a theoretical construct each of the physician's behaviour can be considered rational. In fact, we showed that the current regulatory policies lead to predictably low thresholds for most decisions in contemporary practice. As a result, we may expect continuing motivation for overuse of treatment and diagnostic tests. We argue that rationality should take into account both formal principles of rationality and human intuitions about good decisions along the lines of Rawls' 'reflective equilibrium/considered judgment'. In turn, this can help define a threshold model that is empirically testable.

  16. Quality of Diabetes Care in Primary Health Centres in North Al-Batinah of Oman

    Science.gov (United States)

    Al-Shafaee, Mohammed; Al-Farsi, Yousuf; Al-Kaabi, Yousuf; Banerjee, Yajnavalka; Al-Zadjali, Najat; Al-Zakwani, Ibrahim

    2014-01-01

    Objective: To assess the quality of diabetic care provided in primary health care settings in Oman. Methods: This was a cross-sectional study of randomly selected 500 patients with diabetes mellitus (DM) attending 6 primary care diabetic clinics in the north Al-Batinah region of Oman from January to December 2010. Nine standards on the quality of diabetes care were audited. Results: The mean age of the sample was 51±13 years, ranging from 15 to 87 years; the majority (61%) were females. The mean duration of DM was 4±3 years, ranging from 1 to 18 years. Seventy-seven percent of the patients attended diabetic clinics at least 4 times per year. Of the 9 assessed diabetic standards, HbA1c was documented in 33% of the patients, body mass index in 12%, low-density lipoprotein cholesterol (LDL-C) in 40%, urinary albumin:creatinine ratio in 28%, creatinine in 63% and blood pressure (BP) in 96%. Optimal control among the documented indicators was noted in 32, 21, 25, 85, 95 and 19%, respectively. Twenty percent of the patients had their ECGs done while only 39% of the patients had foot examination. No patient had attained control in all of HbA1c., BP and LDL-C. Conclusion: There is a gap between the recommended DM care guidelines and current practice with consequent poor quality of care in these patients. PMID:25024774

  17. Towards people-centred health services delivery: a Framework for Action for the World Health Organisation (WHO European Region

    Directory of Open Access Journals (Sweden)

    Viktoria Stein

    2013-12-01

    Full Text Available Integrated care has moved from the small niche it traditionally occupied in academia, accessible only to experts in the field and applied merely on a project specific or pilot effort basis, now onto the radar of politicians and health system planners the world over.

  18. The OIE World Animal Health Information System: the role of OIE Reference Laboratories and Collaborating Centres in disease reporting.

    Science.gov (United States)

    Ben Jebara, K

    2010-12-01

    One of the main objectives of the World Organisation for Animal Health (OIE) is to ensure transparency in and knowledge of the world animal health situation. To achieve this objective, the OIE relies on its network of Member Countries, which is complemented by the activities of 221 Reference Laboratories (RLs) and Collaborating Centres. The RL mandate states that, in the case of positive results for diseases notifiable to the OIE, the laboratory should inform the OIE Delegate of the Member Country from which the samples originated and send a copy of the information to OIE Headquarters. However, since 2006 the OIE has received a lower than expected number of notifications from RLs, which implies eitherthat the majority of samples are sent to national laboratories or that some RLs are not fully complying with their mandate. The OIE sent a questionnaire to RLs in preparation for the Second Global Conference of OIE Reference Laboratories and Collaborating Centres (Paris, France, 21-23 June 2010). Two main factors emerged: the need for RLs to clarify their role and responsibilities in disease reporting and the need for an awareness campaign to sensitise national Veterinary Services to the importance of conducting more surveillance (and consequently of submitting samples to RLs) for all OIE-listed diseases. Reference laboratories indicated two main reasons for not sharing more data on positive samples with the OIE: i) a perceived contradiction between their mandate as OIE RLs and the standards of the International Organization for Standardization (ISO) dealing with confidentiality; and ii) certain Member Countries or stakeholders asking RLs not to share positive results with the OIE, for political or economic reasons. The OIE has put forward proposals to help RLs resolve these problems in future. The use of ISO standards must be clarified and there must be improved communication between the OIE and its RLs. A lack of transparency about a significant disease event can

  19. [Provision of continuous health care by a unit connected to primary care centres coordinated by specialist physicians].

    Science.gov (United States)

    Esteban Giner, M J; Giner Galvañ, V; Prats Hernández, J L; Llopis Martínez, F; Cortés i Pérez, P J; Castejón Esteban, J

    2013-10-01

    To evaluate the efficacy and efficiency of a system set up to overcome the current disparity between primary and specialist health care and with the capacity to detect patients with significant diseases. To describe the activity of the Unit for Connection with Primary Care Centres (UCPCC) in the Alcoy Health Area (Alicante) during its first year. A total of 450 visits were made, with 6.5 (95% CI 5.7-7.3) first visits, and 3.9 (95% CI 3.1-4.8) successive ones per day. There were more than 50 reasons for consultation, and more than 60 final diagnoses (65.6% non-significant, 14% undefined and 12.4% significant). Digestive (31%) and functional (14.4%) diseases were the most frequently defined diagnoses, with neoplasic and autoimmune diseases among those defined as significant ones. The great majority (86.9%) of patients required 1-2 visits, with 40% diagnosed by just reviewing the hospital files. More than 20 different complementary examinations were performed, with 38.8%, 34.4%, 21.6%, and 5.2% of patients requiring 0, 1, 2, or ≥ 3, respectively. Patients with a significant pathology were diagnosed more quickly (12.4 ± 19.4 vs. 45.3 ± 52.8 days; P = .001), with less complementary examinations (0,5 ± 0,7 vs. 0,9 ± 0,9 per patient; P = .032. 58.6% vs. 39.6% patients without complementary examinations; P = .052), and were more frequently referred to specialised medicine (58.6% vs. 18.3%, P < .0001). The demonstrated differential management of patients with potentially significant pathology using existing resources, make the UCPCC with internists an efficient model for the connection between health care levels. Copyright © 2012 Sociedad Española de Médicos de Atención Primaria (SEMERGEN). Publicado por Elsevier España. All rights reserved.

  20. A designated centre for people with disabilities operated by Health Service Executive, Meath

    LENUS (Irish Health Repository)

    Devkaran, Subashnie

    2009-01-01

    BACKGROUND: Emergency department (ED) overcrowding is a ubiquitous problem with serious public health implications. The fast track area is a novel method which aims to reduce waiting time, patient dissatisfaction and morbidity. |The study objective was to determine the impact of a fast track area (FTA) on both effectiveness measures (i.e. waiting times [WT] and length of stay [LOS]) and quality measures (i.e. LWBS rates and mortality rates) in non-urgent patients. The secondary objective was to assess if a FTA negatively impacted on urgent patients entering the ED. METHODS: The study took place in a 500 bed, urban, tertiary care hospital in Abu Dhabi, United Arab Emirates. This was a quasi-experimental, which examined the impact of a FTA on a pre-intervention control group (January 2005) (n = 4,779) versus a post-intervention study group (January 2006) (n = 5,706). RESULTS: Mean WTs of Canadian Triage Acuity Scale (CTAS) 4 patients decreased by 22 min (95% CI 21 min to 24 min, P < 0.001). Similarly, mean WTs of CTAS 5 patients decreased by 28 min (95% CI 19 min to 37 min, P < 0.001) post FTA. The mean WTs of urgent patients (CTAS 2\\/3) were also significantly reduced after the FTA was opened (P < 0.001). The LWBS rate was reduced from 4.7% to 0.7% (95% CI 3.37 to 4.64; P < 0.001). Opening a FTA had no significant impact on mortality rates (P = 0.88). CONCLUSION: The FTA improved ED effectiveness (WTs and LOS) and quality measures (LWBS rates) whereas mortality rate remained unchanged.

  1. A designated centre for people with disabilities operated by Health Service Executive, Tipperary

    LENUS (Irish Health Repository)

    Sills, Eric Scott

    2009-01-01

    The development of in vitro fertilisation (IVF) as a treatment for human infertilty was among the most controversial medical achievements of the modern era. In Ireland, the fate and status of supranumary (non-transferred) embryos derived from IVF brings challenges both for clinical practice and public health policy because there is no judicial or legislative framework in place to address the medical, scientific, or ethical uncertainties. Complex legal issues exist regarding informed consent and ownership of embryos, particularly the use of non-transferred embryos if a couple separates or divorces. But since case law is only beginning to emerge from outside Ireland and because legislation on IVF and human embryo status is entirely absent here, this matter is poised to raise contractual, constitutional and property law issues at the highest level. Our analysis examines this medico-legal challenge in an Irish context, and summarises key decisions on this issue rendered from other jurisdictions. The contractual issues raised by the Roche case regarding informed consent and the implications the initial judgment may have for future disputes over embryos are also discussed. Our research also considers a putative Constitutional \\'right to procreate\\' and the implications EU law may have for an Irish case concerning the fate of frozen embryos. Since current Medical Council guidelines are insufficient to ensure appropriate regulation of the advanced reproductive technologies in Ireland, the report of the Commission on Assisted Human Reproduction is most likely to influence embryo custody disputes. Public policy requires the establishment and implementation of a more comprehensive legislative framework within which assisted reproductive medical services are offered.

  2. Evaluation of Electronic Medical Record (EMR at large urban primary care sexual health centre.

    Directory of Open Access Journals (Sweden)

    Christopher K Fairley

    Full Text Available OBJECTIVE: Despite substantial investment in Electronic Medical Record (EMR systems there has been little research to evaluate them. Our aim was to evaluate changes in efficiency and quality of services after the introduction of a purpose built EMR system, and to assess its acceptability by the doctors, nurses and patients using it. METHODS: We compared a nine month period before and after the introduction of an EMR system in a large sexual health service, audited a sample of records in both periods and undertook anonymous surveys of both staff and patients. RESULTS: There were 9,752 doctor consultations (in 5,512 consulting hours in the Paper Medical Record (PMR period and 9,145 doctor consultations (in 5,176 consulting hours in the EMR period eligible for inclusion in the analysis. There were 5% more consultations per hour seen by doctors in the EMR period compared to the PMR period (rate ratio = 1.05; 95% confidence interval, 1.02, 1.08 after adjusting for type of consultation. The qualitative evaluation of 300 records for each period showed no difference in quality (P>0.17. A survey of clinicians demonstrated that doctors and nurses preferred the EMR system (P<0.01 and a patient survey in each period showed no difference in satisfaction of their care (97% for PMR, 95% for EMR, P = 0.61. CONCLUSION: The introduction of an integrated EMR improved efficiency while maintaining the quality of the patient record. The EMR was popular with staff and was not associated with a decline in patient satisfaction in the clinical care provided.

  3. Enabling and Barriers of Implantable Contraceptive Use at Health Centre I North Denpasar

    Directory of Open Access Journals (Sweden)

    Nida Gustikawati

    2015-04-01

    Full Text Available Background and purpose: The objective of this study was to explore the supporting and the inhibiting factors influencing the use of implant contraceptive use by women of childbearing age. Methods: The study was qualitative using a phenomenological approach. Data collection involved a purposively selected sample, conducting two FGD (10 implant users and 10 non-users and 11 in-depth interviews among private midwives, government midwives, husbands, in-laws, and family planning staff. Results: FGD found that perceptions and attitudes towards implants of those already using the contraceptive were positive, while the perceptions and attitudes of non-users were less so. Some respondents intimated that they experienced side effects though these were not a deterring factor in usage. Enabling factors for the use of implant contraceptives were the availability and accessibility to the healthcare facilities and the support of their husbands. Access to facilities and infrastructure were not inhibiting factors either for the users or the non-users. Findings from in-depth interviews indicated that inhibiting factors included were the desire to have more children and the lack of promotion of the implant contraceptives. Healthcare provider informants stated that the lack of training was an inhibiting factor. Conclusion: Enabling factors for the use of implant contraceptives were the availability and accessibility to the healthcare facilities and the support of their husbands. Inhibiting factors were the desire to have more children, the lack of proper training for the health workers, as well as the lack of promotion of the implant contraceptive in the community.

  4. Maximizing microscopy as a diagnostic tool in peripheral health centres of BU endemic areas in Ghana

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    Enid Owusu

    2015-01-01

    Full Text Available Background: Buruli ulcer (BU disease, a skin condition caused by Mycobacterium ulcerans (M. ulcerans is endemic in remote rural areas. Disease diagnosis on clinical basis alone can be misleading, requiring definitive diagnosis based on laboratory tests. Resource constraints in BU endemic areas make microscopy for the detection of acid fast bacilli (AFB an important and useful method. It is rapid, user-friendly, convenient and cheap. Despite its usefulness, its performance is relatively low. This study investigated modifications of the current method aimed at improving its performance. Forty (IS 2404 polymerase chain reactions (PCR positive BU samples were processed by eight physical (centrifugation and overnight sedimentation and chemical (phenol ammonium sulphate and sodium hypochlorite modifications of the current direct method. Assessments were based on standard AFB evaluation coupled with in house criteria; positivity (P, clarity and contrast (C release of bacilli from specimen (R. Overall AFB positivity rate was 64% (409/640. Each protocol had 80 smears. The percentage positivity (P for the conventional method was 58% (46/80 smears. The highest positivity rate of 57/80 (% was by protocol 7 (5% phenol in 4% ammonium sulphate (PhAS and concentrated by overnight gravitational sedimentation. The least positivity rate at 35% (28/80 was by protocol 1 (smears from direct application of swab tips. The differences in performance between the two chemical tested; 5% phenol in 4% ammonium sulphate (PhAS and 3.5% NaHOCl was significant (p 0.05. This study concluded that BU samples treated with a solution of 5% phenol in 4% ammonium sulphate and concentrated by either centrifugation or overnight sedimentation is useful for maximizing AFB detection by bright field microscopy. This can be useful in rural health facilities with resource constraints.

  5. [Potentially inappropriate prescribing in patients over 65 years-old in a primary care health centre].

    Science.gov (United States)

    Parodi López, Naldy; Villán Villán, Yuri Fabiola; Granados Menéndez, María Isabel; Royuela, Ana

    2014-01-01

    To identify potentially inappropriate prescriptions (PPI) and prescribing omissions (OP) by means of the STOPP/START criteria, as well as associated factors in ≥65year old patients in a Primary Care setting in Spain. A cross-sectional, descriptive study. Centro de Salud Monóvar, Primary Health Care. 6months. 247patients. ≥65years patients who attended an urban Primary Care clinic 2 or more times were studied. Terminally ill and nursing home residents were excluded. Data were collected from electronic clinical records. STOPP and START criteria were evaluated in each clinical record, including age, sex, co-morbidity, number of chronic prescriptions. PPI and OP identified by STOPP and START criteria, respectively. A total of 81 patients (32.8%) had PPI, with the most common being the long-term use of long-acting benzodiazepines in 17 (6.9%). OP was found in 73 (29.6%) patients, with the most common being the omission of statins in patients diagnosed with diabetes mellitus and/or one or more major cardiovascular risk factors in 21 (8.5%). After adjustment by gender and age, correlations were found between PPI and multiple medication (OR: 2.02; 95%CI: 1.15-3.53; P=.014), and OP and polypharmacy (OR: 2.37; 95%CI: 1.32-4.24; P=0.004). Inappropriate prescribing in older people is frequent, and is mainly associated with long-acting benzodiazepines. There are diabetic patients who do not have statins prescribed. Multiple medication is associated with PPI and OP. Copyright © 2013 Elsevier España, S.L. All rights reserved.

  6. Factors related to Acceptance of HIV Testing by Pregnant Mothers in Health Centres in Denpasar City

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    Arniti Ni Ketut

    2014-08-01

    Full Text Available Purpose: To determine reasons of pregnant mothers to undergo HIV testing and factors influencing this decision.in two sites: Puskesmas I Denpasar Utara and Puskesmas II Denpasar Selatan, during the period of 26 March to 22 April2014. Data were collected through interviews using a structured questionnaire. Data were analysed using univariate todetermine the frequency distribution of each variable, bivariate to determine the relationship between the dependentvariable with each independent variable by the chi-squared test and multivariate analysis performed by logisticregression to determine the dominant factors to improve the acceptance of pregnant mothers to HIV testing.Results: Reasons to undergo HIV testing were on recommendation from health providers (65.8%, concern for personalstatus (61.7% and concerns about possibility of vertical transmission (19.2%. Bivariate analysis showed that theacceptance by pregnant mothers was higher in mothers unemployed (75.8%; p=0.033, good knowledge about HIV andits transmission (78.4%; p=0.001, was susceptible to HIV/AIDS (72.0%; p=0.019, the perception that HIV/AIDS is asevere disease (77.0%; p?0.001, perceptions of the benefits of HIV testing (70.8%; p=0.002, absence perceivedbarriers (100%; p?0.001 as well as good support from husband/family (87.7%; p?0.001. Multivariate analysis showedthat factors influencing were support from husband/family with OR=8.71 (95%CI: 2.89-26.28, perception of severity ofHIV with OR=3.39 (95%CI: 1.08-10.69 and employment status with OR=2.82 (95%CI: 1.07-7.42.Conclusion: The majority of women to undergo HIV testing because of recommendations by staff and a desire to knowHIV status. Acceptance of HIV testing among pregnant mothers was influenced by the support of the husband/family,the perception of the severity of HIV / AIDS, and employment status.Keywords: acceptance of HIV testing, pregnant mothers, Denpasar

  7. Using discrete event simulation to compare the performance of family health unit and primary health care centre organizational models in Portugal

    Directory of Open Access Journals (Sweden)

    Sá Armando B

    2011-10-01

    Full Text Available Abstract Background Recent reforms in Portugal aimed at strengthening the role of the primary care system, in order to improve the quality of the health care system. Since 2006 new policies aiming to change the organization, incentive structures and funding of the primary health care sector were designed, promoting the evolution of traditional primary health care centres (PHCCs into a new type of organizational unit - family health units (FHUs. This study aimed to compare performances of PHCC and FHU organizational models and to assess the potential gains from converting PHCCs into FHUs. Methods Stochastic discrete event simulation models for the two types of organizational models were designed and implemented using Simul8 software. These models were applied to data from nineteen primary care units in three municipalities of the Greater Lisbon area. Results The conversion of PHCCs into FHUs seems to have the potential to generate substantial improvements in productivity and accessibility, while not having a significant impact on costs. This conversion might entail a 45% reduction in the average number of days required to obtain a medical appointment and a 7% and 9% increase in the average number of medical and nursing consultations, respectively. Conclusions Reorganization of PHCC into FHUs might increase accessibility of patients to services and efficiency in the provision of primary care services.

  8. Associations between demographics and health-related quality of life for chronic non-malignant pain patients treated at a multidisciplinary pain centre

    DEFF Research Database (Denmark)

    Jensen, Hanne Irene; Plesner, Karin; Kvorning, Nina

    2016-01-01

    OBJECTIVE: To describe the associations between demographics and health-related quality of life for chronic non-malignant pain patients. DESIGN: A cohort study. SETTING: A multidisciplinary Danish pain centre. STUDY PARTICIPANTS: All patients treated at the centre between 2007 and 2013. MAIN.......7 ± 14.4 (range 18-89), and 21% were able to work full or part time. On a Numeric Rating Scale from 0 to 10, median pain-intensity was 8 (interquartile range 7-8) and pain-discomfort 8 (interquartile range 7-9) at time of referral. More than half of the patients had symptoms of anxiety and depression...

  9. Determinants of satisfaction with health care provider interactions at health centres in central Ethiopia: a cross sectional study

    Science.gov (United States)

    2010-01-01

    Background In primary health care, provider-patient interaction is fundamental platform and critically affects service delivery. Nevertheless, it is often ignored in medical research and practice and it is infrequently subjected to scientific inquiry, particularly in Ethiopia. This study aimed to assess patient satisfaction with health care provider interactions and its influencing factors among out-patients at health centers in West Shoa, Central Ethiopia. Methods A cross sectional facility based study was conducted on 768 out-patients of six health centers in West Shoa Zone, Central Ethiopia. The total sample size was allocated to each of the six health centers based on patient flow during the ten days prior to the start of data collection. Pre-tested instruments were used for data collection and the data were analyzed using SPSS version 16.0 statistical software. Factor score was computed for the items identified to represent the satisfaction scale by varimax rotation method. Using this regression factor score, multivariate linear regression analysis was performed and the effect of independent variables on the regression factor score was quantified. Results Seventy three percent of the respondents perceived that provider's empathy was good and 35% complained that providers were not technically competent enough. In addition, 82% of the respondents rated non-verbal communication by the providers to be good, very good or excellent on a five-point ordinal scale. Regardless of the process, only 34.1% of the patients implied that the consultations made a difference in understanding their illness and coping with it. Generally speaking, 62.6% of the patients reported that they have been satisfied with their visit. Perceived empathy, perceived technical competency, non-verbal communication, patient enablement, being told the name of once illness, type and frequency of visit, knowing the providers and educational status were main independent predictors of patient

  10. Determinants of satisfaction with health care provider interactions at health centres in central Ethiopia: a cross sectional study

    Directory of Open Access Journals (Sweden)

    Woldie Mirkuzie

    2010-03-01

    Full Text Available Abstract Background In primary health care, provider-patient interaction is fundamental platform and critically affects service delivery. Nevertheless, it is often ignored in medical research and practice and it is infrequently subjected to scientific inquiry, particularly in Ethiopia. This study aimed to assess patient satisfaction with health care provider interactions and its influencing factors among out-patients at health centers in West Shoa, Central Ethiopia. Methods A cross sectional facility based study was conducted on 768 out-patients of six health centers in West Shoa Zone, Central Ethiopia. The total sample size was allocated to each of the six health centers based on patient flow during the ten days prior to the start of data collection. Pre-tested instruments were used for data collection and the data were analyzed using SPSS version 16.0 statistical software. Factor score was computed for the items identified to represent the satisfaction scale by varimax rotation method. Using this regression factor score, multivariate linear regression analysis was performed and the effect of independent variables on the regression factor score was quantified. Results Seventy three percent of the respondents perceived that provider's empathy was good and 35% complained that providers were not technically competent enough. In addition, 82% of the respondents rated non-verbal communication by the providers to be good, very good or excellent on a five-point ordinal scale. Regardless of the process, only 34.1% of the patients implied that the consultations made a difference in understanding their illness and coping with it. Generally speaking, 62.6% of the patients reported that they have been satisfied with their visit. Perceived empathy, perceived technical competency, non-verbal communication, patient enablement, being told the name of once illness, type and frequency of visit, knowing the providers and educational status were main independent

  11. Morbidity and Mortality of Reptiles Admitted to the Australian Wildlife Health Centre, Healesville Sanctuary, Australia, 2000-13.

    Science.gov (United States)

    Scheelings, T Franciscus

    2015-07-01

    Medical records of 931 reptiles admitted to the Australian Wildlife Health Centre, Healesville Sanctuary, Healesville, Victoria, Australia, from 2000 to 2013 were reviewed to determine the causes of morbidity and mortality. Thirty-nine species were presented; the most common were the common long-neck turtle (Chelodina longicollis; n = 311, 33.4%), the eastern bluetongue lizard (Tiliqua scincoides; n = 224, 4.1%), the blotched bluetongue lizard (Tiliqua nigrolutea; n = 136, 14.6%), and the lowland copperhead (Austrelaps superbus; n = 55, 5.9%). Trauma was the most significant reason for admissions, accounting for 73.0% of cases. This was followed by not injured (11.7%), displacement (6.4%), snake removal (4.2%), human interference (3.1%), introduced species (1.1%), sick/diseased (0.2%), and illegal pet (0.2%). Within the category of trauma, impact with motor vehicle (41.0% of trauma cases) and domestic animal attack (33.2% of trauma cases) were the most common subcategories. Our results indicate that indirect anthropogenic factors are a significant cause of morbidity and mortality in Australian reptiles.

  12. Simple algorithms for the management of genital ulcers: evaluation in a primary health care centre in Kigali, Rwanda.

    Science.gov (United States)

    Bogaerts, J.; Vuylsteke, B.; Martinez Tello, W.; Mukantabana, V.; Akingeneye, J.; Laga, M.; Piot, P.

    1995-01-01

    A cross-sectional study was conducted among 395 patients presenting with genital ulcers at a primary health care centre in Kigali, Rwanda. Using clinical data and the results of a rapid plasma reagin (RPR) test, we simulated the diagnostic outcome of two simple WHO flowcharts for the management of genital ulcers. These outcomes and a clinical diagnosis were then compared with the laboratory diagnosis based on culture for genital herpes and Haemophilus ducreyi and serology for syphilis. The prevalence of HIV infection was high (73%) but there was no difference between HIV-positive and HIV-negative patients in the clinical presentation and etiology of genital ulcer disease. The proportion of correctly managed chancroid and/or syphilis cases was 99% using a syndromic approach, 82.1% using a hierarchical algorithm including an RPR test, and 38.3% with a clinical diagnosis. In situations where no laboratory support is available, a simple syndromic approach is preferable to the clinical approach for the management of genital ulcer. If an RPR test can be included in the diagnostic strategy, patients with a reactive RPR test should be treated for both syphilis and chancroid infection. PMID:8907769

  13. Simple algorithms for the management of genital ulcers: evaluation in a primary health care centre in Kigali, Rwanda.

    Science.gov (United States)

    Bogaerts, J; Vuylsteke, B; Martinez Tello, W; Mukantabana, V; Akingeneye, J; Laga, M; Piot, P

    1995-01-01

    A cross-sectional study was conducted among 395 patients presenting with genital ulcers at a primary health care centre in Kigali, Rwanda. Using clinical data and the results of a rapid plasma reagin (RPR) test, we simulated the diagnostic outcome of two simple WHO flowcharts for the management of genital ulcers. These outcomes and a clinical diagnosis were then compared with the laboratory diagnosis based on culture for genital herpes and Haemophilus ducreyi and serology for syphilis. The prevalence of HIV infection was high (73%) but there was no difference between HIV-positive and HIV-negative patients in the clinical presentation and etiology of genital ulcer disease. The proportion of correctly managed chancroid and/or syphilis cases was 99% using a syndromic approach, 82.1% using a hierarchical algorithm including an RPR test, and 38.3% with a clinical diagnosis. In situations where no laboratory support is available, a simple syndromic approach is preferable to the clinical approach for the management of genital ulcer. If an RPR test can be included in the diagnostic strategy, patients with a reactive RPR test should be treated for both syphilis and chancroid infection.

  14. The international spread of Academic Health Science Centres: a scoping review and the case of policy transfer to England.

    Science.gov (United States)

    French, Catherine E; Ferlie, Ewan; Fulop, Naomi J

    2014-09-01

    Academic Health Science Centres (AHSCs) have been a key feature of the North American healthcare landscape for many years, and the term is becoming more widely used internationally. The defining feature of these complex organisations is a tripartite mission of delivering high quality research, medical education and clinical care. The biomedical innovations developed in AHSCs are often well documented, but less is known about the policy and organisational processes which enable the translation of research into patient care. This paper has two linked purposes. Firstly, we present a scoping review of the literature which explores the managerial, political and cultural perspectives of AHSCs. The literature is largely normative with little social science theory underpinning commentary and descriptive case studies. Secondly, we contribute to addressing this gap by applying a policy transfer framework to the English case to examine how AHSC policy has spread internationally. We conclude by suggesting a research agenda on AHSCs using the relevant literatures of policy transfer, professional/managerial relations and boundary theory, and highlighting three key messages for policy makers: (1) competing policy incentives for AHSCs should be minimised; (2) no single AHSC model will fit all settings; (3) AHSC networks operate internationally and this should be encouraged. Copyright © 2014 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  15. Decentralised paediatric HIV care in Ethiopia: a comparison between outcomes of patients managed in health centres and in a hospital clinic

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    Oskar Hagströmer

    2013-11-01

    Full Text Available Background: In order to increase access to antiretroviral therapy (ART in HIV-infected children, paediatric HIV care has been introduced in health centres in Ethiopia, where patients are managed by health professionals with limited training. Objective: To compare outcomes of paediatric HIV care in hospital and health centre clinics and to determine risk factors for death and loss to follow-up (LTFU. Design: Retrospective comparison of patient characteristics and outcomes among children managed in a public hospital and all five public health centres in the uptake area. Results: Among 1,960 patients (health centres 572, hospital clinic 1,388, 34% were lost to follow-up, 2% died, 14% were transferred out, and 46% remained in care. Children initiating ART in the hospital clinic had lower median CD4 cell counts (age <1 year: 575 vs. 1,183 cells/mm3, p=0.024; age 1–5 years: 370 vs. 598 cells/mm3, p<0.001; age >5 years: 186 vs. 259 cells/mm3, p<0.001, and a higher proportion were <1 year of age (22% vs. 15%, p=0.025. ART initiation rates and retention in care were similar between children managed in health centres and in the hospital clinic (36% vs. 37% and 47% vs. 46%, respectively. Among patients starting ART, mortality was associated with age <1 year [hazard ratio (HR 12.0; 95% confidence interval (CI: 3.5, 41]. LTFU was associated with CD4 cell counts <350 cells/mm3 (HR 1.8; 95% CI: 1.2, 3.0, weight-for-age z-scores below −4 (HR 2.8; 95% CI: 1.4, 5.6, and age <5 years (1–5 years: HR 1.6; 95% CI: 1.0, 2.5; <1 year: HR 3.3; 95% CI: 1.6, 6.6. Conclusions: Outcomes of HIV care were similar for Ethiopian children managed in a hospital clinic or in health centres. However, patients treated at the hospital clinic had characteristics of more advanced disease. Rates of LTFU were high in both types of health facility.

  16. Frequency of precancerous changes and cervical cancer recorded in three health centres in tuzla canton in period 2010-2011.

    Science.gov (United States)

    Jahic, Mahira; Mulavdic, Mirsada; Dautbasic, Fatima; Fejzic, Mara; Jahic, Elmir

    2013-12-01

    Cervical cancer is the second most common cancer in the world and the leading cause of death. Frequency and mortality are significantly reduced thanks to cytological Papanicolau test (PAP). Regular PAP test can reduce approximately 80% of cases of this cancer. To examine frequency of cervical cancer and changes of cervix, the age of risk for the changes and effect of frequency of PAP test. 3383 PAP (cytological) findings have been retrospectively ana lysed in three Health Centres of Tuzla Canton: Tuzla, Srebrenik and Sapna. During 2010 and 2011 protocols of Health Centers have been analyzed. Analysis of 3383 smears detected the following: abnormal PAP tests in 20.8% (705) and without abnormalities in 79.1% (2678). Normal findings in 9.1% (311), inflammatory changes in 69.6% (2357), ASCUS in 12.9% (438), ASC-H in 0.3% (11), LSIL in 5.4% (183), HSIL in 1.4% (49) and Squamous cell carcinoma in 0.7% (24). Cervical cancer has mostly been found in women from Srebrenik 1.1% (15) and least in women from Tuzla 0.3%(4).The highest number of abnormal findings (ASCUS, ASC-H , LSIL, H SIL and Cc) was also found in women from Srebrenik 39.5% (279). The average age of the examinees with the cancer was 41.7. In 62.5% (15) of women PAP test was performed for the first time and they were diagnosed with cervical cancer. Cervical cancer hasn't been found in women who had PAP test once a year or more. Women with the abnormal findings in their first PAP test and should be persuaded to accept the treatment in order to prevent development of cervical cancer.

  17. Factors associated to referral of tuberculosis suspects by private practitioners to community health centres in Bali Province, Indonesia.

    Science.gov (United States)

    Artawan Eka Putra, I Wayan Gede; Utami, Ni Wayan Arya; Suarjana, I Ketut; Duana, I Made Kerta; Astiti, Cok Istri Darma; Putra, I W; Probandari, Ari; Tiemersma, Edine W; Wahyuni, Chatarina Umbul

    2013-10-28

    The contrast between the low proportion of tuberculosis (TB) suspects referred from private practitioners in Bali province and the high volume of TB suspects seeking care at private practices suggests problems with TB suspect referral from private practitioners to the public health sector. We aimed to identify key factors associated with the referral of TB suspects by private practitioners. We conducted a case-control study conducted in Bali province, Indonesia. The cases were private practitioners who had referred at least one TB suspect to a community health centre between 1 January 2007 and the start of data collection, while the controls were private practitioners who had not referred a single TB suspect in the same time. The following factors were independently associated with referral of TB suspects by private practitioners: having received information about the directly observed treatment short-course (DOTS) strategy (OR 2.0; 95% CI 1.1-3.8), ever having been visited by a district TB program officer (OR 2.1; 95% CI 1.0-4.5), availability of TB suspect referral forms in the practice (OR 2.8; 95% CI 1.5-5.2), and less than 5 km distance between the private practice and the laboratory for smear examination (OR 2.2; 95% CI 1.2-4.0). Education and exposure of private practitioners to the TB program improves referral of TB suspects from private practitioners to the national TB program. We recommend that the TB program provides all private practitioners with information about the DOTS strategy and TB suspect referral forms, and organizes regular visits to private practitioners.

  18. Gastro-enteritis outbreak among Nordic patients with psoriasis in a health centre in Gran Canaria, Spain: a cohort study

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    Rose Angela MC

    2004-10-01

    Full Text Available Abstract Background Between November 2 and 10, 2002 several patients with psoriasis and personnel staying in the health centre in Gran Canaria, Spain fell ill with diarrhoea, vomiting or both. Patient original came from Norway, Sweden and Finland. The patient group was scheduled to stay until 8 November. A new group of patients were due to arrive from 7 November. Methods A retrospective cohort study was conducted to assess the extent of the outbreak, to identify the source and mode of transmission and to prevent similar problems in the following group. Results Altogether 41% (48/116 of persons staying at the centre fell ill. Norovirus infection was suspected based on clinical presentations and the fact that no bacteria were identified. Kaplan criteria were met. Five persons in this outbreak were hospitalised and the mean duration of diarrhoea was 3 days. The consequences of the illness were more severe compared to many other norovirus outbreaks, possibly because many of the cases suffered from chronic diseases and were treated with drugs reported to affect the immunity (methotrexate or steroids. During the two first days of the outbreak, the attack rate was higher in residents who had consumed dried fruit (adjusted RR = 3.1; 95% CI: 1.4–7.1 and strawberry jam (adjusted RR = 1.9; 95% CI: 0.9–4.1 than those who did not. In the following days, no association was found. The investigation suggests two modes of transmission: a common source for those who fell ill during the two first days of the outbreak and thereafter mainly person to person transmission. This is supported by a lower risk associated with the two food items at the end of the outbreak. Conclusions We believe that the food items were contaminated by foodhandlers who reported sick before the outbreak started. Control measures were successfully implemented; food buffets were banned, strict hygiene measures were implemented and sick personnel stayed at home >48 hours after last

  19. How to manage organisational change and create practice teams: experiences of a South African primary care health centre.

    Science.gov (United States)

    Mash, B J; Mayers, P; Conradie, H; Orayn, A; Kuiper, M; Marais, J

    2008-07-01

    In South Africa, first-contact primary care is delivered by nurses in small clinics and larger community health centres (CHC). CHCs also employ doctors, who often work in isolation from the nurses, with poor differentiation of roles and little effective teamwork or communication. Worcester CHC, a typical public sector CHC in rural South Africa, decided to explore how to create more successful practice teams of doctors and nurses. This paper is based on their experience of both unsuccessful and successful attempts to introduce practice teams and reports on their learning regarding organisational change. An emergent action research study design utilised a co-operative inquiry group. The first nine months of inquiry focused on understanding the initial unsuccessful attempt to create practice teams. This paper reports primarily on the subsequent nine months (four cycles of planning, action, observation and reflection) during which practice teams were re-introduced. The central question was how more effective practice teams of doctors and nurses could be created. The group utilised outcome mapping to assist with planning, monitoring and evaluation. Outcome mapping defined a vision, mission, boundary partners, outcome challenges, progress markers and strategies for the desired changes and supported quantitative monitoring of the process. Qualitative data were derived from the co-operative inquiry group (CIG) meetings and interviews with doctors, nurses, practice teams and patients. The CIG engaged effectively with 68% of the planned strategies, and more than 60% of the progress markers were achieved for clinical nurse practitioners, doctors, support staff and managers, but not for patients. Key themes that emerged from the inquiry group's reflection on their experience of the change process dealt with the amount of interaction, type of communication, team resilience, staff satisfaction, leadership style, reflective capacity, experimentation and evolution of new

  20. Monitoring the referral system through benchmarking in rural Niger: an evaluation of the functional relation between health centres and the district hospital

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    Miyé Hamidou

    2006-04-01

    Full Text Available Abstract Background The main objective of this study is to establish a benchmark for referral rates in rural Niger so as to allow interpretation of routine referral data to assess the performance of the referral system in Niger. Methods Strict and controlled application of existing clinical decision trees in a sample of rural health centres allowed the estimation of the corresponding need for and characteristics of curative referrals in rural Niger. Compliance of referral was monitored as well. Need was matched against actual referral in 11 rural districts. The referral patterns were registered so as to get an idea on the types of pathology referred. Results The referral rate benchmark was set at 2.5 % of patients consulting at the health centre for curative reasons. Niger's rural districts have a referral rate of less than half this benchmark. Acceptability of referrals is low for the population and is adding to the deficient referral system in Niger. Mortality because of under-referral is highest among young children. Conclusion Referral patterns show that the present programme approach to deliver health care leaves a large amount of unmet need for which only comprehensive first and second line health services can provide a proper answer. On the other hand, the benchmark suggests that well functioning health centres can take care of the vast majority of problems patients present with.

  1. Cost of installing and operating an electronic clinical decision support system for maternal health care: case of Tanzania rural primary health centres.

    Science.gov (United States)

    Saronga, Happiness Pius; Dalaba, Maxwell Ayindenaba; Dong, Hengjin; Leshabari, Melkizedeck; Sauerborn, Rainer; Sukums, Felix; Blank, Antje; Kaltschmidt, Jens; Loukanova, Svetla

    2015-04-02

    electronic CDSS for maternal health care in six rural health centres. From these findings one can understand exactly what goes into a similar investment and thus determine sorts of input modification needed to fit their context.

  2. The effect of health literacy level on health outcomes in patients with diabetes at a type v health centre in Western Jamaica

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    Sherryon Gordon Singh

    2017-07-01

    Conclusion: Limited health literacy and high likelihood of limited health literacy are predominant in the study population. Age and educational level are significantly associated with health literacy levels. However, these findings suggest no association between health literacy level and diabetic health outcomes.

  3. Air pollution and health implications of regional electricity transfer at generational centre and design of compensation mechanism

    Science.gov (United States)

    Relhan, Nemika

    India's electricity generation is primarily from coal. As a result of interconnection of grid and establishment of pithead power plants, there has been increased electricity transfer from one region to the other. This results in imbalance of pollution loads between the communities located in generation vis-a-vis consumption region. There may be some states, which are major power generation centres and hence are facing excessive environmental degradation. On the other hand, electricity importing regions are reaping the benefits without paying proper charges for it because present tariff structure does not include the full externalities in it. The present study investigates the distributional implications in terms of air pollution loads between the electricity generation and consumption regions at the state level. It identifies the major electricity importing and exporting states in India. Next, as a case study, it estimates the health damage as a result of air pollution from thermal power plants (TPPs) located in a critically polluted region that is one of the major generator and exporter of electricity. The methodology used to estimate the health damage is based on impact pathway approach. In this method, air pollution modelling has been performed in order to estimate the gridded Particulate Matter (PM) concentration at various receptor locations in the study domain. The air quality modeling exercise helps to quantify the air pollution concentration in each grid and also apportion the contribution of power plants to the total concentration. The health impacts as a result of PM have been estimated in terms of number of mortality and morbidity cases using Concentration Response Function (CRF's) available in the literature. Mortality has been converted into Years of Life Lost (YOLL) using life expectancy table and age wise death distribution. Morbidity has been estimated in terms of number of cases with respect to various health end points. To convert this health

  4. Factors influencing choice of care-seeking for acute fever comparing private chemical shops with health centres and hospitals in Ghana: a study using case-control methodology.

    Science.gov (United States)

    Ansah, Evelyn K; Gyapong, Margaret; Narh-Bana, Solomon; Bart-Plange, Constance; Whitty, Christopher J M

    2016-05-25

    Several public health interventions to improve management of patients with fever are largely focused on the public sector yet a high proportion of patients seek care outside the formal healthcare sector. Few studies have provided information on the determinants of utilization of the private sector as against formal public sector. Understanding the differences between those who attend public and private health institutions, and their pathway to care, has significant practical implications. The chemical shop is an important source of care for acute fever in Ghana. Case-control methodology was used to identify factors associated with seeking care for fever in the Dangme West District, Ghana. People presenting to health centres, or hospital outpatients, with a history or current fever were compared to counterparts from the same community with fever visiting a chemical shop. Of 600 patients, 150 each, were recruited from the district hospital and two health centres, respectively, and 300 controls from 51 chemical shops. Overall, 103 (17.2 %) patients tested slide positive for malaria. Specifically, 13.7 % (41/300) of chemical shop patients, 30.7 % (46/150) health centre and 10.7 % (16/150) hospital patients were slide positive. While it was the first option for care for 92.7 % (278/300) chemical shop patients, 42.7 % (64/150) of health centre patients first sought care from a chemical shop. More health centre patients (61.3 %; 92/150) presented with fever after more than 3 days than chemical shop patients (27.7 %; 83/300) [AOR = 0.19; p < 0.001 CI 0.11-0.30]. Although the hospital was the first option for 83.3 % (125/150) of hospital patients, most (63.3 %; 95/150) patients arrived there over 3 days after their symptoms begun. Proximity was significantly associated with utilization of each source of care. Education, but not other socioeconomic or demographic factors were significantly associated with chemical shop use. The private drug retail sector is

  5. A qualitative study of the role of workplace and interpersonal trust in shaping service quality and responsiveness in Zambian primary health centres

    Science.gov (United States)

    Topp, Stephanie M; Chipukuma, Julien M

    2016-01-01

    Background: Human decisions, actions and relationships that invoke trust are at the core of functional and productive health systems. Although widely studied in high-income settings, comparatively few studies have explored the influence of trust on health system performance in low- and middle-income countries. This study examines how workplace and inter-personal trust impact service quality and responsiveness in primary health services in Zambia. Methods: This multi-case study included four health centres selected for urban, peri-urban and rural characteristics. Case data included provider interviews (60); patient interviews (180); direct observation of facility operations (two weeks/centre) and key informant interviews (14) that were recorded and transcribed verbatim. Case-based thematic analysis incorporated inductive and deductive coding. Results: Findings demonstrated that providers had weak workplace trust influenced by a combination of poor working conditions, perceptions of low pay and experiences of inequitable or inefficient health centre management. Weak trust in health centre managers’ organizational capacity and fairness contributed to resentment amongst many providers and promoted a culture of blame-shifting and one-upmanship that undermined teamwork and enabled disrespectful treatment of patients. Although patients expressed a high degree of trust in health workers’ clinical capacity, repeated experiences of disrespectful or unresponsive care undermined patients’ trust in health workers’ service values and professionalism. Lack of patient–provider trust prompted some patients to circumvent clinic systems in an attempt to secure better or more timely care. Conclusion: Lack of resourcing and poor leadership were key factors leading to providers’ weak workplace trust and contributed to often-poor quality services, driving a perverse cycle of negative patient–provider relations across the four sites. Findings highlight the importance

  6. A qualitative study of the role of workplace and interpersonal trust in shaping service quality and responsiveness in Zambian primary health centres.

