WorldWideScience

Sample records for health challenges posed

  1. [The green rural economy: challenges to research and to public health policies posed by agricultural modernization].

    Science.gov (United States)

    Rigotto, Raquel Maria; Carneiro, Fernando Ferreira; Marinho, Alice Maria Correia Pequeno; Rocha, Mayara Melo; Ferreira, Marcelo José Monteiro; Pessoa, Vanira Matos; Teixeira, Ana Cláudia de Araújo; da Silva, Maria de Lourdes Vicente; Braga, Lara de Queiroz Viana; Teixeira, Maiana Maia

    2012-06-01

    In this paper, we ask ourselves who should, can and has the will to promote health in the rural zone today. The fields of science and public policy were chosen as our primary focus of dialogue conducted from the perspective of the right to health and a healthy environment. Seven lessons emerged: (1) in addition to the surveillance of isolated chemical risks, the relation between agrochemicals and health should be investigated in the context of conservative agricultural modernization; (2) it is mandatory and urgent to discover the health problems related to the use of agrochemicals; (3) the State has been successful in its support of agribusiness, but highly inefficient at enforcing policies to safeguard social rights; (4) sectors of society linked to rural organizations have played an important role in the public policies combating agrochemicals and protecting health; (5) studies must help deconstruct the myths surrounding the Green Revolution model; (6) we are faced with the challenge of contributing to the construction of an emerging scientific paradigm founded on an ethical-political commitment to the most vulnerable social elements; (7) rural communities are creating agro-ecological alternatives for life in semiarid areas.

  2. Are universities preparing nurses to meet the challenges posed by the Australian mental health care system?

    Science.gov (United States)

    Wynaden, D; Orb, A; McGowan, S; Downie, J

    2000-09-01

    The preparedness of comprehensive nurses to work with the mentally ill is of concern to many mental health professionals. Discussion as to whether current undergraduate nursing programs in Australia prepare a graduate to work as a beginning practitioner in the mental health area has been the centre of debate for most of the 1990s. This, along with the apparent lack of interest and motivation of these nurses to work in the mental health area following graduation, remains a major problem for mental health care providers. With one in five Australians now experiencing the burden of a major mental illness, the preparation of a nurse who is competent to work with the mentally ill would appear to be a priority. The purpose of the present study was to determine third year undergraduate nursing students' perceived level of preparedness to work with mentally ill clients. The results suggested significant differences in students' perceived level of confidence, knowledge and skills prior to and following theoretical and clinical exposure to the mental health area. Pre-testing of students before entering their third year indicated that the philosophy of comprehensive nursing: integration, although aspired to in principle, does not appear to occur in reality.

  3. Challenges HIV/AIDS poses on the nursing workforce in rural health ...

    African Journals Online (AJOL)

    The nurses also indicated that they get very limited support from managers. The effects of all these culminate to a stressed and burnout workforce that is detrimental to health care in the region. Recommendations focused on supporting nurses to cope with caring through provision of work-based support programmes.

  4. Challenges posed by tick-borne rickettsiae: eco-epidemiology and public health implications.

    Science.gov (United States)

    Eremeeva, Marina E; Dasch, Gregory A

    2015-01-01

    Rickettsiae are obligately intracellular bacteria that are transmitted to vertebrates by a variety of arthropod vectors, primarily by fleas and ticks. Once transmitted or experimentally inoculated into susceptible mammals, some rickettsiae may cause febrile illness of different morbidity and mortality, and which can manifest with different types of exhanthems in humans. However, most rickettsiae circulate in diverse sylvatic or peridomestic reservoirs without having obvious impacts on their vertebrate hosts or affecting humans. We have analyzed the key features of tick-borne maintenance of rickettsiae, which may provide a deeper basis for understanding those complex invertebrate interactions and strategies that have permitted survival and circulation of divergent rickettsiae in nature. Rickettsiae are found in association with a wide range of hard and soft ticks, which feed on very different species of large and small animals. Maintenance of rickettsiae in these vector systems is driven by both vertical and horizontal transmission strategies, but some species of Rickettsia are also known to cause detrimental effects on their arthropod vectors. Contrary to common belief, the role of vertebrate animal hosts in maintenance of rickettsiae is very incompletely understood. Some clearly play only the essential role of providing a blood meal to the tick while other hosts may supply crucial supplemental functions for effective agent transmission by the vectors. This review summarizes the importance of some recent findings with known and new vectors that afford an improved understanding of the eco-epidemiology of rickettsiae; the public health implications of that information for rickettsial diseases are also described. Special attention is paid to the co-circulation of different species and genotypes of rickettsiae within the same endemic areas and how these observations may influence, correctly or incorrectly, trends, and conclusions drawn from the surveillance of

  5. Incomplete Markets and Imperfect Institutions: Some Challenges Posed by Trust for Contemporary Health Care and Health Policy.

    Science.gov (United States)

    Schlesinger, Mark; Gray, Bradford H

    2016-08-01

    As contemporary health policy promotes evidence-based practices using targeted incentives, policy makers may lose track of vital aspects of care that are difficult to measure. For more than a half century, scholars have recognized that these latter aspects play a crucial role in high-quality care and equitable health system performance but depend on the potentially frail reed of providers' trustworthiness: that is, their commitment to facets and outcomes of care not easily assessed by external parties. More recently, early experience with pay for performance in health settings suggests that enhancing financial rewards for the measurable undermines providers' commitment to the unmeasurable, degrading the trustworthiness of their practices. Reformers have looked to revised professional norms or reorganized practice arrangements to bolster the intrinsic motivations required for trustworthiness. We suggest here that these responses are likely to prove inadequate. We propose that they be complemented by a renewed policy-making commitment to nonprofit ownership among health care providers, insurers, and integrated delivery systems. We identify some of the concerns raised in the past with ownership-based policies and propose a set of responses. If these are pursued in combination, they hold the promise of a sustainable ownership-based policy reform for the United States. Copyright © 2016 by Duke University Press.

  6. Health Issues: Do Cell Phones Pose a Health Hazard?

    Science.gov (United States)

    ... Procedures Home, Business, and Entertainment Products Cell Phones Health Issues Share Tweet Linkedin Pin it More sharing ... it Email Print Do cell phones pose a health hazard? Many people are concerned that cell phone ...

  7. Challenges Posed by Novel Psychoactive Substances – Middle East Perspective

    Directory of Open Access Journals (Sweden)

    Maciej J. Bogusz

    2017-04-01

    Full Text Available New psychoactive substances (NPS are defined as substances of abuse, either in a pure form or a preparation, that are not controlled by the 1961 Single Convention on Narcotic Drugs or the 1971 Convention on Psychotropic Substances, but which may pose a public health threat. In this context, the term “new” does not necessarily refer to new inventions but to substances that have recently become available or popular in a given society or country. This definition indicates that the problem of NPS is not new; however, the availability of any information via new communication technologies in the 21st century has enabled the spread of unwanted and socially harmful information, like information on the commercial availability of various NPS, offered in rising amounts and brands.

  8. Deep Space Exploration: Will We Be Ready? Infectious Diseases, Microgravity and Other Forces Affecting Health Pose Challenges for Humans Planning to Explore Space

    Science.gov (United States)

    LaRocco, Mark T.; Pierson, Duane L.

    1999-01-01

    In contemplating space travel beyond earth orbits, we humans face significant barriers and major challenges. Although researchers involved in several scientific subdisciplines, including space medicine and space life sciences, may provide insights to help overcome those barriers, their efforts are at an early stage of development, leaving open many questions of potentially major consequence.

  9. Medical rehabilitation in low and middle income countries for adult acquired disability: challenges posed by rapidity of health system change and position on the individualistic-collectivist axis

    Directory of Open Access Journals (Sweden)

    Karl Sandin

    2015-01-01

    Full Text Available Chronic illness prevalence has rapidly increased in low or middle income countries (LMIC and with it, the need for medical rehabilitation for adults with acquired conditions that stem from aging and long-term conditions. While Western medical rehabilitation programs have had at least two generations to develop, in LMIC, post-acute health care delivery change has been much more rapid. As a result, there has been little opportunity for models of medical rehabilitation to deliberately emerge in LMIC that reflect societal values. While adaptation of an independence-foremost model of medical rehabilitation may succeed in non-Western societies, there is a risk that adaptation of such a model will be ineffective where many value collectivism more than individualism. The rapid change in medical rehabilitation service delivery in LMIC gives Christian providers and organizations an opportunity to pause and reflect whether the dominant Western medical rehabilitation paradigm serves LMIC cultures and reflects Biblical principles.

  10. Challenges posed by diversity: looking at language and assessment

    Directory of Open Access Journals (Sweden)

    Kari Smith

    2010-09-01

    Full Text Available It is common in many institutions of higher education to have a diverse student population with respect to language and culture in addition to diversity in ability and talent. For many students the language of instruction is not their first language, a situation which offers numerous challenges for the students as well as for the hosting universities. Students have different reasons to undertake an education in a foreign language, a fact which requires higher education institutions to be flexible in addressing the needs of these students. Thus assessment becomes a major challenge. This presentation discusses gains and losses related to studying in an additional language with a special focus on assessment issues. A small study carried out in Israel among Arab and Jewish students of English as a foreign language is presented to illustrate issues discussed. The presentation concludes with a few recommendations.

  11. Migrated esophageal stent posing a challenge for ventilation

    Directory of Open Access Journals (Sweden)

    Nita D'souza

    2017-01-01

    Full Text Available Self-expandable esophageal stents are being commonly used for palliative treatment in advanced esophageal cancer patients to relieve dysphagia, prevent tracheoesophageal fistula, and facilitate symptomatic betterment. The modern covered stents reduce the ingrowth of the tumor but have seen an increase in the incidence of stent migrations. We report a rather complicated presentation of an esophageal stent for esophageal dilatation and a challenging management of a difficult tracheostomy.

  12. Power distribution faced with the challenges posed by competition

    International Nuclear Information System (INIS)

    Angelier, J.P.; Hadjsaid, N.; Sabonnadiere, J.C.

    2009-01-01

    The introduction of liberalization, the increasing share of decentralized electricity generation, the aging of electrical infrastructures, ambitious generation objectives and technological evolution are the key drivers that require substantial investments in the distribution grid. The most urgent challenges are to adapt the network architecture and operation, modernize and improve metering equipment, renovate existing facilities. The Energy Regulatory Commission sets the price to be paid by users of the distribution grid; this price is set rather low, in order to encourage the system operator to make productivity gains. But resultant low income may deprive the operator of the financial resources needed to adapt the system to the new conditions. (authors)

  13. Addressing socioeconomic and political challenges posed by climate change

    Science.gov (United States)

    Fernando, Harindra Joseph; Klaic, Zvjezdana Bencetic

    2011-08-01

    NATO Advanced Research Workshop: Climate Change, Human Health and National Security; Dubrovnik, Croatia, 28-30 April 2011; Climate change has been identified as one of the most serious threats to humanity. It not only causes sea level rise, drought, crop failure, vector-borne diseases, extreme events, degradation of water and air quality, heat waves, and other phenomena, but it is also a threat multiplier wherein concatenation of multiple events may lead to frequent human catastrophes and intranational and international conflicts. In particular, urban areas may bear the brunt of climate change because of the amplification of climate effects that cascade down from global to urban scales, but current modeling and downscaling capabilities are unable to predict these effects with confidence. These were the main conclusions of a NATO Advanced Research Workshop (ARW) sponsored by the NATO Science for Peace and Security program. Thirty-two invitees from 17 counties, including leading modelers; natural, political, and social scientists; engineers; politicians; military experts; urban planners; industry analysts; epidemiologists; and health care professionals, parsed the topic on a common platform.

  14. Strategic management of health risks posed by buried transuranic wastes

    International Nuclear Information System (INIS)

    Jump, R.A.

    1994-01-01

    A strategy is presented for reducing health risks at sites contaminated with buried transuranic (TRU) wastes by first taking measures to immobilize the contaminants until the second step, final action, becomes cost-effective and poses less risk to the remediation workers. The first step of this strategy does not preclude further action if it is warranted and is in harmony with environmental laws and regulations

  15. Invasive Lionfish (Pterosis volitans) Pose Public Health Threats.

    Science.gov (United States)

    Diaz, James H

    2015-01-01

    The lionfish, Pterosis volitans, a native of Indo-Pacific oceans, is a popular saltwater aquarium fish despite venomous spines on its fins. Lionfish were inadvertently introduced into the western Atlantic from Florida in the early 1990s and have overpopulated and dispersed widely into the Caribbean Sea and Gulf of Mexico. Initiatives to control lionfish populations were launched, including the National Oceanographic and Atmospheric Administration (NOAA)-sponsored "Lionfish as Food Campaign".2 Recently, scientists from the Food and Drug Administration (FDA) reported that lionfish caught off the US Virgin Islands contained ciguatoxins and could cause ciguatera fish poisoning (CFP); a seafood-borne poisoning without an antidote or any specific treatment, and a potential for prolonged neurotoxicity. Lionfish pose several public health threats. New strategies to control the lionfish population explosion in coastal waters and offshore fisheries are needed now to ensure seafood safety and public health. The lionfish, Pterosis volitans, is native to the reefs of the western Indian and Pacific Oceans (Figure 1). Brightly colored with red, white, and black stripes and adorned with feathery fins, the lionfish is a popular saltwater aquarium fish despite venomous spines on its fins (Figure 2). Lionfish were introduced into the western North Atlantic from Florida in the early 1990s after some specimens were discarded by dissatisfied amateur aquarists and others escaped from hurricane-flooded public aquariums.1 Since lionfish are voracious carnivores, have few natural predators, and reproduce prolifically, they have overpopulated and dispersed widely from Cape Hatteras to Florida, throughout the Caribbean Sea, and into the Gulf of Mexico.1 The population density of lionfish in its new, invaded territory now exceeds that of its native habitat.1 As a result, campaigns to control lionfish populations were launched in Florida and the Caribbean. Lionfish now pose several public

  16. Problem-Posing in Education: Transformation of the Practice of the Health Professional.

    Science.gov (United States)

    Casagrande, L. D. R.; Caron-Ruffino, M.; Rodrigues, R. A. P.; Vendrusculo, D. M. S.; Takayanagui, A. M. M.; Zago, M. M. F.; Mendes, M. D.

    1998-01-01

    Studied the use of a problem-posing model in health education. The model based on the ideas of Paulo Freire is presented. Four innovative experiences of teaching-learning in environmental and occupational health and patient education are reported. Notes that the problem-posing model has the capability to transform health-education practice.…

  17. Will learning to solve one-step equations pose a challenge to 8th grade students?

    Science.gov (United States)

    Ngu, Bing Hiong; Phan, Huy P.

    2017-08-01

    Assimilating multiple interactive elements simultaneously in working memory to allow understanding to occur, while solving an equation, would impose a high cognitive load. Element interactivity arises from the interaction between elements within and across operational and relational lines. Moreover, operating with special features (e.g. negative pronumeral) poses additional challenge to master equation solving skills. In an experiment, 41 8th grade students (girls = 16, boys = 25) sat for a pre-test, attended a session about equation solving, completed an acquisition phase which constituted the main intervention and were tested again in a post-test. The results showed that at post-test, students performed better on one-step equations tapping low rather than high element interactivity knowledge. In addition, students performed better on those one-step equations that contained no special features. Thus, both the degree of element interactivity and the operation with special features affect the challenge posed to 8th grade students on learning how to solve one-step equations.

  18. Cellular phones were found to pose no health risks

    International Nuclear Information System (INIS)

    Puranen, L.

    1997-01-01

    A cellular phone emits radiation very close to a person's head. Any harmful effects that might arise from the use of cellular phones are being studied carefully, but so far no health risks have been determined. However, the phones may interfere with the operation of electrical devices located close-by, such as a cardiac pacemaker. The biological effects of the microwaves emitted by cellular phones might be based on the resultant higher temperatures in the tissues of the head. Since, even in the worst cases, a cellular phone cannot raise the temperature of tissues by more than some tenths of a degree, no health risks based on thermal effects can be attributed to the use of a cellular phone. No reliable theory has been presented for the non-thermal effects of microwaves. Such effects may exist, however. The studies conducted so far have been unable to show that these effects might be harmful to human health. (orig.)

  19. Bed Bug Epidemic: A Challenge to Public Health

    Science.gov (United States)

    Ratnapradipa, Dhitinut; Ritzel, Dale O.; Haramis, Linn D.; Bliss, Kadi R.

    2011-01-01

    In recent years, reported cases of bed bug infestations in the U.S. and throughout the world have escalated dramatically, posing a global public health problem. Although bed bugs are not known to transmit disease to humans, they pose both direct and indirect public health challenges in terms of health effects, treatment, cost, and resource…

  20. Surety of the nation`s critical infrastructures: The challenge restructuring poses to the telecommunications sector

    Energy Technology Data Exchange (ETDEWEB)

    Cox, R.; Drennen, T.E.; Gilliom, L.; Harris, D.L.; Kunsman, D.M.; Skroch, M.J.

    1998-04-01

    The telecommunications sector plays a pivotal role in the system of increasingly connected and interdependent networks that make up national infrastructure. An assessment of the probable structure and function of the bit-moving industry in the twenty-first century must include issues associated with the surety of telecommunications. The term surety, as used here, means confidence in the acceptable behavior of a system in both intended and unintended circumstances. This paper outlines various engineering approaches to surety in systems, generally, and in the telecommunications infrastructure, specifically. It uses the experience and expectations of the telecommunications system of the US as an example of the global challenges. The paper examines the principal factors underlying the change to more distributed systems in this sector, assesses surety issues associated with these changes, and suggests several possible strategies for mitigation. It also studies the ramifications of what could happen if this sector became a target for those seeking to compromise a nation`s security and economic well being. Experts in this area generally agree that the U. S. telecommunications sector will eventually respond in a way that meets market demands for surety. Questions remain open, however, about confidence in the telecommunications sector and the nation`s infrastructure during unintended circumstances--such as those posed by information warfare or by cascading software failures. Resolution of these questions is complicated by the lack of clear accountability of the private and the public sectors for the surety of telecommunications.

  1. Challenges to Public Health

    Indian Academy of Sciences (India)

    First page Back Continue Last page Graphics. Challenges to Public Health. Tracing of the infection. Isolation of patients to stop spread. Laboratory diagnosis. Hospitalization &Treatment. Stock pile & supply of drugs. Planning & mitigation. Information to public. Support to SEARO countries.

  2. Teachers Implementing Mathematical Problem Posing in the Classroom: Challenges and Strategies

    Science.gov (United States)

    Leung, Shuk-kwan S.

    2013-01-01

    This paper reports a study about how a teacher educator shared knowledge with teachers when they worked together to implement mathematical problem posing (MPP) in the classroom. It includes feasible methods for getting practitioners to use research-based tasks aligned to the curriculum in order to encourage children to pose mathematical problems.…

  3. Challenges that Preventive Conservation poses to the Cultural Heritage documentation field

    Science.gov (United States)

    Van Balen, K.

    2017-08-01

    This contribution examines the challenges posed to the cultural heritage documentation community (the CIPA community and others) in implementing a preventive conservation approach of the built heritage in today's society. The "DNA" of Preventive Conservation. Various authors so far support the argument that preventive conservation is an effective way to respond to the challenges society faces with the preservation of its Cultural Heritage (Van Balen, 2013). A few decades of experiences with the application of preventive conservation in the field of immovable heritage in the form of Monumentenwacht in The Netherland and in Flanders have shown that a good monitoring of the state of preservation with a strong push for maintenance activities contributes to more preservation of authenticity, to more cost-effective preservation and to empowering society in dealing with heritage preservation. (Cebron, 2008) An analysis of these and similar experiences demonstrates that these "Monumentenwacht" activities represent only a part of what could be named a preventive conservation system. Other fields in which prevention is advocated for its higher efficiency, show the importance of system thinking in the development of improved strategies. Applying this approach to the field of the immovable heritage, referring to the initial results shown by the Monumentenwacht practices, it becomes clear that different dimension are at stake simultaneously: the preservation of authenticity or integrity, the management of resources and the connection with society. It shows that the analysis of challenges in heritage preservation and the development of strategies is à priori multifaceted and therefor has a certain level of complexity. The sustainability of the preservation of cultural heritage buildings and sites can be measured according to its multiple economic, social, environmental and cultural support. The Cultural Heritage Counts for Europe report shows that the more diverse the support

  4. Challenges that Preventive Conservation poses to the Cultural Heritage documentation field

    Directory of Open Access Journals (Sweden)

    K. Van Balen

    2017-08-01

    Full Text Available This contribution examines the challenges posed to the cultural heritage documentation community (the CIPA community and others in implementing a preventive conservation approach of the built heritage in today’s society. The “DNA” of Preventive Conservation. Various authors so far support the argument that preventive conservation is an effective way to respond to the challenges society faces with the preservation of its Cultural Heritage (Van Balen, 2013. A few decades of experiences with the application of preventive conservation in the field of immovable heritage in the form of Monumentenwacht in The Netherland and in Flanders have shown that a good monitoring of the state of preservation with a strong push for maintenance activities contributes to more preservation of authenticity, to more cost-effective preservation and to empowering society in dealing with heritage preservation. (Cebron, 2008 An analysis of these and similar experiences demonstrates that these “Monumentenwacht” activities represent only a part of what could be named a preventive conservation system. Other fields in which prevention is advocated for its higher efficiency, show the importance of system thinking in the development of improved strategies. Applying this approach to the field of the immovable heritage, referring to the initial results shown by the Monumentenwacht practices, it becomes clear that different dimension are at stake simultaneously: the preservation of authenticity or integrity, the management of resources and the connection with society. It shows that the analysis of challenges in heritage preservation and the development of strategies is à priori multifaceted and therefor has a certain level of complexity. The sustainability of the preservation of cultural heritage buildings and sites can be measured according to its multiple economic, social, environmental and cultural support. The Cultural Heritage Counts for Europe report shows that the

  5. The challenges posed by radiation and radionuclide releases to the environment.

    Science.gov (United States)

    Wenning, Richard J; Apitz, Sabine E; Backhaus, Thomas; Barnthouse, Lawrence; Batley, Graeme; Brooks, Bryan; Chapman, Peter M; Griffin, Michael; Kapustka, Lawrence; Landis, Wayne; Leung, Kenneth M Y; Linkov, Igor; Seager, Thomas P; Suter, Glenn; Tannenbaum, Lawrence

    2011-07-01

    The recent accident at the Fukushima I nuclear power plant in Japan (also known as Fukushima Daiichi) captured the world's attention and re-invigorated concerns about the safety of nuclear power technology. The Editors of Integrated Environmental Assessment and Management invited experts in the field to describe the primary issues associated with the control and release of radioactive materials to the environment, particularly those that are of importance to the health of the human populations and the ecological systems that populate our planet. This collection of invited short commentaries aims to inform on the safety of nuclear power plants damaged by natural disasters and provide a primer on the potential environmental impacts. The intent of these invited commentaries is not to fuel the excitement and fears about the Fukushima Daiichi incident; rather, it is to collect views and comments from some of the world's experts on the broad science and policy challenges raised by this event, and to provide high-level views on the science issues that surround this situation in order to improve our collective ability to avoid or at least minimize the consequences of future events. Copyright © 2011 SETAC.

  6. Environmental challenges posed by veld fires in fragile regions: The case of the Bulilima and Mangwe districts in southern Zimbabwe

    Directory of Open Access Journals (Sweden)

    Ernest Dube

    2015-11-01

    Full Text Available This original research confronted challenges to environmental management and sustainability posed by veld fires in the Bulilima and Mangwe Districts of Matabeleland in the South Province in southern Zimbabwe. Veld fires have affected the fauna and flora, polluted air and water, and destroyed livelihoods. The study aimed at establishing challenges to environmental sustainability posed by veld fires, identifying the type of environment upon which veld fires have impacted, analysing legal issues and other interventions surrounding the control of veld fires and suggesting new control measures for veld fires. A qualitative research design and quota sampling were used. The study involved 30 participants. Data was collected through a questionnaire, an interview guide and participant observation. Challenges to environmental management and sustainability posed by veld fires include property damage, reduced soil fertility, destruction of vegetation, air and water pollution and destruction of wildlife. Most veld fires are a result of human actions that emanate from the disposal of cigarettes, the burning of vegetation when preparing fields, the use of fire by hunters, smoking out bees and the making of fires by motorists along highways. The government should consider reviewing the current environmental statues. Fireguards should be wide enough to lessen veld-fire impact. Lastly, veld-fire campaigns and rehearsals should be run on a regular basis. It is hoped that this work would make a significant contribution through improving the current thinking about environmental management and sustainability, thereby benefiting policy makers, practitioners and stakeholders.

  7. Metals and metalloids in PM10 in Nandan County, Guangxi, China, and the health risks posed.

    Science.gov (United States)

    Guo, Guanghui; Song, Bo; Xia, Deshang; Yang, Zijie; Wang, Fopeng

    2018-03-16

    Intense mining, smelting, and tailing activities of polymetallic ore deposits have affected the environment in Nandan County, Guangxi, China. Samples of particulates with aerodynamic diameters low or equal 10 μm (PM 10 ) were collected in Nandan County to investigate the concentrations of and health risks posed by 17 metals and metalloids in the PM 10 . The metal and metalloid concentrations were lower than those found in other industrial cities. The mean Cr concentration was 7.48 ng/m 3 . Significant higher metal and metalloid concentrations were found in PM 10 from mining areas (Dachang and Chehe) than from the control area (Liuzhai) (p metalloids in PM 10 at all the sites were low, but the non-carcinogenic risks posed to children by all the metals and metalloids together exceeded the safe level (i.e., risk value > 1). The carcinogenic risks posed by Cd, Ni, and Pb were negligible at all sites, while As, Co, and Cr posed potential carcinogenic risks to the residents.

  8. "You're dealing with an emotionally charged individual...": an industry perspective on the challenges posed by medical tourists' informal caregiver-companions.

    Science.gov (United States)

    Casey, Victoria; Crooks, Valorie A; Snyder, Jeremy; Turner, Leigh

    2013-07-26

    Patients engage in medical tourism when they privately obtain a medical care abroad. Previous research shows that many medical tourists travel abroad with friends and family members who provide support and assistance. Meanwhile, very little is known about this important stakeholder group, referred to here as caregiver-companions. In this article we examine the challenges that can be posed by caregiver-companions and the overall practice of informal caregiving in medical tourism from an industry perspective. Specifically, we report on the findings of interviews conducted with international patient coordinators (IPCs) who work at destination facilities. IPCs come into regular contact with caregiver-companions in their professional positions and thus are ideally suited to comment on trends they have observed among this stakeholder group as well as the challenges they can pose to medical tourists, health workers, and facilities. We conducted 20 semi-structured interviews with 21 IPCs from 16 different facilities across nine countries. Topics probed in the interviews included caregiver-companion roles, IPCs' and others' interaction with caregiver-companions, and potential health and safety risks posed to medical tourists and caregiver-companions. Thematic analysis of the verbatim transcripts was employed. Although most participants encouraged medical tourists to travel with a caregiver-companion, many challenges associated with caregiver-companions were identified. Three themes best characterize the challenges that emerged: (1) caregiver-companions require time, attention and resources; (2) caregiver-companions can disrupt the provision of quality care; and (3) caregiver-companions can be exposed to risks. IPCs pointed out that caregiver-companions may, for example, have a negative impact on the patient through cost of accompaniment or inadequate care provision. Caregiver-companions may also create unanticipated or extra work for IPCs, as additional clients and by

  9. “You’re dealing with an emotionally charged individual…”: an industry perspective on the challenges posed by medical tourists’ informal caregiver-companions

    Science.gov (United States)

    2013-01-01

    Background Patients engage in medical tourism when they privately obtain a medical care abroad. Previous research shows that many medical tourists travel abroad with friends and family members who provide support and assistance. Meanwhile, very little is known about this important stakeholder group, referred to here as caregiver-companions. In this article we examine the challenges that can be posed by caregiver-companions and the overall practice of informal caregiving in medical tourism from an industry perspective. Specifically, we report on the findings of interviews conducted with international patient coordinators (IPCs) who work at destination facilities. IPCs come into regular contact with caregiver-companions in their professional positions and thus are ideally suited to comment on trends they have observed among this stakeholder group as well as the challenges they can pose to medical tourists, health workers, and facilities. Methods We conducted 20 semi-structured interviews with 21 IPCs from 16 different facilities across nine countries. Topics probed in the interviews included caregiver-companion roles, IPCs’ and others’ interaction with caregiver-companions, and potential health and safety risks posed to medical tourists and caregiver-companions. Thematic analysis of the verbatim transcripts was employed. Results Although most participants encouraged medical tourists to travel with a caregiver-companion, many challenges associated with caregiver-companions were identified. Three themes best characterize the challenges that emerged: (1) caregiver-companions require time, attention and resources; (2) caregiver-companions can disrupt the provision of quality care; and (3) caregiver-companions can be exposed to risks. IPCs pointed out that caregiver-companions may, for example, have a negative impact on the patient through cost of accompaniment or inadequate care provision. Caregiver-companions may also create unanticipated or extra work for IPCs, as

  10. D3R Grand Challenge 2: blind prediction of protein-ligand poses, affinity rankings, and relative binding free energies

    Science.gov (United States)

    Gaieb, Zied; Liu, Shuai; Gathiaka, Symon; Chiu, Michael; Yang, Huanwang; Shao, Chenghua; Feher, Victoria A.; Walters, W. Patrick; Kuhn, Bernd; Rudolph, Markus G.; Burley, Stephen K.; Gilson, Michael K.; Amaro, Rommie E.

    2018-01-01

    The Drug Design Data Resource (D3R) ran Grand Challenge 2 (GC2) from September 2016 through February 2017. This challenge was based on a dataset of structures and affinities for the nuclear receptor farnesoid X receptor (FXR), contributed by F. Hoffmann-La Roche. The dataset contained 102 IC50 values, spanning six orders of magnitude, and 36 high-resolution co-crystal structures with representatives of four major ligand classes. Strong global participation was evident, with 49 participants submitting 262 prediction submission packages in total. Procedurally, GC2 mimicked Grand Challenge 2015 (GC2015), with a Stage 1 subchallenge testing ligand pose prediction methods and ranking and scoring methods, and a Stage 2 subchallenge testing only ligand ranking and scoring methods after the release of all blinded co-crystal structures. Two smaller curated sets of 18 and 15 ligands were developed to test alchemical free energy methods. This overview summarizes all aspects of GC2, including the dataset details, challenge procedures, and participant results. We also consider implications for progress in the field, while highlighting methodological areas that merit continued development. Similar to GC2015, the outcome of GC2 underscores the pressing need for methods development in pose prediction, particularly for ligand scaffolds not currently represented in the Protein Data Bank (http://www.pdb.org), and in affinity ranking and scoring of bound ligands.