    Science.gov (United States)

    Topp, Stephanie M; Chipukuma, Julien M

    2016-03-01

    Human decisions, actions and relationships that invoke trust are at the core of functional and productive health systems. Although widely studied in high-income settings, comparatively few studies have explored the influence of trust on health system performance in low- and middle-income countries. This study examines how workplace and inter-personal trust impact service quality and responsiveness in primary health services in Zambia. This multi-case study included four health centres selected for urban, peri-urban and rural characteristics. Case data included provider interviews (60); patient interviews (180); direct observation of facility operations (two weeks/centre) and key informant interviews (14) that were recorded and transcribed verbatim. Case-based thematic analysis incorporated inductive and deductive coding. Findings demonstrated that providers had weak workplace trust influenced by a combination of poor working conditions, perceptions of low pay and experiences of inequitable or inefficient health centre management. Weak trust in health centre managers' organizational capacity and fairness contributed to resentment amongst many providers and promoted a culture of blame-shifting and one-upmanship that undermined teamwork and enabled disrespectful treatment of patients. Although patients expressed a high degree of trust in health workers' clinical capacity, repeated experiences of disrespectful or unresponsive care undermined patients' trust in health workers' service values and professionalism. Lack of patient-provider trust prompted some patients to circumvent clinic systems in an attempt to secure better or more timely care. Lack of resourcing and poor leadership were key factors leading to providers' weak workplace trust and contributed to often-poor quality services, driving a perverse cycle of negative patient-provider relations across the four sites. Findings highlight the importance of investing in both structural factors and organizational

  7. Spatio-temporal factors associated with meningococcal meningitis annual incidence at the health centre level in Niger, 2004-2010.

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    Juliette Paireau

    2014-05-01

    Full Text Available BACKGROUND: Epidemics of meningococcal meningitis (MM recurrently strike the African Meningitis Belt. This study aimed at investigating factors, still poorly understood, that influence annual incidence of MM serogroup A, the main etiologic agent over 2004-2010, at a fine spatial scale in Niger. METHODOLOGY/PRINCIPAL FINDINGS: To take into account data dependencies over space and time and control for unobserved confounding factors, we developed an explanatory Bayesian hierarchical model over 2004-2010 at the health centre catchment area (HCCA level. The multivariate model revealed that both climatic and non-climatic factors were important for explaining spatio-temporal variations in incidence: mean relative humidity during November-June over the study region (posterior mean Incidence Rate Ratio (IRR = 0.656, 95% Credible Interval (CI 0.405-0.949 and occurrence of early rains in March in a HCCA (IRR = 0.353, 95% CI 0.239-0.502 were protective factors; a higher risk was associated with the percentage of neighbouring HCCAs having at least one MM A case during the same year (IRR = 2.365, 95% CI 2.078-2.695, the presence of a road crossing the HCCA (IRR = 1.743, 95% CI 1.173-2.474 and the occurrence of cases before 31 December in a HCCA (IRR = 6.801, 95% CI 4.004-10.910. At the study region level, higher annual incidence correlated with greater geographic spread and, to a lesser extent, with higher intensity of localized outbreaks. CONCLUSIONS: Based on these findings, we hypothesize that spatio-temporal variability of MM A incidence between years and HCCAs result from variations in the intensity or duration of the dry season climatic effects on disease risk, and is further impacted by factors of spatial contacts, representing facilitated pathogen transmission. Additional unexplained factors may contribute to the observed incidence patterns and should be further investigated.

  8. Spatio-temporal factors associated with meningococcal meningitis annual incidence at the health centre level in Niger, 2004-2010.

    Science.gov (United States)

    Paireau, Juliette; Maïnassara, Halima B; Jusot, Jean-François; Collard, Jean-Marc; Idi, Issa; Moulia-Pelat, Jean-Paul; Mueller, Judith E; Fontanet, Arnaud

    2014-05-01

    Epidemics of meningococcal meningitis (MM) recurrently strike the African Meningitis Belt. This study aimed at investigating factors, still poorly understood, that influence annual incidence of MM serogroup A, the main etiologic agent over 2004-2010, at a fine spatial scale in Niger. To take into account data dependencies over space and time and control for unobserved confounding factors, we developed an explanatory Bayesian hierarchical model over 2004-2010 at the health centre catchment area (HCCA) level. The multivariate model revealed that both climatic and non-climatic factors were important for explaining spatio-temporal variations in incidence: mean relative humidity during November-June over the study region (posterior mean Incidence Rate Ratio (IRR) = 0.656, 95% Credible Interval (CI) 0.405-0.949) and occurrence of early rains in March in a HCCA (IRR = 0.353, 95% CI 0.239-0.502) were protective factors; a higher risk was associated with the percentage of neighbouring HCCAs having at least one MM A case during the same year (IRR = 2.365, 95% CI 2.078-2.695), the presence of a road crossing the HCCA (IRR = 1.743, 95% CI 1.173-2.474) and the occurrence of cases before 31 December in a HCCA (IRR = 6.801, 95% CI 4.004-10.910). At the study region level, higher annual incidence correlated with greater geographic spread and, to a lesser extent, with higher intensity of localized outbreaks. Based on these findings, we hypothesize that spatio-temporal variability of MM A incidence between years and HCCAs result from variations in the intensity or duration of the dry season climatic effects on disease risk, and is further impacted by factors of spatial contacts, representing facilitated pathogen transmission. Additional unexplained factors may contribute to the observed incidence patterns and should be further investigated.

  9. Analysis of 4-Year Dog-Bite Cases Treated At Ahmadu Bello University Health Centre, Zaria, Nigeria

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    Istifanus Anekoson Joshua

    2012-12-01

    Full Text Available AIM: Rabies is one of the most typical zoonosis; the disease is endemic in Nigeria and remains an important public health issue. The disease is transmitted mainly through the bite of rabid animal and dog is very important because of the close relationship between humans and dogs. The aim of the study was to analyze the 4 year dog bite cases treated at Ahmadu Bello University (ABU Medical Centre (UHC Zaria, Nigeria. METHOD: A longitudinal study was conducted between 2008 and 2011. Relevant information were obtained using structured questionnaire, interview and participant’s observation was used to study the ecology of the dogs. The medical and veterinary doctors were involved in the collection of the information. Data were analyzed with the aid of SPSS Version 17.0 and Chi square statistics was used to test for significance of association at P< 0.05. RESULTS: A total of 132 cases of dog bite were recorded for the period of the study. Majority (35.4% of the victims of the bite were within the age bracket of 1-10 years (mean age 25± 1.7 years, minimum age - 1 year and maximum age- 68 years, male: female ratio 1: 1.9 , 43.6% were staff family, The most common site of the bites was leg (35.2%. First aid treatment given to the victims before presentation at the hospital, were inadequate. Sixty (45.5% of the victims were given treatment against rabies. 63.6% of the dogs involved in the biting were aged 1-4 years, 55% were not vaccinated against rabies, 81.8% were local breed of dog, 13.6% were stray dogs and the most common likely cause of the bites was provocation (54.5%. CONCLUSION: Dog bite is a common medical condition seen in UHC, ABU Zaria. Factors such as poor vaccination of dogs by owners, high proportion of stray dogs, and poor first aid treatment of dog bite injuries, among others are of public health importance. There is need for intensive public enlightenment. [TAF Prev Med Bull 2012; 11(6.000: 661-666

  10. A qualitative study on barriers in the prevention of anaemia during pregnancy in public health centres: perceptions of Indonesian nurse-midwives

    OpenAIRE

    Widyawati, W.; Jans, S.M.P.J.; Utomo, S.; Dillen, J. van; Janssen, A.L.

    2015-01-01

    BACKGROUND: Anemia in pregnancy remains a major problem in Indonesia over the past decade. Early detection of anaemia in pregnancy is one of the components which is unsuccessfully implemented by nurse-midwives. This study aims to explore nurse-midwives' experiences in managing pregnant women with anaemia in Public Health Centres. METHODS: We conducted a qualitative study with semi-structured face to face interviews from November 2011 to February 2012 with 23 nurse-midwives in five districts i...

  11. Job strain and supervisor support in primary care health centres and glycaemic control among patients with type 2 diabetes: a cross-sectional study

    OpenAIRE

    Koponen, Anne; Vahtera, Jussi; Pitkäniemi, Janne; Virtanen, Marianna; Pentti, Jaana; Simonsen-Rehn, Nina; Kivimäki, Mika; Suominen, Sakari

    2013-01-01

    Objectives This study investigates associations between healthcare personnel's perceived job strain, supervisor support and the outcome of care in terms of glycaemic control among patients with type 2 diabetes. Design A cross-sectional study from 2006. Setting 18 primary care health centres (HCs) from five municipalities in Finland. Participants Aggregated survey data on perceived job strain and supervisor support from healthcare personnel (doctors, n=122, mean age 45.5 years, nurses, n=300, ...

  12. A cyborg ontology in health care: traversing into the liminal space between technology and person-centred practice.

    Science.gov (United States)

    Lapum, Jennifer; Fredericks, Suzanne; Beanlands, Heather; McCay, Elizabeth; Schwind, Jasna; Romaniuk, Daria

    2012-10-01

    Person-centred practice indubitably seems to be the antithesis of technology. The ostensible polarity of technology and person-centred practice is an easy road to travel down and in their various forms has been probably travelled for decades if not centuries. By forging ahead or enduring these dualisms, we continue to approach and recede, but never encounter the elusive and the liminal space between technology and person-centred practice. Inspired by Haraway's work, we argue that healthcare practitioners who critically consider their cyborg ontology may begin the process to initiate and complicate the liminal and sought after space between technology and person-centred practice. In this paper, we draw upon Haraway's idea that we are all materially and ontologically cyborgs. Cyborgs, the hybridity of machine and human, are part of our social reality and embedded in our everyday existence. By considering our cyborg ontology, we suggest that person-centred practice can be actualized in the contextualized, embodied and relational spaces of technology. It is not a question of espousing technology or person-centred practice. Such dualisms have been historically produced and reproduced over many decades and prevented us from recognizing our own cyborg ontology. Rather, it is salient that we take notice of our own cyborg ontology and how technological, habitual ways of being may prevent (and facilitate) us to recognize the embodied and contextualized experiences of patients. A disruption and engagement with the habitual can ensure we are not governed by technology in our logics and practices of care and can move us to a conscious and critical integration of person-centred practice in the technologized care environments. By acknowledging ourselves as cyborgs, we can recapture and preserve our humanness as caregivers, as well as thrive as we proceed in our technological way of being.

  13. [For a coordination of the supportive care for people affected by severe illnesses: proposition of organization in the public and private health care centres].

    Science.gov (United States)

    Krakowski, Ivan; Boureau, François; Bugat, Roland; Chassignol, Laurent; Colombat, Philippe; Copel, Laure; d'Hérouville, Daniel; Filbet, Marylène; Laurent, Bernard; Memran, Nadine; Meynadier, Jacques; Parmentier, Gérard; Poulain, Philippe; Saltel, Pierre; Serin, Daniel; Wagner, Jean-Philippe

    2004-05-01

    The concept of continuous and global care is acknowledged today by all as inherent to modern medicine. A working group gathered to propose models for the coordination of supportive care for all severe illnesses in the various private and public health care centres. The supportive care are defined as: "all care and supports necessary for ill people, at the same time as specific treatments, along all severe illnesses". This definition is inspired by that of "supportive care" given in 1990 by the MASCC (Multinational Association for Supportive Care in Cancer): "The total medical, nursing and psychosocial help which the patients need besides the specific treatment". It integrates as much the field of cure with possible after-effects as that of palliative care, the definition of which is clarified (initial and terminal palliative phases). Such a coordination is justified by the pluridisciplinarity and hyperspecialisation of the professionals, by a poor communication between the teams, by the administrative difficulties encountered by the teams participating in the supportive care. The working group insists on the fact that the supportive care is not a new speciality. He proposes the creation of units. departments or pole of responsibility of supportive care with a "basic coordination" involving the activities of chronic pain, palliative care, psycho-oncology, and social care. This coordination can be extended, according to the "history" and missions of health care centres. Service done with the implementation of a "unique counter" for the patients and the teams is an important point. The structure has to comply with the terms and conditions of contract (Consultation, Unit or Centre of chronic pain, structures of palliative care, of psycho-oncology, of nutrition, of social care). A common technical organization is one of the interests. The structure has to set up strong links with the private practitioners, the networks, the home medical care (HAD) and the nurses

  14. Opening the black-box of person-centred care: An arts-informed narrative inquiry into mental health education and practice.

    Science.gov (United States)

    Schwind, Jasna K; Lindsay, Gail M; Coffey, Sue; Morrison, Debbie; Mildon, Barb

    2014-08-01

    Nursing education has a history of encouraging students to know their patients and to negotiate the in-between of art/science, person/profession, and intuition/evidence. Nurse-teachers know that students may abandon some values and practices when they encounter practice environments that are complex and have competing agendas. We are concerned that nursing knowledge is black-boxed, invisible and taken-for-granted, in healthcare settings. Our research explores how nursing students and nurses are constructing and enacting person-centred care in mental health education and practice. We want to understand the nursing standpoint on this significant ontological issue and to make nursing knowledge construction and utilization visible; illuminating how person-centred theory emerges from practice. The process involved four 3-hour group meetings and an individual follow-up telephone conversation. Students and nurses met at a tertiary-care mental health organization. Fourteen nurses (Registered Nurses and Registered Practical Nurses) and nursing students (Bachelor of Science in Nursing and Practical Nursing) participated in our inquiry. We used arts-informed narrative inquiry to explore experience through the arts such as metaphor, collage, poems, letters, and group conversations. The black-box is opened as the inquiry reveals how nursing knowledge is constructed, assumptions are challenged and new practices emerge. Our research is significant for education and for practice and is transferable to other populations and settings. Nurses are affirmed in person-centred values and practices that include partnership with those in their care, role modeling for colleagues and mentoring students and new nurses. Students participate in transferring their learning from school to practice, in the company of experienced colleagues; together they open the black-box to show how nurses conceptualize and enact person-centred care. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. Television as a medium for psycho-education in South Africa: analysis of calls to a mental health information centre after screening of a TV series on psychiatric disorders.

    Science.gov (United States)

    Wessels, C; Van Kradenberg, J; Mbanga, I; Emsley, R A; Stein, D J

    1999-01-01

    As one of the most powerful media, television may have an important role to play in providing psycho-education in both developed and developing countries. The South African Broadcasting Corporation (SABC) recently screened a TV series that focused on the signs and symptoms of the main psychiatric disorders. The aim of this paper is to describe calls to our Mental Health Information Centre after screening of the series. The TV series "Improve Your Frames of Mind" was developed by an independent producer in collaboration with the Society of Psychiatrists of South Africa, and was screened by the SABC. At the end of each show, the telephone number of our Mental Health Information Centre was given to viewers. All calls to our centre were entered into a database and later analysed. A mental Health Information Centre in South Africa. Callers to the Mental Health Information Centre. Almost 3,000 calls were taken by three psychiatric nurses working at the Mental Health Information Centre. Calls related to each of the major psychiatric disorders, particularly the mood and anxiety disorders. Callers expressed satisfaction with the information that they received from the Centre. A TV series on psychiatric disorders appeared successful in encouraging viewers to seek additional information. Indeed, additional telephone lines would have allowed even more calls to be fielded. Further research is necessary to determine whether it would be useful for TV to portray specific treatment interventions.

  16. Treatment of fibromyalgia at the Maharishi Ayurveda Health Centre in Norway II--a 24-month follow-up pilot study.

    Science.gov (United States)

    Rasmussen, Lars Bjørn; Mikkelsen, Knut; Haugen, Margaretha; Pripp, Are H; Fields, Jeremy Z; Førre, Øystein T

    2012-05-01

    Treatments offered at the Maharishi Ayurveda Health Centre in Norway are based on Maharishi Vedic Medicine (MVM). MVM is a consciousness-based revival by Maharishi Mahesh Yogi, the founder of the Transcendental Meditation (TM) program of the ancient Ayurvedic medicine tradition in India. To extend from 6 to 24 months, a pilot study of the effects of the treatment program at the Health Centre on fibromyalgia. Retesting 2 years after a clinical trial. In this intention to treat study, 31 women with a diagnosis of fibromyalgia received an individually tailored program of (1) physiological purification therapy (Maharishi Panchakarma) and (2) Ayurvedic recommendations regarding daily routine and diet including a novel approach to food intolerance. Five subjects chose to learn TM for stress reduction, pain management and personal development. All were recommended Ayurvedic herbal products for follow-up treatment. A modified Fibromyalgia Impact Questionnaire (FIQ) that included seven dimensions. Scores at 24 months follow-up were compared with pre-treatment scores. At 24-months follow-up, there were significant reductions (26% to 44%) in six of the seven fibromyalgia dimensions: impairment of working ability, pain, tiredness, morning tiredness, stiffness and anxiety. The 7th, depression, decreased 32% (borderline significant). At 24 months, the four subjects who continued practising TM, had almost no symptoms and significantly lower FIQ change scores (-92% to 97%) than the non-meditators on all outcomes. This pilot study suggests that the treatments and health promotion programs offered at the Maharishi Ayurveda Health Centre in Norway lead to long-term reductions in symptoms of fibromyalgia, which is considered a treatment-resistant condition, and further studies are warranted.

  17. Preconsult interactive computer-assisted client assessment survey for common mental disorders in a community health centre: a randomized controlled trial

    Science.gov (United States)

    Ahmad, Farah; Lou, Wendy; Shakya, Yogendra; Ginsburg, Liane; Ng, Peggy T.; Rashid, Meb; Dinca-Panaitescu, Serban; Ledwos, Cliff; McKenzie, Kwame

    2017-01-01

    Background: Access disparities for mental health care exist for vulnerable ethnocultural and immigrant groups. Community health centres that serve these groups could be supported further by interactive, computer-based, self-assessments. Methods: An interactive computer-assisted client assessment survey (iCCAS) tool was developed for preconsult assessment of common mental disorders (using the Patient Health Questionnaire [PHQ-9], Generalized Anxiety Disorder 7-item [GAD-7] scale, Primary Care Post-traumatic Stress Disorder [PTSD-PC] screen and CAGE [concern/cut-down, anger, guilt and eye-opener] questionnaire), with point-of-care reports. The pilot randomized controlled trial recruited adult patients, fluent in English or Spanish, who were seeing a physician or nurse practitioner at the partnering community health centre in Toronto. Randomization into iCCAS or usual care was computer generated, and allocation was concealed in sequentially numbered, opaque envelopes that were opened after consent. The objectives were to examine the interventions' efficacy in improving mental health discussion (primary) and symptom detection (secondary). Data were collected by exit survey and chart review. Results: Of the 1248 patients assessed, 190 were eligible for participation. Of these, 148 were randomly assigned (response rate 78%). The iCCAS (n = 75) and usual care (n = 72) groups were similar in sociodemographics; 98% were immigrants, and 68% were women. Mental health discussion occurred for 58.7% of patients in the iCCAS group and 40.3% in the usual care group (p ≤ 0.05). The effect remained significant while controlling for potential covariates (language, sex, education, employment) in generalized linear mixed model (GLMM; adjusted odds ratio [OR] 2.2; 95% confidence interval [CI] 1.1-4.5). Mental health symptom detection occurred for 38.7% of patients in the iCCAS group and 27.8% in the usual care group (p > 0.05). The effect was not significant beyond potential

  18. Examining the impact of health research facilitated by small peer-reviewed research operating grants in a women's and children's health centre

    Directory of Open Access Journals (Sweden)

    McGrath Patrick J

    2010-04-01

    Full Text Available Abstract Background There has been limited research on the impact of research funding for small, institutional grants. The IWK Health Centre, a children and women's hospital in Maritime Canada, provides small amounts (up to $15,000 of research funding for staff and trainees at all levels of experience through its Research Operating Grants. These grants are rigorously peer-reviewed. To evaluate the impact of these grants, an assessment was completed of several different areas of impact. Findings An online questionnaire was sent to 64 Principal Investigators and Co-Investigators from Research Operating Grants awarded from 2004 to 2006. The questionnaire was designed to assess five areas of potential impact: (1 research, (2 policy, (3 practice, (4 society and (5 personal. Research impact reported by participants included publications (72%, presentations (82% and knowledge transfer beyond the traditional formats (51%. Practice impact was reported by 67% of participants, policy impact by 15% and societal impact by 18%. All participants reported personal impact. Conclusions Small research grants yield similar impacts to relatively large research grants. Regardless of the total amount of research funds awarded, rigorously peer-reviewed research projects have the potential for significant impact at the level of knowledge transfer and changes in clinical practice and policy. Additional findings in the present research indicate that small awards have the potential to have significant impact on the individual grant holder across a variety of capacity building variables. These personal impacts are particularly noteworthy in the context of developing the research programs of novice researchers.

  19. Behind the scenes of the PRIME intervention: designing a complex intervention to improve malaria care at public health centres in Uganda

    Directory of Open Access Journals (Sweden)

    Deborah D. DiLiberto

    2015-10-01

    Full Text Available Background: In Uganda, health system challenges limit access to good quality healthcare and contribute to slow progress on malaria control. We developed a complex intervention (PRIME, which was designed to improve quality of care for malaria at public health centres. Objective: Responding to calls for increased transparency, we describe the PRIME intervention's design process, rationale, and final content and reflect on the choices and challenges encountered during the design of this complex intervention. Design: To develop the intervention, we followed a multistep approach, including the following: 1 formative research to identify intervention target areas and objectives; 2 prioritization of intervention components; 3 review of relevant evidence; 4 development of intervention components; 5 piloting and refinement of workshop modules; and 6 consolidation of the PRIME intervention theories of change to articulate why and how the intervention was hypothesized to produce desired outcomes. We aimed to develop an intervention that was evidence-based, grounded in theory, and appropriate for the study context; could be evaluated within a randomized controlled trial; and had the potential to be scaled up sustainably. Results: The process of developing the PRIME intervention package was lengthy and dynamic. The final intervention package consisted of four components: 1 training in fever case management and use of rapid diagnostic tests for malaria (mRDTs; 2 workshops in health centre management; 3 workshops in patient-centred services; and 4 provision of mRDTs and antimalarials when stocks ran low. Conclusions: The slow and iterative process of intervention design contrasted with the continually shifting study context. We highlight the considerations and choices made at each design stage, discussing elements we included and why, as well as those that were ultimately excluded. Reflection on and reporting of ‘behind the scenes’ accounts of intervention

  20. Nurse managers' perceptions related to their leadership styles, knowledge, and skills in these areas-a viewpoint: case of health centre wards in Finland.

    Science.gov (United States)

    Vesterinen, Soili; Suhonen, Marjo; Isola, Arja; Paasivaara, Leena; Laukkala, Helena

    2013-01-01

    The purpose of this study was to explore nurse managers' perceptions related to their leadership styles, knowledge, and their skills in these areas in health centre wards in Finland. The data were collected from nurse managers (n = 252) in health centre hospitals in Finland using a structured questionnaire (response rate 63%). Six leadership styles-visionary, coaching, affiliate, democratic, commanding, and isolating-were reflected on. Almost all respondents in every age group considered four leadership styles-visionary, coaching, affiliate, and democratic-to be very important or important. Nurse managers estimated their knowledge and skills in leadership styles to be essentially fairly sufficient or sufficient. Nurse managers' abilities to reflect, understand, and, if necessary, change their leadership style influence the work unit's success and employees' job satisfaction. Nurse managers, especially new nurse managers, need more theoretic, evidence-based education to cope with these expectations and to develop their professional abilities. Together with universities, health care organizations should start planning nurse manager education programmes that focus on strategic issues, leadership, job satisfaction, challenging situations in leadership, change management, work unit management (e.g., economy, efficiency, and resources), and how the nurse managers consider their own wellbeing.

  1. Nurse Managers' Perceptions Related to Their Leadership Styles, Knowledge, and Skills in These Areas—A Viewpoint: Case of Health Centre Wards in Finland

    Science.gov (United States)

    Suhonen, Marjo; Isola, Arja; Paasivaara, Leena; Laukkala, Helena

    2013-01-01

    The purpose of this study was to explore nurse managers' perceptions related to their leadership styles, knowledge, and their skills in these areas in health centre wards in Finland. The data were collected from nurse managers (n = 252) in health centre hospitals in Finland using a structured questionnaire (response rate 63%). Six leadership styles—visionary, coaching, affiliate, democratic, commanding, and isolating—were reflected on. Almost all respondents in every age group considered four leadership styles—visionary, coaching, affiliate, and democratic—to be very important or important. Nurse managers estimated their knowledge and skills in leadership styles to be essentially fairly sufficient or sufficient. Nurse managers' abilities to reflect, understand, and, if necessary, change their leadership style influence the work unit's success and employees' job satisfaction. Nurse managers, especially new nurse managers, need more theoretic, evidence-based education to cope with these expectations and to develop their professional abilities. Together with universities, health care organizations should start planning nurse manager education programmes that focus on strategic issues, leadership, job satisfaction, challenging situations in leadership, change management, work unit management (e.g., economy, efficiency, and resources), and how the nurse managers consider their own wellbeing. PMID:23691356

  2. Treatment of Chronic Hepatitis C Infection among Current And Former Injection Drug Users within a Multidisciplinary Treatment Model at a Community Health Centre

    Directory of Open Access Journals (Sweden)

    Adam I Newman

    2013-01-01

    Full Text Available The aim of the present prospective observational study was to assess uptake and success of hepatitis C virus (HCV treatment among a group of former and current injection drug users with chronic HCV infection at the Street Health Centre in Kingston, Ontario. The Street Health Centre offers hepatitis C education, assessment and treatment within a multidisciplinary, integrated and collaborative treatment model of care delivered by primary care professionals. The study enrolled a convenience sample of 34 patients. Seventy per cent of study patients had no postsecondary education, 85% were unemployed and one-third were unstably housed. A majority of study patients self-reported mental health problems. Of the 14 patients who initiated antiviral treatment in the study period, eight (57% achieved sustained virological response. Regardless of virological outcome, patients who initiated treatment showed positive trends toward increased social and psychiatric stability, and decreases in high-risk behaviours. These results suggest that not only is successful treatment of chronic HCV infection in current and former injection drug users with concurrent psychiatric disorders possible, but the benefits of such treatment delivered in a community-based, multidisciplinary, primary care model may extend beyond narrowly defined virological outcomes.

  3. Avoiding "culture rejection" in healthcare mergers and acquisitions: how New Heights Community Health Centres and York Community Services minimized the culture risk when forming Unison Health and Community Services.

    Science.gov (United States)

    Chan, Jeff

    2013-01-01

    Among the requirements for a successful merger or acquisition are strategic rationale, rigorous due diligence, the right price and revenue and cost synergies. However, bridging the culture gap between organizations is frequently overlooked. The leaders of New Heights Community Health Centres and York Community Services explicitly considered culture in their merger to form Unison Health and Community Services, and they used employee engagement surveys to assess culture in their merger planning and post-merger integration. How Unison Health leaders avoided the risk of culture rejection to achieve a successful merger, and the lessons learned from their experience, is the focus of this article.

  4. Predictors of Self-Care Behaviors among Diabetic Patients Referred to Yazd Diabetes Research Centre Based on Extended Health Belief Model

    Directory of Open Access Journals (Sweden)

    MH Baghianimoghadam

    2007-12-01

    Full Text Available Introduction: Diabetes is the most common disease related to metabolism disorders with long term complications. It needs lifelong specific self-care, as it causes a promotion in quality of life and decreases disease costs. The Health Belief Model (HBM is a psychological model that attempts to explain and predict health behaviors. This is done by focusing on the attitudes and beliefs of individuals. The model has been used for studying diabetes self care behaviors. The aim of this study was determination of predictors of self-care behaviors among diabetes patients referred to Yazd diabetes research centre based on extended health belief model. Methods: This cross-sectional study carried out on 120 diabetic patients referred to Yazd diabetes research centre who were entered in the study by convenience sampling. A questionnaire was used for data collection with a private interview which included questions regarding extended health belief model constructs including perceived benefits, barriers, severity, sensitivity, threat, self-efficacy, social support, metabolic control and locus of control and some demographic variables. Results: There was a positive significant correlation between model variable of perceived benefits, severity, sensitivity, threat, self-efficacy, social support, metabolic control and internal locus of control with self-care behaviors, and also a negative significant correlation between perceived barriers (P=0.001,chance locus of control (P=0.037 and self-care behaviors. The above variables explained 45.3 % of variance in diabetes self-care behaviors, with self-efficacy as the strongest predictor. Conclusion: The results of this study approved the effectiveness of extended health belief model in predicting self-care behaviors among diabetic patients, which can therefore be used as a framework for designing and implementing educational intervention programs for control of diabetes.

  5. Emissions during the BHP Billiton mozal aluminium smelter Fume Treatment Centre (FTC) rebuild – A human health perspective

    CSIR Research Space (South Africa)

    Wright, C

    2011-02-01

    Full Text Available some are probable human carcinogens. As a result MOZAL initiated a human health risk assessment (HHRA) study concerning this operation, in order to understand the potential health impacts on the surrounding communities, including Mahlampsene, Sikuama...

  6. Implementing people-centred health systems governance in 3 provinces and 11 districts of Afghanistan: a case study

    OpenAIRE

    Anwari, Zelaikha; Shukla, Mahesh; Maseed, Basir Ahmad; Wardak, Ghulam Farooq Mukhlis; Sardar, Sakhi; Matin, Javid; Rashed, Ghulam Sayed; Hamedi, Sayed Amin; Sahak, Hedayatullah; Aziz, Abdul Hakim; Boyd-Boffa, Mariah; Trasi, Reshma

    2015-01-01

    Background Previous studies show that health systems governance influences health system performance and health outcomes. However, there are few examples of how to implement and monitor good governing practices in fragile and conflict affected environments. Good governance has the potential to make the health system people-centered. More research is needed on implementing a people-centered governance approach in these environments. Case description We piloted an intervention that placed a peo...

  7. Families and health-care professionals' perspectives and expectations of family-centred care: hidden expectations and unclear roles.

    Science.gov (United States)

    Coyne, Imelda

    2015-10-01

    Family-centred care (FCC) is viewed as a pivotal concept in the provision of high-quality nursing care for children and their families, yet implementation continues to be problematic worldwide. This research investigated how FCC was enacted from families and nurses' perspectives. Descriptive qualitative approach using elements of analysis from grounded theory method. Data were collected though individual interviews with 18 children aged 7-16 years, their parents (n = 18) and 18 nurses from two children's hospital and one children's unit in a large general hospital in Ireland. Four key themes were identified: expectations; relying on parents' help; working out roles; and barriers to FCC. Nurses wholeheartedly endorsed FCC because of the benefits for families and their reliance on parents' contribution to the workload. There was minimal evidence of collaboration or negotiation of roles which resulted in parents feeling stressed or abandoned. Nurses cited busy workload, under-staffing and inappropriate documentation as key factors which resulted in over-reliance on parents and hindered their efforts to negotiate and work alongside parents. Families are willing to help in their child's care but they require clear guidance, information and support from nurses. Hidden expectations and unclear roles are stressful for families. Nurses need skills training, adequate resources and managerial support to meet families' needs appropriately, to establish true collaboration and to deliver optimal family-centred care. © 2013 John Wiley & Sons Ltd.

  8. Relationship between Knowledge and Attitudes with Contraceptive Use among Women of Childbearing Age at the Comoro Health Centre, Dili, Timor Leste

    Directory of Open Access Journals (Sweden)

    Marilia Juvi Gonçalves

    2014-08-01

    Full Text Available Background and purpose: Timor-Leste's population growth rate increased by 2.4%. Data in 2013 showed thecontraceptive use among women of childbearing is only 37.3%. This study was aimed to determine the relationshipbetween knowledge and attitudes with contraceptive use.Methods: A cross-sectional was conducted with 83 female respondents. The dependent variable was contraceptiveuse. Knowledge concerning contraceptive use and attitudes were the independent variables. Data were collectedthrough a self-administered questionnaire, however, for illiterate respondents, researcher assisted with questionnairecompletion. Data analysis was conducted in stages: univariate and bivariate (chi-squared test.Results: The majority of respondents 41 (49.4% were aged 25-34 years, 37 (44.6% respondents obtained high schooleducation, and 62 (74.7%, good knowledge regarding family planning (39.8% had positive attitude (45,8%. Resultsindicate that there was a significant relationship between maternal knowledge (p=0.006 and attitude (p=0.017 withcontraceptives use among women of childbearing age.Conclusion: Level of knowledge and attitude are correlated to contraceptive use among women at Comoro HealthCentre, Dili District, Timor Leste.Keywords: knowledge, attitudes, contraceptive use, Comoro Health Centre

  9. Using data envelopment analysis to measure the extent of technical efficiency of public health centres in Ghana

    Directory of Open Access Journals (Sweden)

    Jehu-Appiah Caroline

    2008-11-01

    Full Text Available Abstract Background Data Envelopment Analysis (DEA has been used to analyze the efficiency of the health sector in the developed world for sometime now. However, in developing economies and particularly in Africa only a few studies have applied DEA in measuring the efficiency of their health care systems. Methods This study uses the DEA method, to calculate the technical efficiency of 89 randomly sampled health centers in Ghana. The aim was to determine the degree of efficiency of health centers and recommend performance targets for the inefficient facilities. Results The findings showed that 65% of health centers were technically inefficient and so were using resources that they did not actually need. Conclusion The results broadly point to grave inefficiency in the health care delivery system of public health centers and that significant amounts of resources could be saved if measures were put in place to curb the waste.

  10. The EU-project United4Health: User-Centred Design and Evaluation of a Collaborative Information System for a Norwegian Telehealth Service.

    Science.gov (United States)

    Smaradottir, Berglind; Gerdes, Martin; Martinez, Santiago; Fensli, Rune

    2015-01-01

    This study presents the user-centred design and evaluation process of a Collaborative Information System (CIS), developed for a new telehealth service for remote monitoring of chronic obstructive pulmonary disease patients after hospital discharge. The CIS was designed based on the information gathered in a workshop, where target end-users described the context of use, a telehealth workflow and their preferred ways of interaction with the solution. Evaluation of the iterative refinements were made through user tests, semi-structured interviews and a questionnaire. A field trial reported results on the ease of use and user satisfaction during the interaction with the fully developed system. The implemented CIS was successfully deployed within the secured Norwegian Health Network. The research was a result of cooperation between international partners within the EU FP7 project United4Health.

  11. THE INVESTIGATION OF FACTORS INVOLVED IN "HOW JOINT VACCINATION IS CARRIED OUT IN QUALIFIED WOMEN WHO TURNED TO ZAHEDAN HEALTH CARE CENTRES IN 1380

    Directory of Open Access Journals (Sweden)

    Z MOUDI

    2003-12-01

    Full Text Available Introduction: Tetanus Neonatorum is due to The infection of umbilical cord That Causes mortality rate of neonatal tetanus is 5-60 in 1000 live births that can be prevented by joint vaccination of mother. Objective: The determination of factors involved in "how joint vaccination is carried out in qualified women. Method: According to a case control study In side, each Health center random sampling That data were collected from 300 women of which 150 with a perfect vaccination programme, and 150 without vaccination programme or with an imperfect vaccination programme who turned to 12 Health & Care Centres in Zahedan to vaccinate their babies, and the impact of (vaccination recording system, women"s information - care unit - the number of births -care frequency during pregnancy–mother"s age and education on the way in which joint vaccination is carried out (perfect-imperfect and without vaccination were investigated in two groups. Result: the results indicated a significant correlation with vaccination recording system ,care unit during pregnancy ,the frequency of care by health centre during pregnancy and the number of pregnancies. and on the basis of logestic. Regression The main reasons associated with vaccination Condition first was recording system, second was care unit during pregnancy. Discussion: In order to improve the vaccination condition of qualified women it is necessary 1-to run refreshment courses on "how to carry out vaccination programme using the most recent directions and instructions" for Health personnel. and to have an efficient recording system. 2- to have a monitoring and controlling system on the part of officials with regard to efficient implementation of affairs.

  12. El Centro Sainsbury de Salud Mental: Los Servicios Forenses de Salud Mental en Inglaterra y el País de Gales The Sainsbury Centre for Mental Health: Forensic Mental Health Services in England and Wales

    Directory of Open Access Journals (Sweden)

    M. Rutherford

    2008-06-01

    Full Text Available El Centro Sainsbury de Salud Mental (Sainsbury Centre for Mental Health es una organización benéfica fundada en 1985 por la Fundación Caritativa Gatsby (Gatsby Charitable Foundation. El SCMH trabaja para mejorar la calidad de vida de personas con problemas de salud mental influyendo sobre las políticas y prácticas en salud mental y servicios relacionados. El trabajo para mejorar la calidad de atención de salud mental en los centros penitenciarios es un eje central en la labor de SCMH. Este artículo describe algunos aspectos epidemiológicos con respeto a la salud mental de reclusos en Inglaterra y el País de Gales y los servicios y prestaciones forenses disponibles para el manejo de este tipo de paciente en el entorno penitenciario.The Sainsbury Centre for Mental Health (SCMH is a charity founded in 1985 by Gatsby Charitable Foundation. The SCMH works to improve the quality of life for people with mental health problems by influencing policy and practice in mental health and related services. Working to improve the quality of mental health care for people in prison is one of SCMH main work theme. This paper describes some epidemiological aspects of mental health situation of prisoners in England and Wales and the available forensic facilities to manage this kind of patients in prison.

  13. Strengthening health disaster risk management in Africa: multi-sectoral and people-centred approaches are required in the post-Hyogo Framework of Action era.

    Science.gov (United States)

    Olu, Olushayo; Usman, Abdulmumini; Manga, Lucien; Anyangwe, Stella; Kalambay, Kalula; Nsenga, Ngoy; Woldetsadik, Solomon; Hampton, Craig; Nguessan, Francois; Benson, Angela

    2016-08-02

    . Health system-based, multi-sectoral, and people-centred approaches are proposed to accelerate implementation of the strategy in the post-Hyogo Framework of Action era.

  14. The experiences of staff in a specialist mental health service in relation to development of skills for the provision of person centred care for people with dementia.

    Science.gov (United States)

    Smythe, Analisa; Bentham, Pete; Jenkins, Catharine; Oyebode, Jan R

    2015-03-01

    It is estimated that 820,000 people in the UK have dementia. Dementia costs the UK 17 billion a year and in the next 30 years this will treble to over £50 billion a year. There is a need to raise competence of staff delivering care to people living with dementia across health, social and voluntary sector provision. Effective education and training will build capacity and improve staff knowledge. However, at present not enough is known about the experiences of staff involved in gaining the skills, knowledge and attitudes required to support provision of high quality care for people with dementia. This study was conducted within a large National Health Service Trust in the UK serving an urban, ethnically mixed population, in collaboration with a local university. The trust responded to government policy by seeking to identify staff training needs. The aim was to explore the experiences of staff working within a specialist mental health service in relation to development of skills for the provision of person-centred care for people with dementia. To achieve this, staff roles, experiences of dementia training and the ways in which staff feel they learn were explored through focus group interviews. Relatives' views of staff competencies necessary for effective care provision were also explored to supplement the data from staff. A total of 70 staff and 16 family carers participated and data were subjected to inductive thematic analysis. Five themes emerged: competency-based skills, beliefs, enablers and barriers and ways of learning. Findings suggested participants felt that skills for person-centred care were innate and could not be taught, while effective ways of learning were identified as learning by doing, learning from each other and learning from experience. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  15. The Health and Safety Benefits of New Technologies in Mining: A Review and Strategy for Designing and Deploying Effective User-Centred Systems

    Directory of Open Access Journals (Sweden)

    Tim Horberry

    2012-10-01

    Full Text Available Mining is currently experiencing a rapid growth in the development and uptake of automation and other new technologies (such as collision detection systems; however, they are often developed from a technology-centred perspective that does not explicitly consider the end-user. This paper first presents a review of the technologies currently available (or near-market and the likely human factors issues associated with them. The second part of the paper presents a potential long term strategy for research and development that aims to maximise the safety and health benefits for operators of such new technologies. The strategy includes a four stage research and development process, this covers: better understanding the needs for technology, user requirements and risk/cost analysis; human element design, procurement and deployment processes; evaluation and verification of the strategy; and dissemination of it to relevant stakeholders (including equipment manufacturers, mine site purchasers and regulators. The paper concludes by stressing the importance of considering the human element with respect to new mining technologies and the likely benefits of adopting the type of strategy proposed here. The overall vision is for mining to become safer and healthier through effective user-centred design and deployment of new technologies that serve both operator needs and the demands of the workplace.

  16. From autopsy to autonomy in writing centres: Postgraduate students' response to two forms of feedback in a health professions education module

    Directory of Open Access Journals (Sweden)

    Daniels, Sharifa

    2016-12-01

    Full Text Available In post-apartheid South Africa, writing centres exist in almost every university to address the academic writing needs of students. At Stellenbosch University Writing Lab, writing consultants use collaborative learning and peer feedback in their work with writers in one-to-one consultations. As part of a larger research project about how students in a Health Professions Education Master’s degree responded to different types of feedback, our study focuses on whether the feedback received in a writing consultation compares to, or differs from, the feedback from the class group members. Our findings suggest that in general the students were open to interventions such as writing consultations. Furthermore, peer feedback from both a class group member as well as a writing consultant was experienced as useful. The study further shows that the consultants’ approach to giving feedback was in line with the pedagogy practised in writing centres. The article concludes with measures that were implemented to address uncertainties identified in the study. We recommend that the purpose of consultations be clarified to lecturers, that consultations be integrated in the writing process before the assignment is marked and, to minimise role confusion, that consultants describe to students the way consultations work at the beginning of the consultation.

  17. Challenges to the implementation of the integrated management of childhood illness (IMCI) at community health centres in West Java province, Indonesia.

    Science.gov (United States)

    Titaley, C R; Jusril, H; Ariawan, I; Soeharno, N; Setiawan, T; Weber, M W

    2014-01-01

    The integrated management of childhood illness (IMCI) is a comprehensive approach to child health, which has been adopted in Indonesia since 1997. This study aims to provide an overview of IMCI implementation at community health centres (puskesmas) in West Java province, Indonesia. Data were derived from a cross-sectional study conducted in 10 districts of West Java province, from November to December 2012. Semi-structured interviews were used to obtain information from staff at 80 puskesmas, including the heads (80 informants), pharmacy staff (79 informants) and midwives/nurses trained in IMCI (148 informants), using semi-structured interviews. Quantitative data were analysed using frequency tabulations and qualitative data were analysed by identifying themes that emerged in informants' responses. Almost all (N = 79) puskesmas implemented the IMCI strategy; however, only 64% applied it to all visiting children. Several barriers to IMCI implementation were identified, including shortage of health workers trained in IMCI (only 43% of puskesmas had all health workers in the child care unit trained in IMCI and 40% of puskesmas conducted on-the-job training). Only 19% of puskesmas had all the essential drugs and equipment for IMCI. Nearly all health workers acknowledged the importance of IMCI in their routine services and very few did not perceive its benefits. Lack of supervision from district health office staff and low community awareness regarding the importance of IMCI were reported. Complaints received from patients'families were generally related to the long duration of treatment and no administration of medication after physical examination. Interventions aiming to create local regulations endorsing IMCI implementation; promoting monitoring and supervision; encouraging on-the-job training for health workers; and strengthening training programmes, counselling and other promotional activities are important for promoting IMCI implementation in West Java province

  18. Quality of antenatal care provided by nurse midwives in an Urban health centre with regard to low-risk antenatal mothers

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    Ruby Angeline Pricilla

    2017-01-01

    Full Text Available Background:India contributes to 19% of the global maternal deaths. Good quality antenatal care can prevent maternal deaths by early detection of complications and maintaining maternal health. There are few studies documenting quality of antenatal care in India. This study aimed to document the antenatal services provided by nurse midwives to low-risk pregnant mothers from an urban population. Aims: The primary objective was to describe the quality of the antenatal care provided by nurse midwives of an urban health centre with regard to low-risk mothers. The secondary objective was to document the maternal and early neonatal outcomes of the enrolled mothers during the period of study. Methods: This prospective cohort study was done on 200 pregnant women who had antenatal care by nurse midwives between April 2014 and November 2014. The quality of care was assessed by a checklist adapted from World Health Organization (WHO. Results: We report that the quality of antenatal care for all domains was above 90% except for the health education domain, which was poor with regard to breastfeeding and family planning in the enrolled 200 pregnant women. Conclusion: Our study concluded that trained nurse midwives when regularly monitored, audited and linked with reliable referral facilities can deliver good quality antenatal care.