  11. Using physics-based pose predictions and free energy perturbation calculations to predict binding poses and relative binding affinities for FXR ligands in the D3R Grand Challenge 2

    Science.gov (United States)

    Athanasiou, Christina; Vasilakaki, Sofia; Dellis, Dimitris; Cournia, Zoe

    2018-01-01

    Computer-aided drug design has become an integral part of drug discovery and development in the pharmaceutical and biotechnology industry, and is nowadays extensively used in the lead identification and lead optimization phases. The drug design data resource (D3R) organizes challenges against blinded experimental data to prospectively test computational methodologies as an opportunity for improved methods and algorithms to emerge. We participated in Grand Challenge 2 to predict the crystallographic poses of 36 Farnesoid X Receptor (FXR)-bound ligands and the relative binding affinities for two designated subsets of 18 and 15 FXR-bound ligands. Here, we present our methodology for pose and affinity predictions and its evaluation after the release of the experimental data. For predicting the crystallographic poses, we used docking and physics-based pose prediction methods guided by the binding poses of native ligands. For FXR ligands with known chemotypes in the PDB, we accurately predicted their binding modes, while for those with unknown chemotypes the predictions were more challenging. Our group ranked #1st (based on the median RMSD) out of 46 groups, which submitted complete entries for the binding pose prediction challenge. For the relative binding affinity prediction challenge, we performed free energy perturbation (FEP) calculations coupled with molecular dynamics (MD) simulations. FEP/MD calculations displayed a high success rate in identifying compounds with better or worse binding affinity than the reference (parent) compound. Our studies suggest that when ligands with chemical precedent are available in the literature, binding pose predictions using docking and physics-based methods are reliable; however, predictions are challenging for ligands with completely unknown chemotypes. We also show that FEP/MD calculations hold predictive value and can nowadays be used in a high throughput mode in a lead optimization project provided that crystal structures of

  12. A Teacher Tablet Toolkit to meet the challenges posed by 21st ...

    African Journals Online (AJOL)

    The course, as outcome, is presented as a Teacher Tablet Toolkit, designed to meet the challenges inherent to the 21st century rural technology enhanced teaching and learning environment. The paper documents and motivates design decisions, derived from literature and adapted through three iterations of a Design ...

  13. Challenges posed to the European pharmaceutical regulatory system by highly personalized medicines.

    Science.gov (United States)

    Johnston, John D; Feldschreiber, Peter

    2014-03-01

    The European pharmaceutical regulatory system has not yet been challenged by issues related to highly personalized medicines such as those to be found with active substances that affect RNA biochemistry. We review the current status of RNA-based pharmacology and present three possible case histories. The implications for the European pharmaceutical regulatory system are discussed. © 2013 The British Pharmacological Society.

  14. Economic opportunities and challenges posed by China for Mexico and Central America

    OpenAIRE

    Dussel Peters, Enrique

    2005-01-01

    "This study offers a basis for understanding China's performance from a Latin American perspective, and stressing the massive economic opportunities and challenges, and particularly for Central America and Mexico. Moreover, the document assesses in detail the macroeconomic, trade and employment policy and institutional changes in China and its potential effects in Central America and Mexico. These effects are analyzed in the Chinese, Central American, Mexican and US market in general, but als...

  15. The Challenge Posed by Geomagnetic Activity to Electric Power Reliability: Evidence From England and Wales

    Science.gov (United States)

    Forbes, Kevin F.; St. Cyr, O. C.

    2017-10-01

    This paper addresses whether geomagnetic activity challenged the reliability of the electric power system during part of the declining phase of solar cycle 23. Operations by National Grid in England and Wales are examined over the period of 11 March 2003 through 31 March 2005. This paper examines the relationship between measures of geomagnetic activity and a metric of challenged electric power reliability known as the net imbalance volume (NIV). Measured in megawatt hours, NIV represents the sum of all energy deployments initiated by the system operator to balance the electric power system. The relationship between geomagnetic activity and NIV is assessed using a multivariate econometric model. The model was estimated using half-hour settlement data over the period of 11 March 2003 through 31 December 2004. The results indicate that geomagnetic activity had a demonstrable effect on NIV over the sample period. Based on the parameter estimates, out-of-sample predictions of NIV were generated for each half hour over the period of 1 January to 31 March 2005. Consistent with the existence of a causal relationship between geomagnetic activity and the electricity market imbalance, the root-mean-square error of the out-of-sample predictions of NIV is smaller; that is, the predictions are more accurate, when the statistically significant estimated effects of geomagnetic activity are included as drivers in the predictions.

  16. Challenges posed by alien culture diffusion for employees of call centers in Mumbai

    OpenAIRE

    Hegde, Sandeep

    2016-01-01

    Since the last decade, there has been a tremendous growth in the call center businesses in several metropolitan and urban cities in India. Mumbai city is no exception to this sudden boom. The call center businesses employ over 500,000 nascent employees in the age group of 18-28 yrs in Mumbai. The nature of outsourced work along with the odd working hours in this industry leads to high employee attrition in the call centers. Job satisfaction, high levels of stress, health issues, employee safe...

  17. Generation Y’s expectations of their future employment relationships pose a challenge for their employers

    Directory of Open Access Journals (Sweden)

    Katarzyna Dziewanowska

    2016-06-01

    Full Text Available Generation Y is starting to represent a significant proportion of the labor force and adds to the diversity challenges faced by companies, especially those operating in a global market. Although many characteristics of Generation Y with regard to work and employment have been identified through research, most comes from developed Western countries. We explored the employment expectations of business students in Poland, Slovenia, the UK and South Korea from the psychological contract perspective. We aimed to identify and explain differences between anticipated employee and employer obligations of future entrants to the labor market. Overall, students expect more relational and balanced dimensions of a psychological contract than transactional. However, there are significant differences in the elements, dimensions and types of psychological contract between countries. Polish and Slovenian responses show more elements of a transactional contract than the UK and Korean. The differences can be explained by taking into account economic context and national culture characteristics. The implications of the results for employers’ approach to managing young talent are also discussed.

  18. Changing patterns of inpatient respiratory care services over a decade at the Cleveland Clinic: challenges posed and proposed responses.

    Science.gov (United States)

    Orens, Douglas K; Kester, Lucy; Konrad, Dale J; Stoller, James K

    2005-08-01

    Changing characteristics of hospitalized patients over the last decade have created challenges for all health-care providers in delivering optimal care. In the specific case of respiratory care, trends that hospitalized patients have generally become sicker over time and that average lengths of stay have generally become shorter have posed the challenge of meeting demands for more services delivered with greater immediacy. We undertook the current analysis to assess how the delivery of respiratory care services at a tertiary-care academic medical center, the Cleveland Clinic Foundation Hospital, has evolved over the decade 1991 to 2001. In this observational study, we examined concurrent departmental trends and speculated that the capability to increase clinical activity with maintained or improved clinical outcomes, preserved costs, and a lower turnover rate among respiratory therapists reflects features of the professional environment within our Section of Respiratory Therapy. This analysis compares patterns of respiratory care service delivery in two 5-year intervals: from 1991 to 1996 and from 1996 to 2001. Data were collected using a respiratory care information-management system and an inpatient hospital information system, which track the volume and actual cost of services provided. These analyses accounted for the actual time-based cost of the services, including labor (with benefits), necessary equipment and supplies, medications, and equipment maintenance and depreciation. Hospital case-mix index values were determined according to guidelines from the Centers for Medicare and Medicaid Services, as the weighted average of resource allocation scores assigned to diagnosis-related-group categories of hospitalized patients. From 1991 to 2001, there were important expansions in the scope of respiratory care practice by our Section of Respiratory Care, while the volume of respiratory care services delivered per year increased 1.96-fold (from 339,600 to 665

  19. Sustainable Materials Management (SMM) Web Academy Webinar: An Introduction to Lithium Batteries and the Challenges that they Pose to the Waste and Recycling Industry

    Science.gov (United States)

    This is a webinar page for the Sustainable Management of Materials (SMM) Web Academy webinar titled, An Introduction to Lithium Batteries and the Challenges that they Pose to the Waste and Recycling Industry.

  20. Consistent Treatment of Variables and Causation Poses a Challenge for Behavioral Research Methods: A Commentary on Nesselroade and Molenaar (2016).

    Science.gov (United States)

    Markus, Keith A

    2016-01-01

    Nesselroade and Molenaar presented the ideographic filter as a proposal for analyzing lawful regularities in behavioral research. The proposal highlights an inconsistency that poses a challenge for behavioral research more generally. One can distinguish a broadly Humean approach from a broadly non-Humean approach as they relate to variables and to causation. Nesselroade and Molenaar rejected a Humean approach to latent variables that characterizes them as nothing more than summaries of their manifest indicators. By contrast, they tacitly accepted a Humean approach to causes characterized as nothing more than summaries of their manifest causal effects. A non-Humean treatment of variables coupled with a Humean treatment of causation creates a theoretical tension within their proposal. For example, one can interpret the same model elements as simultaneously representing both variables and causes. Future refinement of the ideographic filter proposal to address this tension could follow any of a number of strategies.

  1. Challenges posed by diversity in Academic institutions as they implement Information Literacy: the experiences of Makerere University Library in Uganda

    Directory of Open Access Journals (Sweden)

    Faith Beatrice Akiteng

    2010-09-01

    Full Text Available Over the years, academic libraries have been conducting information literacy (IL programmes for their users. This paper shares Makerere University Library's experience in implementing IL programmes at Makerere University and other academic institutions of learning in Uganda. The findings of this paper are based on the IL sessions' evaluation forms, together with the authors' experiences as instructors. A sample of one thousand (1000 participants' evaluation feedback forms was used in assessing the IL sessions conducted by Makerere University Library in two years (2008-2009. The evaluation focused on the duration and relevancy of training, nature of content, its organization; the instructors, new skills participants gained and how they hoped to pass them to others. Initial findings indicate that IL sessions are highly regarded with repeated recommendations for increased duration and frequency of information literacy sessions in different universities. The various challenges posed by diversity are explained as follows: Difference in age groups arise because admissions to the various universities cater for direct entrants from high school and mature age entrants'. Students also come from different social backgrounds that dictate the standard of schools they attend i.e.; urban schools where education standards are high and skills such as using computers are imparted visa-a-vis the rural schools where such skills are not imparted. To the IL instructor, this implies conducting the training with patience and extending the time allocated for each session in order to impart the basic ICT skills prior to imparting the IL skills. Internationalization on the other hand is not a very big challenge because the proportion of foreign students is small and their ICT skills are moderate. Gender aspects and the diverse disciplines of research in the Ugandan universities also pose challenges when conducting IL sessions in that the groups handled at a time are

  2. Addressing the psychosocial and communication challenges posed by radiological/nuclear terrorism: key developments since NCRP Report No. 138.

    Science.gov (United States)

    Becker, Steven M

    2005-11-01

    One of the most innovative aspects of NCRP Report No. 138 (Management of Terrorist Incidents Involving Radioactive Material) was the high priority it accorded to psychosocial and communication issues. While previous discussions of radiological and nuclear terrorism had occasionally referred to these topics, NCRP Report No. 138 was the first report of its kind to recognize the profound challenges posed by these issues and to place them at the heart of preparedness and response efforts. In the years since the report's release, a host of important developments have taken place in relation to psychosocial and communication issues. This paper reviews key changes and advances in five broad areas: (1) training exercises, (2) policy and guidance development, (3) findings on hospital and clinician needs, (4) survey research on public perceptions of radiological terrorism, and (5) risk communication for radiological and nuclear terrorism situations. The article concludes with a discussion of continuing psychosocial and communication challenges, including critical areas needing further attention as the nation moves to meet the threat of terrorism involving radioactive materials.

  3. eHealth Recruitment Challenges

    Science.gov (United States)

    Thompson, Debbe; Canada, Ashanti; Bhatt, Riddhi; Davis, Jennifer; Plesko, Lisa; Baranowski, Tom; Cullen, Karen; Zakeri, Issa

    2006-01-01

    Little is known about effective eHealth recruitment methods. This paper presents recruitment challenges associated with enrolling African-American girls aged 8-10 years in an eHealth obesity prevention program, their effect on the recruitment plan, and potential implications for eHealth research. Although the initial recruitment strategy was…

  4. Does intake of trace elements through urban gardening in Copenhagen pose a risk to human health?

    International Nuclear Information System (INIS)

    Warming, Marlies; Hansen, Mette G.; Holm, Peter E.; Magid, Jakob; Hansen, Thomas H.; Trapp, Stefan

    2015-01-01

    This study investigates the potential health risk from urban gardening. The concentrations of the trace elements arsenic (As), cadmium (Cd), chromium (Cr), copper (Cu), lead (Pb), nickel (Ni), and zinc (Zn) in five common garden crops from three garden sites in Copenhagen were measured. Concentrations (mg/kg dw) of As were 0.002–0.21, Cd 0.03–0.25, Cr < 0.09–0.38, Cu 1.8–8.7, Ni < 0.23–0.62, Pb 0.05–1.56, and Zn 10–86. Generally, elemental concentrations in the crops do not reflect soil concentrations, nor exceed legal standards for Cd and Pb in food. Hazard quotients (HQs) were calculated from soil ingestion, vegetable consumption, measured trace element concentrations and tolerable intake levels. The HQs for As, Cd, Cr, Cu, Ni, and Zn do not indicate a health risk through urban gardening in Copenhagen. Exposure to Pb contaminated sites may lead to unacceptable risk not caused by vegetable consumption but by unintentional soil ingestion. - Highlights: • We measured trace metal concentrations in urban soil and vegetables. • We calculated hazard quotients (HQs) to determine the human health risk. • Consumption of urban vegetables does not result in HQs exceeding unity. • Unintentional ingestion of contaminated soil causes a risk to the human health. - Consumption of vegetables grown in Copenhagen does not pose a risk to the human health, while unintentional ingestion of contaminated soil remains a risk factor with respect to lead

  5. Problem Posing

    OpenAIRE

    Šilhavá, Marie

    2009-01-01

    This diploma thesis concentrates on problem posing from the students' point of view. Problem posing can be either seen as a teaching method which can be used in the class, or it can be used as a tool for researchers or teachers to assess the level of students' understanding of the topic. In my research, I compare three classes, one mathematics specialist class and two generalist classes, in their ability of problem posing. As an assessment tool it seemed that mathemathics specialists were abl...

  6. Zoonotic pathogens from feral swine that pose a significant threat to public health.

    Science.gov (United States)

    Brown, V R; Bowen, R A; Bosco-Lauth, A M

    2018-06-01

    The natural fecundity of suids, great ability to adapt to new habitats and desire for local hunting opportunities leading to translocation of feral pigs to regions where they are not yet established have all been instrumental in the home range expansion of feral swine. Feral swine populations in the United States continue to expand, wreaking havoc on agricultural lands, further compromising threatened and endangered species, and posing a microbiological threat to humans, domestic livestock and companion animals. This manuscript thoroughly reviews zoonotic diseases of concern including brucellosis, bovine tuberculosis, leptospirosis, enteric pathogens, both Salmonella spp. and shiga toxin-producing Escherichia coli, and hepatitis E. These pathogens are not a comprehensive list of microbes that are capable of infecting both humans and feral swine, but rather have been selected as they are known to infect US feral swine, direct transmission between wild suids and humans has previously been documented, or they have been shown to be readily transmitted during processing or consumption of feral swine pork. Humans that interact directly or indirectly with feral swine are at much higher risk for the development of a number of zoonotic pathogens. Numerous case reports document transmission events from feral swine and wild boar to humans, and the resulting diseases may be mild and self-limiting, chronic or fatal. Individuals that interact with feral swine should take preventative measures to minimize the risk of disease transmission and all meat should be thoroughly cooked. Additionally, public health campaigns to increase knowledge of the risks associated with feral swine are imperative. © 2018 Blackwell Verlag GmbH.

  7. Ranking docking poses by graph matching of protein-ligand interactions: lessons learned from the D3R Grand Challenge 2

    Science.gov (United States)

    da Silva Figueiredo Celestino Gomes, Priscila; Da Silva, Franck; Bret, Guillaume; Rognan, Didier

    2018-01-01

    A novel docking challenge has been set by the Drug Design Data Resource (D3R) in order to predict the pose and affinity ranking of a set of Farnesoid X receptor (FXR) agonists, prior to the public release of their bound X-ray structures and potencies. In a first phase, 36 agonists were docked to 26 Protein Data Bank (PDB) structures of the FXR receptor, and next rescored using the in-house developed GRIM method. GRIM aligns protein-ligand interaction patterns of docked poses to those of available PDB templates for the target protein, and rescore poses by a graph matching method. In agreement with results obtained during the previous 2015 docking challenge, we clearly show that GRIM rescoring improves the overall quality of top-ranked poses by prioritizing interaction patterns already visited in the PDB. Importantly, this challenge enables us to refine the applicability domain of the method by better defining the conditions of its success. We notably show that rescoring apolar ligands in hydrophobic pockets leads to frequent GRIM failures. In the second phase, 102 FXR agonists were ranked by decreasing affinity according to the Gibbs free energy of the corresponding GRIM-selected poses, computed by the HYDE scoring function. Interestingly, this fast and simple rescoring scheme provided the third most accurate ranking method among 57 contributions. Although the obtained ranking is still unsuitable for hit to lead optimization, the GRIM-HYDE scoring scheme is accurate and fast enough to post-process virtual screening data.

  8. Enrichment and assessment of the health risks posed by heavy metals in PM1 in Changji, Xinjiang, China.

    Science.gov (United States)

    Liu, Yu Y; Shen, Ya X; Liu, Cheng; Liu, Hao F

    2017-04-16

    The present study aims to investigate the influence of human activity on heavy metals in a typical arid urban area of China and assess human health risks posed by heavy metals in PM 1 (particles <1.0 μm in diameter) for different people. In this paper, Changji (Xinjiang, China) was selected as the study area, and samples were collected from March 2014 to March 2015. A total 14 elements in PM 1 were quantified using ICP-MS. An enrichment factor (EF) was used to assess the influence of human activity on the contamination of these metals. The results indicated that Mn was not enriched; Co, Cu, Cr, Ni, Tl, and V were slightly enriched; Mo, Pb, and Sb were moderately enriched; and Ag, As, and Cd were strongly enriched. To assess the health risks associated with inhaling PM 1 , the risk assessment code and loss in life expectancy based on the individual metals were calculated. The results showed that the elements Ag, Cu, Mo, Pb, Sb, Tl, and V in PM 1 posed low levels of non-carcinogenic risks, but these metals may still pose risks to certain susceptible populations. In addition, the results also showed that As, Co, and Cr posed an appreciable carcinogenic risk, while Cd and Ni posed low levels of carcinogenic risk. The total predicted loss of life expectancy caused by the three metals As, Co, and Ni was 63.67 d for the elderly, 30.95 d for adult males, 26.62 d for adult females, and 48.22 d for children. Therefore, the safety of the elderly and children exposed to PM 1 should be given more attention than the safety of adults. The results from this study demonstrate that the health risks posed by heavy metals in PM 1 in Changji, Xinjiang, China should be examined.

  9. Refugee health and rehabilitation: Challenges and response.

    Science.gov (United States)

    Khan, Fary; Amatya, Bhasker

    2017-05-16

    The current global refugee crisis poses major challenges in providing effective healthcare to refugees, particularly for non-communicable diseases management and disability. This article provides an overview of refugee health and potential challenges from the rehabilitation perspective. A literature search (both academic and grey literature) was conducted using medical and health science electronic databases and internet search engines (2001-2016). Both authors independently selected studies. Due to heterogeneity amongst identified articles, a narrative analysis was performed for best-evidence synthesis to outline the current health and rehabilitation status of refugees and existing gaps in care. Data suggest that infectious diseases requiring treatment in refugees are a minority; whilst non-communicable diseases, musculoskeletal conditions are prevalent. Many refugees arrive with complex health needs. One in 6 refugees have a physical health problem severely affecting their lives and two-thirds experience mental health problems, signifying the important role of rehabilitation. Refugees face continued disadvantage, poverty and dependence due to lack of cohesive support in their new country, which are determinants of both poor physical and mental health. This is compounded by language barriers, impoverishment, and lack of familiarity with the local environment and healthcare system. In Australia, there are concerns about sexual and gender-based violence in off-shore detention camps. Targeted physical and cognitive rehabilitative strategies have much to offer these vulnerable people to allow for improved activity and participation. Strong leadership and effective action from national and international bodies is urgently needed to develop comprehensive rehabilitation-inclusive medical care for refugees.

  10. Health Journalism: Health Reporting Status and Challenges.

    Science.gov (United States)

    Keshvari, Mahrokh; Yamani, Niko; Adibi, Peyman; Shahnazi, Hossein

    2018-01-01

    Media play crucial role in disseminating health information. Due to the importance of accurate health news reports, and the national need to professionalism in health journalism, this study aimed to investigate the characteristics of health journalists, and health reporting status and the challenges involved. Using consensus sampling, this descriptive cross-sectional study was conducted on all health news reporters in Isfahan (34 journalists) in 2015-2016. Data collection was done via a researcher-made questionnaire. Content validity of the questionnaire was determined by qualitative method and based on the opinions of six experts. The test-retest reliability coefficient was 98.0. Data analysis was done by Statistical Package for the Social Sciences, version 16 and descriptive statistics and content analysis were used for analyzing the responses to two open questions. Among 34 journalists, 56% were women and 44% men; the majority of journalists (65%) had no specialized training on health reporting, 35% of journalists were not able to understand the health issues, and the knowledge of medical terminology in 59% of them was moderate to low. The most important required skill for reporters was the ability to interpret medical research reports (88%), 97% were eager to participate in specialized health education. Our study showed that health journalists lacked knowledge and specialized training for dissemination of health news. This has brought about serious challenges. Thus, development and implementation of training courses in close collaboration with educational department of the Ministry of Health and news programs professionals at Islamic Republic of Iran Broadcasting is highly recommended.

  11. eHealth recruitment challenges.

    Science.gov (United States)

    Thompson, Debbe; Canada, Ashanti; Bhatt, Riddhi; Davis, Jennifer; Plesko, Lisa; Baranowski, Tom; Cullen, Karen; Zakeri, Issa

    2006-11-01

    Little is known about effective eHealth recruitment methods. This paper presents recruitment challenges associated with enrolling African-American girls aged 8-10 years in an eHealth obesity prevention program, their effect on the recruitment plan, and potential implications for eHealth research. Although the initial recruitment strategy was literature-informed, it failed to enroll the desired number of girls within a reasonable time period. Therefore, the recruitment strategy was reformulated to incorporate principles of social marketing and traditional marketing techniques. The resulting plan included both targeted, highly specific strategies (e.g., selected churches), and more broad-based approaches (e.g., media exposure, mass mailings, radio advertisements). The revised plan enabled recruitment goals to be attained. Media appeared to be particularly effective at reaching the intended audience. Future research should identify the most effective recruitment strategies for reaching potential eHealth audiences.

  12. Myth of reincarnation: a challenge for mental health profession.

    Science.gov (United States)

    Gadit, A A Muhammad

    2009-02-01

    Mental health practitioners often come across a number of challenges in their clinical practice. One such challenge that posed a management dilemma presented with the history of reincarnation. This subject has been discussed in non-scientific literature at length but there is an absolute paucity in scientific literature. This paper describes a case where a boy presented with memories of previous life that started haunting him and caused significant anxiety. The subject of reincarnation needs extensive research in order to understand and manage the resultant clinical challenges.

  13. ?You?re dealing with an emotionally charged individual??: an industry perspective on the challenges posed by medical tourists? informal caregiver-companions

    OpenAIRE

    Casey, Victoria; Crooks, Valorie A; Snyder, Jeremy; Turner, Leigh

    2013-01-01

    Background Patients engage in medical tourism when they privately obtain a medical care abroad. Previous research shows that many medical tourists travel abroad with friends and family members who provide support and assistance. Meanwhile, very little is known about this important stakeholder group, referred to here as caregiver-companions. In this article we examine the challenges that can be posed by caregiver-companions and the overall practice of informal caregiving in medical tourism ...

  14. Potential Health Risks Posed by Plant-Derived Cumulative Neurotoxic Bufadienolides in South Africa

    Directory of Open Access Journals (Sweden)

    Christo Botha

    2016-03-01

    Full Text Available Bufadienolide-type cardiac glycosides have a worldwide distribution and are mainly synthesized by plants, but there are also animal sources. In South Africa, members of three genera of the Crassulaceae (Cotyledon, Tylecodon and Kalanchoe cause a unique chronic form of cardiac glycoside poisoning, predominantly in small stock. This paretic/paralytic condition is referred to as “krimpsiekte”, cotyledonosis or “nenta”. “Krimpsiekte” is a plant poisoning only reported from South Africa and is regarded as the most important plant poisoning of small stock in the semi-arid Little Karoo and southern fringes of the Great Karoo. The toxicosis is caused by cumulative bufadienolides which have neurotoxic properties. Four types of cumulative neurotoxic bufadienolides, namely cotyledoside, and the tyledosides, orbicusides and lanceotoxins, have been isolated. Based on the structure activity relationships and certain toxicokinetic parameters possible reasons for their accumulation are presented. Consumption of edible tissues from animals that have ingested these plants poses a potential risk to humans.

  15. Does air pollution pose a public health problem for New Zealand?

    Science.gov (United States)

    Scoggins, Amanda

    2004-02-01

    Air pollution is increasingly documented as a threat to public health and a major focus of regulatory activity in developed and developing countries. Air quality indicators suggest New Zealand has clean air relative to many other countries. However, media releases such as 'Christchurch wood fires pump out deadly smog' and 'Vehicle pollution major killer' have sparked public health concern regarding exposure to ambient air pollution, especially in anticipation of increasing emissions and population growth. Recent evidence is presented on the effects of air quality on health, which has been aided by the application of urban airshed models and Geographic Information Systems (GIS). Future directions for research into the effects of air quality on health in New Zealand are discussed, including a national ambient air quality management project: HAPINZ--Health and Air Pollution in New Zealand.

  16. Would Aluminum and Nickel Content of Apricot Pose Health Risk to Human?

    Directory of Open Access Journals (Sweden)

    Gholamhossein DAVARYNEJAD

    2012-05-01

    Full Text Available Higher demands of food production for human consumption increased uses of fertilizers and other chemicals that arise in a major public problem and heavy-metal pollution. Levels of Aluminum and Nickel which affect mankind health in exact doses, were determined in fresh and dried samples of Jumbo Cot, Tom Cot, Gold Strike, Gold Bar, Bergeron, Bergarouge, Sweet Cot, Yellow cot and Zebra apricot cultivars to assess possible health risk of apricot (Prunus armeniaca L. consumption. Highest content of Al and Ni among all cultivars, where 9.71 and 2.14 mg/kg of dehydrated apricot samples. Fresh fruit samples maximally contain 2.9 and 0.425 mg/kg of Aluminum and Nickel respectively. Data analysis showed significant differences between cultivars for Al and Ni. Furthermore, to reveal the health-risk possibility of dried and fresh fruit consumption daily intake of elements and health-risk index were calculated and compared.

  17. Does intake of trace elements through urban gardening in Copenhagen pose a risk to human health?

    DEFF Research Database (Denmark)

    Warming, Marlies; Hansen, Mette G.; Holm, Peter E.

    2015-01-01

    This study investigates the potential health risk from urban gardening. The concentrations of the trace elements arsenic (As), cadmium (Cd), chromium (Cr), copper (Cu), lead (Pb), nickel (Ni), and zinc (Zn) in five common garden crops from three garden sites in Copenhagen were measured. Concentra......This study investigates the potential health risk from urban gardening. The concentrations of the trace elements arsenic (As), cadmium (Cd), chromium (Cr), copper (Cu), lead (Pb), nickel (Ni), and zinc (Zn) in five common garden crops from three garden sites in Copenhagen were measured...

  18. Would Aluminum and Nickel Content of Apricot Pose Health Risk to Human?

    Directory of Open Access Journals (Sweden)

    Gholamhossein DAVARYNEJAD

    2012-05-01

    Full Text Available Higher demands of food production for human consumption increased uses of fertilizers and other chemicals that arise in a major public problem and heavy-metal pollution. Levels of Aluminum and Nickel which affect mankind health in exact doses, were determined in fresh and dried samples of �Jumbo Cot�, �Tom Cot�, �Gold Strike�, �Gold Bar�, Bergeron�, �Bergarouge�, �Sweet Cot�, �Yellow cot� and �Zebra� apricot cultivars to assess possible health risk of apricot (Prunus armeniaca L. consumption. Highest content of Al and Ni among all cultivars, where 9.71 and 2.14 mg/kg of dehydrated apricot samples. Fresh fruit samples maximally contain 2.9 and 0.425 mg/kg of Aluminum and Nickel respectively. Data analysis showed significant differences between cultivars for Al and Ni. Furthermore, to reveal the health-risk possibility of dried and fresh fruit consumption daily intake of elements and health-risk index were calculated and compared.

  19. Does intake of trace elements through urban gardening in Copenhagen pose a risk to human health?

    Science.gov (United States)

    Warming, Marlies; Hansen, Mette G; Holm, Peter E; Magid, Jakob; Hansen, Thomas H; Trapp, Stefan

    2015-07-01

    This study investigates the potential health risk from urban gardening. The concentrations of the trace elements arsenic (As), cadmium (Cd), chromium (Cr), copper (Cu), lead (Pb), nickel (Ni), and zinc (Zn) in five common garden crops from three garden sites in Copenhagen were measured. Concentrations (mg/kg dw) of As were 0.002-0.21, Cd 0.03-0.25, Cr gardening in Copenhagen. Exposure to Pb contaminated sites may lead to unacceptable risk not caused by vegetable consumption but by unintentional soil ingestion. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Evaluating health risks posed by heavy metals to humans consuming blood cockles (Anadara granosa) from the Upper Gulf of Thailand.

    Science.gov (United States)

    Sudsandee, Suntorn; Tantrakarnapa, Kraichat; Tharnpoophasiam, Prapin; Limpanont, Yanin; Mingkhwan, Ratchaneekorn; Worakhunpiset, Suwalee

    2017-06-01

    There is global concern about heavy metal contamination in the environment. Adverse health effects can be caused by heavy metals in contaminated food and water. Therefore, environmental monitoring studies and risk assessments should be conducted periodically. In this study, we measured levels of Cd, Cr, Cu, Hg, Mn, Ni, Pb, and Zn in blood cockles (Anadara granosa) collected from three locations in the Upper Gulf of Thailand. Hazard quotients and hazard indices were calculated to evaluate the health risks posed by heavy metals in consumed blood cockles. Heavy metal concentrations in all of the blood cockle samples were lower than the relevant food standards. The hazard quotients and hazard indices were heavy metals in blood cockles over a human lifetime.

  1. Contamination of the Conchos River in Mexico: Does It Pose a Health Risk to Local Residents?

    Directory of Open Access Journals (Sweden)

    Hector Rubio-Arias

    2010-05-01

    Full Text Available Presently, water contamination issues are of great concern worldwide. Mexico has not escaped this environmental problem, which negatively affects aquifers, water bodies and biodiversity; but most of all, public health. The objective was to determine the level of water contamination in six tributaries of the Conchos River and to relate their levels to human health risks. Bimonthly samples were obtained from each location during 2005 and 2006. Physical-chemical variables (temperature, pH, electrical conductivity (EC, Total solids and total nitrogen as well as heavy metals (As, Cr, Cu, Fe, Mn, Ni, V, Zn, and Li were determined. The statistical analysis considered yearly, monthly, and location effects, and their interactions. Temperatures differed only as a function of the sampling month (P < 0.001 and the pH was different for years (P = 0.006, months (P < 0.001 and the interaction years x months (P = 0.018. The EC was different for each location (P < 0.001, total solids did not change and total nitrogen was different for years (P < 0.001, months (P < 0.001 and the interaction years x months (P < 0.001. The As concentration was different for months (P = 0.008 and the highest concentration was detected in February samples with 0.11 mg L-1. The Cr was different for months (P < 0.001 and the interaction years x months (P < 0.001, noting the highest value of 0.25 mg L-1. The Cu, Fe, Mn, Va and Zn were different for years, months, and their interaction. The highest value of Cu was 2.50 mg L-1; forFe, it was 16.36 mg L-1; forMn it was 1.66 mg L-1; V was 0.55 mg L-1; and Zn was 0.53 mg L-1. For Ni, there were differences for years (P = 0.030, months (P < 0.001, and locations (P = 0.050, with the highest Ni value being 0.47 mg L-1. The Li level was the same for sampling month (P < 0.001. This information can help prevent potential health risks in the communities established along the river watershed who use this natural resource for swimming and fishing

  2. What Threats to Human Health Does Space Radiation Pose in Orbit

    Science.gov (United States)

    Wu, Honglu; Semones, Eddie; Weyland, Mark; Zapp, Neal; Cucinotta, Francis A.