  19. Assessment of a high-fidelity mobile simulator for intrauterine contraception training in ambulatory reproductive health centres

    Directory of Open Access Journals (Sweden)

    Laura E. Dodge

    2016-02-01

    Full Text Available Objectives. Little is known about the utility of simulation-based training in office gynaecology. The objective of this cross-sectional study was to evaluate the self-reported effectiveness and acceptability of the PelvicSim™ (VirtaMed, a high-fidelity mobile simulator, to train clinicians in intrauterine device (IUD insertion. Methods. Clinicians at ambulatory healthcare centres participated in a PelvicSim IUD training programme and completed a self-administered survey. The survey assessed prior experience with IUD insertion, pre- and post-training competency and comfort and opinions regarding the acceptability of the PelvicSim. Results. The 237 participants were primarily female (97.5% nurse practitioners (71.3%. Most had experience inserting the levonorgestrel LNG20 IUD and the copper T380A device, but only 4.1% had ever inserted the LNG14 IUD. For all three devices, participants felt more competent following training, with the most striking change reported for insertion of the LNG14 IUD. The majority of participants reported increased comfort with uterine sounding (57.7%, IUD insertion on a live patient (69.8%, and minimizing patient pain (72.8% following training. Of the respondents, 89.6% reported the PelvicSim IUD insertion activities as “valuable” or “very valuable.” All participants would recommend the PelvicSim for IUD training, and nearly all (97.2% reported that the PelvicSim was a better method to teach IUD insertion than the simple plastic models supplied by IUD manufacturers. Conclusions. These findings support the use of the PelvicSim for IUD training, though whether it is superior to traditional methods and improves patient outcomes requires evaluation.

  20. Who Are the High-Cost Users? A Method for Person-Centred Attribution of Health Care Spending.

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    Sara J T Guilcher

    Full Text Available To develop person-centered episodes of care (PCE for community-dwelling individuals in the top fifth percentile of Ontario health care expenditures in order to: (1 describe the main clinical groupings for spending; and (2 identify patterns of spending by health sector (e.g. acute care, home care, physician billings within and across PCE.Data were drawn from population-based administrative databases for all publicly funded health care in Ontario, Canada in 2010/11.This study is a retrospective cohort study.A total of 587,982 community-dwelling individuals were identified among those accounting for the top 5% of provincial health care expenditures between April 1, 2010 and March 31, 2011. PCE were defined as starting with an acute care admission and persisting through subsequent care settings and providers until individuals were without health system contact for 30 days. PCE were classified according to the clinical grouping for the initial admission. PCE and non-PCE costs were calculated and compared to provide a comprehensive measurement of total health system costs for the year.Among this community cohort, 697,059 PCE accounted for nearly 70% ($11,815.3 million (CAD of total annual publicly-funded expenditures on high-cost community-dwelling individuals. The most common clinical groupings to start a PCE were Acute Planned Surgical (35.2%, Acute Unplanned Medical (21.0% and Post-Admission Events (10.8%. Median PCE costs ranged from $3,865 (IQR = $1,712-$10,919 for Acute Planned Surgical to $20,687 ($12,207-$39,579 for Post-Admission Events. Inpatient acute ($8,194.5 million and inpatient rehabilitation ($434.6 million health sectors accounted for the largest proportions of allocated PCE spending over the year.Our study provides a novel methodological approach to categorize high-cost health system users into meaningful person-centered episodes. This approach helps to explain how costs are attributable within individuals across sectors and has

  1. Barriers and opportunities for enhancing patient recruitment and retention in clinical research: findings from an interview study in an NHS academic health science centre.

    Science.gov (United States)

    Adams, Mary; Caffrey, Louise; McKevitt, Christopher

    2015-03-12

    In the UK, the recruitment of patients into clinical research is a national health research and development policy priority. There has been limited investigation of how national level factors operate as barriers or facilitators to recruitment work, particularly from the perspective of staff undertaking patient recruitment work. The aim of this study is to identify and examine staff views of the key organisational barriers and facilitators to patient recruitment work in one clinical research group located in an NHS Academic Health Science Centre. A qualitative study utilizing in-depth, one-to-one semi-structured interviews with 11 purposively selected staff with particular responsibilities to recruit and retain patients as clinical research subjects. Thematic analysis classified interview data by recurring themes, concepts, and emergent categories for the purposes of establishing explanatory accounts. The findings highlight four key factors that staff perceived to be most significant for the successful recruitment and retention of patients in research and identify how staff located these factors within patients, studies, the research centre, the trust, and beyond the trust. Firstly, competition for research participants at an organisational and national level was perceived to undermine recruitment success. Secondly, the tension between clinical and clinical research workloads was seen to interrupt patient recruitment into studies, despite national funding arrangements to manage excess treatment costs. Thirdly, staff perceived an imbalance between personal patient burden and benefit. Ethical committee regulation, designed to protect patients, was perceived by some staff to detract from clarification and systematisation of incentivisation strategies. Finally, the structure and relationships within clinical research teams, in particular the low tacit status of recruitment skills, was seen as influential. The results of this case-study, conducted in an exemplary NHS

  2. Community embedded reproductive health interventions for adolescents in Latin America: development and evaluation of a complex multi-centre intervention

    NARCIS (Netherlands)

    Decat, P.; Nelson, E.; de Meyer, S.; Jaruseviciene, L.; Orozco, M.; Segura, Z.; Gorter, A.; Vega, B.; Cordova, K.; Maes, L.; Temmerman, M.; Leye, E.; Degomme, O.

    2013-01-01

    Background Adolescents in Latin America are at high risk for unwanted and unplanned pregnancies, which often result in unsafe abortions or poor maternal health outcomes. Both young men and women in the region face an increased risk of sexually transmitted infections due to inadequate sexual and repr

  3. Social determinants of dementia and caregivers' perspectives in the field practice villages of Rural Health Training Centre, Thiruvennainallur

    Directory of Open Access Journals (Sweden)

    J Gurukartick

    2016-01-01

    Conclusions and Recommendations: Routine screening of elderly for early identification of dementia and its medical and social risk factors should be initiated in primary health care facility. Care of caregivers should be seen as an integral part of dementia care program.

  4. The state of risk prevention in a sample of Australian hospitals, medical centres and allied health services.

    Science.gov (United States)

    Canyon, Deon V

    2013-01-01

    This paper reports on an investigation into five risk prevention factors (technology, people, organisational structure, culture and top management psychology) to inform organisational preparedness planning and to update managers on the state of health care services. Data were collected by means of a 10-question, cross-sectional survey of key decision-making executives in eight different types of 75 health care organisations. Many organisations were found to have deficient risk prevention practices and allied health organisations were considerably worse than health organisations. Forty per cent of hospitals and chiropractic practices had out-dated or poor technology. Results on organisational culture and structure found that many executives associate these factors with risk prevention, but none of them appreciate the relationship between these factors and crisis causation. Gaps and areas for improvement are identified and a change in top management attitude is recommended to address resource allocation and implement appropriate risk prevention systems and mechanisms. Reactive managers need to increase their awareness of risks in order to become capable of preventing them. Proactive managers are those who invest in risk prevention.

  5. Analysis of pan-African Centres of excellence in health innovation highlights opportunities and challenges for local innovation and financing in the continent

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    Nwaka Solomon

    2012-07-01

    Full Text Available Abstract A pool of 38 pan-African Centres of Excellence (CoEs in health innovation has been selected and recognized by the African Network for Drugs and Diagnostics Innovation (ANDI, through a competitive criteria based process. The process identified a number of opportunities and challenges for health R&D and innovation in the continent: i it provides a direct evidence for the existence of innovation capability that can be leveraged to fill specific gaps in the continent; ii it revealed a research and financing pattern that is largely fragmented and uncoordinated, and iii it highlights the most frequent funders of health research in the continent. The CoEs are envisioned as an innovative network of public and private institutions with a critical mass of expertise and resources to support projects and a variety of activities for capacity building and scientific exchange, including hosting fellows, trainees, scientists on sabbaticals and exchange with other African and non-African institutions.

  6. The Quality of Healthcare Service Delivery in Nigeria: An Assessment of the Availability of Some Basic Medical Devices/Equipment in the Primary Health Care Centres in Delta State

    OpenAIRE

    Omuta GED

    2016-01-01

    Background: Ordinarily, accessibility implies locational proximity. However, this study limits its use to the quality of what is accessed. There is, therefore, service-delivery inaccessibility, when health care seekers can only access poor quality service, because of the poor quality of the equipment at the disposal of primary health care centres. Service-delivery equipment are, therefore, surrogate indicators of the quality of the health care services that are geographically accessible. Meth...

  7. Improvement in rheumatic fever and rheumatic heart disease management and prevention using a health centre-based continuous quality improvement approach.

    Science.gov (United States)

    Ralph, Anna P; Fittock, Marea; Schultz, Rosalie; Thompson, Dale; Dowden, Michelle; Clemens, Tom; Parnaby, Matthew G; Clark, Michele; McDonald, Malcolm I; Edwards, Keith N; Carapetis, Jonathan R; Bailie, Ross S

    2013-12-18

    Rheumatic heart disease (RHD) remains a major health concern for Aboriginal Australians. A key component of RHD control is prevention of recurrent acute rheumatic fever (ARF) using long-term secondary prophylaxis with intramuscular benzathine penicillin (BPG). This is the most important and cost-effective step in RHD control. However, there are significant challenges to effective implementation of secondary prophylaxis programs. This project aimed to increase understanding and improve quality of RHD care through development and implementation of a continuous quality improvement (CQI) strategy. We used a CQI strategy to promote implementation of national best-practice ARF/RHD management guidelines at primary health care level in Indigenous communities of the Northern Territory (NT), Australia, 2008-2010. Participatory action research methods were employed to identify system barriers to delivery of high quality care. This entailed facilitated discussion with primary care staff aided by a system assessment tool (SAT). Participants were encouraged to develop and implement strategies to overcome identified barriers, including better record-keeping, triage systems and strategies for patient follow-up. To assess performance, clinical records were audited at baseline, then annually for two years. Key performance indicators included proportion of people receiving adequate secondary prophylaxis (≥80% of scheduled 4-weekly penicillin injections) and quality of documentation. Six health centres participated, servicing approximately 154 people with ARF/RHD. Improvements occurred in indicators of service delivery including proportion of people receiving ≥40% of their scheduled BPG (increasing from 81/116 [70%] at baseline to 84/103 [82%] in year three, p = 0.04), proportion of people reviewed by a doctor within the past two years (112/154 [73%] and 134/156 [86%], p = 0.003), and proportion of people who received influenza vaccination (57/154 [37%] to 86/156 [55%], p

  8. Knowledge and perception of Prevention of Mother to Child services amongst pregnant women accessing antenatal clinic in a Primary Health Care centre in Nigeria

    Directory of Open Access Journals (Sweden)

    Eme T. Owoaje

    2012-10-01

    Full Text Available Background: Few studies have assessed pregnant women’s perceptions regarding prevention of mother to child of HIV and the available services at the primary health care level in Nigeria.Objective: Assessment of knowledge and perception of antenatal clinic (ANC attendees regarding Prevention of Mother to Child Transmission (PMTCT of HIV at primary health care facilities in south-west Nigeria.Method: A cross-sectional survey was conducted amongst 400 antenatal attendees in a Primary Health Care centre in Ibadan, Nigeria.Results: Known methods of PMTCT were: use of anti-retroviral treatment (ART during pregnancy (75.0%, ART at birth (65.8% and not breastfeeding (61.8%. Previous HIV Counselling and Testing (HCT was reported by 71%, significantly higher proportions of thosewho were married, in the third trimester of pregnancy or engaged in professional and/or skilled occupations had been tested. Regarding the HCT services provided, 92.2% understood the HIV-related health education provided, 89.7.2% reported that the timing was appropriate, 92.6% assessed the nurses’ approach as acceptable but 34.0% felt the test was forced upon them. Majority (79.6% were aware of non-breastfeeding options of infant feeding, but only 3.5% were aware of exclusive breastfeeding for a stipulated period as an infant feeding option. Nevertheless, the majority of the women found the non-breast feeding option culturally unacceptable.Conclusion: Women in this survey were knowledgeable about the methods of PMTCT, but had negative perceptions regarding certain aspects of the HCT services and the recommended non-breastfeeding infant feeding option. Health workers should provide client friendly services and infant feeding counselling that is based on current WHO recommendations and culturally acceptable.

  9. Maternal deaths in a tertiary health care centre of Odisha: An in-depth study supplemented by verbal autopsy

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    Biswajit Paul

    2011-01-01

    Full Text Available Background: Maternal mortality is a reflection of the care given to women by its society. It is tragic that deaths occur during the natural process of child birth and most of them are preventable. Objectives: The present study was undertaken to find out the causes and contributing factors of maternal deaths. Materials and Methods: All maternal deaths occurring in a year in the medical college and hospital were traced and interviews were taken from the relatives as well as the health care providers who were present at the time of death of the woman. Results: Out of the total maternal deaths, 72% belonged to 20-30 yrs age group, also 46.5% were illiterate, and majority deaths (60.5% were from low socio-economics status. Direct causes were responsible for 76.7% of maternal deaths. Hypertensive disorders of pregnancy were most common (32.6% cause of direct deaths, while malaria (9.3% and anemia (7% were most common indirect causes. Most of the women had to use their own resources to travel to health care facilities. Delays at different levels, often in combination, contributed to the maternal deaths. Conclusions: The study will serve as an eye-opener to the bottlenecks present in the community as well as in the health facility so as to take appropriate measures to prevent maternal deaths.

  10. Child Centred Approach to Climate Change and Health Adaptation through Schools in Bangladesh: A Cluster Randomised Intervention Trial.

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    Md Iqbal Kabir

    Full Text Available Bangladesh is one of the most vulnerable countries to climate change. People are getting educated at different levels on how to deal with potential impacts. One such educational mode was the preparation of a school manual, for high school students on climate change and health protection endorsed by the National Curriculum and Textbook Board, which is based on a 2008 World Health Organization manual. The objective of this study was to test the effectiveness of the manual in increasing the knowledge level of the school children about climate change and health adaptation.This cluster randomized intervention trial involved 60 schools throughout Bangladesh, with 3293 secondary school students participating. School upazilas (sub-districts were randomised into intervention and control groups, and two schools from each upazila were randomly selected. All year seven students from both groups of schools sat for a pre-test of 30 short questions of binary response. A total of 1515 students from 30 intervention schools received the intervention through classroom training based on the school manual and 1778 students of the 30 control schools did not get the manual but a leaflet on climate change and health issues. Six months later, a post-intervention test of the same questionnaire used in the pre-test was performed at both intervention and control schools. The pre and post test scores were analysed along with the demographic data by using random effects model.None of the various school level and student level variables were significantly different between the control and intervention group. However, the intervention group had a 17.42% (95% CI: 14.45 to 20.38, P = <0.001 higher score in the post-test after adjusting for pre-test score and other covariates in a multi-level linear regression model.These results suggest that school-based intervention for climate change and health adaptation is effective for increasing the knowledge level of school children on

  11. Early experiences on the feasibility, acceptability, and use of malaria rapid diagnostic tests at peripheral health centres in Uganda-insights into some barriers and facilitators

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    Asiimwe Caroline

    2012-01-01

    Full Text Available Abstract Background While feasibility of new health technologies in well-resourced healthcare settings is extensively documented, it is largely unknown in low-resourced settings. Uganda's decision to deploy and scale up malaria rapid diagnostic tests (mRDTs in public health facilities and at the community level provides a useful entry point for documenting field experience, acceptance, and predictive variables for technology acceptance and use. These findings are important in informing implementation of new health technologies, plans, and budgets in low-resourced national disease control programmes. Methods A cross-sectional qualitative descriptive study at 21 health centres in Uganda was undertaken in 2007 to elucidate the barriers and facilitators in the introduction of mRDTs as a new diagnostic technology at lower-level health facilities. Pre-tested interview questionnaires were administered through pre-structured patient exit interviews and semi-structured health worker interviews to gain an understanding of the response to this implementation. A conceptual framework on technology acceptance and use was adapted for this study and used to prepare the questionnaires. Thematic analysis was used to generate themes from the data. Results A total of 52 of 57 health workers (92% reported a belief that a positive mRDT result was true, although only 41 of 57 (64% believed that treatment with anti-malarials was justified for every positive mRDT case. Of the same health workers, only 49% believed that a negative mRDT result was truly negative. Factors linked to these findings were related to mRDT acceptance and use, including the design and characteristics of the device, availability and quality of mRDT ancillary supplies, health worker capacity to investigate febrile cases testing negative with the device and provide appropriate treatment, availability of effective malaria treatments, reliability of the health commodity supply chain, existing national

  12. Role models and professional development in dentistry: an important resource: The views of early career stage dentists at one academic health science centre in England.

    Science.gov (United States)

    Mohamed Osama, O; Gallagher, J E

    2017-02-08

    The importance of role models, and their differing influence in early, mid- and late careers, has been identified in the process of professional development of medical doctors. There is a paucity of evidence within dentistry on role models and their attributes. To explore the views of early career dentists on positive and negative role models across key phases of professional development, together with role models' attributes and perceived influence. This is a phenomenological study collecting qualitative data through semi-structured interviews based on a topic guide. Dentists in junior (core training) hospital posts in one academic health science centre were all invited to participate. Interviews were recorded, transcribed verbatim and analysed using framework analysis. Twelve early career stage dentists, 10 of whom were female, reported having role models, mainly positive, in their undergraduate and early career phases. Participants defined role models' attributes in relation to three distinct domains: clinical attributes, personal qualities and teaching skills. Positive role models were described as "prioritising the patient's best interests", "delivering learner-centred teaching and training" and "exhibiting a positive personality", whilst negative role models demonstrated the converse. Early career dentists reported having largely positive dentist role models during- and post-dental school and report their impact on professional values and aspirations, learning outcomes and career choice. The findings suggest that these early career dentists in junior hospital posts have largely experienced and benefitted from positive role models, notably dentists, perceived as playing an important and creative influence promoting professionalism and shaping the career choices of early career stage dentists. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. A survey of malaria and some arboviral infections among suspected febrile patients visiting a health centre in Simawa, Ogun State, Nigeria.

    Science.gov (United States)

    Ayorinde, Adenola F; Oyeyiga, Ayorinde M; Nosegbe, Nwakaego O; Folarin, Onikepe A

    2016-01-01

    Most febrile patients are often misdiagnosed with malaria due to similar symptoms, such as fever shared by malaria and certain arboviral infections. This study surveyed the incidence of malaria, chikungunya and dengue infections among a number of suspected febrile patients visiting Simawa Health Centre, Ogun State, Nigeria. Venous blood samples were obtained from 60 febrile patients (age 3-70 years) visiting the centre between April and May 2014. The rapid diagnostic test (RDT) was used to detect the presence of chikungunya (CHK) antibodies (IgM), dengue (DEN) virus and antibodies (NS1, IgM and IgG) and malaria parasites (Plasmodium falciparum and Plasmodium vivax). Malarial confirmatory tests were by microscopy and nested polymerase chain reaction (PCR) using the polymorphic region of Glutamate-Rich Protein (GLURP) gene. The complexity of P. falciparum infection in the community also determined by the use of nested PCR. These three mosquito-borne infections were observed in 63% (38) of the patients. The prevalence of CHK, DEN and malarial infections singularly were 11%, 0% and 63%, respectively, whereas malaria with either CHK or DEN infections were 24% (9) and 3% (1), respectively. No subjects were positive for CHK and DEN co-infection. Malarial microscopic confirmation was in 94% (32) of the malaria RDT-positive samples, 50% (17) were successfully analysed by nested PCR and the mean multiplicity of infection was 1.6 (1-3 clones). One patient sample harboured both P. falciparum and P. vivax. The study reports the presence of some arboviral infections having similar symptoms with malaria at Simawa, Ogun State. The proper diagnosis of infectious diseases is important for controlling them.

  14. Evaluation of planning and performance of health centres of social security organization in relation to occupational diseases

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    Javadzadeh Ahmadi A

    1998-09-01

    Full Text Available The chief aim of this research is intended to study the planning and performance of the health and treatment units of the Social Security Organization about the illnesses that may occur in connection with occupations. We believe, however, that healthy skilled work force are the nmost important factors for the development and progress of a country. Therefore, illnesses and disabilities from chemical, physical, biological, psychological and ergonomic can be drasticly eliminated in order to ensure the safety standards of the work force. Five occupational medicine centers in Tehran, have undergone 35199 tests for pre-employment medical examinations. The results were fit, conditionally fit, and unfit that were introduced to employers, during August 1996 and July 1997. Periodical examinations, visits of workshops and factories, presentation of health care in 200 dispensaries has helped recognizing professional diseases. The results work of committee of medical assistant, showed 56 cases of disabilities due to occupation. Professional causes, 16.07% of the above disabilities are from mechanical and, 16.07% from transportation. Hands amputation 50%, injuries of waist 19.65%, feet 10.71% and head 7.14% had responsibility for invalidity due to occupations. Other results of this research like time distribution, causes of invalidity have been presented.

  15. The Effects of a Locally Developed mHealth Intervention on Delivery and Postnatal Care Utilization; A Prospective Controlled Evaluation among Health Centres in Ethiopia.

    Science.gov (United States)

    Shiferaw, Solomon; Spigt, Mark; Tekie, Michael; Abdullah, Muna; Fantahun, Mesganaw; Dinant, Geert-Jan

    2016-01-01

    Although there are studies showing that mobile phone solutions can improve health service delivery outcomes in the developed world, there is little empirical evidence that demonstrates the impact of mHealth interventions on key maternal health outcomes in low income settings. A non-randomized controlled study was conducted in the Amhara region, Ethiopia in 10 health facilities (5 intervention, 5 control) together serving around 250,000 people. Health workers in the intervention group received an android phone (3 phones per facility) loaded with an application that sends reminders for scheduled visits during antenatal care (ANC), delivery and postnatal care (PNC), and educational messages on dangers signs and common complaints during pregnancy. The intervention was developed at Addis Ababa University in Ethiopia. Primary outcomes were the percentage of women who had at least 4 ANC visits, institutional delivery and PNC visits at the health center after 12 months of implementation of the intervention. Overall 933 and 1037 women were included in the cross-sectional surveys at baseline and at follow-up respectively. In addition, the medical records of 1224 women who had at least one antenatal care visit were followed in the longitudinal study. Women who had their ANC visit in the intervention health centers were significantly more likely to deliver their baby in the same health center compared to the control group (43.1% versus 28.4%; Adjusted Odds Ratio (AOR): 1.98 (95%CI 1.53-2.55)). A significantly higher percentage of women who had ANC in the intervention group had PNC in the same health center compared to the control health centers (41.2% versus 21.1%: AOR: 2.77 (95%CI 2.12-3.61)). Our findings demonstrated that a locally customized mHealth application during ANC can significantly improve delivery and postnatal care service utilization possibly through positively influencing the behavior of health workers and their clients.

  16. The Effects of a Locally Developed mHealth Intervention on Delivery and Postnatal Care Utilization; A Prospective Controlled Evaluation among Health Centres in Ethiopia.

    Directory of Open Access Journals (Sweden)

    Solomon Shiferaw

    Full Text Available Although there are studies showing that mobile phone solutions can improve health service delivery outcomes in the developed world, there is little empirical evidence that demonstrates the impact of mHealth interventions on key maternal health outcomes in low income settings.A non-randomized controlled study was conducted in the Amhara region, Ethiopia in 10 health facilities (5 intervention, 5 control together serving around 250,000 people. Health workers in the intervention group received an android phone (3 phones per facility loaded with an application that sends reminders for scheduled visits during antenatal care (ANC, delivery and postnatal care (PNC, and educational messages on dangers signs and common complaints during pregnancy. The intervention was developed at Addis Ababa University in Ethiopia. Primary outcomes were the percentage of women who had at least 4 ANC visits, institutional delivery and PNC visits at the health center after 12 months of implementation of the intervention.Overall 933 and 1037 women were included in the cross-sectional surveys at baseline and at follow-up respectively. In addition, the medical records of 1224 women who had at least one antenatal care visit were followed in the longitudinal study. Women who had their ANC visit in the intervention health centers were significantly more likely to deliver their baby in the same health center compared to the control group (43.1% versus 28.4%; Adjusted Odds Ratio (AOR: 1.98 (95%CI 1.53-2.55. A significantly higher percentage of women who had ANC in the intervention group had PNC in the same health center compared to the control health centers (41.2% versus 21.1%: AOR: 2.77 (95%CI 2.12-3.61.Our findings demonstrated that a locally customized mHealth application during ANC can significantly improve delivery and postnatal care service utilization possibly through positively influencing the behavior of health workers and their clients.

  17. Upscaling the recruitment and retention of human resources for health at primary healthcare centres in Lebanon: a qualitative study.

    Science.gov (United States)

    Alameddine, Mohamad; Khodr, Hiba; Mourad, Yara; Yassoub, Rami; Abi Ramia, Jinane

    2016-05-01

    The sustainability of primary healthcare (PHC) worldwide has been challenged by a global shortage in human resources for health (HRH). This study is a unique attempt at systematically soliciting and synthesising the voice of PHC and community stakeholders on the HRH recruitment and retention strategies at the PHC sector in Lebanon, the obstacles and challenges hindering their optimisation and the recommendations to overcome such obstacles. A qualitative design was utilised, involving 22 semi-structured interviews with PHC experts in Lebanon conducted in 2013. Nvivo qualitative data analysis software was employed for the thematic analysis of data collected from interviews. Five comprehensive themes emerged: understanding PHC scope, HRH recruitment issues, HRH retention challenges, rural areas' specific challenges and stakeholders' recommendations. Analysis of stakeholders' responses revealed a lack of a unified understanding of the PHC scope impacting the capacity for appropriate HRH planning. Identified impediments to recruitment included the suboptimal supply of HRH, financial constraints and poor management. Retention difficulties were attributed to poor working environments, financial constraints and lack of professional development. There was consensus that HRH challenges faced were aggravated in rural areas, jeopardising the equitable access to PHC services of quality. Equitable access was also jeopardised by the reported shortage of female HRH in a sociocultural context where many females prefer providers of the same gender. The study sets the path towards upscaling recruitment and retention policies and practices through the endorsement of a nationally acknowledged PHC definition and scope, the sustainable development of the PHC workforce and through the implementation of targeted recruitment and retention strategies addressing rural settings and gender equity. Decision-makers and planners are urged to identify HRH as the most important input for the success

  18. Barriers and facilitators to recruitment of physicians and practices for primary care health services research at one centre

    Directory of Open Access Journals (Sweden)

    Hogg William

    2010-12-01

    Full Text Available Abstract Background While some research has been conducted examining recruitment methods to engage physicians and practices in primary care research, further research is needed on recruitment methodology as it remains a recurrent challenge and plays a crucial role in primary care research. This paper reviews recruitment strategies, common challenges, and innovative practices from five recent primary care health services research studies in Ontario, Canada. Methods We used mixed qualitative and quantitative methods to gather data from investigators and/or project staff from five research teams. Team members were interviewed and asked to fill out a brief survey on recruitment methods, results, and challenges encountered during a recent or ongoing project involving primary care practices or physicians. Data analysis included qualitative analysis of interview notes and descriptive statistics generated for each study. Results Recruitment rates varied markedly across the projects despite similar initial strategies. Common challenges and creative solutions were reported by many of the research teams, including building a sampling frame, developing front-office rapport, adapting recruitment strategies, promoting buy-in and interest in the research question, and training a staff recruiter. Conclusions Investigators must continue to find effective ways of reaching and involving diverse and representative samples of primary care providers and practices by building personal connections with, and buy-in from, potential participants. Flexible recruitment strategies and an understanding of the needs and interests of potential participants may also facilitate recruitment.

  19. (Correlation between Family Social Economy Status and Exclusive Breastfeeding in Tanah Kali Kedinding Public Health Centre, Surabaya

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    Suci Wulansari

    2014-11-01

    Full Text Available Background: The result of Basic Health Research (Riskesdas 2010 showed that the coverage of exclusive breastfeeding until 6 months were lower than the exclusive breastfeeding coverage target in Indonesia that is 80%. One of the factor that assumed can affect the continuity of exclusive breastfeeding is social economy condition. Methods: This study was a descriptive research with cross sectional design. Samples were taken from population who were mothers with 6-12 months old children within the area of Puskesmas Tanah Kali Kedinding on 2011. Closed quistionnaire was used to collect data and analyzed with Chi Square. The aim of the study was described the correlation between social economy factors and exclusive breastfeeding on babies. Result: Only a small portion of respondents that had good knowledge of exclusive breastfeeding. There was a significant correlation between good knowledge of exclusive breastfeeding with exclusive breastfeeding practice. There was a significant correlation between vocational status of mother and knowledge about exclusive breastfeeding with exclusive breastfeeding practice. There was no significant correlation between education level and family income with exclusive breastfeeding practice. Conclusions: The scope of exclusive breastfeeding must be enhanced. Poor of knowledge about exclusive breastfeeding and working mothers influence the low level of exclusive breastfeeding practice. Recomendation: Increasing knowledge of mothers and families about the benefits of exclusive breastfeeding, preparation and technical, as well as how storage and giving stored breastfeeding to the baby. Working mothers should try to give the exclusive breastfeeding which it must be facilitated by the company.

  20. Health Related Quality of Life (HRQoL) among Breast Cancer Patients Receiving Chemotherapy in Hospital Melaka: Single Centre Experience

    Science.gov (United States)

    Chee Chean, Dang; Kuo Zang, Wong; Lim, Michelle; Zulkefle, Nooraziah

    2016-12-01

    Objective: To investigate the impact of chemotherapy on quality of life (QoL) among breast cancer patients and to evaluate the relationship with age, cancer stage and presence of any comorbidity. Methods: A prospective study was conducted among breast cancer patients receiving chemotherapy in Hospital Melaka from 1st January 2014 to 31st July 2014. The European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) was given to patients to fill in prior chemotherapy (baseline) and after the third cycle of chemotherapy. Socio-demographic and clinical data were collected and analyzed using SPSS version 20. Result: Respondents were 32 female patients [mean age (SD): 49.7(9.93) years]. They reported a significant lower global health status (P 0.05). Conclusion: Chemotherapy did reduce the QoL of breast cancer patients. Management of chemotherapy-induced loss of appetite, diarrhea, nausea and vomiting should be improved for a better outcome.

  1. The Evaluation Of Effectiveness Of ICDS In 7 Anganwadi Centres On The Health Status Of Pre-School Children

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    Kulkarni M.N

    1988-01-01

    Full Text Available Impact of Integrated child Development Services (ICDS scheme in 7 Anganwadi centers of Davangere Block on the health status of pre-school children were studied for a period of one year. Total of 547 children, who were enrolled for supplementary nutrition and non-formal education, formed the study group. Impact of the programme on nutritional status was seen only in severely malnourished children (Grade III & IV. Severely malnourished children constituted 9.3% of total initially and 3.9 percent at the end of the study. The number of children belonging to grade I & II malnutrition were 74% initially and 81.5% at the end of the study. Not much improvement in the immunization status for BCG., all three doses of oral polio vaccine and DPT was 42.4, 59.4 and 73.3 percent at the baseline study and 56, 67.7 and 82 percent respectively at the end of the study. The supply of supplementary nutrients and vaccines was irregular. High prevalence of vit. ‘A’ Deficiency and anemia were noted.

  2. The importance of dietary change for men diagnosed with and at risk of prostate cancer: a multi-centre interview study with men, their partners and health professionals.

    Science.gov (United States)

    Avery, Kerry N L; Donovan, Jenny L; Horwood, Jeremy; Neal, David E; Hamdy, Freddie C; Parker, Chris; Wade, Julia; Lane, Athene

    2014-05-03

    The diagnosis of prostate cancer (PC) can provide a trigger for dietary change, and there is evidence that healthier diets may improve quality of life and clinical outcomes. However, men's views about dietary change in PC survivorship are largely unknown. This multi-centre qualitative interview study explored men's views about dietary change in PC survivorship, to better understand motivations for, and barriers to, achieving desired changes. The role of radical and active surveillance treatments on dietary change and the influence of men's partners were examined. Focus groups also evaluated stakeholder opinion, including healthcare professionals, about the provision of dietary advice to PC patients. A multi-centre interview study explored views about diet and motivations for, and barriers to, dietary change in men at elevated risk or diagnosed with PC following prostate specific antigen (PSA) testing. 58 men and 11 partners were interviewed. Interviews and focus groups were undertaken with 11 healthcare professionals, 5 patients and 4 partners to evaluate stakeholders' opinions about the feasibility and acceptability of providing dietary advice to PC patients. Data were analysed using methods of constant comparison and thematic analysis. Over half of diagnosed men reported making dietary changes, primarily to promote general or prostate health or facilitate coping, despite their uncertainty about diet-PC links. Interest in dietary advice was high. Information needs varied depending on treatment received, with men on active surveillance more frequently modifying their diet and regarding this as an adjunct therapy. Men considered their partners integral to implementing changes. Provision of dietary advice to men diagnosed with PC was considered by healthcare professionals and men to be feasible and appropriate in the context of a holistic 'care package'. Many men make positive dietary changes after PC diagnosis, which are perceived by men and their partners to bring

  3. Tobacco smoking in Poland in 2003-2014. Multi-centre National Population Health Examination Survey (WOBASZ).

    Science.gov (United States)

    Polakowska, Maria; Kaleta, Dorota; Piotrowski, Walerian; Topór-Mądry, Roman; Puch-Walczak, Aleksandra; Niklas, Arkadiusz; Bielecki, Wojciech; Kozakiewicz, Krystyna; Pająk, Andrzej; Tykarski, Andrzej; Zdrojewski, Tomasz; Drygas, Wojciech

    2017-01-17

    INTRODUCTION    The reduction of tobacco smoking is a challenging problem of public health. OBJECTIVES    The main purpose of this work was to evaluate the prevalence and tobacco use patterns in the adult population of Poles and its changes in a period between year 2003 and 2014. Furthermore, changes in the smoking addiction, the declared reasons for smoking as well as readiness and motivation to stop smoking has been assessed.  PATIENTS AND METHODS    Based on data from the Polish studies - WOBASZ and WOBASZ II, the analysis covered a population of 14576 persons from the 1st study (6906 men and 7670 women) and 5696 persons from the 2nd study (2578 men and 3118 women), aged 20 - 74. RESULTS    According to the WOBASZ II study, in Poland 30% of men and 21% of women smoked,  the shares being 9 and 4 % lower for men and women respectively in comparison with the WOBASZ (p<0.001). The average number of cigarettes smoked daily per smoker significantly decreased in the period of observation among men (from 17.9 to 15.8 cigarettes/day) and women (from 13.7 to 12.1). The percentage of never smoking men rose from 29.8% to 36.1% (p<0.0001). The proportion of never smoking women no changed. However, the percentage of those expressing unwillingness to quit tobacco smoking nearly doubled in WOBASZ II vs WOBASZ. CONCLUSIONS    Although we found smoking rates in Poland have declined over the past decade, smoking remains prevalent among men and women. Therefore it is necessary to optimize the tobacco control in Poland including fiscal policy, counseling and tobacco addiction treatment, promotional and educational activities, with a special emphasis on the female population.

  4. AN ASSESSMENT ON THE ROUTINE IMMUNIZATION AT THE BLOCK PRIMARY HEALTH CENTRE (BPHC LEVEL IN FOUR DISTRICTS OF ASSAM

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    Jhankar

    2014-06-01

    Full Text Available Immunization is an investment for today and tomorrow. It is a cost effective and highly successful health intervention, which prevents needless suffering through sickness, disability and death. Immunization is one of the interventions that will help in achieving the MDG-4 i.e. reducing child mortality by 2/3rd between 1990 and 2015. OBJECTIVE: The objective of the study is to evaluate the current quality of the immunization program and to identify the gaps in the Routine immunization with focus on micro-planning, manpower, supervision, funding and community participation. METHODS: The study is conducted in the four selected districts of Assam namely Barpeta, Darrang, Dhubri and Morigaon. This activity was conducted in b November 2012- January 2013 by two researchers. In total 21 no.s of BPHC are assessed using formats along with review of records, micro plans and data. All analysis was completed in Microsoft Excel. RESULTS: The majority of blocks in each district reported availability of all routine vaccines (i.e., BCG, OPV, DTP, and MCV; however, all districts had at least 1 BPHC with a stock out of 1 vaccine in the 3 months prior to the assessment. Across all districts, syringes were adequately available. Funding of immunization services was a challenge in nearly all BPHCs; only 2 of the 21 assessed BPHCs had funding for all major immunization activities (cold chain, supervision, outreach, vaccine transport in the month prior to the assessment. In the 18 BPHCs with written supervision plans, low performing sub centers (SC were not prioritized to receive more supervision visits in 8(44% BPHCs. CONCLUSION: Funding for all immunization activities, particularly supervision and staff salaries, remains an ongoing challenge. ASHAs and AWWs are vital links for delivering immunization-related information to communities. A higher proportion of BPHCs in the districts had monitoring charts. Those charts were generally of good quality across all BPHCs with

  5. A prospective web-based patient-centred interactive study of long-term disabilities, disabilities perception and health-related quality of life in patients with multiple sclerosis in The Netherlands: the Dutch Multiple Sclerosis Study protocol

    OpenAIRE

    Jongen, P.J.; Heerings, M.; Lemmens, W.A.; Donders, R.; Van de Zande, A.; Noort, E.; Kool, A.

    2015-01-01

    BACKGROUND: In the past two decades the widespread use of disease modifying drugs with moderate to strong efficacy has changed the natural course of multiple sclerosis (MS). Health care professionals, researchers, patient organizations and health authorities are in need of recent information about the objectified and subjective long-term clinical outcomes in MS patients. Such information is scarce. METHODS/DESIGN: We started a prospective, web-based, patient-centred, interactive study of long...

  6. [Tooth decay: epidemiological and therapeutic aspects in dental service of University Teaching Hospital Yalgado Ouedraogo and Municipal Centre of Oral Health].

    Science.gov (United States)

    Ouedraogo, Y; Kabore, W A D; Konsem, T; Fall, M; Millogo, M; Ouattara, S; Ouedraogo, D

    2015-12-01

    In order to improve the prevention and treatment of dental caries in Burkina Faso, we conducted a study on the epidemiological and therapeutic aspects of dental caries in the dental services of University Teaching Hospital Yalgado Ouedraogo and in the Municipal Centre of Oral Health of Ouagadougou. A prospective and descriptive study from October, 15th 2012 to January, 15th 2013 was conducted on a sample of 191 patients. The variables recorded were: patient's identity, age, sex, area of residence, food mode, socioeconomic level, reason for consultation, oral hygiene, DMFT index, degree of tissue damage, the topography of the carious lesions and the applied therapy. Caries prevalence was 93.19% more female consultations, with sex ratio at 0.77. The average age was 31 years for a sample often engaged in trade and the informal sector. Carious lesions were usually limited to less than 4 teeth. The main motivation for the consultation was pain at 82.20%. The use of preventive care is quite low in our population. Extractions still occupy an important part of treatment. We need to improve oral hygiene and show to patients the necessity of routine visits to the dentist every year for early treatment.

  7. The research agenda for general practice/family medicine and primary health care in Europe. Part 3. Results: person centred care, comprehensive and holistic approach.

    Science.gov (United States)

    Van Royen, Paul; Beyer, Martin; Chevallier, Patrick; Eilat-Tsanani, Sophia; Lionis, Christos; Peremans, Lieve; Petek, Davorina; Rurik, Imre; Soler, Jean Karl; Stoffers, Henri E J H; Topsever, Pinar; Ungan, Mehmet; Hummers-Pradier, Eva

    2010-06-01

    The recently published 'Research Agenda for General Practice/Family Medicine and Primary Health Care in Europe' summarizes the evidence relating to the core competencies and characteristics of the Wonca Europe definition of GP/FM, and its implications for general practitioners/family doctors, researchers and policy makers. The European Journal of General Practice publishes a series of articles based on this document. In a first article, background, objectives, and methodology were discussed. In a second article, the results for the two core competencies 'primary care management' and 'community orientation' were presented. This article reflects on the three core competencies, which deal with person related aspects of GP/FM, i.e. 'person centred care', 'comprehensive approach' and 'holistic approach'. Though there is an important body of opinion papers and (non-systematic) reviews, all person related aspects remain poorly defined and researched. Validated instruments to measure these competencies are lacking. Concerning patient-centredness, most research examined patient and doctor preferences and experiences. Studies on comprehensiveness mostly focus on prevention/care of specific diseases. For all domains, there has been limited research conducted on its implications or outcomes.

  8. Stroke survivors’ levels of community reintegration, quality of life, satisfaction with the physiotherapy services and the level of caregiver strain at community health centres within the Johannesburg area

    Science.gov (United States)

    Kusambiza-Kiingi, Adrian; Maleka, Douglas

    2017-01-01

    Background Stroke survivors are discharged home before they are functionally independent and return home with activity limitations that would not be manageable without a caregiver. Aim To determine stroke survivors’ levels of community reintegration, quality of life (QOL), satisfaction with the physiotherapy services and the level of caregiver strain at community health centres within the Johannesburg area. Method This was a cross-sectional study using the following outcome measures: Maleka Stroke Community Reintegration Measure, Stroke-specific quality of life scale, Caregiver strain index and Physical therapy patient satisfaction questionnaire. Results A total of 108 stroke survivors and 45 caregivers participated in this study. The average age of the stroke survivors was 54 years (standard deviation = 12.73) and 58% (n = 62) had moderate to full community reintegration. They were happy with physiotherapy services but not with parking availability and cost of services. The QOL was poor with the lowest scores for energy and highest scores for vision and language domains. Twenty five (55%) caregivers were strained. A positive correlation was found between community reintegration and satisfaction with services (r = 0.27, p reintegration and caregiver strain (r = -0.37, p reintegrated into their communities except in the areas of work and education and have poor QOL and most of their caregivers are strained; however, they are satisfied with physiotherapy services. PMID:28730068

  9. Stroke survivors' levels of community reintegration, quality of life, satisfaction with the physiotherapy services and the level of caregiver strain at community health centres within the Johannesburg area.

    Science.gov (United States)

    Kusambiza-Kiingi, Adrian; Maleka, Douglas; Ntsiea, Veronica

    2017-01-01

    Stroke survivors are discharged home before they are functionally independent and return home with activity limitations that would not be manageable without a caregiver. To determine stroke survivors' levels of community reintegration, quality of life (QOL), satisfaction with the physiotherapy services and the level of caregiver strain at community health centres within the Johannesburg area. This was a cross-sectional study using the following outcome measures: Maleka Stroke Community Reintegration Measure, Stroke-specific quality of life scale, Caregiver strain index and Physical therapy patient satisfaction questionnaire. A total of 108 stroke survivors and 45 caregivers participated in this study. The average age of the stroke survivors was 54 years (standard deviation = 12.73) and 58% (n = 62) had moderate to full community reintegration. They were happy with physiotherapy services but not with parking availability and cost of services. The QOL was poor with the lowest scores for energy and highest scores for vision and language domains. Twenty five (55%) caregivers were strained. A positive correlation was found between community reintegration and satisfaction with services (r = 0.27, p reintegration and caregiver strain (r = -0.37, p reintegrated into their communities except in the areas of work and education and have poor QOL and most of their caregivers are strained; however, they are satisfied with physiotherapy services.