    2011-01-01

    The Space Shuttle program spanned more than the entire length of a solar cycle. Investigations aimed towards understanding the health risks of the astronauts from exposures to space radiation involved mostly physical measurements of the dose and the linear energy transfer (LET) spectrum. Measurement of the dose rate on the Shuttle provided invariable new data for different periods of the solar cycle, whereas measurement of the LET spectrum using the tissue equivalent proportional counter (TEPC) produced the most complete mapping of the radiation environment of the low Earth orbits (LEO). Exposures to the Shuttle astronauts were measured by the personal dosimeter worn by the crewmembers. Analysis of over 300 personal dosimeter readings indicated a dependence on the mission duration, the altitude and inclination of the orbit, and the solar cycle, with the crewmembers on the launch and repair of the Hubble telescope receiving the highest doses due to the altitude of the mission. Secondary neutrons inside the Shuttle were determined by recoil protons or with Bonner spheres, and may contribute significantly to the risks of the crewmembers. In addition, the skin dose and the doses received at different organs were compared using a human phantom onboard a Shuttle mission. A number of radiobiology investigations wer e also performed. The biological doses were determined on six astronauts/cosmonauts on long-duration Shuttle/Mir missions and on two crewmembers on a Hubble repair mission by analyzing the damages in the chromosomes of the crewmembers? white blood cells. Several experiments were also conducted to address the question of possible synergistic effects of spaceflight, microgravity in particular, on the repair of radiation-induced DNA damages. The experimental design included exposure of cells before launch, during flight, or after landing. These physical and biological studies were invaluable in predicting the health risks for astronauts on ISS and future

  3. Predicting binding poses and affinities for protein - ligand complexes in the 2015 D3R Grand Challenge using a physical model with a statistical parameter estimation

    Science.gov (United States)

    Grudinin, Sergei; Kadukova, Maria; Eisenbarth, Andreas; Marillet, Simon; Cazals, Frédéric

    2016-09-01

    The 2015 D3R Grand Challenge provided an opportunity to test our new model for the binding free energy of small molecules, as well as to assess our protocol to predict binding poses for protein-ligand complexes. Our pose predictions were ranked 3-9 for the HSP90 dataset, depending on the assessment metric. For the MAP4K dataset the ranks are very dispersed and equal to 2-35, depending on the assessment metric, which does not provide any insight into the accuracy of the method. The main success of our pose prediction protocol was the re-scoring stage using the recently developed Convex-PL potential. We make a thorough analysis of our docking predictions made with AutoDock Vina and discuss the effect of the choice of rigid receptor templates, the number of flexible residues in the binding pocket, the binding pocket size, and the benefits of re-scoring. However, the main challenge was to predict experimentally determined binding affinities for two blind test sets. Our affinity prediction model consisted of two terms, a pairwise-additive enthalpy, and a non pairwise-additive entropy. We trained the free parameters of the model with a regularized regression using affinity and structural data from the PDBBind database. Our model performed very well on the training set, however, failed on the two test sets. We explain the drawback and pitfalls of our model, in particular in terms of relative coverage of the test set by the training set and missed dynamical properties from crystal structures, and discuss different routes to improve it.

  4. A Teacher Tablet Toolkit to meet the challenges posed by 21st century rural teaching and learning environments

    Directory of Open Access Journals (Sweden)

    Adèle Botha

    2015-11-01

    Full Text Available This article draws upon the experiences gained in participating in an Information and Communication Technology for Rural Education (ICT4RED initiative, as part of a larger Technology for Rural Education project (TECH4RED in Cofimvaba in the Eastern Cape Province of South Africa. The aim of this paper is to describe the conceptualisation, design and application of an innovative teacher professional development course for rural teachers, enabling them to use tablets to support teaching and learning in their classrooms. The course, as outcome, is presented as a Teacher Tablet Toolkit, designed to meet the challenges inherent to the 21st century rural technology enhanced teaching and learning environment. The paper documents and motivates design decisions, derived from literature and adapted through three iterations of a Design Science Research Process, to be incorporated in the ICT4RED Teacher Professional Development Course. The resulting course aims to equip participating teachers with a toolkit consisting of technology hardware, pragmatic pedagogical and technology knowledge and skills, and practice based experience. The significance of game design elements such as simulation and fun, technology in need rather than in case, adequate scaffolding and a clear learning path with interim learning goals are noted.

  5. [Would you mind a little bit less? Methodological and ethical challenges posed by the reduction of overtreatment].

    Science.gov (United States)

    Strech, Daniel

    2013-01-01

    The present paper outlines two central challenges that should be taken into account when making a concerted effort to reduce excessive medical care (overdiagnosis and overtreatment): first, the inevitability of value judgements in the risk-benefit assessment of medical treatment measures in conjunction with the need to go beyond the individual doctor-patient relationship and make these value judgements while, at least in part, assuming the role of acting deputy; and second, the need for a sufficient level of competence and trust in evidence-based medicine on the part of both physicians and patients. The paper will explain how one can say in a methodologically reasonable and ethically acceptable manner that a certain medical measure - in the context of the regular care setting - will objectively cause a "net harm" to the patient. Relevant institutions in the German healthcare system will be described that are currently conducting risk-benefit assessments (by different means and with different purposes). Taking the known entity of clinical guidelines as an example, the paper will demonstrate that the subjects of overdiagnosis and overtreatment as well as shortage of medical care can be more explicitly communicated by employing certain additional methodological tools. Finally, some central implementation barriers to a successful application of "Less is more!" will be presented and critically discussed. (As supplied by publisher). Copyright © 2013. Published by Elsevier GmbH.

  6. [Do pharmaceutical waste and drug residue pose a risk to public health?].

    Science.gov (United States)

    Haguenoer, Jean-Marie

    2010-01-01

    Recently, awareness has developed of the environmental consequences of drug waste and disposal. These residues are identified as coming from either diffuse sources, the most significant of which is via the discharge of these residues in urine and feces, and thus the sewage system and water contains these drug remnants and their metabolites, or from point sources, sometimes with very high levels of concentration in waste from chemical and pharmaceutical industries, health care settings, but also from intensive livestock farming and aquaculture. Depending on their physical chemistry properties, these substances are more or less naturally biodegradable and easily treated in sewage purification plants. The effectiveness of these treatment processes is highly random and unpredictable, but is overall around 60%, nevertheless with variations of 2-99% according to the molecules. The silt from these treatment plants, sometimes very rich in lipophilic substances is on occasion reused for agricultural application as fertilizer, paving the way for a possible contamination of crops. Furthermore, the use of veterinary drugs in animals can lead to soil contamination either directly or through manure and slurry. The contamination can equally reach and affect surface water, groundwater and sometimes the water intended for human consumption. The National academy of Pharmacy has established some general recommendations on the proper use of drugs, environmental monitoring and surveillance, risk assessment for humans and the environment, prevention and the need for prevention. Several categories of drugs are more worrying: cancer treatments, antibiotics as well as transfers of anti-bio-resistance, and hormonal derivatives which has been previously demonstrated to contribute, along with other molecules, to detrimental effects on endocrines.

  7. The decline of venture capital investment in early-stage life sciences poses a challenge to continued innovation.

    Science.gov (United States)

    Fleming, Jonathan J

    2015-02-01

    A key element required for translating new knowledge into effective therapies is early-stage venture capital that finances the work needed to identify a lead molecule or medical device prototype and to develop it to the proof-of-concept stage. This early investment is distinguished by great uncertainty over whether the molecule or prototype is safe and effective, the stability of the regulatory standards to which clinical trials are designed, and the likelihood that large follow-on investments for commercial development can be secured. Regulatory and reimbursement policies have a profound impact on the amount of capital and the types of life science projects that investors pursue. In this article I analyze several recent trends in early-stage venture capital funding, describe how these trends are influenced by regulatory and reimbursement policies, and discuss the role of policy makers in bringing new treatments to market. Policy makers can foster renewed private investment into critically needed early-stage products by increasing Small Business Innovation Research (SBIR) funding and public support for clinical trials in targeted areas of interest; creating regulatory pathways to enable early testing of experimental compounds in limited populations; and offering economic incentives for investors and developers in designated therapeutic areas. Project HOPE—The People-to-People Health Foundation, Inc.

  8. Health infrastructural challenges to health management information ...

    African Journals Online (AJOL)

    Aim: This study aims to assess health management information systems at the ... workers' ability to practice and use the health data generated at their Primary Health ... Only 2 (5.7%) of the health centres surveyed were capable of operating the ... The government at all levels should ensure collective effort and political will to ...

  9. What Butterfly Effect? The Contextual Differences in Public Perceptions of the Health Risk Posed by Climate Change

    Directory of Open Access Journals (Sweden)

    James W. Stoutenborough

    2015-08-01

    Full Text Available One of the most difficult aspects of persuading the public to support climate change policy is the lack of recognition that climate change will likely have a direct impact on an individual’s life. Anecdotal evidence and arguments within the media suggest that those who are skeptical of climate change are more likely to believe that the negative externalities associated with climate change will be experienced by others, and, therefore, are not a concern to that individual. This project examines public perceptions of the health risk posed by climate change. Using a large national public opinion survey of adults in the United States, respondents were asked to evaluate the health risk for themselves, their community, the United States, and the world. The results suggest that individuals evaluate the risk for each of these contexts differently. Statistical analyses are estimated to identify the determinants of each risk perception to identify their respective differences. The implications of these findings on support for climate change policy are discussed.

  10. The present global financial and economic crisis poses an additional risk factor for mental health problems on the employees.

    Science.gov (United States)

    Avčin, Bojana Avguštin; Kučina, Andrea Užmah; Sarotar, Brigita Novak; Radovanović, Mirjana; Plesničar, Blanka Kores

    2011-09-01

    The global financial and economic crisis starting in 2007 led to a deterioration of several socio-economic determinants of mental health. The aim of this cross-sectional study was to examine the impact of the present economic crisis on the depression and anxiety levels of the employed in the private and public sector in Slovenia. Altogether 1592 employees completed an internet based self-reported questionnaire. Data about perceived impact of the economic crisis, several socio-demographic, socioeconomic, and health parameters were collected. Depression symptoms were assessed by the Center for Epidemiological Studies-Depression Scale and anxiety symptoms by the Spielberger State-Inventory. Regression models were used 1) to explore the associations of the economic crisis with the level of depression and anxiety symptoms while controlling for some sociodemographic and work characteristic variables, and 2) to understand the relationship between some potentially important socioeconomic variables and the perception of the economic crisis. Depressive and anxiety scores were significantly increased among 590 (46.6%) employees being affected by the economic crisis. The level of depressive symptoms was significantly associated with perceived impact by the crisis, recent sick leave, reported injuries sustained at work, benzodiazepine and analgesic use, the lack of emotional support, and trust in crisis telephone lines. The level of anxiety symptoms yielded the robust association with the level of depression symptoms, reported injuries sustained on the way to work and education. The economic crisis poses an additional risk factor for mental health problems which clinicians should internalize and become more aware of them. Symptoms of depression and anxiety can be masked in high-utilizers of medical care with physical complaints or psychoactive drug use.

  11. Health seeking behaviour and challenges in utilising health facilities ...

    African Journals Online (AJOL)

    ... and long distance to health facilities. Conclusions: There is potential to increase access to health care in rural areas by increasing the frequency of mobile clinic services and strengthening the community health worker strategy. Key words: Health seeking behaviour, Rural community, Health facilities, Challenges, Uganda ...

  12. Nanometrology - challenges for health regulation

    Directory of Open Access Journals (Sweden)

    Jailton Carreteiro Damasceno

    2013-11-01

    Full Text Available The relationship between metrology, nanotechnology and nanoscience and sanitary regulation is discussed from the point of view of its importance and the interrelationship between the themes for the development of products and services involving nanotech-nology. The discussion involves the main techniques for measuring dimensional, chemical and biological properties of materials, and presents some of the challenges for the future. Issues such as processes of standardization and regulation in Europe, U.S. and Brazil are also addressed, providing an overview of how these processes are related to sanitary regulation.

  13. Gender-Specific Health Challenges Facing Women

    Science.gov (United States)

    ... with facebook share with twitter share with linkedin Gender-Specific Health Challenges Facing Women Global Research Global ... adverse reactions to the drugs. Women also suffer gender-specific consequences of HIV, including recurrent vaginal yeast ...

  14. Status of Environmental Management Initiatives to Accelerate the Reduction of Environmental Risks and Challenges Posed by the Legacy of the Cold War

    International Nuclear Information System (INIS)

    2009-01-01

    Fifty years of nuclear weapons production and energy research in the United States during the Cold War generated large amounts of radioactive wastes, spent nuclear fuel (SNF), excess plutonium and uranium, thousands of contaminated facilities, and contaminated soil and groundwater. During most of that half century, the Nation did not have the environmental regulatory structure or nuclear waste cleanup technologies that exist today. The result was a legacy of nuclear waste that was stored and disposed of in ways now considered unacceptable. Cleaning up and ultimately disposing of these wastes is the responsibility of the U.S. Department of Energy (DOE). In 1989, DOE established the Office of Environmental Management (EM) to solve the large scale and technically challenging risks posed by the world's largest nuclear cleanup. This required EM to build a new nuclear cleanup infrastructure, assemble and train a technically specialized workforce, and develop the technologies and tools required to safely decontaminate, disassemble, stabilize, disposition, and remediate unique radiation hazards. The sites where nuclear activities produced legacy waste and contamination include the original Manhattan Project sites--Los Alamos, New Mexico; Hanford, Washington; and Oak Ridge, Tennessee--as well as major Cold War sites, such as Savannah River Site, South Carolina; the Idaho National Laboratory, Idaho; Rocky Flats Plant, Colorado; and Fernald, Ohio. Today EM has responsibility for nuclear cleanup activities at 21 sites covering more than two million acres in 13 states, and employs more than 30,000 Federal and contractor employees, including scientists, engineers and hazardous waste technicians. This cleanup poses unique, technically complex problems, which must be solved under the most hazardous of conditions, and which will require billions of dollars a year for several more decades. The EM program focus during its first 10 years was on managing the most urgent risks and

  15. Status of Environmental Management Initiatives to Accelerate the Reduction of Environmental Risks and Challenges Posed by the Legacy of the Cold War

    Energy Technology Data Exchange (ETDEWEB)

    None

    2009-01-01

    Fifty years of nuclear weapons production and energy research in the United States during the Cold War generated large amounts of radioactive wastes, spent nuclear fuel (SNF), excess plutonium and uranium, thousands of contaminated facilities, and contaminated soil and groundwater. During most of that half century, the Nation did not have the environmental regulatory structure or nuclear waste cleanup technologies that exist today. The result was a legacy of nuclear waste that was stored and disposed of in ways now considered unacceptable. Cleaning up and ultimately disposing of these wastes is the responsibility of the U.S. Department of Energy (DOE). In 1989, DOE established the Office of Environmental Management (EM) to solve the large scale and technically challenging risks posed by the world's largest nuclear cleanup. This required EM to build a new nuclear cleanup infrastructure, assemble and train a technically specialized workforce, and develop the technologies and tools required to safely decontaminate, disassemble, stabilize, disposition, and remediate unique radiation hazards. The sites where nuclear activities produced legacy waste and contamination include the original Manhattan Project sites--Los Alamos, New Mexico; Hanford, Washington; and Oak Ridge, Tennessee--as well as major Cold War sites, such as Savannah River Site, South Carolina; the Idaho National Laboratory, Idaho; Rocky Flats Plant, Colorado; and Fernald, Ohio. Today EM has responsibility for nuclear cleanup activities at 21 sites covering more than two million acres in 13 states, and employs more than 30,000 Federal and contractor employees, including scientists, engineers and hazardous waste technicians. This cleanup poses unique, technically complex problems, which must be solved under the most hazardous of conditions, and which will require billions of dollars a year for several more decades. The EM program focus during its first 10 years was on managing the most urgent risks and

  16. Reentry challenges facing women with mental health problems.

    Science.gov (United States)

    Visher, Christy A; Bakken, Nicholas W

    2014-01-01

    Women entering the correctional system represent a population at high risk for mental health and the body of research on the mental health needs of women offenders is growing. These mental health problems pose challenges for women at every stage of the criminal justice process, from arrest to incarceration to community reentry and reintegration. In this article, we examined mental health status among a sample of 142 women leaving confinement and the role that mental health problems played in shaping their reentry outcomes using data collected between 2002 and 2005 in Houston, Texas. In the year after leaving prison, women with mental health problems reported poorer health, more hospitalizations, more suicidal thoughts, greater difficulties securing housing and employment, more involvement in criminal behavior, and less financial support from family than women with no indication of mental health problems. However, mental health status did not increase the likelihood of substance use relapse or reincarceration. The article concludes with a discussion of recommendations for improved policy and practice.