  10. Stroke survivors’ levels of community reintegration, quality of life, satisfaction with the physiotherapy services and the level of caregiver strain at community health centres within the Johannesburg area

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    Adrian Kusambiza-Kiingi

    2017-01-01

    Full Text Available Background: Stroke survivors are discharged home before they are functionally independent and return home with activity limitations that would not be manageable without a caregiver. Aim: To determine stroke survivors’ levels of community reintegration, quality of life (QOL, satisfaction with the physiotherapy services and the level of caregiver strain at community health centres within the Johannesburg area. Method: This was a cross-sectional study using the following outcome measures: Maleka Stroke Community Reintegration Measure, Stroke-specific quality of life scale, Caregiver strain index and Physical therapy patient satisfaction questionnaire. Results: A total of 108 stroke survivors and 45 caregivers participated in this study. The average age of the stroke survivors was 54 years (standard deviation = 12.73 and 58% (n = 62 had moderate to full community reintegration. They were happy with physiotherapy services but not with parking availability and cost of services. The QOL was poor with the lowest scores for energy and highest scores for vision and language domains. Twenty five (55% caregivers were strained. A positive correlation was found between community reintegration and satisfaction with services (r = 0.27, p < 0.0001 and QOL (r = 0.51, p < 0.0001. A negative correlation was found between community reintegration and caregiver strain (r = -0.37, p < 0.0001. Conclusion: Most stroke survivors are reintegrated into their communities except in the areas of work and education and have poor QOL and most of their caregivers are strained; however, they are satisfied with physiotherapy services.

  11. Reducing HIV-related risk and mental health problems through a client-centred psychosocial intervention for vulnerable adolescents in Addis Ababa, Ethiopia

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    Nrupa Jani

    2016-07-01

    Full Text Available Introduction: Ethiopia is experiencing an increasingly urban HIV epidemic, alongside a rise in urban adolescent migration. Adolescent migrants are often confronted by unique social challenges, including living in a difficult environment, abuse and mental health problems. These issues can increase adolescents’ vulnerability to HIV and compromise their capacity to protect themselves and others from HIV. We piloted and assessed the effects of a targeted psychosocial intervention to reduce mental health problems and improve HIV-related outcomes among migrant adolescents in Addis Ababa. Methods: A pre- and post-comparison design was used in a cohort of 576 female and 154 male migrant adolescents aged 15 to 18 years in Addis Ababa receiving services from two service delivery organizations, Biruh Tesfa and Retrak. We implemented a three-month client-centred, counsellor-delivered psychosocial intervention, based on findings from formative research among the same target population, to address participants’ increased vulnerability to HIV. The intervention package comprised individual, group and creative arts therapy counselling sessions. Key outcome indicators included anxiety, depression, aggressive behaviour, attention problems, social problems, knowledge of HIV, safer sex practices and use of sexual health services. Longitudinal data analysis (McNemar test and random effects regression was used to assess changes over time in key indicators by gender. Results: For females, aggressive behaviour decreased by 60% (adjusted odds ratio (AOR: 0.4 (0.25 to 0.65 and any mental health problem decreased by 50% (AOR: 0.5 (0.36 to 0.81 from baseline to end line. In addition, knowledge of HIV increased by 60% (AOR: 1.6 (1.08 to 2.47, knowledge of a place to test for HIV increased by 70% (AOR: 1.7 (1.12 to 2.51 and HIV testing increased by 80% (AOR: 1.8 (1.13 to 2.97. For males, HIV knowledge increased by 110% (AOR: 2.1 (1.1 to 3.94, knowledge of a place to test

  12. Vitamin D intake and status in immigrant and native Swedish women: a study at a primary health care centre located at 60°N in Sweden

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    Åsa Andersson

    2013-05-01

    Full Text Available Background: Immigration to Sweden from lower latitude countries has increased in recent years. Studies in the general population in other Nordic countries have demonstrated that these groups are at risk of developing vitamin D deficiency, but studies in primary health care patients are rare. Objectives: The aim of this study is to examine possible differences in plasma-25(OH-vitamin D levels and intake of vitamin D between Swedish and immigrant female patients in a primary health care centre located at 60°N, where half of the inhabitants have an immigrant background. Another objective was to estimate what foods contribute with most vitamin D. Design: Thirty-one female patients from the Middle East and Africa and 30 from Sweden were recruited. P-25(OHD was measured and intake of vitamin D was estimated with a modified food frequency questionnaire (FFQ. Results: Vitamin D deficiency (plasma-25(OHD <25 nmol/L was common among immigrant women (61%. One immigrant woman and half of the Swedish women had optimal levels (plasma-25(OHD >50 nmol/L. There was a positive correlation between the intake of vitamin D from food and plasma-25(OHD. Only three women, all Swedish, reached the recommended intake of vitamin D from food. The immigrant women had lower intake compared to Swedish women (median: 3.1 vs. 5.1 µg/day. The foods that contributed with most vitamin D were fatty fish, fortified milk and margarine. Immigrant women consumed less fortified milk and margarine but more meat. Irrespective of origin, patients with plasma-25(OHD <25 nmol/L consumed less margarine but more meat. Conclusion: Vitamin D deficiency was common in the immigrant patients and their intake of vitamin D was lower. This highlights the need to target information about vitamin D to immigrant women in order to decrease the risk for vitamin D deficiency. The FFQ was well adapted to its purpose to estimate intake of vitamin D.

  13. Community-based study of reproductive tract infections among women of the reproductive age group in the urban health training centre area in Hubli, Karnataka

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    Sangeetha S Balamurugan

    2012-01-01

    Full Text Available Background: Reproductive tract infections (RTIs is a global health problem including both sexually transmitted infections (STIs and non-sexually transmitted infections (non-STIs of the reproductive tract. RTI/STI is an important concern, as it possess risk for human immunodeficiency virus transmission. Hence a community study was done in Hubli, in terms of active search of the cases based on the symptoms, clinical examination, and feasible laboratory tests along with providing treatment, counseling, and follow-up. Objectives: The objective was to know the prevalence of RTIs among the reproductive age group women and the socio-demographic factors influencing the occurrence of the disease. Materials and Methods: A cross-sectional study was done using a simple random sampling technique to select households. A pretested structured pro forma was used to collect data on RTIs from 656 women of 15-45 years, residing in the field practice area. This was followed by clinical examination and collection of samples for laboratory tests in Urban Health Training Centre, attached to Karnataka Institute of Medical Sciences, Hubli. Results: The prevalence of RTIs among the reproductive age group women was 40.4% based on their symptoms, with majority having abnormal vaginal discharge. The prevalence of RTIs based on clinical finding was 37.4% with majority having vaginitis. The laboratory test revealed a prevalence of 34.3% with majority having Candidiasis. The influence of socio-demographic factors like increased parity, poor socio-economic conditions, poor menstrual hygiene, illiteracy has its direct effect on occurrence of RTI in the community. Conclusion: This depicts that whereever possible, clinical and laboratory findings should support self-reported morbidity to know the exact prevalence of any disease in the community.

  14. Patient-centred continuing professional development for Canadian ...

    African Journals Online (AJOL)

    Improving clinical practice skills can enhance a patient-centred model of health care. ... of patient-centred care important, and whether the perceived importance is ... than men but men rated patient communication skills higher than women.

  15. [The natural resources of the expedition bay as a basis for the creation of the health resort centre at the coast of the Peter the Great Bay, the Sea of Japan].

    Science.gov (United States)

    Vasil'chenko, V F; Badalov, N G; Derkacheva, L N

    2014-01-01

    The present article presents characteristics of the therapeutic and health promoting potential of the Expedition Bay, (part of the Peter the Great Bay, the Sea of Japan), known to be a deposit of therapeutic sea muds. The great variety of local therapeutic natural resources, viz. sea muds, sea weeds, friendly climate, beeches, etc., can be used for the treatment and prevention of various diseases. The Expedition Bay was designated as a local area of recreational and therapeutic value that can be used as a basis for the creation and further development of the multi-field health resort centre (or medical spa) that would attract patients from other regions of Russia and the surrounding countries. The future centre would provide medical services based in the first place on the classical methods of climatic and peloid therapy, thalassotherapy (heliotherapy, aeroionotherapy, bathing, marine algae therapy, etc.) as well as the modern balneotherapeutic and spa technologies, therapeutic tourism for the purpose of rehabilitation and health promotion.

  16. Person-centred reflective practice.

    Science.gov (United States)

    Devenny, Bob; Duffy, Kathleen

    Person-centred health and person-centred care have gained prominence across the UK following the publication of reports on public inquiries exploring failings in care. Self-awareness and participation in reflective practice are recognised as vital to supporting the person-centred agenda. This article presents an education framework for reflective practice, developed and used in one NHS board in Scotland, and based on the tenets of the clinical pastoral education movement. Providing an insight into the usefulness of a spiritual component in the reflective process, the framework provides an opportunity for nurses and other healthcare professionals to examine the spiritual dimensions of patient encounters, their own values and beliefs, and the effect these may have on their practice.

  17. Orientação sobre saúde bucal em um Centro de Saúde Dental health education in a public health centre

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    Roberto Augusto Castellanos

    1977-06-01

    Full Text Available Foi realizado estudo com o fim de verificar qual a orientação sobre saúde bucal dada aos clientes que pela primeira vez compareceram a um centro de saúde. Durante o período de 2 semanas foram observados 25 clientes; o método utilizado foi o da "observação participante''. Os dados necessários para o "diagnóstico educativo" foram colhidos com o auxílio de uma ficha. Da análise destes dados concluiu-se não haver uma adequada orientação com relação à saúde bucal, por parte do pessoal responsável. Sugere-se como "tratamento educativo" revisão das normas em relação à saúde da boca e desenvolvimento de um programa educativo, incidental e planejado, integrado às diferentes atividades realizadas pelo Centro. Propõe-se um conteúdo programático responsabilizando o dentista pelo adestramento do pessoal, execução e avaliação do programa. Ressalta-se a importância do centro de saúde para o desenvolvimento de programas integrados, preventivos, curativos e educativos.This paper deals with a study made with the purpose of observing dental health, education of patients coming for the first time to a Health Center. The study was carried out during two weeks and 25 patients were observed through "Participant Observation". Data for the "Educational Diagnosis" was collected in a card specially designed for it. Results showed that dental health orientation was not given by the staff to patients. An educational programme about dental health is suggested to be integrated with the activities of the various services, being the Dentist responsible for the staff programme coordination and evaluation. Finally the importance of the health center for the development of preventive, curative and educational integrated programmes is emphasized.

  18. Oral health status and treatment needs of children and young adults attending a day centre for individuals with special health care needs

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    Akindayomi Yinka

    2008-10-01

    Full Text Available Abstract Background The oral health condition of individuals with special health care needs have been reported in literature to be influenced by various sociodemographic factors, including living conditions and severity of impairment. This study was carried out to determine the oral health status and treatment needs of children and young adults attending a day institution for those with special needs. Methods This study was carried out as part of an oral health screening program organized by the institution and consent was obtained from parents and guardians before the screening. All information was supplied by the parents during the screening using a questionnaire completed by the dentist. Oral examination was carried out on all consenting subjects in attendance on the days of screening in the school clinic with parents and teachers in attendance, using standard World Health Organisation oral health indices to assess dental caries, oral hygiene status, malocclusion and other oral health parameters. Results Fifty-four subjects aged 3–26 years (mean 12.28 ± 6.82 years and comprising 72.2% males and 27.8% females participated in the study. Over 90% were from parents of high and middle level educational background. Thirty-six (66.7% were caries free, with a mean dmft score of 0.7 ± 1.77 and mean DMFT score of 0.4 ± 1.44 with no significant difference across gender (p = 0.5 and parents' educational status (p = 0.43. The mean OHI-S of the total population in this study was 1.36 ± 0.16. Females had a mean score of 0.88 ± 1.10 while males had a mean score of 1.55 ± 1.24 with no significant difference (p = 0.6. Twenty-five (46.3% had good oral hygiene, 17 (31.5% had fair oral hygiene and 12 (22.2% had poor oral hygiene, with no significant difference across gender (p = 1.11 and age groups (p = 0.07. Fifteen (27.8% had gingivitis with no significant difference across age groups (p = 0.17. Forty-five (83.3% had Angle's class I malocclusion, 6

  19. Cultural Sensitive Care Provision in a Public Child and Adolescent Mental Health Centre: A Case Study from the Toulouse University Hospital Intercultural Consultation.

    Science.gov (United States)

    Sturm, Gesine; Bonnet, Sylvie; Coussot, Yolaine; Journot, Katja; Raynaud, Jean-Philippe

    2017-05-02

    Child and adolescent mental health services in Europe are confronted with children with increasingly diverse socio-cultural backgrounds. Clinicians encounter cultural environments of hyperdiversity in terms of languages and countries of origin, growing diversity within groups, and accelerated change with regards to social and administrational situations (Hannah, in: DelVecchio Good et al. (eds) Shattering culture: American medicine responds to cultural diversity, Russel Sage Foundation, New York, 2011). Children and families who live in these complex constellations face multiple vulnerabilizing factors related to overlapping or intersecting social identities (Crenshaw in Univ Chic Leg Forum 140:139-167, 1989). Mobilizing existing resources in terms of social and family support, and encouraging creative strategies of interculturation in therapeutic work (Denoux, in: Blomart and Krewer (eds) Perspectives de l'interculturel, L'Harmattan, Paris, 1994) may be helpful in order to enhance resilience. Drawing from experiences in the context of French transcultural and intercultural psychiatry, and inspired by the Mc Gill Cultural Consultation in Child Psychiatry, we developed an innovative model, the Intercultural Consultation Service (ICS). This consultation proposes short term interventions to children and families with complex migration experiences. It has been implemented into a local public health care structure in Toulouse, the Medical and Psychological Centre la Grave. The innovation includes the creation of a specific setting for short term therapeutic interventions and team training via shared case discussions. Our objectives are (a) to improve outcomes of mental health care for the children through a better understanding of the child's family context (exploration of family dynamics and their relatedness to complex migration histories), (b) to enhance intercultural competencies in professionals via shared case discussions, and, (c) to improve the therapeutic

  20. Diagnostic reliability of an immunochromatographic test for Chagas disease screening at a primary health care centre in a rural endemic area

    Directory of Open Access Journals (Sweden)

    Diego Mendicino

    2014-12-01

    Full Text Available Many patients with Chagas disease live in remote communities that lack both equipment and trained personnel to perform a diagnosis by conventional serology (CS. Thus, reliable tests suitable for use under difficult conditions are required. In this study, we evaluated the ability of personnel with and without laboratory skills to perform immunochromatographic (IC tests to detect Chagas disease at a primary health care centre (PHCC. We examined whole blood samples from 241 patients and serum samples from 238 patients. Then, we calculated the percentage of overall agreement (POA between the two groups of operators for the sensitivity (S, specificity (Sp and positive (PPV and negative (NPV predictive values of IC tests compared to CS tests. We also evaluated the level of agreement between ELISAs and indirect haemagglutination (IHA tests. The readings of the IC test results showed 100% agreement (POA = 1. The IC test on whole blood showed the following values: S = 87.3%; Sp = 98.8%; PPV = 96.9% and NPV = 95.9%. Additionally, the IC test on serum displayed the following results: S = 95.7%; Sp = 100%; PPV = 100% and NPV = 98.2%. Using whole blood, the agreement with ELISA was 96.3% and the agreement with IHA was 94.1%. Using serum, the agreement with ELISA was 97.8% and the agreement with IHA was 96.6%. The IC test performance with serum samples was excellent and demonstrated its usefulness in a PHCC with minimal equipment. If the IC test S value and NPV with whole blood are improved, then this test could also be used in areas lacking laboratories or specialised personnel.

  1. Primary care clinicians’ experiences prescribing HIV pre-exposure prophylaxis at a specialized community health centre in Boston: lessons from early adopters

    Directory of Open Access Journals (Sweden)

    Douglas S Krakower

    2016-10-01

    Full Text Available Introduction: An estimated 1.2 million Americans have indications for using antiretroviral pre-exposure prophylaxis (PrEP to prevent HIV acquisition. For many of these at-risk individuals, the best opportunity to learn about and receive PrEP will be during routine visits to their generalist primary care clinicians. However, few generalist clinicians have prescribed PrEP, primarily because of practical concerns about providing PrEP in primary care settings. The experiences of specialized primary care clinicians who have prescribed PrEP can inform the feasibility of PrEP provision by generalists. Methods: During January to February 2015, 35 primary care clinicians at a community health centre in Boston that specializes in the care of sexual and gender minorities completed anonymous surveys about their experiences and practices with PrEP provision. Responses were analyzed with descriptive statistics. Results and discussion: Thirty-two clinicians (response rate=91% completed the surveys. Nearly all clinicians (97% had prescribed PrEP (median 20 patients, interquartile range 11–33. Most clinicians reported testing and risk-reduction counselling practices concordant with U.S. Centers for Disease Control and Prevention guidelines for PrEP. Clinicians indicated that patients using PrEP experienced medication toxicities infrequently and generally reported high adherence. However, some clinicians’ practices differed from guideline recommendations, and some clinicians observed patients with increased risk behaviours. Most clinicians (79% rated PrEP provision as easy to accomplish, and 97% considered themselves likely to prescribe PrEP in the future. Conclusions: In a primary care clinic with specialized expertise in HIV prevention, clinicians perceived that PrEP provision to large numbers of patients was safe, feasible and potentially effective. Efforts to engage generalist primary care clinicians in PrEP provision could facilitate scale-up of this

  2. Mentoring perception, scientific collaboration and research performance: is there a 'gender gap' in academic medicine? An Academic Health Science Centre perspective.

    Science.gov (United States)

    Athanasiou, Thanos; Patel, Vanash; Garas, George; Ashrafian, Hutan; Hull, Louise; Sevdalis, Nick; Harding, Sian; Darzi, Ara; Paroutis, Sotirios

    2016-10-01

    The 'gender gap' in academic medicine remains significant and predominantly favours males. This study investigates gender disparities in research performance in an Academic Health Science Centre, while considering factors such as mentoring and scientific collaboration. Professorial registry-based electronic survey (n=215) using bibliometric data, a mentoring perception survey and social network analysis. Survey outcomes were aggregated with measures of research performance (publications, citations and h-index) and measures of scientific collaboration (authorship position, centrality and social capital). Univariate and multivariate regression models were constructed to evaluate inter-relationships and identify gender differences. One hundred and four professors responded (48% response rate). Males had a significantly higher number of previous publications than females (mean 131.07 (111.13) vs 79.60 (66.52), p=0.049). The distribution of mentoring survey scores between males and females was similar for the quality and frequency of shared core, mentor-specific and mentee-specific skills. In multivariate analysis including gender as a variable, the quality of managing the relationship, frequency of providing corrective feedback and frequency of building trust had a statistically significant positive influence on number of publications (all pscientific collaboration and research performance in the context of gender. It presents a series of initiatives that proved effective in marginalising the gender gap. These include the Athena Scientific Women's Academic Network charter, new recruitment and advertisement strategies, setting up a 'Research and Family Life' forum, establishing mentoring circles for women and projecting female role models. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  3. A prospective observational study to assess quality of life and prescription pattern in osteoarthritis patients at tertiary health centre in Mumbai.

    Science.gov (United States)

    Jadhav, Manoj P; Jadhav, Priyanka M; Mutke, Amol P; Sonawane, Supriya D; Patil, Bhushan D; Naik, Narendra B; Sonawale, Archana S

    2011-02-01

    Osteoarthritis (OA) is a major cause of disability and is focused in "Bone and Joint Decade" declared by WHO which substantially affect different dimensions of quality of life. The aim of present study was to find the disease pattern in OA patients, monitoring prescription pattern to assess prognosis of osteoarthritis by WOMAC index. An observational study on prospective data collected for the evaluation of Quality of Life (QOL) in OA was conducted at tertiary health care centre in Mumbai. Patients with a diagnosis of OA were enrolled. The patient's history and clinical examination was based on classification criteria of the American College of Rheumatology; drugs prescribed were noted on case record form. Same procedure was carried out for the first and second follow-ups at 6 th and 12 th weeks respectively. The patients belong to primary OA (84%) as compared to secondary OA (16%). Females (70.56% and 10%) were affected more commonly than males (13.44% and 6%). Knee Joint was worst affected in 76%, followed by hip joint in 16% and shoulder, ankle, wrist, elbow joint each having 2% (n=1) involvement. NSAIDs continued to dominate prescriptions given to 84% of patients followed by antiarthritic drugs and calcium supplements in 54% cases. The WOMAC score was higher in most of patients. After medication hydroxy chloroquine sulfate has shown maximum reduction in average WOMAC sore followed by paracetamol, indomethacin and diclofenac sodium. Osteoarthritis has a significant impact on quality of life, only partly ameliorated by anti-arthritic drugs, as assessed by the WOMAC scale in this study population. Further, a study with larger sample size is needed to further support our findings.

  4. Addiction research centres and the nurturing of creativity
department of addictive behaviour and addiction medicine, central institute of Mental Health, Mannheim, University of Heidelberg.

    Science.gov (United States)

    Mann, Karl

    2010-12-01

    Addictive behaviour is as prevalent in Germany as in other western countries, but in contrast to some European countries and the United States, very little money was given to this research field. Change came in the early 1990s, when the German government started to launch specific grants for addiction research. The first chair in addiction research was created in 1999 (Karl Mann) at the Central Institute of Mental Health Mannheim (CIMH; University of Heidelberg). The recruitment of a pre-clinical alcohol researcher as head of the department of psychopharmacology followed (Rainer Spanagel). This 'addiction research cluster' collaborates with several research groups at the CIMH (such as genetics). We inaugurated a clinical trial network which now comprises up to 20 treatment centres throughout Germany. Like most authors, we found effect sizes of different treatment modalities more in the low to moderate range, perhaps because of the heterogeneity of large patient samples. Therefore, we concentrated upon the biological basis of addiction in order to define more homogeneous 'subtypes' of patients for a better match with existing treatments. Results concerning genetics and neuroimaging (both animal and human) are promising, and could move our field towards a more personalized treatment approach. Our funding has been extended over the years, including involvement in several large European grants. We are studying substance-related problems as well as so-called 'behavioural addictions'. As a natural consequence of this development, we are deeply involved both in informing the general public on addiction issues as well as in counselling policy makers in Germany. © 2010 The Author, Addiction © 2010 Society for the Study of Addiction.

  5. Primary care clinicians’ experiences prescribing HIV pre-exposure prophylaxis at a specialized community health centre in Boston: lessons from early adopters

    Science.gov (United States)

    Krakower, Douglas S; Maloney, Kevin M; Grasso, Chris; Melbourne, Katherine; Mayer, Kenneth H

    2016-01-01

    Introduction An estimated 1.2 million Americans have indications for using antiretroviral pre-exposure prophylaxis (PrEP) to prevent HIV acquisition. For many of these at-risk individuals, the best opportunity to learn about and receive PrEP will be during routine visits to their generalist primary care clinicians. However, few generalist clinicians have prescribed PrEP, primarily because of practical concerns about providing PrEP in primary care settings. The experiences of specialized primary care clinicians who have prescribed PrEP can inform the feasibility of PrEP provision by generalists. Methods During January to February 2015, 35 primary care clinicians at a community health centre in Boston that specializes in the care of sexual and gender minorities completed anonymous surveys about their experiences and practices with PrEP provision. Responses were analyzed with descriptive statistics. Results and discussion Thirty-two clinicians (response rate=91%) completed the surveys. Nearly all clinicians (97%) had prescribed PrEP (median 20 patients, interquartile range 11–33). Most clinicians reported testing and risk-reduction counselling practices concordant with U.S. Centers for Disease Control and Prevention guidelines for PrEP. Clinicians indicated that patients using PrEP experienced medication toxicities infrequently and generally reported high adherence. However, some clinicians’ practices differed from guideline recommendations, and some clinicians observed patients with increased risk behaviours. Most clinicians (79%) rated PrEP provision as easy to accomplish, and 97% considered themselves likely to prescribe PrEP in the future. Conclusions In a primary care clinic with specialized expertise in HIV prevention, clinicians perceived that PrEP provision to large numbers of patients was safe, feasible and potentially effective. Efforts to engage generalist primary care clinicians in PrEP provision could facilitate scale-up of this efficacious

  6. CMS Centre at CERN

    CERN Multimedia

    2007-01-01

    A new "CMS Centre" is being established on the CERN Meyrin site by the CMS collaboration. It will be a focal point for communications, where physicists will work together on data quality monitoring, detector calibration, offline analysis of physics events, and CMS computing operations. Construction of the CMS Centre begins in the historic Proton Synchrotron (PS) control room. The historic Proton Synchrotron (PS) control room, Opened by Niels Bohr in 1960, will be reused by CMS to built its control centre. TThe LHC@FNAL Centre, in operation at Fermilab in the US, will work very closely with the CMS Centre, as well as the CERN Control Centre. (Photo Fermilab)The historic Proton Synchrotron (PS) control room is about to start a new life. Opened by Niels Bohr in 1960, the room will be reused by CMS to built its control centre. When finished, it will resemble the CERN Contro...

  7. [Sanitation of the health service centre in Warsaw (Samodzielny Zespół Publicznych Zakładów Lecznictwa Otwartego Warszawa-Mokotów). Financial and economic analysis].

    Science.gov (United States)

    Buczak-Stec, Elzbieta

    2010-01-01

    The aim of the financial and economic analysis, conducted in March 2010, was to identify all significant factors that had a positive influence on the restructuring process in the health service centre (Samodzielny Zespół Publicznych Zakładów Lecznictwa Otwartego Warszawa--Mokotów) in Warsaw. Within the framework of the analysis, financial data form time period 1999-2009 were analyzed. Also the managing director and financial director were interviewed. Taking into consideration research results it can be stated that not a single factor but a collection of the purposeful efforts influenced the improvement of the health service centre condition. Apart from received public help, the most significant factors include: rational restructuring process, managing of personnel development, professionally managed financial department, cooperation between departments, good internal communication and use of modern management techniques.

  8. The Quality of Healthcare Service Delivery in Nigeria: An Assessment of the Availability of Some Basic Medical Devices/Equipment in the Primary Health Care Centres in Delta State

    Directory of Open Access Journals (Sweden)

    Omuta GED

    2016-05-01

    Full Text Available Background: Ordinarily, accessibility implies locational proximity. However, this study limits its use to the quality of what is accessed. There is, therefore, service-delivery inaccessibility, when health care seekers can only access poor quality service, because of the poor quality of the equipment at the disposal of primary health care centres. Service-delivery equipment are, therefore, surrogate indicators of the quality of the health care services that are geographically accessible. Methodology: Both qualitative and quantitative approaches of investigation were deployed, using structured questionnaires and focus group discussions/key informant interviews, respectively. It covered nine local government areas, three each from the senatorial districts. The paper discusses three basic medical devices/equipment that determine the quality of services delivered by PHCs, namely available and functioning general purpose equipment; most commonly used methods of sterilization; and availability of different types of laboratory tests. The quantitative data were cleaned up, processed and analysed, using the SPSS 10.0. Results: There were variations in the availability of devices and equipment. Syringes/needles and stethoscopes were available in more than three-quarters of the centres, while less than ten (10 per cent had microscopes. About 15 per cent of the centres either had no methods of sterilization at all or used ‘inappropriate’ ones. In spite of the prevalence of malaria, only 28.89 per centres could test for the parasite. Conclusion: The quality of services were perceived as poor because the basic medical devices and equipment were either lacking or inadequate. Policy implication is that government should increase resource allocation to the PHC subsector to procure the basic facilities for efficient service delivery.

  9. The use of ayurvedic medicine in the context of health promotion--a mixed methods case study of an ayurvedic centre in Sweden.

    Science.gov (United States)

    Niemi, Maria; Ståhle, Göran

    2016-02-17

    Ayurveda has its historical roots in India, but has also been internationalised, partly via migration and partly through an increased interest in alternative medicine in the West, where studies point toward increased use. However, there is to date scarce knowledge about the use and experiences of ayurveda in Sweden. We have conducted a case study of a center for ayurvedic healthcare in Sweden. We have collected information on client background data from the center's documentation, and compiled data from all clients who visited the centre for ayurvedic consultation during spring 2014. In total, 55 individuals were included in the study, and 18 of them were chosen for individual semi-structured interviews, to gain a deeper understanding of their motives for seeking, and experiences of ayurvedic health care. The material was analysed and compiled through a mix of qualitative and quantitative methods. Among the 55 clients, 91% were female the mean age was 47 years, and 64% gave a specific illness as a reason for seeking ayurveda. The most common illnesses were respiratory, musculoskeletal, circulatory, tumor, and cutaneous illnesses. The qualitative results showed that ayurveda was being used in combination with other methods, including various diets, other alternative medicine methods and conventional medicine. Some participants recounted having sought ayurveda as a complement to conventional medicine, or in cases when conventional medicine had been experienced as insufficient in terms of diagnosis or treatment. However, some participants experienced it as difficult to follow the ayurvedic life-style advice in the midst of their everyday life. Many participants reported positive experiences of pulse diagnostics, which was the main diagnostic method used in ayurvedic consultation. Some reported concrete, physical improvement of their symptoms. This study points towards important aspects of participant experience of ayurveda, that may be subject to further research. The

  10. Client Centred Desing

    DEFF Research Database (Denmark)

    Ørngreen, Rikke; Nielsen, Janni; Levinsen, Karin

    2008-01-01

    In this paper we argue for the use of Client Centred preparation phases when designing complex systems. Through Client Centred Design human computer interaction can extend the focus on end-users to alse encompass the client's needs, context and resources....

  11. Effectiveness of Onsite Nurse Mentoring in Improving Quality of Institutional Births in the Primary Health Centres of High Priority Districts of Karnataka, South India: A Cluster Randomized Trial

    Science.gov (United States)

    Bradley, Janet; Mony, Prem; Cunningham, Troy; Washington, Maryann; Bhat, Swarnarekha; Rao, Suman; Thomas, Annamma; S, Rajaram; Kar, Arin; N, Swaroop; B M, Ramesh; H L, Mohan; Fischer, Elizabeth; Crockett, Maryanne; Blanchard, James; Moses, Stephen; Avery, Lisa

    2016-01-01

    Background In India, although the proportion of institutional births is increasing, there are concerns regarding quality of care. We assessed the effectiveness of a nurse-led onsite mentoring program in improving quality of care of institutional births in 24/7 primary health centres (PHCs that are open 24 hours a day, 7 days a week) of two high priority districts in Karnataka state, South India. Primary outcomes were improved facility readiness and provider preparedness in managing institutional births and associated complications during child birth. Methods All functional 24/7 PHCs in the two districts were included in the study. We used a parallel, cluster randomized trial design in which 54 of 108 facilities received six onsite mentoring visits, along with an initial training update and specially designed case sheets for providers; the control arm received just the initial training update and the case sheets. Pre- and post-intervention surveys were administered in April-2012 and August-2013 using facility audits, provider interviews and case sheet audits. The provider interviews were administered to all staff nurses available at the PHCs and audits were done of all the filled case sheets during the month prior to data collection. In addition, a cost analysis of the intervention was undertaken. Results Between the surveys, we achieved coverage of 100% of facilities and 91.2% of staff nurse interviews. Since the case sheets were newly designed, case-sheet audit data were available only from the end line survey for about 80.2% of all women in the intervention facilities and 57.3% in the control facilities. A higher number of facilities in the intervention arm had all appropriate drugs, equipment and supplies to deal with gestational hypertension (19 vs.3, OR (odds ratio) 9.2, 95% C.I 2.5 to33.6), postpartum haemorrhage (29 vs. 12, OR 3.7, 95% C.I 1.6 to8.3); and obstructed labour (25 vs.9, OR 3.4, 95% CI 1.6 to8.3). The providers in the intervention arm had better

  12. Virtual particle therapy centre

    CERN Multimedia

    2015-01-01

    Particle therapy is an advanced technique of cancer radiation therapy, using protons or other ions to target the cancerous mass. This advanced technique requires a multi-disciplinary team working in a specialised centre. 3D animation: Nymus3D

  13. The IGU Knowledge Centre

    NARCIS (Netherlands)

    Huizing, Bernardus

    2005-01-01

    This article describes an innovative service for members of the International Gas Union - IGU. The IGU Knowledge Centre provides members with relevant information and data. In this article is described why, how and where.

  14. CENTRE FOR GEOMETRICAL METROLOGY

    DEFF Research Database (Denmark)

    De Chiffre, Leonardo

    The objective of this Annual Report is to give a general introduction to CGM as well as to give an account of the tasks carried out using the facilities of CGM's Instrument Centre during 1998 and 1999....

  15. Counselling in STD/HIV/AIDS in the context of rapid test: Perception of users and health professionals at a counselling and testing centre in Porto Alegre.

    Science.gov (United States)

    Carvalho, Fernanda T; Both, Nalu S; Alnoch, Edi M; Conz, Jaqueline; Rocha, Katia B

    2016-03-01

    This article discusses the perceptions of professionals and users about counselling practices at a counselling and testing centre in Porto Alegre/RS based on interviews with 27 service users and 14 members of the staff. The following categories emerged from thematic analysis: professionals' perceptions on counselling, users' perceptions on counselling and changes in counselling due to the introduction of rapid test procedures. The results show that, although initially there were some imprecision and apparent contradictions in its use, rapid testing was considered an invitation to rethink practices, bringing service closer to users' needs.

  16. Training health visitors in cognitive behavioural and person-centred approaches for depression in postnatal women as part of a cluster randomised trial and economic evaluation in primary care: the PoNDER trial.

    Science.gov (United States)

    Morrell, C Jane; Ricketts, Tom; Tudor, Keith; Williams, Chris; Curran, Joe; Barkham, Michael

    2011-01-01

    This paper aims to describe the training preparation for health visitors who took part in the intervention arm of a cluster randomised controlled trial and economic evaluation of training for health visitors - the POstNatal Depression Economic evaluation and Randomised (the PoNDER) trial. A secondary aim is to make available, by electronic links, the training manuals developed for and used for the cognitive behavioural approach (CBA) and the person-centred approach (PCA) training for the health visitors. The paper is of relevance to health visitors, general practitioners, nurse practitioners, midwives, clinical psychologists, mental health nurses, community psychiatric nurses, counsellors, and service commissioners. The trial clinical outcomes have been published, indicating the pragmatic effectiveness of the package of training for health visitors to identify depressive symptoms and provide a psychologically informed intervention. The training was associated with a reduction in depressive symptoms at six months postnatally among intervention group women and some evidence of a benefit for the intervention group for some of the secondary outcomes at 18 months follow-up. The two experimental interventions examined in the PoNDER trial built upon promising work on the potential for psychological interventions to help women recover from postnatal depression as an alternative to pharmaceutical interventions and to address the limitations of previous research in the area. The package of health visitor training comprised the development of clinical skills in assessing postnatal women and identifying depressive symptoms, and the delivery of a CBA or a PCA for eligible women. This was the largest trial a health visitor intervention and of postnatal depression ever conducted. We are aware of no other rigorously performed trial that has published details of an extensively tested training programme for the benefit of health-care professionals and clients.

  17. A qualitative study of the role of workplace and interpersonal trust in shaping service quality and responsiveness in Zambian primary health centres

    OpenAIRE

    Topp, Stephanie M; Chipukuma, Julien M.

    2015-01-01

    Background: Human decisions, actions and relationships that invoke trust are at the core of functional and productive health systems. Although widely studied in high-income settings, comparatively few studies have explored the influence of trust on health system performance in low- and middle-income countries. This study examines how workplace and inter-personal trust impact service quality and responsiveness in primary health services in Zambia. Methods: This multi-case study included four h...

  18. Academic Drug Discovery Centres

    DEFF Research Database (Denmark)

    Kirkegaard, Henriette Schultz; Valentin, Finn

    2014-01-01

    Academic drug discovery centres (ADDCs) are seen as one of the solutions to fill the innovation gap in early drug discovery, which has proven challenging for previous organisational models. Prior studies of ADDCs have identified the need to analyse them from the angle of their economic...... their performance....

  19. CENTRE IN NIGERIA.

    African Journals Online (AJOL)

    PATTERN OF NEURO-OPHTHALMIC DISORDERS IN A TERTIARY EYE. CENTRE IN NIGERIA. A E Omoti , M J M ... movement or light was determined. The external ... assessed by color desaturation tests and visual field assessment by the ...

  20. Implementing Responsibility Centre Budgeting

    Science.gov (United States)

    Vonasek, Joseph

    2011-01-01

    Recently, institutes of higher education (universities) have shown a renewed interest in organisational structures and operating methodologies that generate productivity and innovation; responsibility centre budgeting (RCB) is one such process. This paper describes the underlying principles constituting RCB, its origin and structural elements, and…

  1. The GSO Data Centre

    CERN Document Server

    Paletou, F; Génot, V; Rouillard, A; Petit, P; Palacios, A; Caux, E; Wakelam, V

    2015-01-01

    Hereafter we describe the activities of the $Grand \\, Sud-Ouest$ Data Centre operated for INSU/CNRS by the OMP-IRAP and the Universit\\'e Paul Sabatier (Toulouse), in a collaboration with the OASU-LAB (Bordeaux) and OREME-LUPM (Montpellier).

  2. Implementing Responsibility Centre Budgeting

    Science.gov (United States)

    Vonasek, Joseph

    2011-01-01

    Recently, institutes of higher education (universities) have shown a renewed interest in organisational structures and operating methodologies that generate productivity and innovation; responsibility centre budgeting (RCB) is one such process. This paper describes the underlying principles constituting RCB, its origin and structural elements, and…

  3. ATLAS Visitors Centre

    CERN Multimedia

    claudia Marcelloni

    2009-01-01

    ATLAS Visitors Centre has opened its shiny new doors to the public. Officially launched on Monday February 23rd, 2009, the permanent exhibition at Point 1 was conceived as a tour resource for ATLAS guides, and as a way to preserve the public’s opportunity to get a close-up look at the experiment in action when the cavern is sealed.

  4. Youth Research Centre Annual Report, 2002.

    Science.gov (United States)

    Melbourne Univ. (Australia). Youth Research Centre.

    This report details the activities of the Youth Research Centre (YRC) at the University of Melbourne in 2002 in research project work involving a balance between the completion of projects, the development of new areas, and the continuation of longer-term projects as well as the supervision and teaching of a range of postgraduate health and…

  5. Application of PDCA circulation method in quality control at health examination centre%PDCA循环法在体检中心质量控制中的应用

    Institute of Scientific and Technical Information of China (English)

    陈庆瑜; 陈锦武; 甘小玲; 廖蓓

    2014-01-01

    目的 探讨如何做好体检中心质量控制工作,促进健康体检规范化建设和学科管理水平的全面提升.方法 将PDCA循环法运用于健康体检的各个环节,在组织计划、执行实施、检查监控和信息反馈处理的全过程进行体检质量的全面控制管理.结果 客户满意度呈现上升趋势,学科管理水平和综合效益进一步提升.结论 PDCA循环法对体检质量的持续改进和学科管理水平的不断提高具有重要意义.%Objective To investigate how to carry out quality control at health examination centre,in order to promote the standardization of health examination and management level.Method PDCA circulation method was applied in every link of health examination to control the quality with plan,do,check and action.Result Customers' satisfaction degree rose.The management level and comprehensive effectiveness promoted.Conclusion PDCA circulation method is important for continuous improvement of the quality of health examination and the promotion of management level.

  6. Predictors of Self-Care Behaviors among Diabetic Patients Referred to Yazd Diabetes Research Centre Based on Extended Health Belief Model

    OpenAIRE

    MH Baghianimoghadam; N Rouhani Tonekaboni; MA Morowati -Sharifabad

    2007-01-01

    Introduction: Diabetes is the most common disease related to metabolism disorders with long term complications. It needs lifelong specific self-care, as it causes a promotion in quality of life and decreases disease costs. The Health Belief Model (HBM) is a psychological model that attempts to explain and predict health behaviors. This is done by focusing on the attitudes and beliefs of individuals. The model has been used for studying diabetes self care behaviors. The aim of this study was d...

  7. Evidence-informed person-centred health care (part II): are 'cognitive biases plus' underlying the EBM paradigm responsible for undermining the quality of evidence?

    Science.gov (United States)

    Seshia, Shashi S; Makhinson, Michael; Young, G Bryan

    2014-12-01

    Recently, some leaders of the evidence-based medicine (EBM) movement drew attention to the "unintended" negative consequences associated with EBM. The term 'cognitive biases plus' was introduced in part I to encompass cognitive biases, conflicts of interests, fallacies and certain behaviours. 'Cognitive biases plus' in those closely involved in creating and promoting the EBM paradigm are responsible for their (1) inability to anticipate and then recognize flaws in the tenets of EBM; (2) discounting alternative views; and (3) delaying reform. A narrative review style was used, with methods as in part I. Over the past two decades there has been mounting qualitative and quantitative methodological evidence to suggest that the faith placed in (1) the EBM hierarchy with randomized controlled trials and systematic reviews at the summit; (2) the reliability of biostatistical methods to quantitate data; and (3) the primacy of sources of pre-appraised evidence, is seriously misplaced. Consequently, the evidence that informs person-centred care is compromised. Arguments focusing on 'cognitive biases plus' are offered to support our hypothesis. To the best of our knowledge, EBM proponents have not provided an explanation. Reform is urgently needed to minimize continuing risks to patients. If our hypothesis is correct, then in addition to the suggestions made in part I, deficiencies in the paradigm must be corrected. Meaningful solutions are only possible if the biases of scientific inbreeding and groupthink are minimized by collaboration between EBM leaders and those who have been sounding warning bells. © 2014 John Wiley & Sons, Ltd.

  8. Town Centre Redevelopment Strategies

    DEFF Research Database (Denmark)

    Vagnby, Bo Hellisen

    as slum clearence and urban renewal. To a certain extent parallels are drawn to international experiences, especially where these are of such a nature that they can be assumed transferred to Danish connctions. Conclusively, the strategies are discussed in the light of the turn of Danish urban planning...... urban planning and design strategieswhich have been practised in most of the larger Danish towns: pedestrian streets, shopping centres, preservation of historic features, waterfronts, concentration of offices, conference and sports facilities, improvement og traffic and transport conditions as well...... during late years, where increased internationalisation is in focus and where it seems as if the social dimension of the town centre planning is slipping out of the hands of the urban planners....

  9. Elderly Care Centre

    Science.gov (United States)

    Wagiman, Aliani; Haja Bava Mohidin, Hazrina; Ismail, Alice Sabrina

    2016-02-01

    The demand for elderly centre has increased tremendously abreast with the world demographic change as the number of senior citizens rose in the 21st century. This has become one of the most crucial problems of today's era. As the world progress into modernity, more and more people are occupied with daily work causing the senior citizens to lose the care that they actually need. This paper seeks to elucidate the best possible design of an elderly care centre with new approach in order to provide the best service for them by analysing their needs and suitable activities that could elevate their quality of life. All these findings will then be incorporated into design solutions so as to enhance the living environment for the elderly especially in Malaysian context.

  10. Call centres: constructing flexibility

    OpenAIRE

    Arzbächer, Sandra; Holtgrewe, Ursula; Kerst, Christian

    2002-01-01

    "The development of call centres as a flexible interface between firms and their environments has been seen as exemplary or even symptomatic of flexible capitalism (Sennett 1998). We are going to point out that they do not just stand for organisational change but also for changes of institutions towards deregulation. Employers and managers hoped for gains of flexibility, decreasing labour costs, and market gains by an expanded 24-hour-service. Surveillance and control by flexib...