  17. Urban mental health: Challenges and perspectives

    DEFF Research Database (Denmark)

    Okkels, Niels

    2018-01-01

    Purpose of review: To provide an update on urban mental health and highlight the challenges that require urgent attention. Recent findings: The majority of the world's population live in towns and urbanization is expected to increase in all areas of the world. Challenges to mental health in urban...... services. Fast and unstructured urbanization, such as that seen in many developing countries, further exacerbates these challenges. There are promising initiatives emerging including initiatives to end homelessness, to improve access to green areas in urban environments, to provide emergency psychiatric...

  18. Public health challenges in sun protection.

    Science.gov (United States)

    Eide, Melody J; Weinstock, Martin A

    2006-01-01

    Sunscreens are a popular choice for protection from ultraviolet radiation, and hence, important components in the public health campaign to reduce the burden of skin cancer. Public health messages in skin cancer prevention have been used effectively in educational campaigns. The benefits of sunscreen extend beyond skin cancer prevention into other aspects of health and disease prevention: sunscreen decreases the risk for sunburn during physical activity outdoors and seems not to increase the risk for osteoporosis. Public health efforts have laid a solid foundation on which to face the continuing challenge of promoting and developing effective public health campaigns and health policies that encourage sunscreen use, sun protection, and the primary prevention of skin cancer. In this article, the controversies, concerns, and challenges of sunscreen use as it relates to public health are discussed.

  19. "Do your homework…and then hope for the best": the challenges that medical tourism poses to Canadian family physicians' support of patients' informed decision-making.

    Science.gov (United States)

    Snyder, Jeremy; Crooks, Valorie A; Johnston, Rory; Dharamsi, Shafik

    2013-09-22

    Medical tourism-the practice where patients travel internationally to privately access medical care-may limit patients' regular physicians' abilities to contribute to the informed decision-making process. We address this issue by examining ways in which Canadian family doctors' typical involvement in patients' informed decision-making is challenged when their patients engage in medical tourism. Focus groups were held with family physicians practicing in British Columbia, Canada. After receiving ethics approval, letters of invitation were faxed to family physicians in six cities. 22 physicians agreed to participate and focus groups ranged from two to six participants. Questions explored participants' perceptions of and experiences with medical tourism. A coding scheme was created using inductive and deductive codes that captured issues central to analytic themes identified by the investigators. Extracts of the coded data that dealt with informed decision-making were shared among the investigators in order to identify themes. Four themes were identified, all of which dealt with the challenges that medical tourism poses to family physicians' abilities to support medical tourists' informed decision-making. Findings relevant to each theme were contrasted against the existing medical tourism literature so as to assist in understanding their significance. Four key challenges were identified: 1) confusion and tensions related to the regular domestic physician's role in decision-making; 2) tendency to shift responsibility related to healthcare outcomes onto the patient because of the regular domestic physician's reduced role in shared decision-making; 3) strains on the patient-physician relationship and corresponding concern around the responsibility of the foreign physician; and 4) regular domestic physicians' concerns that treatments sought abroad may not be based on the best available medical evidence on treatment efficacy. Medical tourism is creating new challenges for

  20. Serious Games for Health: Features, Challenges, Next Steps.

    Science.gov (United States)

    Blumberg, Moderators Fran C; Burke, Lauren C; Hodent, Participants Celia; Evans, Michael A; Lane, H Chad; Schell, Jesse

    2014-10-01

    As articles in this journal have demonstrated over the past 3 years, serious game development continues to flourish as a vehicle for formal and informal health education. How best to characterize a "serious" game remains somewhat elusive in the literature. Many researchers and practitioners view serious games as capitalizing on computer technology and state-of-the-art video graphics as an enjoyable means by which to provide and promote instruction and training, or to facilitate attitude change among its players. We invited four distinguished researchers and practitioners to further discuss with us how they view the characteristics of serious games for health, how those characteristics differ from those for academic purposes, the challenges posed for serious game development among players of different ages, and next steps for the development and empirical examination of the effectiveness of serious games for players' psychological and physical well-being.

  1. Health recommender systems: concepts, requirements, technical basics and challenges.

    Science.gov (United States)

    Wiesner, Martin; Pfeifer, Daniel

    2014-03-03

    During the last decades huge amounts of data have been collected in clinical databases representing patients' health states (e.g., as laboratory results, treatment plans, medical reports). Hence, digital information available for patient-oriented decision making has increased drastically but is often scattered across different sites. As as solution, personal health record systems (PHRS) are meant to centralize an individual's health data and to allow access for the owner as well as for authorized health professionals. Yet, expert-oriented language, complex interrelations of medical facts and information overload in general pose major obstacles for patients to understand their own record and to draw adequate conclusions. In this context, recommender systems may supply patients with additional laymen-friendly information helping to better comprehend their health status as represented by their record. However, such systems must be adapted to cope with the specific requirements in the health domain in order to deliver highly relevant information for patients. They are referred to as health recommender systems (HRS). In this article we give an introduction to health recommender systems and explain why they are a useful enhancement to PHR solutions. Basic concepts and scenarios are discussed and a first implementation is presented. In addition, we outline an evaluation approach for such a system, which is supported by medical experts. The construction of a test collection for case-related recommendations is described. Finally, challenges and open issues are discussed.

  2. Health Recommender Systems: Concepts, Requirements, Technical Basics and Challenges

    Directory of Open Access Journals (Sweden)

    Martin Wiesner

    2014-03-01

    Full Text Available During the last decades huge amounts of data have been collected in clinical databases representing patients’ health states (e.g., as laboratory results, treatment plans, medical reports. Hence, digital information available for patient-oriented decision making has increased drastically but is often scattered across different sites. As as solution, personal health record systems (PHRS are meant to centralize an individual’s health data and to allow access for the owner as well as for authorized health professionals. Yet, expert-oriented language, complex interrelations of medical facts and information overload in general pose major obstacles for patients to understand their own record and to draw adequate conclusions. In this context, recommender systems may supply patients with additional laymen-friendly information helping to better comprehend their health status as represented by their record. However, such systems must be adapted to cope with the specific requirements in the health domain in order to deliver highly relevant information for patients. They are referred to as health recommender systems (HRS. In this article we give an introduction to health recommender systems and explain why they are a useful enhancement to PHR solutions. Basic concepts and scenarios are discussed and a first implementation is presented. In addition, we outline an evaluation approach for such a system, which is supported by medical experts. The construction of a test collection for case-related recommendations is described. Finally, challenges and open issues are discussed.

  3. Challenges to Native American health care.

    Science.gov (United States)

    Noren, J; Kindig, D; Sprenger, A

    1998-01-01

    Native American health care programs face complex and unprecedented challenges resulting from the increased assumption of clinical operations by tribal authorities, shortfalls in Federal funding, modifications in state and Federal health and welfare programs, and intensifying involvement with managed care organizations. These challenges are further complicated by service populations that are increasing at a faster rate than the growth in funding. The authors conducted onsite surveys of 39 Native American health programs in 10 states in order to assess the organizational and management problems they faced. The trend toward transfer of health programs from the Indian Health Service to tribal operation seems likely to continue and accelerate. The survey results indicate that in order for programs to be effective in the long run, they will need to be guided by skilled managers able to adapt to these powerful changes in the health care environment.

  4. Challenges in mental health nursing: current opinion

    Directory of Open Access Journals (Sweden)

    Sabella D

    2014-01-01

    Full Text Available Donna Sabella, Theresa Fay-Hillier College of Nursing and Health Professions, Drexel University, Philadelphia, PA, USA Abstract: The current mental health care system in the US continues to struggle with providing adequate care and services to all that require it due to limited resources, biases from both other professions and the public, and the complexities of treatment of many of those individuals or populations that suffer from mental illness. Mental health nurses, also referred to as psychiatric nurses, are impacted by those same biases, limited resources, and complexities in their role. This paper provides a brief history of mental health nursing and a discussion of the current challenges faced within the profession. It will also include how the public's perception of both those who have mental illness and those who treat it is based on the sensationalism of those who are violent, and misunderstanding of current treatments. It is imperative that mental health nurses continue to define and educate other health care professionals as well as the general public of the role of the mental health nurse and those who suffer from mental illness. Unfortunately, some of the same bias that was present in the 1930s remains today, but perhaps with perseverance and education it will not continue into the future. Keywords: mental health, psychiatric nursing, pre- licensure, post-licensure challenges, professional obstacles, public perception

  5. The challenge of gun control for mental health advocates.

    Science.gov (United States)

    Pandya, Anand

    2013-09-01

    Mass shootings, such as the 2012 Newtown massacre, have repeatedly led to political discourse about limiting access to guns for individuals with serious mental illness. Although the political climate after such tragic events poses a considerable challenge to mental health advocates who wish to minimize unsympathetic portrayals of those with mental illness, such media attention may be a rare opportunity to focus attention on risks of victimization of those with serious mental illness and barriers to obtaining psychiatric care. Current federal gun control laws may discourage individuals from seeking psychiatric treatment and describe individuals with mental illness using anachronistic, imprecise, and gratuitously stigmatizing language. This article lays out potential talking points that may be useful after future gun violence.

  6. Digital danger: a review of the global public health, patient safety and cybersecurity threats posed by illicit online pharmacies

    Science.gov (United States)

    Mackey, Tim K.; Nayyar, Gaurvika

    2016-01-01

    Background Amidst the rise of e-commerce, there has been a proliferation of illicit online pharmacies that threaten global patient safety by selling drugs without a prescription directly to the consumer. Despite this clear threat, little is known about the key risk characteristics, central challenges and current legal, regulatory and law enforcement responses. Sources of data A review was conducted of the English literature with search terms ‘online pharmacies’, ‘Internet pharmacies’, ‘cyber pharmacies’, ‘rogue pharmacies’, and ‘e-pharmacies’ using PubMed, JSTOR, and Google Scholar from 1999–2005. Areas of agreement Illicit online pharmacies are a rapidly growing public health threat and are characterized by a number of complex and interrelated risk factors. Areas of controversy Solutions are varied and are of questionable utility in the face of evolving technology that enables this form of transnational cybercrime. Growing points Legal, regulatory and technology solutions must address the entire illicit online pharmacy ecosystem in order to be effective. Areas timely for developing research There is a critical need to build international consensus, conduct additional research and develop technology to combat illicit online pharmacies. PMID:27151957

  7. Digital danger: a review of the global public health, patient safety and cybersecurity threats posed by illicit online pharmacies.

    Science.gov (United States)

    Mackey, Tim K; Nayyar, Gaurvika

    2016-06-01

    Amidst the rise of e-commerce, there has been a proliferation of illicit online pharmacies that threaten global patient safety by selling drugs without a prescription directly to the consumer. Despite this clear threat, little is known about the key risk characteristics, central challenges and current legal, regulatory and law enforcement responses. A review was conducted of the English literature with search terms 'online pharmacies', 'Internet pharmacies', 'cyber pharmacies', 'rogue pharmacies', and 'e-pharmacies' using PubMed, JSTOR, and Google Scholar from 1999-2005. Illicit online pharmacies are a rapidly growing public health threat and are characterized by a number of complex and interrelated risk factors. Solutions are varied and are of questionable utility in the face of evolving technology that enables this form of transnational cybercrime. Legal, regulatory and technology solutions must address the entire illicit online pharmacy ecosystem in order to be effective. There is a critical need to build international consensus, conduct additional research and develop technology to combat illicit online pharmacies. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. Potential challenges facing distributed leadership in health care: evidence from the UK National Health Service.

    Science.gov (United States)

    Martin, Graeme; Beech, Nic; MacIntosh, Robert; Bushfield, Stacey

    2015-01-01

    The discourse of leaderism in health care has been a subject of much academic and practical debate. Recently, distributed leadership (DL) has been adopted as a key strand of policy in the UK National Health Service (NHS). However, there is some confusion over the meaning of DL and uncertainty over its application to clinical and non-clinical staff. This article examines the potential for DL in the NHS by drawing on qualitative data from three co-located health-care organisations that embraced DL as part of their organisational strategy. Recent theorising positions DL as a hybrid model combining focused and dispersed leadership; however, our data raise important challenges for policymakers and senior managers who are implementing such a leadership policy. We show that there are three distinct forms of disconnect and that these pose a significant problem for DL. However, we argue that instead of these disconnects posing a significant problem for the discourse of leaderism, they enable a fantasy of leadership that draws on and supports the discourse. © 2014 The Authors. Sociology of Health & Illness © 2014 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

  9. THE QATAR HEALTH SYSTEM: CHALLENGES AND OPPORTUNITIES

    Directory of Open Access Journals (Sweden)

    Shaher ALSHAMARI

    2017-06-01

    Full Text Available Qatar’s healthcare system is comparatively new and has experienced noteworthy developments over its brief history. In this paper, our aim is to look at the unique challenges this small nation has faced in building that system. This paper will describe the accomplishments of Qatar’s medical authorities and the challenges they faced. It will also compare public and private healthcare providers. Today, the government of Qatar has financed all the health care for this rapidly-developing, multicultural nation, but it is now planning to introduce medical insurance. This report of its experience will benefit other nations wanting to develop their own healthcare systems.

  10. e-Health Cloud: Opportunities and Challenges

    Directory of Open Access Journals (Sweden)

    Jameela Al-Jaroodi

    2012-07-01

    Full Text Available As the costs of healthcare services rise and healthcare professionals are becoming scarce and hard to find, it is imminent that healthcare organizations consider adopting health information technology (HIT systems. HIT allows health organizations to streamline many of their processes and provide services in a more efficient and cost-effective manner. The latest technological trends such as Cloud Computing (CC provide a strong infrastructure and offer a true enabler for HIT services over the Internet. This can be achieved on a pay-as-you-use model of the “e-Health Cloud” to help the healthcare industry cope with current and future demands yet keeping their costs to a minimum. Despite its great potential, HIT as a CC model has not been addressed extensively in the literature. There are no apparent frameworks which clearly encompass all viable schemes and interrelationships between HIT and CC. Therefore, analyzing and comparing the effectiveness of such schemes is important. In this paper we introduce the concept of “e-Health Cloud” highlighting many of its constituents and proposing building an e-health environment and elucidating many of the challenges confronting the success of the e-Health Cloud. We will also discuss different possible solutions to address challenges such as security and privacy.

  11. Mobile mental health: a challenging research agenda.

    Science.gov (United States)

    Olff, Miranda

    2015-01-01

    The field of mobile health ("m-Health") is evolving rapidly and there is an explosive growth of psychological tools on the market. Exciting high-tech developments may identify symptoms, help individuals manage their own mental health, encourage help seeking, and provide both preventive and therapeutic interventions. This development has the potential to be an efficient cost-effective approach reducing waiting lists and serving a considerable portion of people globally ("g-Health"). However, few of the mobile applications (apps) have been rigorously evaluated. There is little information on how valid screening and assessment tools are, which of the mobile intervention apps are effective, or how well mobile apps compare to face-to-face treatments. But how feasible is rigorous scientific evaluation with the rising demands from policy makers, business partners, and users for their quick release? In this paper, developments in m-Health tools-targeting screening, assessment, prevention, and treatment-are reviewed with examples from the field of trauma and posttraumatic stress disorder. The academic challenges in developing and evaluating m-Health tools are being addressed. Evidence-based guidance is needed on appropriate research designs that may overcome some of the public and ethical challenges (e.g., equity, availability) and the market-driven wish to have mobile apps in the "App Store" yesterday rather than tomorrow.

  12. Framing global health: the governance challenge.

    Science.gov (United States)

    McInnes, Colin; Kamradt-Scott, Adam; Lee, Kelley; Reubi, David; Roemer-Mahler, Anne; Rushton, Simon; Williams, Owain David; Woodling, Marie

    2012-01-01

    With the emergence of global health comes governance challenges which are equally global in nature. This article identifies some of the initial limitations in analyses of global health governance (GHG) before discussing the focus of this special supplement: the framing of global health issues and the manner in which this impacts upon GHG. Whilst not denying the importance of material factors (such as resources and institutional competencies), the article identifies how issues can be framed in different ways, thereby creating particular pathways of response which in turn affect the potential for and nature of GHG. It also identifies and discusses the key frames operating in global health: evidence-based medicine, human rights, security, economics and development.

  13. Four Challenges That Global Health Networks Face

    Directory of Open Access Journals (Sweden)

    Jeremy Shiffman

    2017-04-01

    Full Text Available Global health networks, webs of individuals and organizations with a shared concern for a particular condition, have proliferated over the past quarter century. They differ in their effectiveness, a factor that may help explain why resource allocations vary across health conditions and do not correspond closely with disease burden. Drawing on findings from recently concluded studies of eight global health networks—addressing alcohol harm, early childhood development (ECD, maternal mortality, neonatal mortality, pneumonia, surgically-treatable conditions, tobacco use, and tuberculosis—I identify four challenges that networks face in generating attention and resources for the conditions that concern them. The first is problem definition: generating consensus on what the problem is and how it should be addressed. The second is positioning: portraying the issue in ways that inspire external audiences to act. The third is coalition-building: forging alliances with these external actors, particularly ones outside the health sector. The fourth is governance: establishing institutions to facilitate collective action. Research indicates that global health networks that effectively tackle these challenges are more likely to garner support to address the conditions that concern them. In addition to the effectiveness of networks, I also consider their legitimacy, identifying reasons both to affirm and to question their right to exert power.

  14. Wildlife health investigations: needs, challenges and recommendations

    Science.gov (United States)

    2013-01-01

    In a fast changing world with growing concerns about biodiversity loss and an increasing number of animal and human diseases emerging from wildlife, the need for effective wildlife health investigations including both surveillance and research is now widely recognized. However, procedures applicable to and knowledge acquired from studies related to domestic animal and human health can be on partly extrapolated to wildlife. This article identifies requirements and challenges inherent in wildlife health investigations, reviews important definitions and novel health investigation methods, and proposes tools and strategies for effective wildlife health surveillance programs. Impediments to wildlife health investigations are largely related to zoological, behavioral and ecological characteristics of wildlife populations and to limited access to investigation materials. These concerns should not be viewed as insurmountable but it is imperative that they are considered in study design, data analysis and result interpretation. It is particularly crucial to remember that health surveillance does not begin in the laboratory but in the fields. In this context, participatory approaches and mutual respect are essential. Furthermore, interdisciplinarity and open minds are necessary because a wide range of tools and knowledge from different fields need to be integrated in wildlife health surveillance and research. The identification of factors contributing to disease emergence requires the comparison of health and ecological data over time and among geographical regions. Finally, there is a need for the development and validation of diagnostic tests for wildlife species and for data on free-ranging population densities. Training of health professionals in wildlife diseases should also be improved. Overall, the article particularly emphasizes five needs of wildlife health investigations: communication and collaboration; use of synergies and triangulation approaches; investments

  15. Mobile mental health: a challenging research agenda

    Directory of Open Access Journals (Sweden)

    Miranda Olff

    2015-05-01

    Full Text Available The field of mobile health (“m-Health” is evolving rapidly and there is an explosive growth of psychological tools on the market. Exciting high-tech developments may identify symptoms, help individuals manage their own mental health, encourage help seeking, and provide both preventive and therapeutic interventions. This development has the potential to be an efficient cost-effective approach reducing waiting lists and serving a considerable portion of people globally (“g-Health”. However, few of the mobile applications (apps have been rigorously evaluated. There is little information on how valid screening and assessment tools are, which of the mobile intervention apps are effective, or how well mobile apps compare to face-to-face treatments. But how feasible is rigorous scientific evaluation with the rising demands from policy makers, business partners, and users for their quick release? In this paper, developments in m-Health tools—targeting screening, assessment, prevention, and treatment—are reviewed with examples from the field of trauma and posttraumatic stress disorder. The academic challenges in developing and evaluating m-Health tools are being addressed. Evidence-based guidance is needed on appropriate research designs that may overcome some of the public and ethical challenges (e.g., equity, availability and the market-driven wish to have mobile apps in the “App Store” yesterday rather than tomorrow.

  16. Health challenges in Kazakhstan and Central Asia.

    Science.gov (United States)

    Adambekov, Shalkar; Kaiyrlykyzy, Aiym; Igissinov, Nurbek; Linkov, Faina

    2016-01-01

    The Central Asian region, which encompasses Kazakhstan, Uzbekistan, Tajikistan, Turkmenistan and Kyrgyzstan, is an interesting geographic region with a rich history dating back to the Silk Road, Mongol conquests and expansion of the Russian Empire. However, from a public health viewpoint, the Central Asian region is under-investigated, and many public health challenges exist, as countries of Central Asia inherited the centralised medical systems practiced in the Soviet Union, and are currently undergoing rapid transitions. A large number of low and middle-income countries around the world, including countries of Central Asia, face a double burden of chronic and infectious disease. This essay focuses on the exploration of the most important public health challenges in the Central Asian region, including limited scientific productivity, the double burden of chronic and infectious disease, the need for healthcare reform and the reduction in care variation. Central Asia has a large number of medical schools, medical centres, and emerging research institutes that can be used to foster a change in medical and public health practice in the region. 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/

  17. [Health literacy as one of the contemporary public health challenges].

    Science.gov (United States)

    Iwanowicz, Eliza

    2009-01-01

    One of the fundamental public health challenges in the 21st century should be the improvement of people's health literacy, namely the understanding of health messages. The acquired high level of health literacy means that one knows how and where information concerning health determinants can be found, is able to assess it critically and in favorable conditions even modify them, which seems to be of particular importance from the perspective of heath promotion, prevention or treatment of diseases. Therefore, for professionals in these fields, knowledge of ways how to improve health literacy, as well as awareness of related benefits and the consequences of its poor level, seems to be indispensable. Thus, the aim of this paper is to explain the term of "health literacy", its determinants and implications.

  18. The effect of risk perception on public preferences and willingness to pay for reductions in the health risks posed by toxic cyanobacterial blooms.

    Science.gov (United States)

    Hunter, Peter D; Hanley, Nick; Czajkowski, Mikołaj; Mearns, Kathryn; Tyler, Andrew N; Carvalho, Laurence; Codd, Geoffrey A

    2012-06-01

    Mass populations of toxin-producing cyanobacteria are an increasingly common occurrence in inland and coastal waters used for recreational purposes. These mass populations pose serious risks to human and animal health and impose potentially significant economic costs on society. In this study, we used contingent valuation (CV) methods to elicit public willingness to pay (WTP) for reductions in the morbidity risks posed by blooms of toxin-producing cyanobacteria in Loch Leven, Scotland. We found that 55% of respondents (68% excluding protest voters) were willing to pay for a reduction in the number of days per year (from 90, to either 45 or 0 days) that cyanobacteria pose a risk to human health at Loch Leven. The mean WTP for a risk reduction was UK£9.99-12.23/household/year estimated using a logistic spike model. In addition, using the spike model and a simultaneous equations model to control for endogeneity bias, we found the respondents' WTP was strongly dependent on socio-demographic characteristics, economic status and usage of the waterbody, but also individual-specific attitudes and perceptions towards health risks. This study demonstrates that anticipated health risk reductions are an important nonmarket benefit of improving water quality in recreational waters and should be accounted for in future cost-benefit analyses such as those being undertaken under the auspices of the European Union's Water Framework Directive, but also that such values depend on subjective perceptions of water-related health risks and general attitudes towards the environment. Copyright © 2012 Elsevier B.V. All rights reserved.

  19. Kazakhstan's Environment-Health system, a Big Data challenge

    Science.gov (United States)

    Vitolo, Claudia; Bella Gazdiyeva, Bella; Tucker, Allan; Russell, Andrew; Ali, Maged; Althonayan, Abraham

    2016-04-01

    Kazakhstan has witnessed a remarkable economic development in the past 15 years, becoming an upper-middle-income country. However it is still widely regarded as a developing nation, partially because of its population's low life expectancy which is 5 years below the average in similar economies. The environment is in a rather fragile state, affected by soil, water, air pollution, radioactive contamination and climate change. However, Kazakhstan's government is moving towards clean energy and environmental protection and calling on scientists to help prioritise investments. The British Council-funded "Kazakhstan's Environment-Health Risk Analysis (KEHRA)" project is one of the recently launched initiatives to support Kazakhstan healthier future. The underlying hypothesis of this research is that the above mentioned factors (air/water/soil pollution, etc.) affecting public health almost certainly do not act independently but rather trigger and exacerbate each other. Exploring the environment-health links in a multi-dimensional framework is a typical Big Data problem, in which the volume and variety of the data needed poses technical as well as scientific challenges. In Kazakhstan, the complexities related to managing and analysing Big Data are worsened by a number of obstacles at the data acquisition step: most of the data is not in digital form, spatial and temporal attributes are often ambiguous and the re-use and re-purpose of the information is subject to restrictive licenses and other mechanisms of control. In this work, we document the first steps taken towards building an understanding of the complex environment-health system in Kazakhstan, using interactive visualisation tools to identify and compare hot-spots of pollution and poor health outcomes, Big Data and web technologies to collect, manage and explore available information. In the future, the knowledge acquired will be modelled to develop evidence-based recommendation systems for decision makers in

  20. Transdisciplinary Higher Education—A Challenge for Public Health Science

    Directory of Open Access Journals (Sweden)

    Alexandra Krettek

    2011-01-01

    Full Text Available This paper highlights and discusses issues associated with transdisciplinary teaching and suggests ways to overcome the challenges posed by different epistemologies, methods, and ethical positions. Our own transdisciplinary teaching experience in public health helped us identify some important questions including (i what is transdisciplinary research in practice, and does methods triangulation yield more valid results?, (ii from a teaching perspective, how do biopsychosocial and medical research differ?, (iii what is the difference between deductive and inductive research, and does each discipline represent a different ethical position?, and (iv does pure inductive research lack theories, and does it require a hypothesis—a “rule of thumb”—on how to proceed? We also suggest ways to facilitate and enhance transdisciplinary teaching, focusing on what unites us and not on what sets us apart, openly underlining and highlighting our differences. Using diverse methodologies, a newly educated transdisciplinary workforce will likely extend current knowledge and facilitate solutions for complex public health issues.

  1. Digital health and the challenge of health systems transformation.

    Science.gov (United States)

    Alami, Hassane; Gagnon, Marie-Pierre; Fortin, Jean-Paul

    2017-01-01

    Information and communication technologies have transformed all sectors of society. The health sector is no exception to this trend. In light of "digital health", we see multiplying numbers of web platforms and mobile health applications, often brought by new unconventional players who produce and offer services in non-linear and non-hierarchal ways, this by multiplying access points to services for people. Some speak of a "uberization" of healthcare. New realities and challenges have emerged from this paradigm, which question the abilities of health systems to cope with new business and economic models, governance of data and regulation. Countries must provide adequate responses so that digital health, based increasingly on disruptive technologies, can benefit for all.

  2. Concentrations of and health risks posed by polychlorinated dibenzo-p-dioxins and dibenzofurans around industrial sites in Hebei Province, China

    DEFF Research Database (Denmark)

    Han, Ying; Liu, Wenbin; Hansen, Hans Chr. Bruun

    2016-01-01

    Sintering and steel production as the main emission sources of polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs) may affect environment and human health. The concentrations, profiles, and distributions of PCDD/Fs in soil samples from around four typical sintering and steel production...... plants in Hebei Province, China, were determined. Forty-six soil samples were collected at distances from 500 to 9000 m from industrial plant chimneys. The concentrations of total 17 2,3,7,8-substituted PCDD/F congeners in the soil samples from sites A, B, C, and D were in the range 11-130, 13-284, 2...... will be exposed to low amounts of PCDD/Fs in soil from around the industrial sites, and this exposure will pose potential health risks for the local population living at distances of less than 1000 m from nearest stack but will have no high health risks for people living further away. These results...

  3. Emerging health issues: the widening challenge for population health promotion.

    Science.gov (United States)

    McMichael, Anthony J; Butler, Colin D

    2006-12-01

    The spectrum of tasks for health promotion has widened since the Ottawa Charter was signed. In 1986, infectious diseases still seemed in retreat, the potential extent of HIV/AIDS was unrecognized, the Green Revolution was at its height and global poverty appeared less intractable. Global climate change had not yet emerged as a major threat to development and health. Most economists forecast continuous improvement, and chronic diseases were broadly anticipated as the next major health issue. Today, although many broadly averaged measures of population health have improved, many of the determinants of global health have faltered. Many infectious diseases have emerged; others have unexpectedly reappeared. Reasons include urban crowding, environmental changes, altered sexual relations, intensified food production and increased mobility and trade. Foremost, however, is the persistence of poverty and the exacerbation of regional and global inequality. Life expectancy has unexpectedly declined in several countries. Rather than being a faint echo from an earlier time of hardship, these declines could signify the future. Relatedly, the demographic and epidemiological transitions have faltered. In some regions, declining fertility has overshot that needed for optimal age structure, whereas elsewhere mortality increases have reduced population growth rates, despite continuing high fertility. Few, if any, Millennium Development Goals (MDG), including those for health and sustainability, seem achievable. Policy-makers generally misunderstand the link between environmental sustainability (MDG #7) and health. Many health workers also fail to realize that social cohesion and sustainability--maintenance of the Earth's ecological and geophysical systems--is a necessary basis for health. In sum, these issues present an enormous challenge to health. Health promotion must address population health influences that transcend national boundaries and generations and engage with the

  4. Public engagement on global health challenges.

    Science.gov (United States)

    Cohen, Emma R M; Masum, Hassan; Berndtson, Kathryn; Saunders, Vicki; Hadfield, Tom; Panjwani, Dilzayn; Persad, Deepa L; Minhas, Gunjeet S; Daar, Abdallah S; Singh, Jerome A; Singer, Peter A

    2008-05-20

    Experience with public engagement activities regarding the risks and benefits of science and technology (S&T) is growing, especially in the industrialized world. However, public engagement in the developing world regarding S&T risks and benefits to explore health issues has not been widely explored. This paper gives an overview about public engagement and related concepts, with a particular focus on challenges and benefits in the developing world. We then describe an Internet-based platform, which seeks to both inform and engage youth and the broader public on global water issues and their health impacts. Finally, we outline a possible course for future action to scale up this and similar online public engagement platforms. The benefits of public engagement include creating an informed citizenry, generating new ideas from the public, increasing the chances of research being adopted, increasing public trust, and answering ethical research questions. Public engagement also fosters global communication, enables shared experiences and methodology, standardizes strategy, and generates global viewpoints. This is especially pertinent to the developing world, as it encourages previously marginalized populations to participate on a global stage. One of the core issues at stake in public engagement is global governance of science and technology. Also, beyond benefiting society at large, public engagement in science offers benefits to the scientific enterprise itself. Successful public engagement with developing world stakeholders will be a critical part of implementing new services and technologies. Interactive engagement platforms, such as the Internet, have the potential to unite people globally around relevant health issues.