  11. Historical centres: changing definitions

    Directory of Open Access Journals (Sweden)

    Roberta Lazzarotti

    2014-02-01

    Full Text Available Since the end of the Second World War, the architectural and planning culture has been showing a fluctuating attention to the theme of historical centres and their enhancement. First of all this uneven progress explains the difficulty to reach a homogeneous definition and this is still lacking. During a long phase of this period, the historical parts of the town were considered as objects to be preserved in an integral way, as urban monuments. This is mostly due to the high symbolic value of these settlements, that represent fundamental landmarks. Identity building and empowerment of local communities are indispensable conditions for any development programme, especially in the case of centres or other historic environments at risk of abandonment. The progressive evolution of this concept brings awareness of the impossibility of separating – either in analytical or in planning terms ­ historical centres from their urban and territorial contexts, which are linked by mutual, deep relationships. This article attempts to retrace the steps signaled by the publication of international documents and conventions, from the Charter of Gubbio (1960 to the Charter of Krakow and the European Landscape Convention (2000; they obviously represent particular points of view, not exhaustive of the richness of the positions in the debate, but extremely significant in terms of diffusion and consensus.

  12. The geo-spatial information infrastructure at the Centre for Control and Prevention of Zoonoses, University of Ibadan, Nigeria: an emerging sustainable One-Health pavilion.

    Science.gov (United States)

    Olugasa, B O

    2014-12-01

    The World-Wide-Web as a contemporary means of information sharing offers a platform for geo-spatial information dissemination to improve education about spatio-temporal patterns of disease spread at the human-animal-environment interface in developing countries of West Africa. In assessing the quality of exposure to geospatial information applications among students in five purposively selected institutions in West Africa, this study reviewed course contents and postgraduate programmes in zoonoses surveillance. Geospatial information content and associated practical exercises in zoonoses surveillance were scored.. Seven criteria were used to categorize and score capability, namely, spatial data capture; thematic map design and interpretation; spatio-temporal analysis; remote sensing of data; statistical modelling; the management of spatial data-profile; and web-based map sharing operation within an organization. These criteria were used to compute weighted exposure during training at the institutions. A categorical description of institution with highest-scoring of computed Cumulative Exposure Point Average (CEPA) was based on an illustration with retrospective records of rabies cases, using data from humans, animals and the environment, that were sourced from Grand Bassa County, Liberia to create and share maps and information with faculty, staff, students and the neighbourhood about animal bite injury surveillance and spatial distribution of rabies-like illness. Uniformly low CEPA values (0-1.3) were observed across academic departments. The highest (3.8) was observed at the Centre for Control and Prevention of Zoonoses (CCPZ), University of Ibadan, Nigeria, where geospatial techniques were systematically taught, and thematic and predictive maps were produced and shared online with other institutions in West Africa. In addition, a short course in zoonosis surveillance, which offers inclusive learning in geospatial applications, is taught at CCPZ. The paper

  13. [A mental health awareness anti-stigma program including user-trainers has a significant impact on knowledge, beliefs and attitudes of job centre professionals in Paris].

    Science.gov (United States)

    Jouet, E; Moineville, M; Favriel, S; Leriche, P; Greacen, T

    2014-04-01

    Developing programs and actions to fight stigma and discrimination against people living with mental disorders is a priority both internationally and in France. Involving mental health service users in these anti-stigma programs has proved to be a key element for effective programs. The present study evaluates the impact of user-trainers in an anti-stigma campaign with job counselors on their knowledge, beliefs, and desire for social distance with regard to mental illness and the mentally ill. Eighty-nine professionals participated in eight mental health awareness days from December 2008 to June 2009. Each training day was built around two pedagogical units: firstly, a psychiatrist providing a theoretical overview of mental illness and care and secondly, user-trainers describing their point of view on mental illness and exchanging with participants. A questionnaire administered at the beginning and at the end of the mental health awareness day assessed the impact of the day on participants' knowledge, beliefs, and desire for social distance. Answers to open questions were evaluated using thematic qualitative analysis. The intervention had statistically significant positive effects on all three training objectives: knowledge, beliefs and desire for social distance. Analysis of qualitative data confirmed participants' need for information and training with regard to providing support to clients with mental health problems; participants frequently attributed their improved self-confidence at the end of the day with regard to providing job coaching for this population group to the presence of user-trainers. A mental health awareness day using mental health service users and psychiatrists as trainers had significant positive effects in terms of reducing stigma with regard to people with mental illness. Further research is needed to understand whether the impact of such awareness approaches can be maintained in everyday professional practice over time. Copyright © 2013

  14. Use of Interferon-Gamma Release Assays in a Health Care Worker Screening Program: Experience from a Tertiary Care Centre in the United States

    OpenAIRE

    2012-01-01

    BACKGROUND: Interferon-gamma release assays including the QuantiFERON-TB Gold In-Tube test (QFT-GIT [Cellestis Ltd, Australia]) may be used in place of the tuberculin skin test (TST) in surveillance programs for Mycobacterium tuberculosis infection control. However, data on performance and practicality of the QFT-GIT in such programs for health care workers (HCWs) are limited.OBJECTIVES: To assess the performance, practicality and reversion rate of the QFT-GIT among HCWs at a tertiary health ...

  15. Tele-centres in Ghana

    DEFF Research Database (Denmark)

    Falch, Morten

    2004-01-01

    Tele-centres offer a low cost opportunity for the many who cannot afford their own phone or Internet connection. This paper presents a field study of tele-centres in Ghana and analyses how they contribute to universal access.......Tele-centres offer a low cost opportunity for the many who cannot afford their own phone or Internet connection. This paper presents a field study of tele-centres in Ghana and analyses how they contribute to universal access....

  16. Level of distress, somatisation and beliefs on health-disease in newly arrived immigrant patients attended in primary care centres in Catalonia and definition of professional competences for their most effective management: PROMISE Project.

    Science.gov (United States)

    Torán-Monserrat, Pere; Cebrià-Andreu, Jordi; Arnau-Figueras, Josep; Segura-Bernal, Jordi; Ibars-Verdaguer, Anna; Massons-Cirera, Josep; Barreiro-Montaña, M Carmen; Santamaria-Bayes, Sandra; Limón-Ramírez, Esther; Montero-Alia, Juan José; Pérez-Testor, Carles; Pera-Blanco, Guillem; Muñoz-Ortiz, Laura; Palma-Sevillano, Carolina; Segarra-Gutiérrez, Gerard; Corbella-Santomà, Sergi

    2013-05-04

    Newly arrived immigrant patients who frequently use primary health care resources have difficulties in verbal communication. Also, they have a system of beliefs related to health and disease that makes difficult for health care professionals to comprehend their reasons for consultation, especially when consulting for somatic manifestations. Consequently, this is an important barrier to achieve optimum care to these groups. The current project has two main objectives: 1. To define the different stressors, the level of distress perceived, and its impact in terms of discomfort and somatisation affecting the main communities of immigrants in our area, and 2. To identify the characteristics of cross-cultural competence of primary health care professionals to best approach these reasons for consultation. It will be a transversal, observational, multicentre, qualitative-quantitative study in a sample of 980 people from the five main non-European Union immigrant communities residing in Catalonia: Maghrebis, Sub-Saharans, Andean South Americans, Hindustanis, and Chinese. Sociodemographic data, level of distress, information on the different stressors and their somatic manifestations will be collected in specific questionnaires. Through a semi-structured interview and qualitative methodology, it will be studied the relation between somatic manifestations and particular beliefs of each group and how these are associated with the processes of disease and seeking for care. A qualitative methodology based on individual interviews centred on critical incidents, focal groups and in situ questionnaires will be used to study the cross-cultural competences of the professionals. It is expected a high level of chronic stress associated with the level of somatisations in the different non-European Union immigrant communities. The results will provide better knowledge of these populations and will improve the comprehension and the efficacy of the health care providers in prevention

  17. Exploiting SNOMED CT Concepts & Relationships for Clinical Information Retrieval: Australian e-Health Research Centre and Queensland University of Technology at the TREC 2012 Medical Track

    Science.gov (United States)

    2012-11-01

    data. References [1] Gaudinat, A., Ruch, P., Joubert, M., Uziel, P., Strauss, A., Thonnet, M., Baud , R., Spahni, S., Weber, P., Bonal, J., Boyer, C...Retrieval. Australasian Medical Journal: Special Issue on Artificial Intelligence in Health 5, 9 (2012), 482–488. 7 [4] Koopman, B., Zuccon, G ., Bruza...Pakhomov, S. V. S., Patwardhan, S., and Chute, C. G . Measures of semantic similarity and relatedness in the biomedical domain. Journal of Biomedical

  18. The contribution of Australian residential early parenting centres to comprehensive mental health care for mothers of infants: evidence from a prospective study

    Directory of Open Access Journals (Sweden)

    Fisher Jane RW

    2010-04-01

    Full Text Available Abstract Background Australia's public access residential early parenting services provide programs to assist parents who self-refer, to care for their infants and young children. Treatment programs target infant feeding and sleeping difficulties and maternal mental health. There is limited systematic evidence of maternal and infant mental health, psychosocial circumstances or presenting problems, or the effectiveness of the programs. The aim of this study was to contribute to the evidence base about residential early parenting services. Methods A prospective cohort design was used. A consecutive sample of mothers with infants under one year old recruited during admission to a public access residential early parenting service for a 4 or 5 night stay in Melbourne, Australia was recruited. They completed structured self-report questionnaires, incorporating standardised measures of infant behaviour and maternal mood, during admission and at one and six months after discharge. Changes in infant behaviour and maternal psychological functioning after discharge were observed. Results 79 women completed the first questionnaire during admission, and 58 provided complete data. Women admitted to the residential program have poor physical and mental health, limited family support, and infants with substantial behaviour difficulties. One month after discharge significant improvements in infant behaviour and maternal psychological functioning were observed (mean (SD daily crying and fussing during admission = 101.02 (100.8 minutes reduced to 37.7 (55.2 at one month post discharge, p Conclusions This psycho-educational approach is an effective and acceptable early intervention for parenting difficulties and maternal mood disturbance, and contributes to a system of comprehensive mental health care for mothers of infants.

  19. Town Centre Redevelopment Strategies

    DEFF Research Database (Denmark)

    Vagnby, Bo Hellisen

    After many years of urban growth Danish downtowns are facing some important choices. Shall the stake one-sidedly be on the town centres as driving forces for growth and 'city marketing', or do they still have a role to play in a broader socio-economic context? In the paper we look back on eight...... as slum clearence and urban renewal. To a certain extent parallels are drawn to international experiences, especially where these are of such a nature that they can be assumed transferred to Danish connctions. Conclusively, the strategies are discussed in the light of the turn of Danish urban planning...

  20. Determinants of young people’s sexual behaviour concerning HIV and AIDS in the practice population of a university health centre in Lagos, Nigeria

    Directory of Open Access Journals (Sweden)

    Olayinka O. Ayankogbe

    2011-02-01

    Full Text Available Background: AIDS has been a scourge of universities in Africa for a long time. This study was launched at ground-level to fight the dreaded disease by concentrating on young people and to counter the ignorance that surrounds the disease even in numerous African universities. This study of the student community was carried out by family doctors at the University Health Department to determine the prevalence of the determinants of young people’s reproductive health behaviour. Objectives: This study is aimed at determining young people’s sexual behaviour concerning HIV and AIDS in the practice population of a university in Lagos, Nigeria.Method: Self-administered 63-item questionnaires were distributed amongst 2000 randomly selected students of the University of Lagos, Lagos, Nigeria in September 2005, using a semistructured form of the Comprehensive Youth Survey questionnaire, developed by FOCUS (led by Pathfinder International, Futures Group International and Tulane University School of Public Health.Results: The age distribution of the respondents was designated in the age groups of 15–19 years (15.8%, 20–24 years (60.1%, 25–29 years (19.6%, 30–34 years (2.8%.Demographics of note were that 88.3% of the fathers of the respondents were literate and that 94.5% of the fathers earned more than one US $ per day. The majority of the respondents (99.1% indicated adherence to one religious faith or the other and 58.8% believed definitely that religion shaped their attitudes about sexual intercourse and sexuality. More than half (64.0% denied having had sex at all in the three months preceding the study. Furthermore, 68.8% affirmed that it was common amongst friends of their age to use condoms. A significant number of respondents (65.5% thought that their friends have drunken alcohol. Almost all of the respondents (94.3% had a positive perception of their family.Conclusion: The Programming for HIV and AIDS Reduction on university campuses in

  1. Evolución de la lactancia materna en la población que atiende el Centro de Salud de Mendillorri Evolution of breastfeeding in the population attending the Mendillorri Health Centre

    Directory of Open Access Journals (Sweden)

    I. Baztán

    2009-04-01

    Full Text Available Este estudio tiene como objetivo estimar cuál es la prevalencia y duración de la lactancia materna y cómo ha variado en la población que atiende al centro de salud de Mendillorri entre los años 2002 y 2006. Se estudiaron dos cohortes de neonatos (nacidos en 2002 y nacidos en 2006, que acudían a nuestro centro, mediante revisión de la historia clínica informatizada. Se comparan las cifras de prevalencia de las diversas categorías de lactancia en el momento del alta de la maternidad, y con periodicidad mensual, hasta el primer año de vida. Se registra también si se realizó la visita domiciliaria de enfermería. De los resultados obtenidos se puede concluir que el panorama de la lactancia materna ha cambiado sustancialmente en esta zona tras al alta hospitalaria, demostrándose que las cifras de prevalencia a lo largo del primer año de vida son significativamente superiores en 2006 versus 2002.The aim of this study is to estimate the prevalence and duration of breastfeeding, and how this has varied in the population attending the Mendillorri health centre between the years 2002 and 2006. We studied two cohorts of neonates (born in 2002 and 2006, respectively, who attended our centre, through a revision of their computerised clinical history. The prevalence figures of the different lactation categories were compared, with a monthly periodicity from the time of maternity discharge until the first year of life. Home visits by nurses were also registered where these occurred. The conclusion drawn from the results is that the panorama of maternal lactation has changed substantially in this area following hospital discharge; the results show that the prevalence figures over the first year of life are significantly higher in 2006 compared with 2002.

  2. A study of prevalence of Sexually Transmitted Infections & response to syndromic treatment among married women of reproductive age group in rural area of Parol Primary Health Centre under Thane district

    Directory of Open Access Journals (Sweden)

    Vibha V. Gosalia

    2013-05-01

    Full Text Available Objectives To study prevalence of Sexually Transmitted Infections (STIs - symptomatic, clinical & laboratorial& response to syndromic treatment in among STI groups. Design Community based interventional study Setting Rual area-Parol Primary Health Centre(PHC, District Thane, Maharashtra state. Poulation Women of reproductive age groups 15 -45 years Methods Present Community based interventional study was conducted among representative group of 415 women of reproductive age groups who were selected by simple random sampling technique in Parol PHC, District Thane, Maharashtra state. All symptomatic & asymptomatic women were counseled for examination & investigations & given syndromic treatment. Follow-up done to assess impact of syndromic treatment. Main Outcome Prevalence of STI symptomatically was 39%, clinically 32.3% & Laboratorial 26%. After syndromic treatment, prevalence of STIs was significantly reduced. Statistical Analysis Z test Results Of the surveyed women (415, prevalence of STI symptomatically was 39%, clinically 32.3% & Laboratorial 26%. The most common presenting symptom was vaginal discharge (36.4% followed by Burning Micturition (24.7%, Vulval itching (17.3%, Lower abdominal pain (13% & Genital ulcer (8.6%. Clinically, 55.2% women were diagnosed as cervicitis & 44.8% as PID. Laboratorial diagnosed STIs were - vaginal candidiasis 46.3%, Bacterial vaginosis 25%, Trichmoniasis 19.4 %, Genital Herpes 7.4% & HIV 1.9%. After syndromic treatment, prevalence of STIs has statistically significantly reduced. Conclusion Syndromic Rx & health education can definitely reduce STIs.

  3. Employment and Education as Risk Factors of Cataract Incidence on Patients Treated in Eye Health Centre Mataram City West Nusa Tenggara

    Directory of Open Access Journals (Sweden)

    Ni Nyoman Santi Tri Ulandari

    2015-04-01

    Full Text Available Background and purpose: The purpose of the study was to determine the risk factors of employment, education and other risk factors on the occurrence of cataracts in patients seeking treatment at Eye Health Center in the City of Mataram, West Nusa Tenggara.Methods: The study was a case-control with a sample of cases and controls, respectively amounted to 40 (1: 1. The dependent variable was the incidence of cataract and independent variables were: education, employment, income, diabetes mellitus, history of cataracts, smoking behavior, and exposure to smoke and sun exposure. Data were collected by means of interviews using questionnaires and tracking documents of patients’ medical records. Data analysis was performed using univariate, bivariate to determine the comparability between cases and controls and tosee the crude of OR. Multivariate analyses were performed to determine the adjusted OR.Results: Four variables were found to be risk factors to the occurrence of cataracts: education, income, occupation and exposure to sunlight with each crude OR of 10.50 (95% CI: 3.39 to 32.52; 6.23 (95% CI: 2.35 to 16.51, 10.52 (95%CI: 3.56 to 31.12; and 3.11 (95% CI: 1.25 to 7.78. While diabetes mellitus, history of cataracts, smoking behavior and exposure to smoke was not statistically proven as a risk factor for cataracts. The multivariate analysis showed that most risk factors played a role in the occurrence of cataract was employment with OR=9.81 (95% CI: 1.85 to 52.02 and education with OR=6.53 (95% CI: 1.42 to 29.92.Conclusion: Employment and education were significant risk factors to the occurrence of cataracts in patients who visited the Eye Health Center in the City of Mataram, West Nusa Tenggara.Keywords: cataract, case-control, BKMM-NTB, risk factors

  4. Factors Affecting Health-Related Quality of Life and Physical Activity after Liver Transplantation for Autoimmune and Nonautoimmune Liver Diseases: A Prospective, Single Centre Study

    Directory of Open Access Journals (Sweden)

    Katarzyna Kotarska

    2014-01-01

    Full Text Available Background/Aim. With the improvement of the outcomes after liver transplantation (LTx, health-related quality of life (HRQoL and physical activity are becoming significant outcome parameters. We prospectively assessed these parameters in patients with autoimmune and nonautoimmune liver disorders undergoing LTx. Materials and Methods. Patients (n=107 were subdivided into 3 groups depending on the time after LTx: group-A (n=21: 6–12 months; group-B (n=48: 13–36 months; and group-C (n=38: >37 months. SF-36 and IPAQ were applied in HRQoL and physical activity assessment. Results. Females had impaired HRQoL in most SF-36 domains. Younger patients showed higher scores at SF-36 physical functioning domain but IPAQ was not influenced by age. Group-B had higher general health and physical component summary than group-A (P=0.037, P=0.04, resp. and total IPAQ than group-C (P=0.047. The sitting time domain was longer in group-A than in group-B and group-C (P=0.0157;  P=0.042, resp.. Employed patients had better HRQoL and higher physical activity than those not working. SF-36 and IPAQ were unrelated to the autoimmune etiology of liver disease. Conclusions. These findings show that female and unemployed patients have worse HRQoL, while gender and age at LTx time do not affect IPAQ’s physical activity. The autoimmune etiology of liver disease does not influence HRQoL and physical activity after LTx.

  5. 27 February 2012 - Director of the Health Directorate at the Research DG European Commission R. Draghia-Akli in the ATLAS visitor centre with ATLAS Former Collaboration Spokesperson P. Jenni and Head of CERN EU Projects Office S. Stavrev; in the LHC superconducting magnet test hall with E. Todesco; and signing the guest book with CERN Director-General R. Heuer.

    CERN Multimedia

    Michel Blanc

    2012-01-01

    27 February 2012 - Director of the Health Directorate at the Research DG European Commission R. Draghia-Akli in the ATLAS visitor centre with ATLAS Former Collaboration Spokesperson P. Jenni and Head of CERN EU Projects Office S. Stavrev; in the LHC superconducting magnet test hall with E. Todesco; and signing the guest book with CERN Director-General R. Heuer.

  6. Stavanger Squash Centre, Norway

    Energy Technology Data Exchange (ETDEWEB)

    Rostvik, H. [Sunlab/ABB, Stavanger (Norway)

    1999-07-01

    Although Stavanger is the technological and financial oil-capital of Norway, the Stavanger Squash Centre was until recently the largest solar building in Norway, with 120 m{sup 2} of collectors. The active, building-integrated, solar air collector in the 45 {sup o} roof facing 15 {sup o} east of due south, has now been delivering solar-heated hot water for the showers for 15 years. The solar system consists of several standard products put together in a new way. Monitoring has shown that the system produced 18,000 kWh/m{sup 2} a (150 kWh/m{sub coll} {sup 2}a). If operated as planned, it could have had a solar contribution of 45,000 kWh/a) (375 kWh/m{sub coll} {sup 2}a), resulting in a 19% solar fraction of total demand. (author)

  7. A cancer help centre.

    Science.gov (United States)

    Daniel, R

    1996-06-01

    The diagnosis of cancer can be shattering to all involved. The treatment of cancer is intense and often very challenging. Prevailing attitudes to cancer are sometimes fearful, negative and depressing. This combination may leave those affected by cancer shocked, disorientated and without hope. Even worse than this, on asking consultants 'What can I do to help myself?' patients are frequently told 'Absolutely nothing'--crushing in one fell swoop their remaining fighting spirit. Not so in the case of Penny Brohn, who, when faced with the diagnosis of breast cancer, travelled the world to find alternative cancer treatments, and having successfully brought her own cancer under control, dedicated her life to creating a Centre for others wishing to fight their disease.

  8. Person-centred care in nursing documentation.

    LENUS (Irish Health Repository)

    Broderick, Margaret C

    2012-12-07

    BACKGROUND: Documentation is an essential part of nursing. It provides evidence that care has been carried out and contains important information to enhance the quality and continuity of care. Person-centred care (PCC) is an approach to care that is underpinned by mutual respect and the development of a therapeutic relationship between the patient and nurse. It is a core principle in standards for residential care settings for older people and is beneficial for both patients and staff (International Practice Development in Nursing and Healthcare, Chichester, Blackwell, 2008 and The Implementation of a Model of Person-Centred Practice in Older Person Settings, Dublin, Health Service Executive, 2010a). However, the literature suggests a lack of person-centredness within nursing documentation (International Journal of Older People Nursing 2, 2007, 263 and The Implementation of a Model of Person-Centred Practice in Older Person Settings, Dublin, Health Service Executive, 2010a). AIMS AND OBJECTIVES: To explore nursing documentation in long-term care, to determine whether it reflected a person-centred approach to care and to describe aspects of PCC as they appeared in nursing records. METHOD: A qualitative descriptive study using the PCN framework (Person-centred Nursing; Theory and Practice, Oxford, Wiley-Blackwell, 2010) as the context through which nursing assessments and care plans were explored. RESULTS: Findings indicated that many nursing records were incomplete, and information regarding psychosocial aspects of care was infrequent. There was evidence that nurses engaged with residents and worked with their beliefs and values. However, nursing documentation was not completed in consultation with the patient, and there was little to suggest that patients were involved in decisions relating to their care. IMPLICATIONS FOR PRACTICE: The structure of nursing documentation can be a major obstacle to the recording of PCC and appropriate care planning. Documentation

  9. Remote midwifery in Nunavik, Québec, Canada: outcomes of perinatal care for the Inuulitsivik health centre, 2000-2007.

    Science.gov (United States)

    Van Wagner, Vicki; Osepchook, Claire; Harney, Evelyn; Crosbie, Colleen; Tulugak, Mina

    2012-09-01

    The Inuulitsivik midwifery service is a community-based, Inuit-led initiative serving the Hudson coast of the Nunavik region of northern Québec. This study of outcomes for the Inuulitsivik birth centers, aims to improve understanding of maternity services in remote communities. We used a retrospective review of perinatal outcome data collected at each birth at the Inuulitsivik birth centers to examine outcomes for 1,372 labors and 1,382 babies from 2000 to 2007. Data were incomplete for some indicators, particularly for transfers to Montreal. Findings revealed low rates of intervention with safe outcomes in this young, largely multiparous "all risk" Inuit population. Ninety-seven percent of births were documented as spontaneous vaginal deliveries, and 85 percent of births were attended by midwives. Eighty-six percent of the labors occurred in Nunavik, whereas 13.7 percent occurred outside Nunavik. The preterm birth rate was found to be 10.6 percent. Postpartum hemorrhage was documented in 15.4 percent of women; of these cases, 6.9 percent had blood loss greater than 1,000 mL. Four fetal deaths (2.9 per 1,000) and five neonatal deaths (midwifery service rests on the knowledge and skills of the Inuit midwives, and support of an interprofessional health team. Our study points to the potential for safe, culturally competent local care in remote communities without cesarean section capacity. Our findings support recommendations for integration of midwifery services and Aboriginal midwifery education programs in remote communities. © 2012, Copyright the Authors, Journal compilation © 2012, Wiley Periodicals, Inc.

  10. Multidisciplinary integrated Parent and Child Centres in Amsterdam: a qualitative study

    NARCIS (Netherlands)

    Busch, Vincent; Van Stel, Henk François; De Leeuw, Johannes Rob Josephus; Melhuish, Edward; Schrijvers, Augustinus Jacobus Petrus

    2013-01-01

    Background: In several countries centres for the integrated delivery of services to the parent and child have been established. In the Netherlands family health care service centres, called Parent and Child Centres (PCCs) involve multidisciplinary teams. Here doctors, nurses, midwives, maternity hel

  11. Call Centre- Computer Telephone Integration

    Directory of Open Access Journals (Sweden)

    Dražen Kovačević

    2012-10-01

    Full Text Available Call centre largely came into being as a result of consumerneeds converging with enabling technology- and by the companiesrecognising the revenue opportunities generated by meetingthose needs thereby increasing customer satisfaction. Regardlessof the specific application or activity of a Call centre, customersatisfaction with the interaction is critical to the revenuegenerated or protected by the Call centre. Physical(v, Call centreset up is a place that includes computer, telephone and supervisorstation. Call centre can be available 24 hours a day - whenthe customer wants to make a purchase, needs information, orsimply wishes to register a complaint.

  12. Should "Teacher Centred Teaching" Replace "Student Centred Learning"?

    Science.gov (United States)

    Bailey, Patrick D.

    2008-01-01

    Mission statements of most HEIs across the UK support "student centred learning". In this paper, it is suggested that "teacher centred teaching" should also have a major role to play, improving the quality of the learning experience in higher education. Students are extremely diverse in their skills, weaknesses, and learning…

  13. Do primary health centres and hospitals contribute equally towards achievement of the transversal clinical competencies of medical students? Performance on the Objective Structured Clinical Examination (OSCE) in competency acquisition.

    Science.gov (United States)

    Soler-González, Jorge; Buti, Miquel; Boada, Jordi; Ayala, Victoria; Peñascal, Eduard; Rodriguez, Toni

    2016-01-01

    The adaptation of the educational programmes of European faculties of medicine to the European Higher Education Area guidelines has focused curricula design on competence acquisition. Competencies are defined as the achievements of a predetermined level of efficacy in real-world scenarios. Our objective was to assess whether performance on a common competence evaluation test, the Objective Structured Clinical Examination (OSCE), resulted in different scores for second-year students after a practical medical training course took place in a primary health centre (PHC) or in a hospital. A descriptive study was conducted during the 2010-2014 academic year of the OSCE test scores obtained by all second-year students. Faculty of Medicine at the University of Lleida (Catalonia, Spain). We performed a correlation analysis between students who completed their practical medical training at the PHC and hospitals utilising Student's t-test for comparison of means. 423 students who completed internships at the PHC and at hospitals obtained OSCE mean scores of 7.32 (SD; IC) (0.82; 7.18-7.47) points and 7.17 (0.83; 6.07-7.26) points, respectively (p=0.07). Second-year medical students acquired similar competency levels in the two analysed training scenarios. The two areas both serve their teaching purpose. Copyright © 2014 Elsevier España, S.L.U. All rights reserved.

  14. The Magical Effect of Music Therapy in the Bloodletting Room of Health Management Centre%音乐疗法在健康管理中心抽血室的妙用

    Institute of Scientific and Technical Information of China (English)

    胡翠玉

    2013-01-01

    目的通过音乐疗法,减轻体检客户抽血时带来的疼痛不适和烦燥情绪。方法对前来体检客户采用问卷式调查方式。结果90%客户对抽血室采取音乐疗法表示满意。结论健康体检中心抽血室对前来体检的客户采用音乐疗法,达到预期效果,不管是从心理或生理上都给客户消除紧张、烦燥情绪,达到理想效果。%Objective: To al eviate pain and irritable mood of examination customers when exsanguinated through music therapy. Methods: Questionnaires were used for examination customers. Results:Questionnaires show that 90%of customers expressed satisfaction with music therapy in the bloodlet ing room. Conclusion:Music therapy used for examination customers in the bloodlet ing room of health management centre had achieved expected results,and the mood of tension and irritability of customers were eliminated in psychological or physiological aspect.

  15. Cell Centred Database (CCDB)

    Data.gov (United States)

    U.S. Department of Health & Human Services — The Cell Centered Database (CCDB) is a web accessible database for high resolution 2D, 3D and 4D data from light and electron microscopy, including correlated imaging.

  16. A Cross-sectional Descriptive Study was to Estimate the Prevalence of the Early Initiation of and Exclusive Breast Feeding in the Rural Health Training Centre of a Medical College in Tamilnadu, South India.

    Science.gov (United States)

    Jennifer, H Gladius; Muthukumar, K

    2012-11-01

    The World Health Organization and the National guidelines on infant and young child feeding recommend the practice of exclusive breastfeeding of infants for the first 6 months after their birth. The objective of this study was to estimate the prevalence of the early initiation of and exclusive breast feeding. A cross sectional, descriptive study was done. 79 infants and children who attended the under five clinic in the Rural Health Training Centre (RHTC), Pulipakkam Village, were chosen for the study by convenient sampling. This study was conducted by interviewing 79 mothers of the children in the ages of 0-24 months, who attended the under five clinic of RHTC, Pulipakkam. The data was collected by using a pre tested, structured questionnaire to obtain the information on the breast feeding and the hygienic feeding practices among mothers. The statistical analysis was done by the authors by using the SPSS, version 16. The significance in the differences were evaluated by using the Chi square test and the relationship between the variables were evaluated by using Kendall's tau correlation. A p value of practices among the mothers were significantly associated with an increased incidence of upper and lower respiratory tract infections and gastro intestinal infections in the infants and the children. The education of the antenatal mothers on the benefits of breast feeding and hygienic feeding practices and making all hospitals baby friendly have to be focused on, in order to achieve 80% exclusive breast feeding as per the national guidelines on infant and young child feeding. We need to strengthen the MCH services in the study area in order to achieve 100% immunization.

  17. Council celebrates CERN Control Centre

    CERN Multimedia

    2006-01-01

    With the unveiling of its new sign, the CERN Control Centre was officially inaugurated on Thursday 16 March. To celebrate its startup, CERN Council members visited the sleek centre, a futuristic-looking room filled with a multitude of monitoring screens.

  18. Uptake and performance of prevention of mother-to-child transmission and early infant diagnosis in pregnant HIV-infected women and their exposed infants at seven health centres in Addis Ababa, Ethiopia.

    Science.gov (United States)

    Girma, Marshet; Wendaferash, Rahel; Shibru, Hailu; Berhane, Yemane; Hoelscher, Michael; Kroidl, Arne

    2017-06-01

    To assess the uptake of WHO-recommended PMTCT procedures in Ethiopia's health services. Prospective observational study of HIV-positive pregnant mothers and their newborns attending PMTCT services at seven health centres in Addis Ababa. Women were recruited during antenatal care and followed up with their newborns at delivery, Day 6 and Week 6 post-partum. Retention to PMCTC procedures, self-reported antiretroviral treatment (ART) adherence and HIV infant outcome were assessed. Turnaround times of HIV early infant diagnosis (EID) procedures were extracted from health registers. Of 494 women enrolled, 4.9% did not complete PMTCT procedures due to active denial or loss to follow-up. HIV was first diagnosed in 223 (45.1%) and ART initiated in 321 (65.0%) women during pregnancy. ART was initiated in a median of 1.3 weeks (IQR 0-4.3) after HIV diagnosis. Poor self-reported treatment adherence was higher post-partum than during pregnancy (12.5% vs. 7.0%, P = 0.002) and significantly associated with divorced/separated marital status (RR 2.2, 95% CI 1.3-3.8), low family income (RR 2.1, 95% CI 1.1-4.1), low CD4 count (RR 1.7, 95% CI 1.0-3.0) and ART initiation during delivery (RR 2.5, 95% CI 1.1-5.6). Of 435 infants born alive, 98.6% received nevirapine prophylaxis. The mother-to-child HIV transmission rate was 0.7% after a median of 6.7 weeks (IQR 6.4-10.4), but EID results were received for only 46.6% within 3 months of birth. High retention in PMTCT services, triple maternal ART and high infant nevirapine prophylaxis coverage were associated with low mother-to-child HIV transmission. Declining post-partum ART adherence and challenges of EID linkage require attention. © 2017 The Authors. Tropical Medicine & International Health Published by John Wiley & Sons Ltd.

  19. Trainee resident participation in health research in a resource-constrained setting in south-eastern Nigeria: perspectives, issues and challenges. A cross-sectional survey of three residency training centres

    Directory of Open Access Journals (Sweden)

    Eze Boniface

    2012-06-01

    Full Text Available Abstract Background The participation of trainers and trainees in health research is critical to advance medical science. Overcoming barriers and enhancing incentives are essential to sustain a research culture and extend the frontiers of medical education. In this study, we investigated the roles of individual and system factors influencing trainee resident participation in health research in Enugu, south-eastern Nigeria. Methods This cross-sectional survey of trainee residents was conducted across three residency training centres in Enugu, Nigeria, between February and March, 2010. The number and speciality distribution of trainee residents were determined from personnel records at each centre. A 19-item questionnaire was used to record demographic characteristics, research training/experience, and attitudes toward and perceived barriers to health research. Data were analysed to yield frequencies, percentages and proportions. Values of p  Results The response rate was 93.2%. The respondents (n = 136 comprised 109 males and 27 females. Their mean ± standard deviation age was 35.8 ± 5.6 years (range: 25–53 years. Participation in research was significantly associated with previous research training [odds ratio (OR: 2.90; 95% confidence interval (CI: 1.35–6.25, p = 0.003, β = 22.57], previous research participation (OR: 2.21; 95% CI: 0.94–5.29, p = 0.047, β = 22.53 and research publication (OR: 2.63; 95% CI: 1.00–7.06, p = 0.03, β = 22.57. Attitude towards research was significantly influenced by perceived usefulness of research in patient care (OR: 7.10; 95% CI: 3.33–15.13, p = 0.001, job promotion (OR: 8.97; 95% CI: 4.12–19.53, p = 0.001 and better understanding of disease (OR: 21.37; 95% CI: 8.71–54.44, p = 0.001. Time constraints (OR: 0.06; 95% CI = 0.025–0.14, p = 0.001, funding (OR: 0.028; 95% CI: 0.008–0.10, p = 0.001 and mentorship (OR: 0.086; 95% CI

  20. CMCC Data Distribution Centre

    Science.gov (United States)

    Aloisio, Giovanni; Fiore, Sandro; Negro, A.

    2010-05-01

    The CMCC Data Distribution Centre (DDC) is the primary entry point (web gateway) to the CMCC. It is a Data Grid Portal providing a ubiquitous and pervasive way to ease data publishing, climate metadata search, datasets discovery, metadata annotation, data access, data aggregation, sub-setting, etc. The grid portal security model includes the use of HTTPS protocol for secure communication with the client (based on X509v3 certificates that must be loaded into the browser) and secure cookies to establish and maintain user sessions. The CMCC DDC is now in a pre-production phase and it is currently used only by internal users (CMCC researchers and climate scientists). The most important component already available in the CMCC DDC is the Search Engine which allows users to perform, through web interfaces, distributed search and discovery activities by introducing one or more of the following search criteria: horizontal extent (which can be specified by interacting with a geographic map), vertical extent, temporal extent, keywords, topics, creation date, etc. By means of this page the user submits the first step of the query process on the metadata DB, then, she can choose one or more datasets retrieving and displaying the complete XML metadata description (from the browser). This way, the second step of the query process is carried out by accessing to a specific XML document of the metadata DB. Finally, through the web interface, the user can access to and download (partially or totally) the data stored on the storage device accessing to OPeNDAP servers and to other available grid storage interfaces. Requests concerning datasets stored in deep storage will be served asynchronously.

  1. Minister unveils new nanotech centres

    Science.gov (United States)

    Dumé, Belle

    2009-06-01

    Three new nanotechnology research centres are to be set up in France as part of a €70m government plan to help French companies in the sector. Researchers at the new centres, which will be located in Grenoble, Saclay (near Paris) and Toulouse, will be encouraged to collaborate with industry to develop new nanotech-based products. Dubbed NANO-INNOV, the new plan includes €46m for two new buildings at Saclay, with the rest being used to buy new equipment at the three centres and to fund grant proposals from staff to the French National Research Agency (ANR).

  2. 25 years Nuclear Research Centre

    Energy Technology Data Exchange (ETDEWEB)

    Harde, R.

    1981-07-01

    On June 12, the Karlsruhe Nuclear Research Centre celebrated its 25th anniversary. The Centre was founded on July 19, 1956. The importance of this institution became apparent by the large number of prominent guests, at the head, the Federal President, Karl Carstens. Minister President Spaeth and the Federal Minister for Research and Technology, von Buelow, appreciated the achievements obtained by this big science centre of nuclear technology. The ceremony held in the State theatre of Baden-Wuerttemberg gave testimony of an impressing confession in favour of nuclear energy. Excerpts from the speech of the Chairman of the Managing Board, Prof. Harde, are quoted.

  3. The World Heritage Centr

    Directory of Open Access Journals (Sweden)

    Ayman G. Abdel Tawab

    2014-09-01

    Full Text Available New Gourna Village, which is located inside one of the World Heritage Sites in Egypt, has never been recognized as an element contributing to the site’s Outstanding Universal Value. The recognition of the village as a contributing element is reliant on the successful assessment of its authenticity and integrity. Responding to the dramatically declining integrity of the village, the World Heritage Centre has carried out an architectural study to guide the potential conservation works in the property. The study has recommended that a group of objectives and two approaches to the conservation of the village should be adopted. One of these two approaches has been concerned with the conservation of the village according to the architect’s original intentions and principles. The previous approach can be called the principles-based approach. The main aim of this study was to examine the agreement of the World Heritage Centre’s objectives and their proposed principles-based approach to the conservation of the village with the aim to improve its chance in meeting the conditions of authenticity and integrity. The study approached the previous aim by assessing, by means of a proposed methodology; the level of significance, authenticity and integrity of the property. Based on the previous assessment, a list of conservation interventions was proposed to improve the property’s chance in meeting the conditions of authenticity and integrity. Finally, the World Heritage Centre’s recommended approaches and objectives were examined against the previous proposed conservation interventions. The findings indicated the possibility to adopt the principles-based approach to the conservation of New Gourna Village, as well as the other World Heritage Centre’s objectives, without limiting the property’s chance in meeting the conditions of authenticity and integrity. The study recommends to carry out further studies that are concerned with the identification

  4. Lifestyle modifications to prevent and control hypertension. 4. Recommendations on physical exercise training. Canadian Hypertension Society, Canadian Coalition for High Blood Pressure Prevention and Control, Laboratory Centre for Disease Control at Health Canada, Heart and Stroke Foundation of Canada.

    Science.gov (United States)

    Cléroux, J; Feldman, R D; Petrella, R J

    1999-05-04

    of moderate rhythmic exercise of the lower limbs, such as brisk walking or cycling, 3 or 4 times per week to reduce blood pressure, (2) Exercise should be prescribed as an adjunctive therapy for people who require pharmacologic therapy for hypertension, especially those who are not receiving beta-blockers. (3) People who do not have hypertension should participate in regular exercise as it will decrease blood pressure and reduce the risk of coronary artery disease, although there is no direct evidence that it will prevent hypertension. These recommendations agree with those of the World Hypertension League, the American College of Sports Medicine, the report of the US Surgeon General on physical activity and health, and the US National Institutes of Health Consensus Development Panel on Physical Activity and Cardiovascular Health. These guidelines have not been clinically tested. The Canadian Hypertension Society, the Canadian Coalition for High Blood Pressure Prevention and Control, the Laboratory Centre for Disease Control at Health Canada, and the Heart and Stroke Foundation of Canada.

  5. Interrater agreement of two adverse drug reaction causality assessment methods: A randomised comparison of the Liverpool Adverse Drug Reaction Causality Assessment Tool and the World Health Organization-Uppsala Monitoring Centre system

    Science.gov (United States)

    Mehta, Ushma; Rossiter, Dawn P.; Maartens, Gary; Cohen, Karen

    2017-01-01

    Introduction A new method to assess causality of suspected adverse drug reactions, the Liverpool Adverse Drug Reaction Causality Assessment Tool (LCAT), showed high interrater agreement when used by its developers. Our aim was to compare the interrater agreement achieved by LCAT to that achieved by another causality assessment method, the World Health Organization-Uppsala Monitoring Centre system for standardised case causality assessment (WHO-UMC system), in our setting. Methods Four raters independently assessed adverse drug reaction causality of 48 drug-event pairs, identified during a hospital-based survey. A randomised design ensured that no washout period was required between assessments with the two methods. We compared the methods’ interrater agreement by calculating agreement proportions, kappa statistics, and the intraclass correlation coefficient. We identified potentially problematic questions in the LCAT by comparing raters’ responses to individual questions. Results Overall unweighted kappa was 0.61 (95% CI 0.43 to 0.80) on the WHO-UMC system and 0.27 (95% CI 0.074 to 0.46) on the LCAT. Pairwise unweighted Cohen kappa ranged from 0.33 to 1.0 on the WHO-UMC system and from 0.094 to 0.71 on the LCAT. The intraclass correlation coefficient was 0.86 (95% CI 0.74 to 0.92) on the WHO-UMC system and 0.61 (95% CI 0.39 to 0.77) on the LCAT. Two LCAT questions were identified as significant points of disagreement. Discussion We were unable to replicate the high interrater agreement achieved by the LCAT developers and instead found its interrater agreement to be lower than that achieved when using the WHO-UMC system. We identified potential reasons for this and recommend priority areas for improving the LCAT. PMID:28235001

  6. Getting our house in order: an audit of the registration and publication of clinical trials supported by the National Institute for Health Research Oxford Biomedical Research Centre and the Musculoskeletal Biomedical Research Unit.

    Science.gov (United States)

    Tompson, A C; Petit-Zeman, S; Goldacre, B; Heneghan, C J

    2016-03-02

    To audit the proportion of clinical trials that had been publically registered and, of the completed trials, the proportion published. 2 major research institutions supported by the National Institute of Health Research (NIHR). The proportion of trials reporting results within 12 months, 24 months and 'ever'. Factors associated with non-publication were analysed using logistic regression. Phases 2-4 clinical trials identified from internal documents and publication lists. In total, 286 trials were identified. We could not find registration for 4 (1.4%) of these, all of which were completed and published. Of the trials with a registered completion date pre-January 2015, just over half (56%) were published, and half of these were published within 12 months (36/147, 25%). For some trials, information on the public registers was found to be out-of-date and/or inaccurate. No clinical trial characteristics were found to be significantly associated with non-publication. We have produced resources to facilitate similar audits elsewhere. It was feasible to conduct an internal audit of registration and publication in 2 major research institutions. Performance was similar to, or better than, comparable cohorts of trials sampled from registries. The major resource input required was manually seeking information: if all registry entries were maintained, then almost the entire process of audit could be automated--and routinely updated--for all research centres and funders. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  7. The centre of the action

    CERN Multimedia

    2008-01-01

    The CERN Control Centre (CCC) has all the ingredients of an action movie control room: hundreds of screens, technicians buzzing in and out, huge floor-to-ceiling windows revealing the looming vista of a mountain range, flashing lights, microphones… This is the place where not just the LHC, but the whole of CERN’s accelerator complex and technical support is based - truly the centre of the action at CERN.

  8. The Centre for Veterinary Epidemiology and Risk Analysis, The TB Diagnostics and Immunology Research Centre, The Badger Vaccine Project: Biennial Report, 2012-13

    OpenAIRE

    More, Simon John; Collins, Daniel M.

    2014-01-01

    The UCD Centre for Veterinary Epidemiology and Risk Analysis (UCD CVERA) is the national resource centre for veterinary epidemiology in Ireland, located within the UCD School of Veterinary Medicine at University College Dublin. The Centre was initially established as the Tuberculosis Investigation Unit, but in recent years has broadened its remit to cover a wide range of international, national and local animal health matters, including: - Epidemiological support for the control and eradicati...

  9. The Centre for Veterinary Epidemiology and Risk Analysis, The TB Diagnostics and Immunology Research Centre, The Badger Vaccine Project: Biennial Report, 2010-11

    OpenAIRE

    More, Simon John; Collins, Daniel M.

    2012-01-01

    The UCD Centre for Veterinary Epidemiology and Risk Analysis (UCD CVERA) is the national resource centre for veterinary epidemiology in Ireland, located within the UCD School of Veterinary Medicine at University College Dublin. The Centre was initially established as the Tuberculosis Investigation Unit, but in recent years has broadened its remit to cover a wide range of international, national and local animal health matters, including: - Epidemiological support for the control and eradicati...

  10. The Centre for Veterinary Epidemiology and Risk Analysis, The TB Diagnostics and Immunology Research Centre, The Badger Vaccine Project. Biennial Report, 2014-15

    OpenAIRE

    More, Simon John; Collins, Daniel M.

    2016-01-01

    The UCD Centre for Veterinary Epidemiology and Risk Analysis (UCD CVERA) is the national resource centre for veterinary epidemiology in Ireland, located within the UCD School of Veterinary Medicine at University College Dublin. The Centre was initially established as the Tuberculosis Investigation Unit, but in recent years has broadened its remit to cover a wide range of international, national and local animal health matters, including: - Epidemiological support for the control and eradicati...

  11. The costs of providing antiretroviral therapy services to HIV-infected individuals presenting with advanced HIV disease at public health centres in Dar es Salaam, Tanzania: Findings from a randomised trial evaluating different health care strategies

    Science.gov (United States)

    Kimaro, Godfather Dickson; Mfinanga, Sayoki; Simms, Victoria; Kivuyo, Sokoine; Bottomley, Christian; Hawkins, Neil; Harrison, Thomas S.; Jaffar, Shabbar; Guinness, Lorna

    2017-01-01

    Background Understanding the costs associated with health care delivery strategies is essential for planning. There are few data on health service resources used by patients and their associated costs within antiretroviral (ART) programmes in Africa. Material and methods The study was nested within a large trial, which evaluated screening for cryptococcal meningitis and tuberculosis and a short initial period of home-based adherence support for patients initiating ART with advanced HIV disease in Tanzania and Zambia. The economic evaluation was done in Tanzania alone. We estimated costs of providing routine ART services from the health service provider's perspective using a micro-costing approach. Incremental costs for the different novel components of service delivery were also estimated. All costs were converted into US dollars (US$) and based on 2012 prices. Results Of 870 individuals enrolled in Tanzania, 434 were enrolled in the intervention arm and 436 in the standard care/control arm. Overall, the median (IQR) age and CD4 cell count at enrolment were 38 [31, 44] years and 52 [20, 89] cells/mm3, respectively. The mean per patient costs over the first three months and over a one year period of follow up following ART initiation in the standard care arm were US$ 107 (95%CI 101–112) and US$ 265 (95%CI 254–275) respectively. ART drugs, clinic visits and hospital admission constituted 50%, 19%, and 19% of the total cost per patient year, while diagnostic tests and non-ART drugs (co-trimoxazole) accounted for 10% and 2% of total per patient year costs. The incremental costs of the intervention to the health service over the first three months was US$ 59 (p<0.001; 95%CI 52–67) and over a one year period was US$ 67(p<0.001; 95%CI 50–83). This is equivalent to an increase of 55% (95%CI 51%–59%) in the mean cost of care over the first three months, and 25% (95%CI 20%–30%) increase over one year of follow up. PMID:28234969

  12. The ideal Atomic Centre; Le Centre Atomique ideal

    Energy Technology Data Exchange (ETDEWEB)

    Mas, R. [Commissariat a l' Energie Atomique, Saclay (France). Centre d' Etudes Nucleaires

    1965-07-01

    The author presents considerations which should prove to be of interest to all those who have to design, to construct and to operate a nuclear research centre. A large number of the ideas presented can also be applied to non-nuclear scientific research centres. In his report the author reviews: various problems with which the constructor is faced: ground-plan, infrastructure, buildings and the large units of scientific equipment in the centre, and those problems facing the director: maintenance, production, supplies, security. The author stresses the relationship which ought to exist between the research workers and the management. With this aim in view he proposes the creation of National School for Administration in Research which would train administrative executives for public or private organisations; they would be specialised in the fields of fundamental or applied research. (author) [French] L'auteur propose une base de reflexions a tous ceux qui doivent concevoir, realiser et faire vivre un Centre d'Etudes Nucleaires. Un grand nombre des idees exprimees peut d'ailleurs s'appliquer a un Centre d'Etudes Scientifiques non nucleaires. Dans son ouvrage, l'auteur passe en revue les differents problemes qui se posent au constructeur: plan, masse, infrastructure, batiments et grands appareils du Centre, et ceux qu'a a resoudre le directeur: entretien, fabrication, approvisionnements, securite. L'auteur insiste sur l'aspect des rapports qui doivent exister entre les chercheurs et ceux qui les administrent. Il propose a cette fin la creation d'une Ecole Nationale d'Administration de la Recherche qui formerait des cadres administratifs pour les organismes publics ou prives, specialises dans la Recherche fondamentale ou appliquee. (auteur)

  13. Stakeholder perceptions of a nurse led walk-in centre

    Directory of Open Access Journals (Sweden)

    Parker Rhian M

    2012-11-01

    Full Text Available Abstract Background As many countries face primary care medical workforce shortages and find it difficult to provide timely and affordable care they seek to find new ways of delivering first point of contact health care through developing new service models. In common with other areas of rural and regional Australia, the Australian Capital Territory (ACT is currently experiencing a general practitioner (GP workforce shortage which impacts significantly on the ability of patients to access GP led primary care services. The introduction of a nurse led primary care Walk-in Centre in the ACT aimed to fulfill an unmet health care need in the community and meet projected demand for health care services as well as relieve pressure on the hospital system. Stakeholders have the potential to influence health service planning and policy, to advise on the potential of services to meet population health needs and to assess how acceptable health service innovation is to key stakeholder groups. This study aimed to ascertain the views of key stakeholders about the Walk-in Centre. Methods Stakeholders were purposively selected through the identification of individuals and organisations which had organisational or professional contact with the Walk-in Centre. Semi structured interviews around key themes were conducted with seventeen stakeholders. Results Stakeholders were generally supportive of the Walk-in Centre but identified key areas which they considered needed to be addressed. These included the service's systems, full utilisation of the nurse practitioner role and adequate education and training. It was also suggested that a doctor could be available to the Centre as a source of referral for patients who fall outside the nurses' scope of practice. The location of the Centre was seen to impact on patient flows to the Emergency Department. Conclusion Nurse led Walk-in Centres are one response to addressing primary health care medical workforce shortages

  14. Enhanced performance feedback and patient participation to improve hand hygiene compliance of health-care workers in the setting of established multimodal promotion: a single-centre, cluster randomised controlled trial.

    Science.gov (United States)

    Stewardson, Andrew James; Sax, Hugo; Gayet-Ageron, Angèle; Touveneau, Sylvie; Longtin, Yves; Zingg, Walter; Pittet, Didier

    2016-12-01

    Hand hygiene compliance of health-care workers remains suboptimal despite standard multimodal promotion, and evidence for the effectiveness of novel interventions is urgently needed. We aimed to assess the effect of enhanced performance feedback and patient participation on hand hygiene compliance in the setting of multimodal promotion. We did a single-centre, cluster randomised controlled trial at University of Geneva Hospitals (Geneva, Switzerland). All wards hosting adult, lucid patients, and all health-care workers and patients in these wards, were eligible. After a 15-month baseline period, eligible wards were assigned by computer-generated block randomisation (1:1:1), stratified by the type of ward, to one of three groups: control, enhanced performance feedback, or enhanced performance feedback plus patient participation. Standard multimodal hand hygiene promotion was done hospital-wide throughout the study. The primary outcome was hand hygiene compliance of health-care workers (according to the WHO Five Moments of Hand Hygiene) at the opportunity level, measured by direct observation (20-min sessions) by 12 validated infection control nurses, with each ward audited at least once every 3 months. This trial is registered with ISRCTN, number ISRCTN43599478. We randomly assigned 67 wards to the control group (n=21), enhanced performance feedback (n=24), or enhanced performance feedback plus patient participation (n=22) on May 19, 2010. One ward in the control group became a high-dependency unit and was excluded from analysis. During 1367 observation sessions, 12 579 hand hygiene opportunities were recorded. Between the baseline period (April 1, 2009, to June 30, 2010) and the intervention period (July 1, 2010, to June 30, 2012), mean hand hygiene compliance increased from 66% (95% CI 62-70) to 73% (70-77) in the control group (odds ratio [OR] 1·41, 95% CI 1·21-1·63), from 65% (62-69) to 75% (72-77) in the enhanced performance feedback group (1·61, 1·41-1

  15. Actividad clínica en la consulta médica a demanda de un Centro Penitenciario frente a la de un Centro de Salud Comparisons between clinical practice consultation in a prison and in community health centres: differences and repercussions

    Directory of Open Access Journals (Sweden)

    C. Chérrez

    2007-02-01

    y de la conflictividad, sugiere un papel más relevante del médico general en un CP que en el conjunto del SPS y puede ser un dato a tener en cuenta en la planificación de la anunciada integración de la SP en el SPS.Objectives: To describe and quantify clinical practice consultancy in a prison health care unit so as to evaluate likely differences from a community Health Care Centre. To identify possible training needs when transferring health care staff from one system to another in the light of probable integration of Prison Health Care into the Public Health System. Methods: A transversal descriptive study was used for three Primary Health Care teams: an urban health centre with a high work load, a rural health centre with a low work load, and the health care unit of a provincial prison (not a mega-prison. Ransom sequential sampling was used to include all the medical activity generated in the consultancy. All activity programmed by the health professional and administrative consultancy was excluded, while efforts were made to locate troubled consultations. Comparisons were made by contrasting differences in proportions. Results: The Prison Health Care Unit showed higher statistically significant clinical activity in mental health, drug abuse, HIV and HCV infection management and specific Primary Health Care problems (biopsychosocial integration is a therapeutic priority. In both community Health Centres there is more statistically significant activity in Internal Medicine and Geriatrics. In the prison environment there is significantly higher troubled consultation. Conclusions: In a future context of integration of prison health care services into the Public Health Service, training in mental health care (especially addictive disorders and in HIV-HCV infection management may be necessary for community health centre professionals wishing to transfer to prison health care units. The prison health care professional who wants to work in a public health centre may

  16. The emergence of urban centres

    DEFF Research Database (Denmark)

    Lazaro, Evelyn; Agergaard, Jytte; Larsen, Marianne Nylandsted

    In this paper we aim at understanding how social and spatial transformation of dynamic rural regions is driving spatial concentration and urbanization. We are particularly concerned with the processes of spatial change, verbalized as the emergence of urban centres in rural areas. Emerging Urban...... Centres (EUCs) are characterized by rapid population growth related to continuous and diverse flows of migrants from rural hinterlands and more detached rural locations. Many of these centres are also characterized by economic dynamics related to agricultural sector activities that have been stimulated...... by Tanzanian market liberalizations and its long term effects on private enterprise. The paper is based on a study of four EUCs in Tanzania (Ilula, Igowole, Madizini and Kibaigwa) and seeks to answer three research questions: 1) What economic and spatial trends, including national policies, have formed...

  17. Construction of the Wigner Data Centre

    CERN Multimedia

    2013-01-01

    A remote extension of the CERN data centre has recently been inaugurated. Hosted at the Wigner Research Centre for Physics in Hungary, it provides extra computing power required to cover CERN’s needs. This video presents the construction of the Wigner Data Centre from initial demolishing work through to its completion and details the major technical characteristics of the Data Centre.

  18. Construction of the Wigner Data Centre

    CERN Document Server

    2013-01-01

    A remote extension of the CERN data centre has recently been inaugurated. Hosted at the Wigner Research Centre for Physics in Hungary, it provides extra computing power required to cover CERN’s needs. This video presents the construction of the Wigner Data Centre from initial demolishing work through to its completion and details the major technical characteristics of the Data Centre.

  19. Scheduling participants of Assessment Centres

    DEFF Research Database (Denmark)

    Lysgaard, Jens; Løber, Janni

      Assessment Centres are used as a tool for psychologists and coaches to observe a number of dimensions in a person's behaviour and test his/her potential within a number of chosen focus areas. This is done in an intense course, with a number of different exercises which expose each participant...... Centres usually last two days and involve 3-6 psychologists or trained coaches as assessors. An entire course is composed of a number of rounds, with each round having its individual duration. In each round, the participants are divided into a number of groups with prespecifed pairing of group sizes...

  20. Research projects of the Finnish Centre for Radiation and Nuclear Safety 1996-1997; Saeteilyturvakeskuksen tutkimushankkeet 1996-1997

    Energy Technology Data Exchange (ETDEWEB)

    Mustonen, R.; Koponen, H. [eds.

    1996-02-01

    The research activities of the Finnish Centre for Radiation and Nuclear Safety (STUK) are based on the Centre`s primary task of preventing and restricting adverse effects of radiation. As a rule, studies concerning nuclear safety (part 1 of the publication) are studies originating from the regulatory function of STUK; these are directed and funded by the Centre but the Centre does not carry them out itself. In contrast, studies dealing with radiation exposure and health risks (part 2 of the publication) are conducted by the Centre itself, often in cooperation with some other research institute or university. Results of these studies are published in open scientific literature.

  1. LDE centres: sprint or marathon?

    NARCIS (Netherlands)

    Bonger, S.; Van Rein, E.

    2015-01-01

    The aim of the Strategic Leiden-Delft-Erasmus Alliance, established by the three universities in 2012, was to improve research and education and competitiveness. Projects are intended to develop from the ground up, which led to the establishment of eight joint centres in 2013. A quick look around re

  2. Person-centred care: Principle of Nursing Practice D.

    Science.gov (United States)

    Manley, Kim; Hills, Val; Marriot, Sheila

    This is the fifth article in a nine-part series describing the Principles of Nursing Practice developed by the Royal College of Nursing (RCN) in collaboration with patient and service organisations, the Department of Health, the Nursing and Midwifery Council, nurses and other healthcare professionals. This article discusses Principle D, the provision of person-centred care.

  3. The CCCB is a cultural centre, not a tourist centre

    Directory of Open Access Journals (Sweden)

    Elena Xirau

    2004-04-01

    Full Text Available Last February, Barcelona's Centre of Contemporary Culture (CCCB celebrated its first ten years in existence. During this time, this institution has looked to be a showcase to the most modern and innovative cultural expressions focused on reflecting on the concept of the city. In this interview, Josep Ramoneda offers his personal view, as the CCCB's director. He talks of how this cultural project was born, of how the concept of the institution took shape in the CCCB, of its relations with Barcelona's Strategic Plan, of how the project has evolved, of the architectural remodelling of the Casa de la Caritat building for its conversion into a cultural centre, of the relations with other institutions and its future.

  4. Comparison of planned menus and centre characteristics with foods and beverages served in New York City child-care centres

    Science.gov (United States)

    Breck, Andrew; Dixon, L Beth; Khan, Laura Kettel

    2016-01-01

    Objective The present study evaluated the extent to which child-care centre menus prepared in advance correspond with food and beverage items served to children. The authors identified centre and staff characteristics that were associated with matches between menus and what was served. Design Menus were collected from ninety-five centres in New York City (NYC). Direct observation of foods and beverages served to children were conducted during 524 meal and snack times at these centres between April and June 2010, as part of a larger study designed to determine compliance of child-care centres with city health department regulations for nutrition. Setting Child-care centres were located in low-income neighbourhoods in NYC. Results Overall, 87% of the foods and beverages listed on the menus or allowed as substitutions were served. Menu items matched with foods and beverages served for all major food groups by > 60%. Sweets and water had lower match percentages (40 and 32%, respectively), but water was served 68% of the time when it was not listed on the menu. The staff person making the food and purchasing decisions predicted the match between the planned or substituted items on the menus and the foods and beverages served. Conclusions In the present study, child-care centre menus included most foods and beverages served to children. Menus planned in advance have potential to be used to inform parents about which child-care centre to send their child or what foods and beverages their enrolled children will be offered throughout the day. PMID:27280341

  5. Glatiramer acetate treatment persistence - but not adherence - in multiple sclerosis patients is predicted by health-related quality of life and self-efficacy: a prospective web-based patient-centred study (CAIR study).

    Science.gov (United States)

    Jongen, Peter Joseph; Lemmens, Wim A; Hoogervorst, Erwin L; Donders, Rogier

    2017-03-14

    In patients with relapsing remitting multiple sclerosis (RRMS) the persistence of and adherence to disease modifying drug (DMD) treatment is inadequate. To take individualised measures there is a need to identify patients with a high risk of non-persistence or non-adherence. As patient-related factors have a major influence on persistence and adherence, we investigated whether health-related quality of life (HRQoL) and self-efficacy could predict persistence or adherence. In a prospective web-based patient-centred study in 203 RRMS patients, starting treatment with glatiramer acatete (GA) 20 mg subcutaneously daily, we measured physical and mental HRQoL (Multiple Sclerosis Quality of Life-54 questionnaire), functional and control self-efficacy (Multiple Sclerosis Self-Efficacy Scale), the 12-month persistence rate and, in persistent patients, the percentage of missed doses. HRQoL and self-efficacy were compared between persistent and non-persistent patients, and between adherent and non-adherent patients. Logistic regression analysis was used to assess whether persistence and adherence were explained by HRQoL and self-efficacy. Persistent patients had higher baseline physical (mean 58.1 [standard deviation, SD] 16.9) and mental HRQoL (63.8 [16.8]) than non-persistent patients (49.5 [17.6]; 55.9 [20.4]) (P = 0.001; P = 0.003) with no differences between adherent and non-adherent patients (P = 0.46; P = 0.54). Likewise, in persistent patients function (752 [156]) and control self-efficacy (568 [178]) were higher than in non-persistent patients (689 [173]; 491 [192]) (P = 0.009; P = 0.004), but not in adherent vs. non-adherent patients (P = 0.26; P = 0.82). Logistic regression modelling identified physical HRQoL and control self-efficacy as factors that explained persistence. Based on predicted scores from the model, patients were classified into quartiles and the percentage of non-persistent patients per quartile was calculated: non

  6. Establishment of the National Centre for Multidisciplinary Studies of Back Pain. An historical overview.

    Science.gov (United States)

    Giles, L G; Walker, B F

    1996-11-01

    Spinal pain of mechanical origin, with or without referred pain, is a serious health problem suffered by many Australians. In order to help patients with this ailment, and to investigate this costly and debilitating condition, the National Centre for Multidisciplinary Studies of Back Pain was established at Townsville General Hospital as a joint venture between James Cook University of North Queensland and the Northern Regional Health Authority. The Centre has a multidisciplinary clinical team including a chiropractor. The Centre functions successfully, contributes to the public health of the community and shows that a multidisciplinary clinical team which includes a chiropractor can work harmoniously in an Australian hospital setting. The need for such a centre is demonstrated by an ever increasing demand for its professional services in Townsville as indicated by a review of the number of new patients and overall patient visits. The Centre could act as a model for the inclusion of chiropractic into the Australian hospital setting.

  7. WISB: Warwick Integrative Synthetic Biology Centre.

    Science.gov (United States)

    McCarthy, John

    2016-06-15

    Synthetic biology promises to create high-impact solutions to challenges in the areas of biotechnology, human/animal health, the environment, energy, materials and food security. Equally, synthetic biologists create tools and strategies that have the potential to help us answer important fundamental questions in biology. Warwick Integrative Synthetic Biology (WISB) pursues both of these mutually complementary 'build to apply' and 'build to understand' approaches. This is reflected in our research structure, in which a core theme on predictive biosystems engineering develops underpinning understanding as well as next-generation experimental/theoretical tools, and these are then incorporated into three applied themes in which we engineer biosynthetic pathways, microbial communities and microbial effector systems in plants. WISB takes a comprehensive approach to training, education and outreach. For example, WISB is a partner in the EPSRC/BBSRC-funded U.K. Doctoral Training Centre in synthetic biology, we have developed a new undergraduate module in the subject, and we have established five WISB Research Career Development Fellowships to support young group leaders. Research in Ethical, Legal and Societal Aspects (ELSA) of synthetic biology is embedded in our centre activities. WISB has been highly proactive in building an international research and training network that includes partners in Barcelona, Boston, Copenhagen, Madrid, Marburg, São Paulo, Tartu and Valencia.

  8. Building National Infrastructures for Patient-Centred Digital Services

    DEFF Research Database (Denmark)

    Thorseng, Anne; Jensen, Tina Blegind

    2015-01-01

    Patient-centred digital services are increasingly gaining impact in the healthcare sector. The premise is that patients will be better equipped for taking care of their own health through instant access to relevant information and by enhanced electronic communication with healthcare providers. One...... infrastructure theory, we highlight the enabling and constraining dynamics when designing and building a national infrastructure for patient-centred digital services. Furthermore, we discuss how such infrastructures can accommodate further development of services. The findings show that the Danish national e...

  9. The effects of nutrition rehabilitation at three Family Life Training Centres in Central Province, Kenya

    NARCIS (Netherlands)

    Hoorweg, J.C.; Niemeijer, R.

    1982-01-01

    During the course of 1978, the three Family Life Training Centres studied admitted 273 women accompanied by 674 children. Women with malnourished children (and their siblings) are admitted to these centres for a 3-week course consisting primarily of nutrition and health education, but also covering

  10. European Centre for Disease Prevention and Control.

    Science.gov (United States)

    Evans, Roger

    2014-11-04

    The European Centre for Disease Prevention and Control was set up in 2005 to strengthen Europe's defences against infectious diseases. The centre is an independent agency of the European Union and is based in Stockholm, Sweden.

  11. Patient-centred Prevention among PAD Patients

    DEFF Research Database (Denmark)

    Pii, Kathrine Hoffmann

    2014-01-01

    -centredness is thus promoted as a way to organize health more effectively (in terms of cost and treatment outcomes) and as a way to ensure patients’ autonomy and fundamental right to make their own decisions regarding their treatment. Critical voices within social and nursing theory have however argued...... that the patient-centred approach does not ensure patient autonomy, but continues to be organized according to biomedical regimes and thereby carry on a paternalistic approach. In this paper, I present findings from a PhD project, which investigates how the ideal of patient-centredness is practiced in the case...... as a relational property/entity, which implies that professionals intervene in the development of patients’ autonomy by expanding their capacity to make and actualize choices. The dilemma regarding the concern to ensure patient autonomy and still wanting patients to make the “right” choices is not one...

  12. Communicating astronomy by the Unizul Science Centre

    Science.gov (United States)

    Beesham, A.; Beesham, N.

    2015-03-01

    The University of Zululand, situated along the east coast of KwaZulu-Natal, has a thriving Science Centre (USC) situated in the developing port city of Richards Bay. Over 30 000 learners visit the centre annually, and it consists of an exhibition area, an auditorium, lecture areas and offices. The shows consist of interactive games, science shows, competitions, quizzes and matriculation workshops. Outreach activities take place through a mobile science centre for schools and communities that cannot visit the centre.

  13. The IOC Centres of Excellence bring prevention to sports medicine.

    Science.gov (United States)

    Engebretsen, Lars; Bahr, Roald; Cook, Jill L; Derman, Wayne; Emery, Carolyn A; Finch, Caroline F; Meeuwisse, Willem H; Schwellnus, Martin; Steffen, Kathrin

    2014-09-01

    The protection of an athlete's health and preventing injuries and illnesses in sport are top priorities for the IOC and its Medical Commission. The IOC therefore partners with selected research centres around the world and supports research in the field of sports medicine. This has enabled the IOC to develop an international network of expert scientists and clinicians in sports injury and disease prevention research. The IOC wants to promote injury and disease prevention and the improvement of physical health of the athlete by: (1) establishing long-term research programmes on injury and disease prevention (including studies on basic epidemiology, risk factors, injury mechanisms and intervention), (2) fostering collaborative relationships with individuals, institutions and organisations to improve athletes' health, (3) implementing and collaborating with applied, ongoing and novel research and development within the framework and long-term strategy of the IOC and (4) setting up knowledge translation mechanisms to share scientific research results with the field throughout the Olympic Movement and sports community and converting these results into concrete actions to protect the health of the athletes. In 2009, the IOC also identified four research centres that had an established track record in research, educational and clinical activities to achieve these ambitions: (1) the Australian Centre for Research into Injury in Sport and its Prevention (ACRISP), Australia; (2) the Sport Injury Prevention Research Centre (SIPRC), Canada; (3) the Clinical Sport and Exercise Medicine Research (CSEM), South Africa and (4) the Oslo Sports Trauma Research Center (OSTRC), Norway. This paper highlights the work carried out by these four IOC Centres of Excellence over the past 6 years and their contribution to the world of sports medicine. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  14. Small Steps towards Student-Centred Learning

    Science.gov (United States)

    Jacobs, George M.; Toh-Heng, Hwee Leng

    2013-01-01

    Student centred learning classroom practices are contrasted with those in teacher centred learning classrooms. The discussion focuses on the theoretical underpinnings of the former, and provides nine steps and tips on how to implement student centred learning strategies, with the aim of developing the 21st century skills of self-directed and…

  15. Building National Infrastructures for Patient-Centred Digital Services

    DEFF Research Database (Denmark)

    Thorseng, Anne; Jensen, Tina Blegind

    2015-01-01

    Patient-centred digital services are increasingly gaining impact in the healthcare sector. The premise is that patients will be better equipped for taking care of their own health through instant access to relevant information and by enhanced electronic communication with healthcare providers. One...... infrastructure theory, we highlight the enabling and constraining dynamics when designing and building a national infrastructure for patient-centred digital services. Furthermore, we discuss how such infrastructures can accommodate further development of services. The findings show that the Danish national e-health...... initiative to provide such services to patients is the Danish national e-health portal, sundhed.dk, which is at the forefront of governmental initiatives and which serves as a unified hub between the various participants in the healthcare sector. Studying the evolution of sundhed.dk in light of information...

  16. Assessment of reactivity of three treponemal tests in non-treponemal non-reactive cases from sexually transmitted diseases clinic, antenatal clinic, integrated counselling and testing centre, other different outdoor patient departments/indoor patients of a tertiary care centre and peripheral health clinic attendees.

    Science.gov (United States)

    Bala, M; Singh, V; Muralidhar, S; Ramesh, V

    2013-01-01

    In India, many state reference centres for sexually transmitted infections perform only a single screening assay for syphilis diagnosis. In this study, Treponema pallidum haemagglutination (TPHA) was performed on 1115 Venereal Disease Research Laboratory (VDRL)/rapid plasma regain (RPR) non-reactive and 107 reactive sera out of 10,489 tested by VDRL/RPR according to the National AIDS Control Organisation syphilis testing protocol. A total of 47 Specimens reactive in TPHA and non-reactive with VDRL test were subjected to fluorescent treponemal antibody absorption and enzyme-immunoassay. Seroprevalence considering both VDRL and TPHA positivity was highest (4.4%) in sexually transmitted diseases clinic attendees than in other subject groups. Positivity by two treponemal tests in 24 (2.2%) cases non-reactive by VDRL/RPR was representative of the fully treated patients or latent or late syphilis cases. The findings highlight that a suitable treponemal confirmatory test should be performed in all the diagnostic laboratories.

  17. Assessment of reactivity of three treponemal tests in non-treponemal non-reactive cases from sexually transmitted diseases clinic, antenatal clinic, integrated counselling and testing centre, other different outdoor patient departments/indoor patients of a tertiary care centre and peripheral health clinic attendees

    Directory of Open Access Journals (Sweden)

    M Bala

    2013-01-01

    Full Text Available In India, many state reference centres for sexually transmitted infections perform only a single screening assay for syphilis diagnosis. In this study, Treponema pallidum haemagglutination (TPHA was performed on 1115 Venereal Disease Research Laboratory (VDRL/rapid plasma regain (RPR non-reactive and 107 reactive sera out of 10,489 tested by VDRL/RPR according to the National AIDS Control Organisation syphilis testing protocol. A total of 47 Specimens reactive in TPHA and non-reactive with VDRL test were subjected to fluorescent treponemal antibody absorption and enzyme-immunoassay. Seroprevalence considering both VDRL and TPHA positivity was highest (4.4% in sexually transmitted diseases clinic attendees than in other subject groups. Positivity by two treponemal tests in 24 (2.2% cases non-reactive by VDRL/RPR was representative of the fully treated patients or latent or late syphilis cases. The findings highlight that a suitable treponemal confirmatory test should be performed in all the diagnostic laboratories.

  18. Student-Centred and Teacher-Centred Learning Environments: What Students Think

    Science.gov (United States)

    Elen, Jan; Clarebout, Geraldine; Leonard, Rebecca; Lowyck, Joost

    2007-01-01

    This contribution explores the relationship between teacher-centred and student-centred learning environments from a student's perspective. Three different views with respect to this relationship can be retrieved. The "balance" view suggests that the more teacher-centred a learning environment is, the less student-centred it is and vice versa. The…

  19. Powering the Future Data Centre

    DEFF Research Database (Denmark)

    Zhang, Zhe

    2010-01-01

    The extended run Uninterruptible Power Supply system (UPSs) which powered by fuel cells and supercapcitors, is a promising solution for future data centre to obtain environmentfriendly energy efficient and cost effective. There are many challenges in power electronic interface circuits, because...... of the traditional cascaded converters, a novel hybrid bidirectional dcdc converter which combines a fuel cell with a boost-type half bridge converter, and supercaps with a DAB converter, is proposed. With phase-shift plus duty cycle, all the switches realize ZVS in a wide range of load variation. Duty cycle control...

  20. Interprofessional Resource Centre: a knowledge translation strategy

    Directory of Open Access Journals (Sweden)

    Christine Patterson

    2011-01-01

    Full Text Available Christine Patterson1,2, Julie Vohra1, David Price3, Gladys Peachey1, Heather Arthur1,4, Patricia Ellis1, Rob Mariani5, Paul Dymel5, Ellen Spencer5, Kevin Timms5, Ellis Westwood51School of Nursing, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada; 2Ontario Primary Health Care Nurse Practitioner Program, McMaster University, Hamilton, ON, Canada; 3Department of Family Medicine, McMaster University, Hamilton, ON, Canada; 4Heart and Stroke Foundation of Ontario/Michael G. DeGroote Endowed Chair in Cardiovascular Nursing Research, McMaster University, Hamilton, ON, Canada; 5Ascentum, Ottawa, ON, CanadaAbstract: The Interprofessional Resource Centre (IRC was based on an extensive literature search and a provincial consultative process that involved administrators, health care providers, educators, preceptors, and alternative and complementary health care providers from different disciplines. Information from the literature review was synthesized into a logic model that served as a preliminary outline for the IRC to be further developed during the stakeholder consultation. The findings from the literature were triangulated with the opinions of different groups of key stakeholders who participated in three different methods of data collection: 1 a large-scale deliberative survey, 2 an in-person dialogue, and 3 targeted questionnaires. The result of this process was an online tool that presents information on what needs to be considered when planning interprofessional practice and education within an organization with the purpose of: 1 building capacity within agencies for interprofessional, collaborative practice; 2 providing preceptors with educational strategies to develop interprofessional competencies in their students; 3 promoting the use of technology as a strategy for knowledge transfer within the agencies and between educational institutions; and 4 developing an evaluation plan to measure interprofessional practice and

  1. Neighbourhood Centres – Organisation, Management and Finance

    DEFF Research Database (Denmark)

    Larsen, Jacob Norvig

    public subsidy. Some of the centres have high number of users on a daily basis, whereas others are only rarely used. It is explored how organisation, management and financial set-up differs among the centres. Quantitative data on financial issues and annual accounts of fifteen centres were analysed......From the late 1990s neighbourhood centres were brought to the fore of public urban regen-eration policy, because they were seen as a means to accelerate the formation of social capital in deprived urban neighbourhoods. A number of such local community centres were established with substantial...... to identify different financial models and analyse economic sustainability. As regards organisational and management models data were collected through documentary sources and by means of personal interviews and field visits to ten centres. Even within the analysed limited population of centres economic...

  2. Perceptual centres in speech - an acoustic analysis

    Science.gov (United States)

    Scott, Sophie Kerttu

    Perceptual centres, or P-centres, represent the perceptual moments of occurrence of acoustic signals - the 'beat' of a sound. P-centres underlie the perception and production of rhythm in perceptually regular speech sequences. P-centres have been modelled both in speech and non speech (music) domains. The three aims of this thesis were toatest out current P-centre models to determine which best accounted for the experimental data bto identify a candidate parameter to map P-centres onto (a local approach) as opposed to the previous global models which rely upon the whole signal to determine the P-centre the final aim was to develop a model of P-centre location which could be applied to speech and non speech signals. The first aim was investigated by a series of experiments in which a) speech from different speakers was investigated to determine whether different models could account for variation between speakers b) whether rendering the amplitude time plot of a speech signal affects the P-centre of the signal c) whether increasing the amplitude at the offset of a speech signal alters P-centres in the production and perception of speech. The second aim was carried out by a) manipulating the rise time of different speech signals to determine whether the P-centre was affected, and whether the type of speech sound ramped affected the P-centre shift b) manipulating the rise time and decay time of a synthetic vowel to determine whether the onset alteration was had more affect on P-centre than the offset manipulation c) and whether the duration of a vowel affected the P-centre, if other attributes (amplitude, spectral contents) were held constant. The third aim - modelling P-centres - was based on these results. The Frequency dependent Amplitude Increase Model of P-centre location (FAIM) was developed using a modelling protocol, the APU GammaTone Filterbank and the speech from different speakers. The P-centres of the stimuli corpus were highly predicted by attributes of

  3. ESTABLISHMENT OF THE NATIONAL CENTRE FOR MULTIDISCIPLINARY STUDIES OF BACK PAIN

    OpenAIRE

    Giles, Lynton G. F.; Walker, Bruce F

    1996-01-01

    Spinal pain of mechanical origin, with or without referred pain, is a serious health problem suffered by many Australians. In order to help patients with this ailment, and to investigate this costly and debilitating condition, the National Centre for Multidisciplinary Studies of Back Pain was established at Townsville General Hospital as a joint venture between James Cook University of North Queensland and the Northern Regional Health Authority. The Centre has a multidisciplinary clinical tea...

  4. Quality of life and symptoms in patients with malignant diseases admitted to a comprehensive cancer centre

    DEFF Research Database (Denmark)

    Strömgren, Annette Sand; Niemann, Carsten Utoft; Tange, Ulla Brix;

    2014-01-01

    Quality of life and symptomatology in patients with malignancies admitted to comprehensive cancer centres are rarely investigated. Thus, this study aimed to investigate symptomatology and health-related quality of life of inpatients with cancer.......Quality of life and symptomatology in patients with malignancies admitted to comprehensive cancer centres are rarely investigated. Thus, this study aimed to investigate symptomatology and health-related quality of life of inpatients with cancer....

  5. The new AMS control centre

    CERN Multimedia

    Anaïs Schaeffer

    2011-01-01

    Construction work for the future AMS control room began in November 2010 and should be finished this June. The new building, which will have been completed in record time thanks to the professionalism of the project team, will soon be ready to receive the initial data from the AMS experiment.     Luigi Scibile and Michael Poehler, from the GS department, at the AMS control centre construction site.   The Alpha Magnetic Spectrometer (AMS) is due to wing its way towards the International Space Station (ISS) on board the shuttle Discovery in April. Mainly intended for research on antimatter and dark matter, the data collected by AMS will be sent to Houston in the United States and then directly to CERN’s new Building 946. Construction work for the AMS control centre building on the Route Gentner at CERN’s Prévessin site started in November 2010 and must be completed in time to receive the first data from the spectrometer in June. “It normall...

  6. Introducing Midwifery-led Birth Centres to Ontario

    Directory of Open Access Journals (Sweden)

    Cristina A. Mattison

    2015-03-01

    Full Text Available In Ontario, maternal health systems are changing, with an increasing variety of childbirth options being offered to low-risk pregnant women. Midwifery became a regulated profession in the province in 1994: providing primary care throughout pregnancy, labour and for up to six weeks postpartum. Currently there are three midwifery-led birth centres operating in Ontario, two of which opened in early 2014. The Ministry of Health and Long-Term Care (MoHLTC has launched these new birth centres in order to offer women more choice in health care provider and birth setting. This shift is representative of the MoHLTC’s push to move services out of hospitals and into community-based settings. While the birth centre initiative is in its early stages and a formal program evaluation is needed, it has the potential, if scaled up, to decrease the need for hospital beds as well as reduce health care costs through more appropriate care for low-risk pregnancies, leading to fewer interventions.

  7. Introducing Midwifery-led Birth Centres to Ontario

    Directory of Open Access Journals (Sweden)

    Cristina A. Mattison

    2015-03-01

    Full Text Available In Ontario, maternal health systems are changing, with an increasing variety of childbirth options being offered to low-risk pregnant women. Midwifery became a regulated profession in the province in 1994: providing primary care throughout pregnancy, labour and for up to six weeks postpartum. Currently there are three midwifery-led birth centres operating in Ontario, two of which opened in early 2014. The Ministry of Health and Long-Term Care (MoHLTC has launched these new birth centres in order to offer women more choice in health care provider and birth setting. This shift is representative of the MoHLTC’s push to move services out of hospitals and into community-based settings. While the birth centre initiative is in its early stages and a formal program evaluation is needed, it has the potential, if scaled up, to decrease the need for hospital beds as well as reduce health care costs through more appropriate care for low-risk pregnancies, leading to fewer interventions.

  8. The Charles Perkins Centre's Twins Research Node.

    Science.gov (United States)

    Ferreira, Lucas C; Craig, Jeffrey M; Hopper, John L; Carrick, Susan E

    2016-08-01

    Twins can help researchers disentangle the roles of genes from those of the environment on human traits, health, and diseases. To realize this potential, the Australian Twin Registry (ATR), University of Melbourne, and the Charles Perkins Centre (CPC), University of Sydney, established a collaboration to form the Twins Research Node, a highly interconnected research facility dedicated specifically to research involving twins. This collaboration aims to foster the adoption of twin designs as important tools for research in a range of health-related domains. The CPC hosted their Twins Research Node's launch seminar entitled 'Double the power of your research with twin studies', in which experienced twin researchers described how twin studies are supporting scientific discoveries and careers. The launch also featured twin pairs who have actively participated in research through the ATR. Researchers at the CPC were surveyed before the event to gauge their level of understanding and interest in utilizing twin research. This article describes the new Twins Research Node, discusses the survey's main results and reports on the launch seminar.

  9. Powering the Future Data Centre

    DEFF Research Database (Denmark)

    Zhang, Zhe

    2010-01-01

    The extended run Uninterruptible Power Supply system (UPSs) which powered by fuel cells and supercapcitors, is a promising solution for future data centre to obtain environmentfriendly energy efficient and cost effective. There are many challenges in power electronic interface circuits, because...... of the characteristics of these two power sources: long warm-up stage and low dynamics for fuel cell, and variable terminal voltage for supercapacitors. The motivation for this project was to find ways which can overcome those limitations to integrate fuel cells and supercapcitors to the system with high efficiency...... and high reliability. Therefore, special focus is given to hybrid dc conversion circuits. From an overview of current state-of-the-art, based on the work of others, the thesis will show the methods utilized in this project to combining fuel cells and supercapcitors for the frontend dc system with cascaded...

  10. A prospective web-based patient-centred interactive study of long-term disabilities, disabilities perception and health-related quality of life in patients with multiple sclerosis in The Netherlands: the Dutch Multiple Sclerosis Study protocol

    NARCIS (Netherlands)

    Jongen, P.J.; Heerings, M.; Lemmens, W.A.; Donders, R.; Zande, A. van der; Noort, E.; Kool, A.

    2015-01-01

    BACKGROUND: In the past two decades the widespread use of disease modifying drugs with moderate to strong efficacy has changed the natural course of multiple sclerosis (MS). Health care professionals, researchers, patient organizations and health authorities are in need of recent information about t

  11. A prospective web-based patient-centred interactive study of long-term disabilities, disabilities perception and health-related quality of life in patients with multiple sclerosis in The Netherlands : the Dutch Multiple Sclerosis Study protocol

    NARCIS (Netherlands)

    Jongen, Peter Joseph; Heerings, Marco; Lemmens, Wim A.; Donders, Rogier; van der Zande, Anneke; van Noort, Esther; Kool, Anton

    2015-01-01

    Background: In the past two decades the widespread use of disease modifying drugs with moderate to strong efficacy has changed the natural course of multiple sclerosis (MS). Health care professionals, researchers, patient organizations and health authorities are in need of recent information about t

  12. Assessment of the noise exposure of call centre operators.

    Science.gov (United States)

    Patel, Jacqueline A; Broughton, Keith

    2002-11-01

    Call centres now play a major role in the daily operations of financial, technology and utility companies, as well as public bodies. It is predicted that 2002 will see 2.3% of the total British workforce employed in call centres. However, local authority enforcement officers, unions, voluntary organizations, employers and employees have all expressed concern that there are hazards to health and safety unique to this new and developing industry. One of the potential hazards reported in the press is hearing damage from using headsets. In a Health & Safety Executive funded project, the noise exposure of 150 call centre operators was evaluated, in call centres which included financial services, home shopping and telecommunications services. The results show that the daily personal noise exposure of these call centre operators is unlikely to exceed the 85 dB(A) action level defined in the Noise at Work Regulations 1989. The risk of hearing damage is therefore extremely low. Exposure to higher noise levels is possible, for example from fax tones, holding tones and high pitched tones from mobile phones. However, the duration of these events is likely to be short and they are therefore unlikely to have a significant effect on the operators' overall noise exposure. A practical method of limiting exposure to unexpected high noises from headsets is to ensure that the headsets incorporate acoustic shock protection that meets the requirements of the Department of Trade and Industry specification 85/013. In the UK, this limiter ensures any noise above 118 dB is not transmitted through the headset. Operators should receive regular training on the headset and telephone equipment they are using. This training should include correct use of the headset and the volume control facilities, and advice on how and when to clean and maintain the headsets.

  13. Activities of Radiation Protection Centre in 2000

    CERN Document Server

    Radiat. Prot. Cent. Vilnius

    2001-01-01

    Description of the activities of Radiation Protection Centre in 2000 is presented. Radiation Protection Centre is responsible for radiation protection issues. Currently there are six departments at Radiation Protection Centre: two in Vilnius - Department of Radiation Protection Supervision and Control and Department of Programs and Expertise, and four in the districts. Brief information on subject controlled by each departments is provided focusing on main achievements and events.

  14. Criteria of Categorizing Logistics and Distribution Centres

    OpenAIRE

    Darko Babić; Anđelko Šćukanec; Kristijan Rogic

    2011-01-01

    Logistics and distribution centres represent very significant infrastructure elements of the macro-logistic system. The creation of the logistics and distribution centres and their connection into a wide (global) network have resulted in the creation of conditions for an adequate distribution of labour and significant increase in the productivity of all the logistics elements and processes, noting that the logistics and distribution centres in this concept have a superregional significance. ...

  15. Smart work centres in rural areas

    DEFF Research Database (Denmark)

    Lorentzen, Anne Birte

    This paper discusses the establishment of telework centres as an element in local development strategies in rural areas, with a particular view to two new telework centres in region North Denmark. The paper argues that telework centres do not represent an easy solution to problems of local develo...... development and environmental sustainability, and further, that technology may not even be the most important feature needed to make them function as such....

  16. Criteria of Categorizing Logistics and Distribution Centres

    Directory of Open Access Journals (Sweden)

    Darko Babić

    2011-07-01

    Full Text Available Logistics and distribution centres represent very significant infrastructure elements of the macro-logistic system. The creation of the logistics and distribution centres and their connection into a wide (global network have resulted in the creation of conditions for an adequate distribution of labour and significant increase in the productivity of all the logistics elements and processes, noting that the logistics and distribution centres in this concept have a superregional significance. This paper represents the summary (results of the research that was carried out on a large number of logistics and distribution centres with the aim of considering the complexity and the issues related to the logistics and distribution centres and the distribution network, their elements and action of the subsystems according to the following criteria: spatial, technical, technological, and organizational, with the aim of defining the categorisation model of the logistics and distribution centres. The analysis of the selected data collected during the research has resulted in defining of the categorisation model of the logistics and distribution centres which foresees six categories. Each of the foreseen categories has been defined according to the set model by the mentioned traffic, technical and technological, and organisational characteristics and the level of service. This is precisely where the application of the categorisation model of the logistics and distribution centres can be found, which will define the relevant categories of the centres applicable in the creation of effective distribution

  17. Hillary Clinton impressed by the Centre's work.

    Science.gov (United States)

    1995-01-01

    In April 1994, US First Lady Hillary Rodham Clinton, her daughter Chelsea, the Bangladesh Minister for Women and Children's Affairs, and the US Ambassador to Bangladesh visited the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B). The First Lady remarked that ICDDR,B's research programs on health and family planning have many important lessons for the developing and developed regions alike. She noted the development successes in Bangladesh that can be applied in the US and other countries: the Grameen Bank, oral rehydration solution (ORS), and the community outreach programs for health and family planning services. The First Lady was especially interested in ORS and its cost-effectiveness. Most of the 220,000 children hospitalized each year in the US for severe gastrointestinal illness are treated with expensive intravenous (IV) drips (average cost = $2300), while a few ORS packets would be a small fraction of the cost. The average cost of treatment per patient at ICDDR,B was only $12. Patients receive care free of charge. Less than 0.6% of the patients die. The previous year, a USAID administrator asked ICDDR,B for its expertise in fighting cholera at the Rwandan refugee camps in Goma, Zaire. ICDDR,B staff developed diagnostic antisera for the new cholera strain responsible for the epidemic in the Americas, described its pathophysiology, and established its mode of transmission in surface waters. ICDDR,B also provides technical support to the national family planning and maternal and child health programs. In the Matlab, ICDDR,B's work has contributed to a high contraceptive prevalence rate of more than 64% among poor and largely illiterate persons.

  18. Reconciling evidence-based medicine and patient-centred care: defining evidence-based inputs to patient-centred decisions.

    Science.gov (United States)

    Weaver, Robert R

    2015-12-01

    Evidence-based and patient-centred health care movements have each enhanced the discussion of how health care might best be delivered, yet the two have evolved separately and, in some views, remain at odds with each other. No clear model has emerged to enable practitioners to capitalize on the advantages of each so actual practice often becomes, to varying degrees, an undefined mishmash of each. When faced with clinical uncertainty, it becomes easy for practitioners to rely on formulas for care developed explicitly by expert panels, or on the tacit ones developed from experience or habit. Either way, these tendencies towards 'cookbook' medicine undermine the view of patients as unique particulars, and diminish what might be considered patient-centred care. The sequence in which evidence is applied in the care process, however, is critical for developing a model of care that is both evidence based and patient centred. This notion derives from a paradigm for knowledge delivery and patient care developed over decades by Dr. Lawrence Weed. Weed's vision enables us to view evidence-based and person-centred medicine as wholly complementary, using computer tools to more fully and reliably exploit the vast body of collective knowledge available to define patients' uniqueness and identify the options to guide patients. The transparency of the approach to knowledge delivery facilitates meaningful practitioner-patient dialogue in determining the appropriate course of action. Such a model for knowledge delivery and care is essential for integrating evidence-based and patient-centred approaches. © 2015 The Authors. Journal of Evaluation in Clinical Practice published by John Wiley & Sons, Ltd.

  19. Evaluation of telemedicine centres in Madhya Pradesh, Central India.

    Science.gov (United States)

    Bali, Surya; Gupta, Arti; Khan, Asif; Pakhare, Abhijit

    2016-04-01

    In a developing country such as India, there is substantial inequality in health care distribution. Telemedicine facilities were established in Madhya Pradesh in 2007-2008. The purpose of this study was to evaluate the infrastructure, equipment, manpower, and functional status of Indian Space and Research Organisation (ISRO) telemedicine nodes in Madhya Pradesh. All district hospitals and medical colleges with nodes were visited by a team of three members. The study was conducted from December 2013-January 2014. The team recorded the structural facility situation and physical conditions on a predesigned pro forma. The team also conducted interviews with the nodal officers, data entry operator and other relevant people at these centres. Of the six specialist nodes, four were functional and two were non-functional. Of 10 patient nodes, two nodes were functional, four were semi-functional and four were non-functional. Most of the centres were not working due to a problem with their satellite modem. The overall condition of ISRO run telemedicine centres in Madhya Pradesh was found to be poor. Most of these centres failed to provide telemedicine consultations. We recommend replacing this system with another cost effective system available in the state wide area network (SWAN). We suggest the concept of the virtual out-patient department.

  20. Lifestyle modifications to prevent and control hypertension. 4. Recommendations on physical exercise training. Canadian Hypertension Society, Canadian Coalition for High Blood Pressure Prevention and Control, Laboratory Centre for Disease Control at Health Canada, Heart and Stroke Foundation of Canada

    National Research Council Canada - National Science Library

    Cléroux, J; Feldman, R D; Petrella, R J

    1999-01-01

    To provide updated, evidence-based recommendations for health care professionals concerning the effects of regular physical activity on the prevention and control of hypertension in otherwise healthy adults...

  1. Aplicación de Gestión Total Eficiente de Energía en el Centro Internacional de Salud “La Pradera”; Application of Total Management Techniques of Energy Efficiency at the International Health Centre "La Pradera”

    Directory of Open Access Journals (Sweden)

    Leyat Fernández Velázquez

    2015-04-01

    Full Text Available En este artículo se presentan los primeros resultados obtenidos de la aplicación de la Metodología de las Técnicas de Gestión Total Eficiente de la Energía en el Centro Internacional de Salud “La Pradera”. Se realizó una caracterización energética del Centro, determinándose la estructura de consumo de los portadores energéticos. Se efectuó una investigación estadística de los datos del Centro durante los años 2010 y 2011, obteniéndose que el portador energético más influyente en el consumo de la instalación es la energía eléctrica. Se analizó la relación entre el índice de consumo kilowatt hora vs habitación-día-ocupada (kWh/HDO para evaluar correctamente la eficiencia energética del centro, determinándose que la temperatura ambiente es un factor significativo en los consumos de electricidad, lo cual conllevó a la obtención de un nuevo índice de consumo que refleja acertadamente el comportamiento del consumo de energía eléctrica en función de los servicios prestados por esta entidad.  This article presents the first results of the application of the Methodology for Total Management Techniques of Energy Efficiency at the International Health Centre "La Pradera". It was realized an energetic characterization of the Centre, determining the structure of energy carriers consumption. It was conducted a statistical investigation of the data Centre during the years 2010 and 2011, giving the electricity as the more influential energy consumption of the facility. It was analyzed the relationship between kilowatt hour consumption rate vs day-occupied-room (kWh / HDO to assess correctly the energy efficiency of the Centre concluding that the room temperature is a significant factor in the consumption of electricity, which led to the award of a new index that accurately reflects the consumption behaviour of electric energy consumption based on the services provided by this entity.

  2. Aplicación de Gestión Total Eficiente de Energía en el Centro Internacional de Salud “La Pradera” ; Application of Total Management Techniques of Energy Efficiency at the International Health Centre "La Pradera”

    Directory of Open Access Journals (Sweden)

    Leyat Fernández Velázquez

    2014-06-01

    Full Text Available En este artículo se presentan los primeros resultados obtenidos de la aplicación de la Metodología de las Técnicas de Gestión Total Eficiente de la Energía en el Centro Internacional de Salud “La Pradera”. Se realizó una caracterización energética del Centro, determinándose la estructura de consumo de los portadores energéticos. Se efectuó una investigación estadística de los datos del Centro durante los años 2010 y 2011, obteniéndose que el portador energético más influyente en el consumo de la instalación es la energía eléctrica. Se analizó la relación entre el índice de consumo kilowatt hora vs habitación-día-ocupada (kWh/HDO para evaluar correctamente la eficiencia energética del centro, determinándose que la temperatura ambiente es un factor significativo en los consumos de electricidad, lo cual conllevó a la obtención de un nuevo índice de consumo que refleja acertadamente el comportamiento del consumo de energía eléctrica en función de los servicios prestados por esta entidad. This article presents the first results of the application of the Methodology for Total Management Techniques of Energy Efficiency at the International Health Centre "La Pradera". It was realized an energetic characterization of the Centre, determining the structure of energy carriers consumption. It was conducted a statistical investigation of the data Centre during the years 2010 and 2011, giving the electricity as the more influential energy consumption of the facility. It was analyzed the relationship between kilowatt hour consumption rate vs day-occupied-room (kWh / HDO to assess correctly the energy efficiency of the Centre concluding that the room temperature is a significant factor in the consumption of electricity, which led to the award of a new index that accurately reflects the consumption behaviour of electric energy consumption based on the services provided by this entity.

  3. AN EXPERIENCE OF FACILITY-BASED MANAGEMENT OF SEVERE ACUTE MALNUTRITION IN CHILDREN AGED BETWEEN 0-59 MONTHS ADOPTING THE WORLD HEALTH ORGANIZATION RECOMMENDATIONS AT NUTRITION REHABILITATION CENTRE, ANANTHAPURAMU

    Directory of Open Access Journals (Sweden)

    Praveen Deen Kumar

    2016-04-01

    Full Text Available BACKGROUND Severe Acute Malnutrition (SAM increases significantly the risk of death in children under five years of age. It can be an indirect cause of child death by increasing the case fatality rate in children suffering from common illness such as diarrhoea, pneumonia. AIMS The aim of this study is to know the effectiveness of facility based management of children with Severe Acute Malnutrition at Nutrition Rehabilitation Centres (NRCs. SETTINGS AND DESIGN The study was done in the Department of Paediatrics, Government General Hospital at Ananthapuramu as a prospective observational study. METHODS AND MATERIALS A total of 195 patients were selected under Severe Acute Malnutrition as per WHO Child Growth Standards by observing for bilateral pitting oedema and/or MUAC _15% admission weight, while 50 (32.7% did not attain target weight gain (non-recovered. CONCLUSION This study will help to improve the functional activities of NRCs. Conducting audits after such studies will aid in implementation of newer guidelines, which will enhance the functional outcome of NRCs. Such NRCs will greatly help to reduce the under-five child mortality rate.

  4. E Mental Health

    DEFF Research Database (Denmark)

    2017-01-01

    In book: Mental Health. A person-centred approach, Edition: 2, Chapter: 15, Publisher: Cambridge University Press, Editors: Procter, Hamer, McGarry, Wilson, Froggatt......In book: Mental Health. A person-centred approach, Edition: 2, Chapter: 15, Publisher: Cambridge University Press, Editors: Procter, Hamer, McGarry, Wilson, Froggatt...

  5. Does one size really fit all? The effectiveness of a non-diagnosis-specific integrated mental health care program in Germany in a prospective, parallel-group controlled multi-centre trial.

    Science.gov (United States)

    Mueller-Stierlin, Annabel Sandra; Helmbrecht, Marina Julia; Herder, Katrin; Prinz, Stefanie; Rosenfeld, Nadine; Walendzik, Julia; Holzmann, Marco; Dinc, Uemmueguelsuem; Schützwohl, Matthias; Becker, Thomas; Kilian, Reinhold

    2017-08-01

    The Network for Mental Health (NWpG-IC) is an integrated mental health care program implemented in 2009 by cooperation between health insurance companies and community mental health providers in Germany. Meanwhile about 10,000 patients have been enrolled. This is the first study evaluating the effectiveness of the program in comparison to standard mental health care in Germany. In a parallel-group controlled trial over 18 months conducted in five regions across Germany, a total of 260 patients enrolled in NWpG-IC and 251 patients in standard mental health care (TAU) were recruited between August 2013 and November 2014. The NWpG-IC patients had access to special services such as community-based multi-professional teams, case management, crisis intervention and family-oriented psychoeducation in addition to standard mental health care. The primary outcome empowerment (EPAS) and the secondary outcomes quality of life (WHO-QoL-BREF), satisfaction with psychiatric treatment (CSQ-8), psychosocial and clinical impairment (HoNOS) and information about mental health service needs (CAN) were measured four times at 6-month intervals. Linear mixed-effect regression models were used to estimate the main effects and interaction effects of treatment, time and primary diagnosis. Due to the non-randomised group assignment, propensity score adjustment was used to control the selection bias. NWpG-IC and TAU groups did not differ with respect to most primary and secondary outcomes in our participating patients who showed a broad spectrum of psychiatric diagnoses and illness severities. However, a significant improvement in terms of patients' satisfaction with psychiatric care and their perception of treatment participation in favour of the NWpG-IC group was found. Providing integrated mental health care for unspecific mentally ill target groups increases treatment participation and service satisfaction but seems not suitable to enhance the overall outcomes of mental health care in

  6. Capturing Reality at Centre Block

    Science.gov (United States)

    Boulanger, C.; Ouimet, C.; Yeomans, N.

    2017-08-01

    The Centre Block of Canada's Parliament buildings, National Historic Site of Canada is set to undergo a major rehabilitation project that will take approximately 10 years to complete. In preparation for this work, Heritage Conservation Services (HCS) of Public Services and Procurement Canada has been completing heritage documentation of the entire site which includes laser scanning of all interior rooms and accessible confined spaces such as attics and other similar areas. Other documentation completed includes detailed photogrammetric documentation of rooms and areas of high heritage value. Some of these high heritage value spaces present certain challenges such as accessibility due to the height and the size of the spaces. Another challenge is the poor lighting conditions, requiring the use of flash or strobe lighting to either compliment or completely eliminate the available ambient lighting. All the spaces captured at this higher level of detail were also captured with laser scanning. This allowed the team to validate the information and conduct a quality review of the photogrammetric data. As a result of this exercise, the team realized that in most, if not all cases, the photogrammetric data was more detailed and at a higher quality then the terrestrial laser scanning data. The purpose and motivation of this paper is to present these findings, as well provide the advantages and disadvantages of the two methods and data sets.

  7. CAPTURING REALITY AT CENTRE BLOCK

    Directory of Open Access Journals (Sweden)

    C. Boulanger

    2017-08-01

    Full Text Available The Centre Block of Canada’s Parliament buildings, National Historic Site of Canada is set to undergo a major rehabilitation project that will take approximately 10 years to complete. In preparation for this work, Heritage Conservation Services (HCS of Public Services and Procurement Canada has been completing heritage documentation of the entire site which includes laser scanning of all interior rooms and accessible confined spaces such as attics and other similar areas. Other documentation completed includes detailed photogrammetric documentation of rooms and areas of high heritage value. Some of these high heritage value spaces present certain challenges such as accessibility due to the height and the size of the spaces. Another challenge is the poor lighting conditions, requiring the use of flash or strobe lighting to either compliment or completely eliminate the available ambient lighting. All the spaces captured at this higher level of detail were also captured with laser scanning. This allowed the team to validate the information and conduct a quality review of the photogrammetric data. As a result of this exercise, the team realized that in most, if not all cases, the photogrammetric data was more detailed and at a higher quality then the terrestrial laser scanning data. The purpose and motivation of this paper is to present these findings, as well provide the advantages and disadvantages of the two methods and data sets.

  8. Laparoscopic adrenalectomy: Single centre experience.

    LENUS (Irish Health Repository)

    O'Farrell, N J

    2012-02-01

    BACKGROUND: Laparoscopic adrenalectomy is an attractive alternative to the traditional open approach in the surgical excision of an adrenal gland. It has replaced open adrenalectomy in our institution and we review our experience to date. METHODS: All cases of laparoscopic adrenalectomies in our hospital over eight years (from 2001 to May 2009) were retrospectively reviewed. Patient demographics, diagnosis, length of hospital stay, histology and all operative and post-operative details were evaluated. RESULTS: Fifty-five laparoscopic adrenalectomies (LA) were performed on 51 patients over eight years. The mean age was 48 years (Range 16-86 years) with the male: female ratio 1:2. Twenty-three cases had a right adrenalectomy, 24 had a left adrenalectomy and the remaining four patients had bilateral adrenalectomies. 91% were successfully completed laparoscopically with five converted to an open approach. Adenomas (functional and non functional) were the leading indication for LA, followed by phaeochromocytomas. Other indications for LA included Cushing\\'s disease, adrenal malignancies and rarer pathologies. There was one mortality from necrotising pancreatitis following a left adrenalectomy for severe Cushing\\'s disease, with subsequent death 10 days later. CONCLUSION: Laparoscopic adrenalectomy is effective for the treatment of adrenal tumours, fulfilling the criteria for the ideal minimally invasive procedure. It has replaced the traditional open approach in our centre and is a safe and effective alternative. However, in the case of severe Cushing\\'s disease, laparoscopic adrenalectomy has the potential for significant adverse outcomes and mortality.

  9. Oil Trading Centre to Reopen in Shanghai

    Institute of Scientific and Technical Information of China (English)

    2004-01-01

    @@ Chinese oil companies will likely resume activities at the oil trading centre in Shanghai this year, a move to further liberalize the once tightly controlled oil market. The centre will trade forward contracts for refined oil products,including gasoline, diesel oil, kerosene and fuel oil, industrial sources said.

  10. Student-Centred Learning (SCL): Roles Changed?

    Science.gov (United States)

    Onurkan Aliusta, Gülen; Özer, Bekir

    2017-01-01

    This paper addresses the espoused and enacted practices of high school teachers with regard to student-centred learning (SCL). Explanatory mixed-method design, where quantitative strand is followed by qualitative one, is employed. While the quantitative strand aims to explore teachers' perceptions regarding the extent student-centred teacher and…

  11. Neighbourhood Centres – Organisation, Management and Finance

    DEFF Research Database (Denmark)

    Larsen, Jacob Norvig

    From the late 1990s neighbourhood centres were brought to the fore of public urban regen-eration policy, because they were seen as a means to accelerate the formation of social capital in deprived urban neighbourhoods. A number of such local community centres were established with substantial pub...

  12. Student Centred Approaches: Teachers' Learning and Practice

    Science.gov (United States)

    Vale, Colleen; Davies, Anne; Weaven, Mary; Hooley, Neil

    2010-01-01

    Student centred approaches to teaching and learning in mathematics is one of the reforms currently being advocated and implemented to improve mathematics outcomes for students from low socio-economic status (SES) backgrounds. The models, meanings and practices of student centred approaches explored in this paper reveal that a constructivist model…

  13. The Press Research Centre, 1956-1976.

    Science.gov (United States)

    Press Research Centre, Krakow (Poland).

    In 1956, the Press Research Centre was established in Cracow, Poland by a group of journalists and publishers, for the purpose of instituting press research that would have practical applications. The aims of the Centre were to conduct studies on the history of the Polish press, the contemporary press, press readership, and editorial techniques.…

  14. The role of the sexual assault centre.

    LENUS (Irish Health Repository)

    Eogan, Maeve

    2013-02-01

    Sexual Assault Centres provide multidisciplinary care for men and women who have experienced sexual crime. These centres enable provision of medical, forensic, psychological support and follow-up care, even if patients chose not to report the incident to the police service. Sexual Support Centres need to provide a ring-fenced, forensically clean environment. They need to be appropriately staffed and available 24 hours a day, 7 days a week to allow prompt provision of medical and supportive care and collection of forensic evidence. Sexual Assault Centres work best within the context of a core agreed model of care, which includes defined multi-agency guidelines and care pathways, close links with forensic science and police services, and designated and sustainable funding arrangements. Additionally, Sexual Assault Centres also participate in patient, staff and community education and risk reduction. Furthermore, they contribute to the development, evaluation and implementation of national strategies on domestic, sexual and gender-based violence.

  15. Centre for urban ecotechnology in ``Oeksnehallen``

    Energy Technology Data Exchange (ETDEWEB)

    1992-03-01

    The Lord Mayor`s Department of the municipality of Copenhagen, Denmark, has with support from this project made a proposal for the establishment of the Centre for Urban Ecotechnology in ``Oeksnehallen``, located in the Vesterbro area of the city. The centre should contribute to the dissemination of knowledge on ecological techniques (regarding passive solar energy etc.) to the inhabitants of Vesterbro and other citizens of Copenhagen, and also serve as a centre in an European context. The ecological demonstration centre will cover an area of two thousand square meters and will also include a cafe, a room for showing coloured slides, facilities for exhibitions created by the center and interested firms etc. The centre should play an important role as part of the ecological concept of urban renewal in Vesterbro. (author).

  16. Big Surveys, Big Data Centres

    Science.gov (United States)

    Schade, D.

    2016-06-01

    Well-designed astronomical surveys are powerful and have consistently been keystones of scientific progress. The Byurakan Surveys using a Schmidt telescope with an objective prism produced a list of about 3000 UV-excess Markarian galaxies but these objects have stimulated an enormous amount of further study and appear in over 16,000 publications. The CFHT Legacy Surveys used a wide-field imager to cover thousands of square degrees and those surveys are mentioned in over 1100 publications since 2002. Both ground and space-based astronomy have been increasing their investments in survey work. Survey instrumentation strives toward fair samples and large sky coverage and therefore strives to produce massive datasets. Thus we are faced with the "big data" problem in astronomy. Survey datasets require specialized approaches to data management. Big data places additional challenging requirements for data management. If the term "big data" is defined as data collections that are too large to move then there are profound implications for the infrastructure that supports big data science. The current model of data centres is obsolete. In the era of big data the central problem is how to create architectures that effectively manage the relationship between data collections, networks, processing capabilities, and software, given the science requirements of the projects that need to be executed. A stand alone data silo cannot support big data science. I'll describe the current efforts of the Canadian community to deal with this situation and our successes and failures. I'll talk about how we are planning in the next decade to try to create a workable and adaptable solution to support big data science.

  17. Silence as a Part of a Camping Product : Case: Evo Camping Centre

    OpenAIRE

    Syrjäniemi, Meeri

    2015-01-01

    The aim of the Bachelor’s thesis was to research whether there is a need for a silence product in Evo Camping Centre. Silence and nature can have a vast positive effect on a person’s health and the role of silence as a camping product will be examined. The thesis was conducted in co-operation with Metsähallitus, former Finnish National Board of Forestry and the entrepreneurs of Evo Camping Centre. A Visitor Surveys of Evo Camping Centre 2010 and Metsähallitus Annual Book 2014 were used as a o...

  18. Skills development at a paramedic accident simulation centre.

    Science.gov (United States)

    Donaghy, John

    2016-02-01

    Practice simulation in acute and pre-hospital care settings is a growing area of interest for clinicians and health educationalists, and there is much evidence to support its use (Pike and O'Donnell 2010). Most simulation is delivered through computer-aided software or in virtual environments, however last year the University of Hertfordshire opened an accident simulation centre which is an outdoor facility that offers pre- and post-registration paramedics the opportunity to experience a range of scenarios in a 'real life' but secure environment. This article describes how the centre enables students to apply theory to practice in complex situations, such as managing patients injured in road traffic collisions.

  19. Addiction research centres and the nurturing of creativity: National Drug Dependence Treatment Centre, India--a profile.

    Science.gov (United States)

    Ray, Rajat; Dhawan, Anju; Chopra, Anita

    2013-10-01

    The National Drug Dependence Treatment Centre (NDDTC) is a part of the All India Institute of Medical Sciences, a premier autonomous medical university in India. This article provides an account of its origin and its contribution to the field of substance use disorder at the national and international levels. Since its establishment, the NDDTC has played a major role in the development of various replicable models of care, the training of post-graduate students of psychiatry, research, policy development and planning. An assessment of the magnitude of drug abuse in India began in the early 1990s and this was followed by a National Survey on Extent, Patterns and Trends of Drug Abuse in 2004. Several models of clinical care have been developed for population subgroups in diverse settings. The centre played an important role in producing data and resource material which helped to scale up opioid substitution treatment in India. A nationwide database on the profile of patients seeking treatment (Drug Abuse Monitoring System) at government drug treatment centres has also been created. The centre has provided valuable inputs for the Government of India's programme planning. Besides clinical studies, research has also focused on pre-clinical studies. Capacity-building is an important priority, with training curricula and resource material being developed for doctors and paramedical staff. Many of these training programmes are conducted in collaboration with other institutions in the country. The NDDTC has received funding from several national and international organizations for research and scientific meetings, and, most recently (2012), it has been designated as a World Health Organization Collaborating Centre on Substance Abuse.

  20. CHARACTERISTICS OF MENTAL MORBIDITY IN A RURAL PRIMARY HEATH CENTRE OF HARYANA

    Science.gov (United States)

    Kishore, Jugal; Reddaiah, V.P.; Kapoor, Vinay; Gill, J.S.

    1996-01-01

    The prevalence of mental morbidity including comorbidity with physical illnesses in a rural primary health centre is very high. Most common entitites in the diagnostic group according to DSM-IU-R were mood disorders (28%), somatoform disorders (27%), and anxiety disorders (17.6%). Majority of them presented with somatic symptoms. There were significant differences in rates for mental disorders when age (particularly 35-44 years), marital status, types of family, and females operated for tubectomy were analysed. The study emphasises the need for effective mental health care to the rural community through primary health centres. PMID:21584121

  1. Getting our house in order: an audit of the registration and publication of clinical trials supported by the National Institute for Health Research Oxford Biomedical Research Centre and the Musculoskeletal Biomedical Research Unit.

    OpenAIRE

    Tompson, AC; Petit-Zeman, S; Goldacre, B.; Heneghan, CJ

    2016-01-01

    Objectives To audit the proportion of clinical trials that had been publically registered and, of the completed trials, the proportion published. Setting 2 major research institutions supported by the National Institute of Health Research (NIHR). Primary and secondary outcome measures The proportion of trials reporting results within 12 months, 24 months and ‘ever’. Factors associated with non-publication were analysed using logistic regression. Inclusion criteria Phases 2–4 clinical trials i...

  2. Holistic design : learning from the Learning Centre

    Energy Technology Data Exchange (ETDEWEB)

    Simon, C. [Charles Simon Architect and Planner, Eden Mills, ON, (Canada); McKee, C. [Kitchener-Waterloo YMCA Outdoor Services, ON (Canada)

    2004-08-01

    The energy efficiency of several solar technologies currently in operation at the Kitchener-Waterloo YMCA's Environmental Learning Centre was evaluated. The off-grid earth-sheltered building dug into a south-facing slope features a sod roof, and protection from north winds by coniferous tree plantations. Passive solar strategies are evaluated, including average indoor temperatures and lighting requirements in both summer and winter. Also evaluated were the centre's ventilation systems, windows and passive heat recovery ventilators (HRVs), solar collectors, masonry heaters, and photovoltaic panels. The centre's composting toilets and use of the Living Machine{sup TM} were also discussed and details of the centre's building materials were provided. Ten straw-bale cabins are currently under construction at the centre, using passive solar strategies for heating, ventilation and cooling and combination propane fired/solar hot water heaters, straw bale building envelope and wood frame roof. Further suggestions for the centre's potential uses, and an outline of the centre's ongoing priorities were outlined. 4 refs.

  3. New centre for intelligent mining systems

    Energy Technology Data Exchange (ETDEWEB)

    Gibson, W.

    2002-10-01

    A Centre for Intelligent Mining Systems has been opened by the University of Alberta's Computing Science Department, a collaborative effort by the University and Syncrude Canada Ltd. The objective of the new Centre is to apply technologies in the area of artificial intelligence and robotics to the problems of surface mining. The Centre has already attracted attention from other players within the industry and a long-term funding proposal by a consortium that includes Syncrude is in the works. Noranda Inc and Inco Inc have also shown interest.

  4. Modelling total energy costs of sports centres

    Energy Technology Data Exchange (ETDEWEB)

    Boussabaine, A.H.; Kirkham, R.J.; Grew, R.J. [Liverpool Univ., School of Architecture and Building Engineering, Liverpool (United Kingdom)

    1999-12-07

    Providing and maintaining safe and comfortable conditions in sport centres raises many issues, particularly cost. The paper gives an overview of the factors associated with sport centre servicing and attempts to highlight the governing factors associated with this, particularly energy costs. A total of 19 sport centres in the City of Liverpool in the UK are investigated, using data elicited from the Liverpool Leisure Services Directorate. The energy operating costs were analysed using statistical methods. Six models were developed to predict total energy costs. Testing and validation results showed a high level of model accuracy. The models would be of use to professionals involved in feasibility studies at the design stage. (Author)

  5. Centre for human development, stem cells & regeneration.

    Science.gov (United States)

    Oreffo, Richard O C

    2014-01-01

    The Centre for Human Development, Stem Cells and Regeneration (CHDSCR) was founded in 2004 as a cross-disciplinary research and translational program within the Faculty of Medicine at the University of Southampton. The Centre undertakes fundamental research into early development and stem cells together with applied translational research for patient benefit. The Centre has vibrant and thriving multidisciplinary research programs that harness the translational strength of the Faculty together with an innovative Stem Cell PhD program, outstanding clinical infrastructure and enterprise to deliver on this vision.

  6. Review of CERN Data Centre Infrastructure

    CERN Document Server

    Andrade, P; van Eldik, J; McCance, G; Panzer-Steindel, B; Coelho dos Santos, M; Traylen, S; Schwickerath, U

    2012-01-01

    The CERN Data Centre is reviewing strategies for optimizing the use of the existing infrastructure and expanding to a new data centre by studying how other large sites are being operated. Over the past six months, CERN has been investigating modern and widely-used tools and procedures used for virtualisation, clouds and fabric management in order to reduce operational effort, increase agility and support unattended remote data centres. This paper gives the details on the project’s motivations, current status and areas for future investigation.

  7. Planetary Radars Operating Centre PROC

    Science.gov (United States)

    Catallo, C.; Flamini, E.; Seu, R.; Alberti, G.

    2007-12-01

    Planetary exploration by means of radar systems, mainly using Ground Penetrating Radars (GPR) plays an important role in Italy. Numerous scientific international space programs are currently carried out jointly with ESA and NASA by Italian Space Agency, the scientific community and the industry. Three important experiments under Italian leadership ( designed and manufactured by the Italian industry), provided by ASI either as contribution to ESA programs either within a NASA/ASI joint venture framework, are now operating: MARSIS on-board Mars Express, SHARAD on-board Mars Reconnaissance Orbiter and CASSINI Radar on-board Cassini spacecraft. In order to support all the scientific communities, institutional customers and experiment teams operation three Italian dedicated operational centers have been realized, namely SHOC, (Sharad Operating Centre), MOC (Marsis Operating Center) and CASSINI PAD ( Processing Altimetry Data). Each center is dedicated to a single instrument management and control, data processing and distribution. Although they had been conceived to operate autonomously and independently one from each other, synergies and overlaps have been envisaged leading to the suggestion of a unified center, the Planetary Radar Processing Center (PROC). PROC is conceived in order to include the three operational centers, namely SHOC, MOC and CASSINI PAD, either from logistics point of view and from HW/SW capabilities point of view. The Planetary Radar Processing Center shall be conceived as the Italian support facility to the scientific community for on-going and future Italian planetary exploration programs. Therefore, scalability, easy use and management shall be the design drivers. The paper describes how PROC is designed and developed, to allow SHOC, MOC and CASSINI PAD to operate as before, and to offer improved functionalities to increase capabilities, mainly in terms of data exchange, comparison, interpretation and exploitation. Furthermore, in the frame of

  8. Home-based versus centre-based cardiac rehabilitation.

    Science.gov (United States)

    Anderson, Lindsey; Sharp, Georgina A; Norton, Rebecca J; Dalal, Hasnain; Dean, Sarah G; Jolly, Kate; Cowie, Aynsley; Zawada, Anna; Taylor, Rod S

    2017-06-30

    Cardiovascular disease is the most common cause of death globally. Traditionally, centre-based cardiac rehabilitation programmes are offered to individuals after cardiac events to aid recovery and prevent further cardiac illness. Home-based cardiac rehabilitation programmes have been introduced in an attempt to widen access and participation. This is an update of a review previously published in 2009 and 2015. To compare the effect of home-based and supervised centre-based cardiac rehabilitation on mortality and morbidity, exercise-capacity, health-related quality of life, and modifiable cardiac risk factors in patients with heart disease. We updated searches from the previous Cochrane Review by searching the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE (Ovid), Embase (Ovid), PsycINFO (Ovid) and CINAHL (EBSCO) on 21 September 2016. We also searched two clinical trials registers as well as previous systematic reviews and reference lists of included studies. No language restrictions were applied. We included randomised controlled trials, including parallel group, cross-over or quasi-randomised designs) that compared centre-based cardiac rehabilitation (e.g. hospital, gymnasium, sports centre) with home-based programmes in adults with myocardial infarction, angina, heart failure or who had undergone revascularisation. Two review authors independently screened all identified references for inclusion based on pre-defined inclusion criteria. Disagreements were resolved through discussion or by involving a third review author. Two authors independently extracted outcome data and study characteristics and assessed risk of bias. Quality of evidence was assessed using GRADE principles and a Summary of findings table was created. We included six new studies (624 participants) for this update, which now includes a total of 23 trials that randomised a total of 2890 participants undergoing cardiac rehabilitation. Participants had an acute myocardial

  9. Patient-centred mountain medicine.

    Science.gov (United States)

    Szawarski, Piotr; Hillebrandt, David

    2016-08-01

    Venturing into the mountains, doctors have accompanied expeditions to provide routine care to the teams, undertake research and occasionally take on a rescue role. The role of doctors practicing mountain medicine is evolving. Public health issues involving concepts of health and safety have become necessary with the coming of commercial and youth expeditions. Increasingly individuals with a disability or a medical diagnosis choose to ascend to high altitudes. Doctors become involved in assessment of risk and providing advice for such individuals. The field of mountain medicine is perhaps unique in that acceptance of risk is part of the ethos of climbing and adventure. The pursuit of mountaineering goals may represent the ultimate conquest of a disability. Knowledge of mountain environment is essential in facilitating mountain ascents for those who choose to undertake them, in spite of a disability or medical condition.

  10. Brookfield Care Centre, Leamlara, Cork.

    LENUS (Irish Health Repository)

    Petticrew, Mark

    2016-01-01

    It has been argued that the alcohol industry uses corporate social responsibility activities to influence policy and undermine public health, and that every opportunity should be taken to scrutinise such activities. This study analyses a controversial Diageo-funded \\'responsible drinking\\' campaign ("Stop out of Control Drinking", or SOOCD) in Ireland. The study aims to identify how the campaign and its advisory board members frame and define (i) alcohol-related harms, and their causes, and (ii) possible solutions.

  11. Towards Human-Centred Design

    Science.gov (United States)

    Bannon, Liam J.

    The field of HCI has evolved and expanded dramatically since its origin in the early 1980’s. The HCI community embraces a large community of researchers and practitioners around the world, from a variety of disciplinary backgrounds in the human and social sciences, engineering and informatics, and more recently, the arts and design disciplines. This kaleidoscope of cultures and disciplines as seen at INTERACT Conferences provides a rich pool of resources for examining our field. Applications are increasingly exploring our full range of sensory modalities, and merging the digital and physical worlds. WiFi has opened up a huge design space for mobile applications. A focus on usability of products and services has been complemented by an emphasis on engagement, enjoyment and experience. With the advent of ubiquitous computing, and the emergence of “The Internet of Things”, new kinds of more open infrastructures make possible radically new kinds of applications. The sources of innovation have also broadened, to include human and social actors outside of the computing and design organizations. The question is to what extent is our mainstream thinking in the HCI field ready for the challenges of this Brave New World? Do the technological and social innovations that we see emerging require us to re-shape, or even, re-create, our field, or is it a case of a more gradual evolution and development of that which we already know? In this closing Keynote, I will provide a perspective on the evolution and development of the HCI field, looking backwards as well as forwards, in order to determine what are some of the changes of significance in the field. This “broad-brush” approach to what I term “ human-centred design” will be complemented by the examination of specific projects and applications, to help anchor some of the discussion. Areas such as user-centred design, participatory design, computer-supported cooperative work and learning, and interaction design, in

  12. The Rankin Inlet Birthing Centre: community midwifery in the Inuit context.

    Science.gov (United States)

    Douglas, Vasiliki Kravariotis

    2011-04-01

    To trace the historical development of the Rankin Inlet Birthing Centre since its inception in 1993 in the context of plans to make it the nucleus of a system of community birthing centres throughout Nunavut. This is an analytical historical study using a combination of oral history interviews, government documents and existing literature. Oral history interviews with current and former employees of the Birthing Centre, founding organizers and women who gave birth there were combined with a review of the literature using MEDLINE, Anthropology PLUS, CINAHL and Historical Abstracts, as well as a search of the records of the Nunavut Government and the debates of the Nunavut Legislature and its predecessor, the NWT Legislature. Results. The Rankin Inlet Birthing Centre has been successful, but only marginally so. The majority of births for residents of this region still occur in southern hospitals, either in Churchill or Winnipeg. Although the long-term plan for the Centre is to train and employ Inuit midwives, thus far only two maternity care workers are employed at the Centre. All the midwives are from southern Canada and rotate through the Centre and the community on fixed terms. The Centre has been very successful at gaining and retaining support at the political level, with a strong official commitment to it from the Nunavut Legislature, and active support from the medical communities in the Kivalliq and in Manitoba through the Northern Health Unit at the University of Manitoba. Community support within Rankin Inlet is less apparent and has been halting. Plans to extend the model of the Centre to other communities are long-standing, but have been slow to come to fruition. The Rankin Inlet Birthing Centre has remained an important, but peripheral, institution in Rankin Inlet. It is in many ways a southern institution located in the Arctic; for this reason, and due to the social networks present in Rankin Inlet itself, it has suffered from a lack of enthusiastic

  13. Symmetric centres of braided monoidal categories

    Institute of Scientific and Technical Information of China (English)

    2000-01-01

    This paper introduces the concept of‘symmetric centres' of braided monoidal categories. Let H be a Hopf algebra with bijective antipode over a field k. We address the symmetric centre of the Yetter-Drinfel'd module category HH(yD) and show that a left Yetter-Drinfel'd module M belongs to the symmetric centre of HH(yD) if and only if M is trivial. We also study the symmetric centres of categories of representations of quasitriangular Hopf algebras and give a sufficient and necessary condition for the braid of H(M) to induce the braid of (H(H)(A),(○)A,A,φ,l,r), or equivalently, the braid of (A#H(H),(○)A,A,φ,l,r), where A is a quantum commutative H-module algebra.

  14. Potential of Natural Ventilation in Shopping Centres

    DEFF Research Database (Denmark)

    Diederichsen, Alice; Friis, Kristina; Brohus, Henrik

    2008-01-01

    The indoor environmental quality (IEQ) is a fundamental requirement for a well performing shopping centre. This paper contains a pilot study of the potential of using hybrid ventilation (a combination of automatically controlled natural and mechanical ventilation - respectively NV and MV) in shop......The indoor environmental quality (IEQ) is a fundamental requirement for a well performing shopping centre. This paper contains a pilot study of the potential of using hybrid ventilation (a combination of automatically controlled natural and mechanical ventilation - respectively NV and MV......) in shopping centres with focus on both the achieved IEQ and energy consumptions for air movement. By thermal building simulations it is found that there exists an interesting potential for hybrid ventilation of shopping centres, which can lead to great savings in the electrical energy consumptions...

  15. Identity Theft: A Study in Contact Centres

    Science.gov (United States)

    Moir, Iain; Weir, George R. S.

    This paper explores the recent phenomenon of identity theft. In particular, it examines the contact centre environment as a mechanism for this to occur. Through a survey that was conducted amongst forty-five contact centre workers in the Glasgow area we determined that contact centres can and do provide a mechanism for identity theft. Specifically, we found a particularly high incidence of agents who had previously dealt with phone calls that they considered suspicious. Furthermore, there are agents within such environments who have previously been offered money in exchange for customers' details, or who know of fellow workers who received such offers. Lastly, we identify specific practices within contact centres that may contribute to the likelihood of identity theft.

  16. Status of cold chain in routine immunisation centres of the Expanded Programme on Immunisation in Quetta, Pakistan.

    Science.gov (United States)

    Buledi, Rahim; Butt, Zahid Ahmad; Ahmed, Jamil; Alizai, Aamir Akram

    2017-05-01

    To determine the status of cold chain and knowledge and practices of health workers about cold chain maintenance in routine immunisation health centres. This cross-sectional study was conducted in Quetta, Pakistan, from May to July 2012, and comprised health facilities in the district. We interviewed the staff responsible for vaccine storage and cold chain maintenance and used a checklist to assess cold chain maintenance of routine expanded programme on immunisation vaccines. SPSS 16 was used for data analysis.. Of the 42 health facilities, staff of 13(30%) wrongly indicated that measles and Bacillus Calmette-Guérin were cold sensitive vaccines. Temperature of the ice-lined refrigerators was not maintained twice daily in 18(43%) centres. There were no voltage stabilisers and standby power generators in 31(74%) and 38(90%) centres, respectively. Vaccine arrangement was found to be inappropriate in ice-lined refrigerators of 38(90%) centres and ice packs were incorrectly used in carriers in 22(52%) centres. Vaccine stock was not charted in 39(93%) centres. Moreover, 4(10%) facilities did not have dedicated expanded programme on immunisation rooms whereas about 5(12%) and 33(79%) had no vaccinator and separate expanded programme on immunisation incharge appointed. Also, 32(76%) centres did not have a female vaccinator appointed. Although the majority of health staff had adequate knowledge, there were weaknesses in practice of maintaining the cold chain.

  17. Outcomes of Chronic Hepatitis C Therapy in Patients Treated in Community Versus Academic Centres in Canada: Final Results of APPROACH (A Prospective Study of Peginterferon alfa-2a and Ribavirin at Academic and Community Centres in Canada

    Directory of Open Access Journals (Sweden)

    Robert P Myers

    2011-01-01

    Full Text Available BACKGROUND: In patients chronically infected with the hepatitis C virus (HCV, it is not established whether viral outcomes or health-related quality of life (HRQoL differ between individuals treated at academic or community centres.

  18. Social innovation for People-Centred Development

    DEFF Research Database (Denmark)

    Hulgård, Lars; P.K., Shajahan

    2013-01-01

    Social innovation is closely related to the people-centred development (PCD) framework of knowledge production. The discussion of PCD in this chapter particularly expands on the feature of empowerment and socio-political mobilization of people in social innovation......Social innovation is closely related to the people-centred development (PCD) framework of knowledge production. The discussion of PCD in this chapter particularly expands on the feature of empowerment and socio-political mobilization of people in social innovation...

  19. [Input of a laboratory in the management of patients with Ebola virus disease and in the training of health personnel: experience of the Forecariah Ebola treatment centre (Guinea) in 2015].

    Science.gov (United States)

    Gaüzère, B-A; Ouellet, I; Nottebrock, D; Nied, J-C; Beya-Kadiebwe, B; Camara, A K; Camara, D; Camara, M L M; Camara, M; Soumah, A; Tounkara, M K; Monteil, V; Camara, A; Bauffe, F; Camara, A; Camara, I B; Simon, B; Jaspard, M; Tran-Minh, T; L'Hériteau, F

    2016-10-01

    Ebola virus disease (EVD) is associated with a high lethality rate even when the afflicted are provided with good support in an Ebola treatment center (ETC). Basic laboratory tests can help to better understand the pathophysiology of the disease, to guide treatment and to establish simple protocols and procedures tailored to the practice of medicine in the context of such precarious environment for caregivers. Based on a few clinical cases of patients treated in the ETC of Forecariah, Guinea, run by the French Red Cross, this article describes the difficult conditions associated with the provision of medical practice in this challenging environment, aiming to minimize the casualties in the EVD patient and to train the health staff.

  20. Perspectives on recycling centres and future developments.

    Science.gov (United States)

    Engkvist, I-L; Eklund, J; Krook, J; Björkman, M; Sundin, E

    2016-11-01

    The overall aim of this paper is to draw combined, all-embracing conclusions based on a long-term multidisciplinary research programme on recycling centres in Sweden, focussing on working conditions, environment and system performance. A second aim is to give recommendations for their development of new and existing recycling centres and to discuss implications for the future design and organisation. Several opportunities for improvement of recycling centres were identified, such as design, layout, ease with which users could sort their waste, the work environment, conflicting needs and goals within the industry, and industrialisation. Combining all results from the research, which consisted of different disciplinary aspects, made it possible to analyse and elucidate their interrelations. Waste sorting quality was recognized as the most prominent improvement field in the recycling centre system. The research identified the importance of involving stakeholders with different perspectives when planning a recycling centre in order to get functionality and high performance. Practical proposals of how to plan and build recycling centres are given in a detailed checklist.

  1. The Imperial College Thermophysical Properties Data Centre

    Science.gov (United States)

    Angus, S.; Cole, W. A.; Craven, R.; de Reuck, K. M.; Trengove, R. D.; Wakeham, W. A.

    1986-07-01

    The IUPAC Thermodynamic Tables Project Centre in London has at its disposal considerable expertise on the production and utilization of high-accuracy equations of state which represent the thermodynamic properties of substances. For some years they have been content to propagate this information by the traditional method of book production, but the increasing use of the computer in industry for process design has shown that an additional method was needed. The setting up of the IUPAC Transport Properties Project Centre, also at Imperial College, whose products would also be in demand by industry, afforded the occasion for a new look at the problem. The solution has been to set up the Imperial College Thermophysical Properties Data Centre, which embraces the two IUPAC Project Centres, and for it to establish a link with the existing Physical Properties Data Service of the Institution of Chemical Engineers, thus providing for the dissemination of the available information without involving the Centres in problems such as those of marketing and advertising. This paper outlines the activities of the Centres and discusses the problems in bringing their products to the attention of industry in suitable form.

  2. Designing and evaluating a health education session on respiratory infections addressed to caregivers of children under three years of age attending day-care centres in Porto, Portugal: A community-based intervention.

    Science.gov (United States)

    Alexandrino, Ana Manuela Ferreira da Silva; Santos, Rita Isabel Garrido Vieira Dos; Melo, Maria Cristina Damas Argel de; Bastos, José Adelino Mesquita

    2017-12-01

    Acute respiratory infections (ARI) are common in children, increasing the pressure on clinicians to prescribe antibiotics and affecting public health Objectives: This study aimed to design a health education session (HES) for caregivers of children, and to evaluate its effects on caregivers' needs, as well as on their knowledge and attitudes concerning ARI. A generalized model of developing, implementing and evaluating a community-based intervention was followed, including caregivers of children under three years of age. Caregivers were randomly distributed into an intervention group (IG) (n = 41) and a control group (CG) (n = 51) and the HES was administered to the IG. The caregivers' needs as well as knowledge of and attitudes to ARI were evaluated in both groups, before (M0) and two months after the HES (M1). At M0 the caregivers from both groups had 'some or great need' about all HES domains; at M1 the caregivers in the IG expressed 'no or low need', whereas the CG maintained 'some or great need' about all HES domains (0.011 ≤ P ≤ .047). Concerning caregivers' knowledge of and attitudes to ARI, at M1 there was a higher frequency of caregivers with right answers in the IG than in the CG (IG =7.5 ± 1 versus CG =6.0 ± 2; P = .000). Those differences occurred in domain (e) nasal clearance techniques, revealing a higher percentage of caregivers who used correctly nasal irrigation (P = .000), nasal aspirators (0.000 ≤P ≤ .001) and nebulization (P = .000) in IG. The HES met the caregivers' needs regarding ARI and increased their knowledge and attitudes towards ARI, especially regarding nasal clearance techniques.

  3. Participatory citizenship: Critical perspectives on client-centred occupational therapy.

    Science.gov (United States)

    Fransen, Hetty; Pollard, Nick; Kantartzis, Sarah; Viana-Moldes, Inés

    2015-07-01

    This article aims to discuss client-centred practice, the current dominant approach within occupational therapy, in relation to participatory citizenship. Occupational therapists work within structures and policies that set boundaries on their engagement with clients, while working with complex, multidimensional social realities. The authors present a critical discussion shaped by their research, including a survey, discussions at workshops at international conferences, and critical engagement with the literature on occupational therapy, occupation, and citizenship. A focus on citizenship suggests reframing professional development based on the participation in public life of people as citizens of their society. While occupational therapists often refer to clients in the context of communities, groups, families, and wider society, the term client-centred practice typically represents a particular view of the individual and may sometimes be too limited in application for a more systemic and societal approach. The authors question the individual focus which has, until recently, been typical of client-centred occupational therapy. Placing citizenship at the core of intervention is a transformative process that assumes all people are citizens and conceives of health as a collective issue, influencing the way we educate, do research, and practise.

  4. Experiences of women who planned birth in a birth centre compared to alternative planned places of birth. Results of the Dutch Birth Centre Study.

    NARCIS (Netherlands)

    Hitzert, M.; Hermus, M.; Scheerhagen, M.; Boesveld, I.C.; Wiegers, T.; Akker-van Marle, M.E. van den; Dommelen, P. van; Pal-de Bruin, K.M. van der; Graal, J. P. de

    2016-01-01

    Objective: to assess the experiences with maternity care of women who planned birth in a birth centre and to compare them to alternative planned places of birth, by using the responsiveness concept of the World Health Organization. Design: this study is a cross-sectional study using the ReproQ

  5. Cognitive behavioural therapy and client-centred counselling.

    Science.gov (United States)

    Collins, Findlay; Deady, David

    This article reviews the potential for combining cognitive behavioural therapy (CBT) and client-centred counselling (CCC) in nurse education and practice. Currently, CBT and CCC are practiced independently of one another within mental health care. This project attempted to bring together the unique qualities of each intervention while encouraging a synergistic approach. This was undertaken by developing and delivering a three-day pilot study workshop. The experiential workshops were evaluated using two sets of structured questionnaires and six semi-structured interviews with randomly selected participants. A follow-up questionnaire was used to review the combined approach in practice.

  6. Award-winning centre a spur for regeneration.

    Science.gov (United States)

    Baillie, Jonathan

    2010-09-01

    An impressive new health and social care centre designed to act as a focal point for the local community in Dudley in the West Midlands, which brings together a wide range of medical and social care services, has won the architects string of awards, including, most recently, the award for Best Design in the LIFT Awards 2010. The building's construction, however, was not without substantial challenges, among them being difficulties in securing the required funding to treat former mine workings, and construct one and a half floors of underground car parking to make the site ready for building to start. HEJ editor Jonathan Baillie reports.

  7. Evaluate the Effect of Palliative Care in the Jing’an Temple Street Community Health Service Centre%静安寺街道社区卫生服务中心开展舒缓疗护效果评价

    Institute of Scientific and Technical Information of China (English)

    温艳艳

    2015-01-01

    目的:对静安寺街道社区卫生服务中心开展的舒缓疗护进行效果评价。方法选取2014年1月~2014年12月在静安寺社区卫生服务中心舒缓疗护病房住院的临终患者113例,给予舒缓疗护并进行效果评价。结果临终患者接受舒缓疗护后,患者的 SAS、SDS、VAS 评分明显下降(P <0.05),QOL 评分明显上升(P <0.05)。另外111例患者家属对舒缓疗护满意,家属满意度为98.23%。结论对临终患者予以舒缓疗护,可以帮助患者减轻恐惧,使其宁静、安详、有尊严的度过余生,得到家属的高度评价。%Objective To evaluate the effect of palliative care in the Jing’an Street Temple Community Health Service Centre. Methods From January 2014 to December 2014, 113 terminal patients that were admitted to the ward of Jing’an Temple Street Community Health Service Centre were selected. The patients received the palliative care, the effect was evaluated. Results After receiving palliative care, the SAS, SDS and VAS scores of the terminal patients were significantly decreased (P<0.05), and the QOL score was significantly increased (P<0.05). In addition, the family members of 111 patients were satisfied with the treatment of palliative care, and the satisfaction of patients was 98.23%. Conclusion For terminal patients, the palliative care is good to relieve the patient’s fear and peacefully, serenely and dignifiedly live the rest of their life, get a high evaluation of family members.

  8. Transmission of HIV in dialysis centre.

    Science.gov (United States)

    Velandia, M; Fridkin, S K; Cárdenas, V; Boshell, J; Ramirez, G; Bland, L; Iglesias, A; Jarvis, W

    1995-06-01

    In August, 1993, 13 dialysis patients at one dialysis centre in Colombia, South America, were found to be HIV positive, and this prompted an epidemiological investigation. We carried out a cohort study of all dialysis centre patients during January, 1992 to December, 1993 (epidemic period) to determine risk factors for HIV seroconversion. Haemodialysis and medical records were reviewed, dialysis centre staff and surviving patients were interviewed, and dialysis practices were observed. Stored sera from all dialysis centre patients were tested for HIV antibody. 12 (52%) of 23 patients tested positive for HIV antibody by enzyme immunoassay and western blot during the epidemic period. Of the 23 tested, 9 (39%) converted from HIV antibody negative to positive (seroconverters) and 10 (44%) remained HIV negative (seronegatives). The HIV seroconversion rate was higher among patients dialysed at the centre while a new patient, who was HIV seropositive, was dialysed there (90% vs 0%; p dialysis centre reprocessed access needles, dialysers, and bloodlines (60% vs 0%). While 2 of 9 HIV seroconverters had had sex with prostitutes, none had received unscreened blood products or had other HIV risk factors. No surgical or dental procedures were associated with HIV seroconversion. Dialysers were reprocessed separately with 5% formaldehyde and were labelled for use on the same patient. Access needles were reprocessed by soaking them in a common container with a low-level disinfectant, benzalkonium chloride; 4 pairs of needles were placed in one pan creating the potential for cross-contamination or use of one patient's needles on another patient. HIV transmission at the dialysis centre was confirmed. Improperly reprocessed patient-care equipment, most probably access needles, is the likely mechanism of transmission. This outbreak was discovered by accident and similar transmission may be occurring in many other countries where low-level disinfectants are used to sterilise critical

  9. Visits to Tier-1 Computing Centres

    CERN Multimedia

    Dario Barberis

    At the beginning of 2007 it became clear that an enhanced level of communication is needed between the ATLAS computing organisation and the Tier-1 centres. Most usual meetings are ATLAS-centric and cannot address the issues of each Tier-1; therefore we decided to organise a series of visits to the Tier-1 centres and focus on site issues. For us, ATLAS computing management, it is most useful to realize how each Tier-1 centre is organised, and its relation to the associated Tier-2s; indeed their presence at these visits is also very useful. We hope it is also useful for sites... at least, we are told so! The usual participation includes, from the ATLAS side: computing management, operations, data placement, resources, accounting and database deployment coordinators; and from the Tier-1 side: computer centre management, system managers, Grid infrastructure people, network, storage and database experts, local ATLAS liaison people and representatives of the associated Tier-2s. Visiting Tier-1 centres (1-4). ...

  10. Scavenger hunt in the CERN Computing Centre

    CERN Multimedia

    CERN Bulletin

    2013-01-01

    Hidden among the racks of servers and disks in the CERN Computing Centre, you’ll find Hawaiian dancers, space aliens, gorillas… all LEGO® figurines! These characters were placed about the Centre for the arrival of Google’s Street View team for the world to discover.   PLEASE NOTE THAT THE COMPETITION IS OVER. ONLY FOR REFERENCE, HERE IS THE ORIGINAL ARTICLE. We’re pleased to announce our first global scavenger hunt! Spot three LEGO® figurines using Google’s Street View and you’ll be entered to win a gift of your choice from our CERN Gift Guide. A LEGO® figurine in the CERN Computing Centre, as seen on Google Street View. Here are the details: Find at least three LEGO® figurines hidden around the CERN Computing Centre using Google Street View.   Take screencaps of the figurines and e-mail the pictures to TreasureHunt-ComputingCentre@cern.ch. This email is no longer active.   The...

  11. The Aube centre. 1997 statement; Le centre de l`Aube. Bilan 1997

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-09-01

    Since January 1992 the Aube centre ensures the storage of 90% of the short life radioactive wastes produced in France. This educational booklet describes the organization of the activities in the centre from the storage of wastes to the radioactivity surveillance of the environment (air, surface and ground waters, river sediments, plants and milk). (J.S.)

  12. A day in the CERN Control Centre

    CERN Multimedia

    Rosaria Marraffino

    2015-01-01

    The CERN Control Centre (CCC) is the nerve centre of the CERN beam systems. From this room, the experts prepare, monitor, adjust, and control the particle beams that circulate throughout the accelerator complex while ensuring that the services and the technical infrastructure work flawlessly. Buttons, screens, telephones, lights (but no sound): in the CCC, everything is ready to make it possible for the LHC to reach the unprecedented energies expected at Run 2.   Seen from above, the CERN Control Centre resembles the shape of a quadrupole magnet. The consoles are distributed in four circles, called “islands”, dedicated to the LHC, the SPS, the PS Complex and the Technical Infrastructure (TI) respectively. Spread between TI and LHC are the Cryogenics consoles. Being in the same room allows the 24h-manned islands to be constantly in touch with one another, thus ensuring the best performance of the machines. At the LHC island, operators are currently busy training the magnet...

  13. Information Centre Radioactivity Switzerland; Beratungsstelle Radioaktivitaet Schweiz

    Energy Technology Data Exchange (ETDEWEB)

    Mosimann, N.; Balsiger, B.; Burger, M. [Bundesamt fuer Bevoelkerungsschutz (Switzerland). LABOR SPIEZ

    2016-07-01

    The Information Centre Radioactivity Switzerland is meant to assess the radiological condition and serves for psychological-medical care of affected members of the Swiss public following an event of increased radioactivity in the environment. The Centre is structured in a modular way consisting of the following modules: ''Entry Measurement'': The visitors are registered and measured for contamination, ''Decontamination'': Contaminated visitors are decontaminated, ''Additional Measurements'': If required, thyroid and whole body measurements are performed, ''Information'': The visitors are informed about radioactivity, radiation protection, the current situation and their individual next steps, ''Exit'': Administrative release from the Information Centre.

  14. Occupational deprivation in an asylum centre:

    DEFF Research Database (Denmark)

    Morville, Anne-Le; Erlandsson, Lena-Karin

    2013-01-01

    This article presents a study of three asylum-seeking men from Iran and Afghanistan. It aimed to explore how and if they experienced occupations as occupations in a Danish asylum centre and how their life experience shaped their choice and value of current occupations. In-depth narrative interviews...... explored the participants’ occupational history and its influence on their occupations in the asylum centre. A thematic analysis showed that the participants had been subjected to occupational disruption and deprivation by politically oppressive systems even before their flight. Their occupations...... in Denmark were to a certain extent influenced by their earlier occupations and the current occupational deprivation they all experienced was due to limited possibilities in the centre. Although they tried their best to fill their days and create structure, there was a loss of valued occupations...

  15. Learning Styles of Independent Learning Centre Users

    Directory of Open Access Journals (Sweden)

    Tarik Uzun

    2014-09-01

    Full Text Available Learning style research has been a significant field within language teaching and learning. There have been very few attempts, however, to seek possible links between independent learning and learning style preferences. This paper aims to identify the learning styles of students who use the Independent Learning Centre (ILC on a regular basis at a state university in Turkey (n=102. The findings of the learning style analysis revealed that, contrary to expectations, most of the regular users of the centre were synoptic learners, which implies that these learners might not necessarily have conscious control over their own learning processes. An in-depth analysis of learning styles and recommendations to improve the services offered in the centre are also included in the paper.

  16. Optimizing Data Centre Energy and Environmental Costs

    Science.gov (United States)

    Aikema, David Hendrik

    Data centres use an estimated 2% of US electrical power which accounts for much of their total cost of ownership. This consumption continues to grow, further straining power grids attempting to integrate more renewable energy. This dissertation focuses on assessing and reducing data centre environmental and financial costs. Emissions of projects undertaken to lower the data centre environmental footprints can be assessed and the emission reduction projects compared using an ISO-14064-2-compliant greenhouse gas reduction protocol outlined herein. I was closely involved with the development of the protocol. Full lifecycle analysis and verifying that projects exceed business-as-usual expectations are addressed, and a test project is described. Consuming power when it is low cost or when renewable energy is available can be used to reduce the financial and environmental costs of computing. Adaptation based on the power price showed 10--50% potential savings in typical cases, and local renewable energy use could be increased by 10--80%. Allowing a fraction of high-priority tasks to proceed unimpeded still allows significant savings. Power grid operators use mechanisms called ancillary services to address variation and system failures, paying organizations to alter power consumption on request. By bidding to offer these services, data centres may be able to lower their energy costs while reducing their environmental impact. If providing contingency reserves which require only infrequent action, savings of up to 12% were seen in simulations. Greater power cost savings are possible for those ceding more control to the power grid operator. Coordinating multiple data centres adds overhead, and altering at which data centre requests are processed based on changes in the financial or environmental costs of power is likely to increase this overhead. Tests of virtual machine migrations showed that in some cases there was no visible increase in power use while in others power use

  17. THE ELUSIVENESS OF LEARNER-CENTRED TEACHING

    Directory of Open Access Journals (Sweden)

    Ervin Kovačević

    2016-03-01

    Full Text Available This research will explore teaching styles of university professors. Teaching style is an umbrella term for teaching decisions made during the entire teaching process – planning, delivery, and evaluation. Contemporary university teachers are advised to adopt the learner-centred teaching style which is assumed to produce remarkable possibilities. In the Fall Semester 2015 fifty-two respondents in different faculties of International University of Sarajevo were surveyed using The Principles of Adult Learning Scale inventory designed by Gary J. Conti. Inventory scores were calculated according to guidelines suggested by the author of the inventory. The scores revealed that majority of respondents strongly supported teacher-centred rather than learner-centred styles of instruction. Scores were analysed on gender lines and across three different faculties, namely: Arts and Social Sciences; Business and Administration; Engineering and Natural Sciences. In all five groups none of the seven teaching style indicators was found to conform with the learner-centred teaching criteria. There was no statistically significant difference between the two genders’ preference for a teaching style. And there was no statistically significant difference between teaching style preference across the three different faculties.The results of this research imply that the learner-centred style of instruction is not frequently implemented. Secondly, the results indicate that the requirements necessary for proper application of the learner-centred teaching style are not easy to meet in current written and unwritten norms. Finally, the results show that traditional teaching styles, which have been preserved in different scientific fields, still predominate in universities.

  18. Byurakan Astrophysical Observatory as Cultural Centre

    Science.gov (United States)

    Mickaelian, A. M.; Farmanyan, S. V.

    2016-12-01

    NAS RA V. Ambartsumian Byurakan Astrophysical Observatory is presented as a cultural centre for Armenia and the Armenian nation in general. Besides being scientific and educational centre, the Observatory is famous for its unique architectural ensemble, rich botanical garden and world of birds, as well as it is one of the most frequently visited sightseeing of Armenia. In recent years, the Observatory has also taken the initiative of the coordination of the Cultural Astronomy in Armenia and in this field, unites the astronomers, historians, archaeologists, ethnographers, culturologists, literary critics, linguists, art historians and other experts.

  19. Byurakan Astrophysical Observatory as Cultural Centre

    Science.gov (United States)

    Mickaelian, A. M.; Farmanyan, S. V.

    2017-07-01

    NAS RA V. Ambartsumian Byurakan Astrophysical Observatory is presented as a cultural centre for Armenia and the Armenian nation in general. Besides being scientific and educational centre, the Observatory is famous for its unique architectural ensemble, rich botanical garden and world of birds, as well as it is one of the most frequently visited sightseeing of Armenia. In recent years, the Observatory has also taken the initiative of the coordination of the Cultural Astronomy in Armenia and in this field, unites the astronomers, historians, archaeologists, ethnographers, culturologists, literary critics, linguists, art historians and other experts. Keywords: Byurakan Astrophysical Observatory, architecture, botanic garden, tourism, Cultural Astronomy.

  20. Enhancing person-centred communication in NICU

    DEFF Research Database (Denmark)

    Weis, Janne; Zoffmann, Vibeke; Egerod, Ingrid

    2015-01-01

    Aims of this article were (a) to explore how parents of premature infants experience guided family-centred care (GFCC), and (b) to compare how parents receiving GFCC versus standard care (SC) describe nurse-parent communication in the neonatal intensive care unit.......Aims of this article were (a) to explore how parents of premature infants experience guided family-centred care (GFCC), and (b) to compare how parents receiving GFCC versus standard care (SC) describe nurse-parent communication in the neonatal intensive care unit....

  1. Gestión del riesgo biológico y su integración con la Seguridad y Salud del Trabajo en el Centro de Inmunología y Biopreparados de Cuba Biohazard management and its integration into Labor Health at the Immunology and Bioproducts Centre in Cuba

    Directory of Open Access Journals (Sweden)

    Dailín Cobos Valdes

    2011-06-01

    Full Text Available La evaluación de riesgos es útil para planificar y mejorar la Seguridad Biológica, el control de la calidad y la Seguridad y Salud en el Trabajo, considerando el marco legal vigente en Cuba y la inspección constituye una parte importante de estos procesos. Con el objetivo de identificar y evaluar el riesgo biológico en el Centro de Inmunología y Biopreparados se realizó esta investigación. La misma incluyó la identificación del riesgo biológico en tres áreas, la evolución de inspecciones de Seguridad Biológica y las medidas correctivas recomendadas. Los resultados permitieron diseñar e implementar el Reglamento de Seguridad en el se integraron las funciones de Seguridad Biológica y Seguridad y Salud en el Trabajo.Risk assessments are useful to plan and improve biological safety, quality control and in general health and safety at work, taking into account the legal framework in Cuba. Supervision is an important part of these processes. Research was done in order to identify and to evaluate the biohazard in the Immunology and Bioproducts Centre (CIBHO. It included the identification and risk assessment in three areas, the biological safety supervisions and its evolution and the corrective measures recommended. The results allowed to design and to implement a Safety Regulation which includes measures for biological safety and health and safety at work.

  2. [Accreditation criteria and quality standards for Poisons centres: development of a quality management system within the Milan Poisons centre].

    Science.gov (United States)

    Della Puppa, Tiziana; Manfrè, Sergio; Grezzi, Marinella

    2006-01-01

    Poisons centres throughout Italy and Europe vary considerably in terms of their institutions and organisation. The European Association of Poisons Centres and Clinical Toxicologists (EAPCCT) has laid down the activities that a poisons centre must carry out, specifying minimum and maximum standards required. These directions allow an evaluation of the service provided. In 2002 Milan Poisons Centre began a project aiming to introduce concepts and methodology proper of the quality systems within poisons centres' institutional activity. Concluded, the project resulted in the centre's certification and the documentation of its procedures: this may now contribute to help define the status and activity of poisons centres in Italy.

  3. Renovation of the CERN Computer Centre

    CERN Multimedia

    Patrice Loïez

    2003-01-01

    The Computer Centre at CERN is seen after half of the equipment is the large ground floor room has been removed. A large-scale spring-cleaning operation took place before renovation work for the new CERN Grid system began. Fifteen kilometres of cables that were no longer needed were removed from the cavity floor for recycling.

  4. Visiting a science centre: what's on offer?

    Science.gov (United States)

    Russell, Ian

    1990-09-01

    Science centres are a valuable resource, used more frequently by family groups and primary school parties than by secondary schools. The importance of affective learning, involving attitude changes, is stressed. Provided the right approach is used, accompanying adults can help children get the most out of a visit.

  5. Tensions in human-centred design

    NARCIS (Netherlands)

    Steen, M.G.D.

    2011-01-01

    In human-centred design (HCD), researchers and designers attempt to cooperate with and learn from potential users of the products or services which they are developing. Their goal is to develop products or services that match users' practices, needs and preferences. In this position paper it is argu

  6. Centre de formació virtual

    OpenAIRE

    Mòdol Martínez, Oscar

    2012-01-01

    Treball de fi de carrera en .NET sobre un centre de formació virtual, desenvolupat en la plataforma .NET amb ASP.NET, VB.NET i Windows Phone 7. Trabajo de fin de carrera en .NET sobre un centro de formación virtual, desarrollado en la plataforma .NET con ASP.NET, VB.NET y Windows Phone 7.

  7. Self Assessment and Student-Centred Learning

    Science.gov (United States)

    McDonald, Betty

    2012-01-01

    This paper seeks to show how self assessment facilitates student-centred learning (SCL) and fills a gap in the literature. Two groups of students were selected from a single class in a tertiary educational institution. The control group of 25 was selected randomly by the tossing of an unbiased coin (heads = control group). They were trained in the…

  8. Student-Centred Learning: A Humanist Perspective

    Science.gov (United States)

    Tangney, Sue

    2014-01-01

    The notion of student-centred learning is often not defined; within the pedagogic literature it is generally associated with constructivism or principles associated with a constructivist environment such as building on prior knowledge, purposeful active learning and sense-making. An informal enquiry into conceptions of university staff prior to…

  9. Patient-centred tuberculosis treatment in Tanzania

    NARCIS (Netherlands)

    Mkopi, A.B.

    2015-01-01

    The main aim of this thesis was to describe and assess the efficacy of the Patient-Centred Treatment (PCT) strategy for the delivery and supervision of tuberculosis (TB) treatment as implemented by the National Tuberculosis and Leprosy programme of Tanzania. The studies presented in this thesis show

  10. Mandibular trauma: a two-centre study

    NARCIS (Netherlands)

    Boffano, P.; Kommers, S.C.; Karagozoglu, K.H.; Gallesio, C.; Forouzanfar, T.

    2015-01-01

    The aims of this study were to assess and compare epidemiological data on mandibular fractures from two European centres and to perform a review of the literature. Between 2001 and 2010, a total of 752 patients with a total of 1167 mandibular fractures were admitted to a hospital in Turin, and 245 p

  11. Regional Dermatology Training Centre in Moshi, Tanzania ...

    African Journals Online (AJOL)

    31 No. 7. Regional Dermatology Training Centre in Moshi, Tanzania – pursuing a dream ... little training in the management of skin disease.[1] ... through lack of trained personnel or resources ... With time, other facilities such as a library, a pharmaceutical compounding ... of information on dermatology and STIs in a tropical ...

  12. Flexible Processes in Project-Centred Learning

    NARCIS (Netherlands)

    Ceri, Stefano; Matera, Maristella; Raffio, Alessandro; Spoelstra, Howard

    2007-01-01

    Ceri, S., Matera, M., Raffio, A. & Spoelstra, H. (2007). Flexible Processes in Project-Centred Learning. In E. Duval, R. Klamma, and M. Wolpers (Eds.), European Conference on Technology Enhanced Learning, Lecture Notes in Computer Science, Vol. 4753, pp. 463-468. Berlin Heidelberg: Springer-Verlag

  13. Myanmar: The Community Learning Centre Experience.

    Science.gov (United States)

    Middelborg, Jorn; Duvieusart, Baudouin, Ed.

    A community learning centre (CLC) is a local educational institution outside the formal education system, usually set up and managed by local people. CLCs were first introduced in Myanmar in 1994, and by 2001 there were 71 CLCs in 11 townships. The townships are characterized by remoteness, landlessness, unemployment, dependency on one cash crop,…

  14. Cactus: The Centres of a Triangle

    Science.gov (United States)

    Hyde, Hartley

    2009-01-01

    This is the first of two articles which describe how to use "JavaSketchPad" to explore the centres of a triangle. This introductory exercise is suggested in the GSP "Workshop Guide". Students can use "JavaSketchPad Interactive Geometry" (JSP) at home at no cost. They are likely to impress their parents with their enthusiasm for geometry and all…

  15. The INTEGRAL science data centre (ISDC)

    DEFF Research Database (Denmark)

    Courvoisier, T.J.L.; Walter, Rasmus; Beckmann, V.

    2003-01-01

    The INTEGRAL Science Data Centre (ISDC) provides the INTEGRAL data and means to analyse them to the scientific community. The ISDC runs a gamma ray burst alert system that provides the position of gamma ray bursts on the sky within seconds to the community. It operates a quick-look analysis...

  16. Hypertension care at a Cape Town community health centre | Lunt ...

    African Journals Online (AJOL)

    Blood pressure control - mean blood pressure of aggregated readings; and ... There were no significant gender differences with regard to these measures. ... loss to follow-up compared with previous South African studies in similar settings.

  17. ANALYSIS OF THE ARCHITECTURE OF A HEALTH CENTRE: SWOT ANALYSIS

    Directory of Open Access Journals (Sweden)

    Grubich T. Y.

    2015-05-01

    Full Text Available The article conducts a SWOT analysis of medical center. This is the first stage of the method of system analysis of enterprise architecture. According to the method of analysis we have identified strengths, weaknesses, opportunities and threats. We have evaluated opportunities, threats, strengths and weaknesses. Calculated the resulting matrix of the SWOT analysis. The calculations were performed using the software product "extended SWOT matrix 1.0". Conclusions and recommendations for the use of the strengths of the organization to overcome the possible threats were given for the use of opportunities to strengthen the weaknesses of the organization, namely the organization needs to develop a strategy that allows you to use factors such as the availability of electronic patient card and the electronic schedule of the doctors at the center for threat neutralization "of the Deterioration of service quality". That is, clients must be satisfied in the future by the lack of delay in the issue of an appointment and receive a personal card. However, only one SWOT analysis is sufficient to build accurate conclusions and business decisions, and it is therefore necessary to use such methods of analysis, ABC analysis, and analysis of competition porter and segmentation of the consumer market

  18. A survey of hypertensive practices at two community health centres ...

    African Journals Online (AJOL)

    Consecutive patients attending hypertension clinics at two CHCs were ... with hypertension guidelines, factors leading to treatment non-adherence, and delivery of care. ... The mean number of antihypertensive drugs was 2.4 per patient.

  19. ANALYSIS OF THE ARCHITECTURE OF A HEALTH CENTRE: SWOT ANALYSIS

    OpenAIRE

    Grubich T. Y.; Shrolik A. V.

    2015-01-01

    The article conducts a SWOT analysis of medical center. This is the first stage of the method of system analysis of enterprise architecture. According to the method of analysis we have identified strengths, weaknesses, opportunities and threats. We have evaluated opportunities, threats, strengths and weaknesses. Calculated the resulting matrix of the SWOT analysis. The calculations were performed using the software product "extended SWOT matrix 1.0". Conclusions and recommendations for the us...

  20. Virginia Community Health Centre, Dublin Road, Virginia, Cavan.

    LENUS (Irish Health Repository)

    Tong, Pin

    2010-01-01

    Recent studies generating complete human sequences from Asian, African and European subgroups have revealed population-specific variation and disease susceptibility loci. Here, choosing a DNA sample from a population of interest due to its relative geographical isolation and genetic impact on further populations, we extend the above studies through the generation of 11-fold coverage of the first Irish human genome sequence.

  1. Simulating sanitation and waste flows and their environmental impacts in East African urban centres

    NARCIS (Netherlands)

    Oyoo, R.

    2014-01-01

    Simulating Sanitation and Waste Flows and their Environmental Impacts in East African Urban Centres Abstract If improperly managed, urban waste flows can pose a significant threat to the quality of both the natural environment and public health. Just as many urban a

  2. A National Benchmarking Survey of Student Counselling Centres/Units in South Africa

    Science.gov (United States)

    Cilliers, C. D.; Pretorius, K.; van der Westhuizen, L. R.

    2010-01-01

    Students experience various challenges during their studies, such as personal problems, academic difficulties and mental health problems. Therefore, student counselling centres/units play a valuable role in providing support systems for students in need. The most frequent problems South African students experience are relationship problems and…

  3. Food Choice by People with Intellectual Disabilities at Day Centres: A Qualitative Study

    Science.gov (United States)

    Cartwright, Luke; Reid, Marie; Hammersley, Richard; Blackburn, Chrissie; Glover, Lesley

    2015-01-01

    People with intellectual disabilities experience a range of health inequalities. It is important to investigate possible contributory factors that may lead to these inequalities. This qualitative study identified some difficulties for healthy eating in day centres. (1) Service users and their family carers were aware of healthy food choices but…

  4. Food Choice by People with Intellectual Disabilities at Day Centres: A Qualitative Study

    Science.gov (United States)

    Cartwright, Luke; Reid, Marie; Hammersley, Richard; Blackburn, Chrissie; Glover, Lesley

    2015-01-01

    People with intellectual disabilities experience a range of health inequalities. It is important to investigate possible contributory factors that may lead to these inequalities. This qualitative study identified some difficulties for healthy eating in day centres. (1) Service users and their family carers were aware of healthy food choices but…

  5. The job demands-resources model of work engagement in South African call centres

    Directory of Open Access Journals (Sweden)

    Yolandi Janse van Rensburg

    2013-09-01

    Full Text Available Orientation: A ‘sacrificial human resource strategy’ is practised in call centres, resulting in poor employee occupational health. Consequently, questions are posed in terms of the consequences of call centre work and which salient antecedent variables impact the engagement and wellbeing of call centre representatives.Research purpose: Firstly, to gauge the level of employee engagement amongst a sample of call centre representatives in South Africa and, secondly, to track the paths through which salient personal and job resources affect this engagement. More specifically, the relationships between sense of coherence, leadership effectiveness, team effectiveness and engagement were investigated, thus testing the Job Demands-Resources model of work engagement.Motivation for the study: To present an application of the Job Demands-Resources model of work engagement in a call centre environment in order to diagnose current ills and consequently propose remedies.Research design: A cross-sectional survey design was used and a non-probability convenient sample of 217 call centre representatives was selected. The measuring instruments comprise the Utrecht Work Engagement Scale to measure engagement, the Team Diagnostic Survey to measure team effectiveness, the leadership practices inventory to gauge leadership effectiveness, and the Orientation to Life Questionnaire to measure sense of coherence. A series of structural equation modelling analyses were performed.Main findings: Contrary to the ‘electronic sweatshop’ image attached to call centre jobs depicted in the literature, results show a high level of employee engagement for call centre representatives in the sample. Also, personal resources such as sense of coherence and job resources such as team effectiveness related significantly to engagement. A non-significant relationship exists between leadership effectiveness and engagement.Practical/managerial implications: Both the content and

  6. The job demands-resources model of work engagement in South African call centres

    Directory of Open Access Journals (Sweden)

    Yolandi Janse van Rensburg

    2013-01-01

    Full Text Available Orientation: A ‘sacrificial human resource strategy’ is practised in call centres, resulting in poor employee occupational health. Consequently, questions are posed in terms of the consequences of call centre work and which salient antecedent variables impact the engagement and wellbeing of call centre representatives.Research purpose: Firstly, to gauge the level of employee engagement amongst a sample of call centre representatives in South Africa and, secondly, to track the paths through which salient personal and job resources affect this engagement. More specifically, the relationships between sense of coherence, leadership effectiveness, team effectiveness and engagement were investigated, thus testing the Job Demands-Resources model of work engagement.Motivation for the study: To present an application of the Job Demands-Resources model of work engagement in a call centre environment in order to diagnose current ills and consequently propose remedies.Research design: A cross-sectional survey design was used and a non-probability convenient sample of 217 call centre representatives was selected. The measuring instruments comprise the Utrecht Work Engagement Scale to measure engagement, the Team Diagnostic Survey to measure team effectiveness, the leadership practices inventory to gauge leadership effectiveness, and the Orientation to Life Questionnaire to measure sense of coherence. A series of structural equation modelling analyses were performed.Main findings: Contrary to the ‘electronic sweatshop’ image attached to call centre jobs depicted in the literature, results show a high level of employee engagement for call centre representatives in the sample. Also, personal resources such as sense of coherence and job resources such as team effectiveness related significantly to engagement. A non-significant relationship exists between leadership effectiveness and engagement.Practical/managerial implications: Both the content and

  7. Developing compassion through a relationship centred appreciative leadership programme.

    Science.gov (United States)

    Dewar, Belinda; Cook, Fiona

    2014-09-01

    Recent attention in health care focuses on how to develop effective leaders for the future. Effective leadership is embodied in relationships and should be developed in and with staff and patients. This paper describes development, implementation and evaluation of an appreciative and relationship centred leadership programme carried out with 86 nursing staff covering 24 in-patient areas within one acute NHS Board in Scotland. The aim of the programme was to support staff to work together to develop a culture of inquiry that would enhance delivery of compassionate care. The 12 month Leadership Programme used the principles of appreciative relationship centred leadership. Within this framework participants were supported to explore relationships with self, patients and families, and with teams and the wider organisation using caring conversations. Participants worked within communities of practice and action learning sets. They were supported to use a range of structured tools to learn about the experience of others and to identify caring practices that worked well and then explore ways in which these could happen more of the time. A range of methods were used to evaluate impact of the programme including a culture questionnaire and semi structured interviews. Immersion crystallisation technique and descriptive statistics were used to analyse the data. Key themes included; enhanced self-awareness, better relationships, greater ability to reflect on practice, different conversations in the workplace that were more compassionate and respectful, and an ethos of continuing learning and improvement. The programme supported participants to think in different ways and to be reflective and engaged participants rather than passive actors in shaping the cultural climate in which compassionate relationship centred care can flourish. Multidisciplinary programmes where the process and outcomes are explicitly linked to organisational objectives need to be considered in future

  8. Measurement of Eccentricity of the Centre of Mass from the Geometric Centre of a Sphere

    Institute of Scientific and Technical Information of China (English)

    郭俊起; 胡忠坤; 顾邦明; 罗俊

    2004-01-01

    The eccentricity of the centre of mass from the geometric centre of a spherical attracting mass in determining the Newtonian gravitational constant G is tested by means of an electronic balance. The experimental result shows that the eccentricity of the sample is about 0.31 μm with uncertainty of 0.05 μm. Two density distribution models are discussed to estimate the uncertainty to G by the eccentricities of the attracting masses.

  9. HISTORIC CENTRE(S OF BARCELONA: PRACTICAL AND SYMBOLIC ELEMENTS IN TRADITIONAL URBAN SPACE

    Directory of Open Access Journals (Sweden)

    Verónica Martínez Robles

    2007-09-01

    The model of compact city that Barcelona aims, has required the renewal of its historical areas, and in order to improve their level of centrality, taking into account, that in addition of its historical centre “Ciutat Vella”, Barcelona contains diverse traditional neighborhoods each of them having their own historical centre. The difference centre‐periphery should also be perceived among these other historical centers. Integration should not be confused with standardization, neither differentiation with segregation.

  10. WHO Collaborating Centre for Acquired Immunodeficiency Syndrome for the Eastern Mediterranean Regional Office, Faculty of Medicine, Kuwait University, Kuwait.

    Science.gov (United States)

    Altawalah, Haya; Al-Nakib, Widad

    2014-01-01

    In the early 1980s, the World Health Organization (WHO) designated the Virology Unit of the Faculty of Medicine, Health Sciences Centre, Kuwait University, Kuwait, a collaborating centre for AIDS for the Eastern Mediterranean Regional Office (EMRO), recognizing it to be in compliance with WHO guidelines. In this centre, research integral to the efforts of WHO to combat AIDS is conducted. In addition to annual workshops and symposia, the centre is constantly updating and renewing its facilities and capabilities in keeping with current and latest advances in virology. As an example of the activities of the centre, the HIV-1 RNA viral load in plasma samples of HIV-1 patients is determined by real-time PCR using the AmpliPrep TaqMan HIV-1 test v2.0. HIV-1 drug resistance is determined by sequencing the reverse transcriptase and protease regions on the HIV-1 pol gene, using the TRUGENE HIV-1 Genotyping Assay on the OpenGene® DNA Sequencing System. HIV-1 subtypes are determined by sequencing the reverse transcriptase and protease regions on the HIV-1 pol gene using the genotyping assays described above. A fundamental program of Kuwait's WHO AIDS collaboration centre is the national project on the surveillance of drug resistance in human deficiency virus in Kuwait, which illustrates how the centre and its activities in Kuwait can serve the EMRO region of WHO.

  11. Kivalliq Inuit Centre boarding home and the provision of prenatal education

    Science.gov (United States)

    Lawford, Karen M.; Giles, Audrey R.

    2016-01-01

    The Kivalliq Inuit Centre (KIC), a boarding home in Winnipeg, Manitoba, is unique in its provision of a pilot prenatal education class and public health nursing services for Nunavummiut who are beneficiaries of the Nunavut Land Claim Agreement. Through a critical review of literature, policies and interviews related to evacuation for birth, we argue that the pilot at the KIC has the potential to play an important role in improving maternal child health for residents of Nunavut. PMID:27938641

  12. Effects of unstratified and centre-stratified randomization in multi-centre clinical trials.

    Science.gov (United States)

    Anisimov, Vladimir V

    2011-01-01

    This paper deals with the analysis of randomization effects in multi-centre clinical trials. The two randomization schemes most often used in clinical trials are considered: unstratified and centre-stratified block-permuted randomization. The prediction of the number of patients randomized to different treatment arms in different regions during the recruitment period accounting for the stochastic nature of the recruitment and effects of multiple centres is investigated. A new analytic approach using a Poisson-gamma patient recruitment model (patients arrive at different centres according to Poisson processes with rates sampled from a gamma distributed population) and its further extensions is proposed. Closed-form expressions for corresponding distributions of the predicted number of the patients randomized in different regions are derived. In the case of two treatments, the properties of the total imbalance in the number of patients on treatment arms caused by using centre-stratified randomization are investigated and for a large number of centres a normal approximation of imbalance is proved. The impact of imbalance on the power of the study is considered. It is shown that the loss of statistical power is practically negligible and can be compensated by a minor increase in sample size. The influence of patient dropout is also investigated. The impact of randomization on predicted drug supply overage is discussed.

  13. C2-C6 background hydrocarbon concentrations monitored at a roof top and green park site, in Dublin City centre.

    Science.gov (United States)

    O'Donoghue, R T; Broderick, B M

    2007-09-01

    A 5 week monitoring campaign was carried out in Dublin City centre, to establish which site gave a more accurate background city centre estimation: a roof-top or green field site. This background represented a conservative estimate of HC exposure in Dublin City centre, useful for quantifying health effects related to this form of pollution and also for establishing a local background relative to the four surrounding main roads when the wind direction is travelling towards each road with the background receptor upwind. Over the entire monitoring campaign, the lowest concentrations and relative standard deviations were observed at the green field site, regardless of time of day or meteorological effects.

  14. ASTHENOPIA PADA PEKERJA WANITA DI CALL CENTRE<