  5. Digital health and the challenge of health systems transformation

    Science.gov (United States)

    Gagnon, Marie-Pierre; Fortin, Jean-Paul

    2017-01-01

    Information and communication technologies have transformed all sectors of society. The health sector is no exception to this trend. In light of “digital health”, we see multiplying numbers of web platforms and mobile health applications, often brought by new unconventional players who produce and offer services in non-linear and non-hierarchal ways, this by multiplying access points to services for people. Some speak of a “uberization” of healthcare. New realities and challenges have emerged from this paradigm, which question the abilities of health systems to cope with new business and economic models, governance of data and regulation. Countries must provide adequate responses so that digital health, based increasingly on disruptive technologies, can benefit for all. PMID:28894741

  6. Innovating in Health Care – Modern Challenges

    Directory of Open Access Journals (Sweden)

    Sebija Izetbegović

    2013-12-01

    Full Text Available Introduction: The goal of this article is to present that innovating in health care begins to become an imperative in present time. Innovating will enable the achievement of the highest quality health care results and the patients' satisfaction with the least amount of financial resources.Methods: The thorough literature review of multifaceted sources was conducted including: studies, books, monographies and peer – reviewed journals with the goal of achieving the clearer picture of today's modern challenges in the complex fi eld of health care innovation.Discussion: Theoretical and empirical studies clearly indicate that the innovation is one of the key factors in the competitiveness of the organization and its survival in the market. Developed countries of the world today are making significant efforts in order for innovation to become a national priority, with special emphasis placed on measuring innovation performance. Results of theoretical and practical studies show that in the future, treatment of the most diffi cult and complex diseases of our time, through the entirely new discoveries and results, derived from the process of innovation, will project entirely new positive forms and outcomes in the health care.Conclusion: There is no doubt that the humanity and medical science will through innovation succeed to win the battles against the majority of the most complex contemporary diseases. Malignant neoplasm of tomorrow, through the application of a new, innovative approaches to research, processes and treatments will become a chronic diseases. Among many, the particular problem in the process of innovation will represent the cost of research and development (R&D, production and the safety of prescription drugs.

  7. Development of a Patient-Reported Palliative Care-Specific Health Classification System: The POS-E.

    Science.gov (United States)

    Dzingina, Mendwas; Higginson, Irene J; McCrone, Paul; Murtagh, Fliss E M

    2017-06-01

    Generic preference-based measures are commonly used to estimate quality-adjusted life-years (QALYs) to inform resource-allocation decisions. However, concerns have been raised that generic measures may be inappropriate in palliative care. Our objective was to derive a health-state classification system that is amenable to valuation from the ten-item Palliative Care Outcome Scale (POS), a widely used patient-reported outcome measure in palliative care. The dimensional structure of the original POS was assessed using factor analysis. Item performance was assessed, using Rasch analysis and psychometric criteria, to enable the selection of items that represent the dimensions covered by the POS. Data from six studies of patients receiving palliative care were combined (N = 1011) and randomly split into two halves for development and validation. Analysis was undertaken on the development data, and results were validated by repeating the analysis with the validation dataset. Following Rasch and factor analyses, a classification system of seven items was derived. Each item had two to three levels. Rasch threshold map helped identify a set of 14 plausible health states that can be used for the valuation of the instrument to derive a preference-based index. Combining factor analysis and Rasch analysis with psychometric criteria provides a valid method of constructing a classification system for a palliative care-specific preference-based measure. The next stage is to obtain preference weights so the measure can be used in economic evaluations in palliative care.

  8. [Adoption of new technologies by health services: the challenge of analyzing relevant factors].

    Science.gov (United States)

    Trindade, Evelinda

    2008-05-01

    The exponential increase in the incorporation of health technologies has been considered a key factor in increased expenditures by the health sector. Such decisions involve multiple levels and stakeholders. Decentralization has multiplied the decision-making levels, with numerous difficult choices and limited resources. The interrelationship between stakeholders is complex, in creative systems with multiple determinants and confounders. The current review discusses the interaction between the factors influencing the decisions to incorporate technologies by health services, and proposes a structure for their analysis. The application and intensity of these factors in decision-making and the incorporation of products and programs by health services shapes the installed capacity of local and regional networks and modifies the health system. Empirical observation of decision-making and technology incorporation in Brazilian health services poses an important challenge. The structured recognition and measurement of these variables can assist proactive planning of health services.

  9. Public engagement on global health challenges

    Directory of Open Access Journals (Sweden)

    Minhas Gunjeet S

    2008-05-01

    Full Text Available Abstract Background Experience with public engagement activities regarding the risks and benefits of science and technology (S&T is growing, especially in the industrialized world. However, public engagement in the developing world regarding S&T risks and benefits to explore health issues has not been widely explored. Methods This paper gives an overview about public engagement and related concepts, with a particular focus on challenges and benefits in the developing world. We then describe an Internet-based platform, which seeks to both inform and engage youth and the broader public on global water issues and their health impacts. Finally, we outline a possible course for future action to scale up this and similar online public engagement platforms. Results The benefits of public engagement include creating an informed citizenry, generating new ideas from the public, increasing the chances of research being adopted, increasing public trust, and answering ethical research questions. Public engagement also fosters global communication, enables shared experiences and methodology, standardizes strategy, and generates global viewpoints. This is especially pertinent to the developing world, as it encourages previously marginalized populations to participate on a global stage. One of the core issues at stake in public engagement is global governance of science and technology. Also, beyond benefiting society at large, public engagement in science offers benefits to the scientific enterprise itself. Conclusion Successful public engagement with developing world stakeholders will be a critical part of implementing new services and technologies. Interactive engagement platforms, such as the Internet, have the potential to unite people globally around relevant health issues.

  10. Designing a risk communication strategy for health hazards posed by traditional slaughter of goats in Tshwane, South Africa

    Directory of Open Access Journals (Sweden)

    Daniel N. Qekwana

    2014-08-01

    Full Text Available In African societies, traditional slaughter is linked to celebrations like weddings or births, as well as funerals and ancestor veneration. Participants in traditional slaughter of goats are at risk of exposure to hazards during slaughter, food preparation and consumption of goat meat. For risk mitigation strategies to be implemented, identification of the population at risk is required. This study is based on the premise that the demographic profile of people involved in traditional slaughter of goats is important for risk communication. Both structured and informal interviews were recorded and analysed using a thematic analysis. A total of 105 people were interviewed at taxi ranks in Tshwane, Gauteng. Of these, 48 were women and 57 men. The median age of women and men was 40.6 years and 44.3 years, respectively. The majority of respondents (61.9%, n = 65 interviewed were from the Gauteng Province. Sixty percent (n = 63 of respondents had a secondary education, whilst less than 4.81% (n = 5 of respondents had no formal education. This study demonstrated that interviewing commuters at taxi ranks gave access to a cross section of gender, age, language and origin. It was found that both genders were involved in traditional slaughter of goats. Risk communication strategies should thus target women as well as men. Communication strategies to mitigate the risks of traditional slaughter of goats should take into consideration the dynamic nature of demographic and cultural norms. In light of the wide demographic profile of the respondents, it was concluded that it should be possible to use taxi ranks for successful dissemination of food safety and occupational health risk mitigation messages.

  11. Pose Space Surface Manipulation

    Directory of Open Access Journals (Sweden)

    Yusuke Yoshiyasu

    2012-01-01

    Full Text Available Example-based mesh deformation techniques produce natural and realistic shapes by learning the space of deformations from examples. However, skeleton-based methods cannot manipulate a global mesh structure naturally, whereas the mesh-based approaches based on a translational control do not allow the user to edit a local mesh structure intuitively. This paper presents an example-driven mesh editing framework that achieves both global and local pose manipulations. The proposed system is built with a surface deformation method based on a two-step linear optimization technique and achieves direct manipulations of a model surface using translational and rotational controls. With the translational control, the user can create a model in natural poses easily. The rotational control can adjust the local pose intuitively by bending and twisting. We encode example deformations with a rotation-invariant mesh representation which handles large rotations in examples. To incorporate example deformations, we infer a pose from the handle translations/rotations and perform pose space interpolation, thereby avoiding involved nonlinear optimization. With the two-step linear approach combined with the proposed multiresolution deformation method, we can edit models at interactive rates without losing important deformation effects such as muscle bulging.

  12. Managing a scarce resource: addressing critical health workforce challenges.

    NARCIS (Netherlands)

    Giepmans. P.; Dussault, G.; Batenburg, R.; Frich, J.; Olivers, R.; Sermeus, W.

    2013-01-01

    With health care services significantly changing, the challenge is to initiate innovative, situational and integrated workforce forecasting and planning. Many health systems require a shift in mindset to move to the planning of skill mixes for health care professionals. This implies great challenges

  13. Scientific Opinion on the risks to plant health posed by European versus non-European populations of the potato cyst nematodes Globodera pallida and Globodera rostochiensis

    DEFF Research Database (Denmark)

    Baker, R.; Candresse, T.; Dormannsné Simon, E.

    2012-01-01

    The Panel on Plant Health has delivered a scientific opinion on the different risks posed by European and non-European populations of the potato cyst nematodes (PCN) Globodera pallida and Globodera rostochiensis to solanaceous plants in the EU and on the effectiveness of current control measures...... to place of production freedom and soil origin were noted, and the Panel identified additional risk reduction options for certain plants for planting (e.g. bulbs) and additional requirements to confirm the absence of PCN in places of production. The Panel also identified some problems with the existing...... control measures to reduce the spread of PCN within the EU. A thorough and well-coordinated EU-wide survey using standardized methods would be necessary to evaluate the need to maintain these measures. The monitoring of PCN populations should exploit new diagnostic techniques (e.g. mitochondrial DNA...

  14. Health risks posed to infants in rural China by exposure to short- and medium-chain chlorinated paraffins in breast milk.

    Science.gov (United States)

    Xia, Dan; Gao, Li-Rong; Zheng, Ming-Hui; Li, Jing-Guang; Zhang, Lei; Wu, Yong-Ning; Qiao, Lin; Tian, Qi-Chang; Huang, Hui-Ting; Liu, Wen-Bin; Su, Gui-Jin; Liu, Guo-Rui

    2017-06-01

    Chlorinated paraffins (CPs) are complex mixtures of synthetic chemicals found widely in environmental matrices. Short-chain CPs (SCCPs) are candidate persistent organic pollutants under the Stockholm Convention. There should be great concern about human exposure to SCCPs. Data on CP concentrations in human breast milk is scarce. This is the first study in which background SCCP and medium-chain CP (MCCP) body burdens in the general rural population of China have been estimated and health risks posed to nursing infants by CPs in breast milk assessed. The concentrations of 48 SCCP and MCCP formula congeners were determined in 24 pooled human milk samples produced from 1412 individual samples from eight provinces in 2007 and 16 provinces in 2011. The samples were analyzed by comprehensive two-dimensional gas chromatography electron capture negative ionization high-resolution time-of-flight mass spectrometry. The median SCCP and MCCP concentrations were 303 and 35.7ngg -1 lipid weight, respectively, for the 2007 samples and 360 and 45.4ngg -1 lipid weight, respectively, for the 2011 samples. The C 10 and C 14 homologs were the dominant CP carbon-chain-length groups, contributing 51% and 82% of the total SCCP and MCCP concentrations, respectively. There are probably multiple CP sources to the general Chinese population and numerous exposure pathways. The median estimated daily SCCP and MCCP intakes for nursing infants were 1310 and 152ngkg -1 d -1 , respectively, in 2007 and 1520 and 212ngkg -1 d -1 , respectively, in 2011. SCCPs do not currently pose significant risks to infants in China. However, it is necessary to continuously monitor CP concentrations and health risks because CP concentrations in Chinese human breast milk are increasing. Copyright © 2017 Elsevier Ltd. All rights reserved.

  15. Promoting people's health: challenges and opportunities.

    Science.gov (United States)

    Heitkamp, P

    1998-01-01

    Promoting health underlines the right of each individual to the highest attainable standard of health. It stresses the importance of the participation of people and recognizes different sociocultural values and beliefs that are prevalent throughout the world. Working on health development has a sustainable effect only when done comprehensively: personal development, community development, organizational development, and political development. The international conferences that have marked the way of health promotion have been goal posts of an energetic movement to strengthen health worldwide. The Ottawa Charter on Health Promotion has been a worldwide source of guidance for health promotion through its five strategies: building health policy, creating supportive elements, strengthening community action, developing personal skills, and reorienting health services. Moreover, the Jakarta Declaration on "Leading Health Promotion into the 21st Century" identifies five priorities in the next millennium: 1) promote social responsibility for health; 2) increase investments for health development; 3) consolidate and expand partnerships for health; 4) increase community capacity and empower the individual in matters of health; and 5) secure an infrastructure for health promotion. Increasing the investment in health development calls for the need to find new mechanisms for funding as well as reorienting existing resources towards health promotion and health education.

  16. Dealing with Health and Health Care System Challenges in China: assessing health determinants and health care reforms

    NARCIS (Netherlands)

    H. Zhang (Hao)

    2017-01-01

    markdownabstractThis dissertation investigates the challenges faced by China around 2010 in two domains – population health and the health care system. Specifically, chapters 2 and 3 are devoted to health challenges, explaining the female health disadvantage in later life and assessing the effect

  17. Rationalising health care in india : Challenges & strategies

    Directory of Open Access Journals (Sweden)

    K I Mathai

    2014-01-01

    Full Text Available An overview of health care delivery in India is essential, if we are to plan and to improve health care delivery and the indices of health in the coming decades. The health sector in India is a mix of private and government services. While some health care indices appear dismal, several others, including life expectancy are heartening. A balance between regulation and free enterprise is possibly the best option. In this paper we provide a glimpse of health and health related statistics & a n overview of the public health care delivery systems. In the end, we offer suggestion on rationalisation of health care delivery to provide maximum services for the majority of our population within the budget of an optimal health care system outlay

  18. Mass-gathering Events: The Public Health Challenge of the Kumbh Mela 2013.

    Science.gov (United States)

    Dwivedi, Suresh; Cariappa, Mudera P

    2015-12-01

    Mass-gathering (MG) events pose challenges to the most adept of public health practitioners in ensuring the health safety of the population. These MGs can be for sporting events, musical festivals, or more commonly, have religious undertones. The Kumbh Mela 2013 at Allahabad, India may have been the largest gathering of humanity in history with nearly 120 million pilgrims having thronged the venue. The scale of the event posed a challenge to the maintenance of public health security and safety. A snapshot of the experience of managing the hygiene and sanitation aspects of this mega event is presented herein, highlighting the importance of proactive public health planning and preparedness. There having been no outbreaks of disease is vindication of the steps undertaken in planning and preparedness, notwithstanding obvious limitations of unsanitary behaviors and traditional beliefs of those attending the festival. The evident flaw on post-event analyses was the failure to cater adequately for environmental mopping-up operations after the festival. Besides, a system of real-time monitoring of disease and morbidity patterns, harnessing low cost technology alternatives, should be planned for at all such future events.

  19. Vested Interests in Addiction Research and Policy The challenge corporate lobbying poses to reducing society’s alcohol problems: insights from UK evidence on minimum unit pricing

    Science.gov (United States)

    McCambridge, Jim; Hawkins, Benjamin; Holden, Chris

    2014-01-01

    Background There has been insufficient research attention to alcohol industry methods of influencing public policies. With the exception of the tobacco industry, there have been few studies of the impact of corporate lobbying on public health policymaking more broadly. Methods We summarize here findings from documentary analyses and interview studies in an integrative review of corporate efforts to influence UK policy on minimum unit pricing (MUP) of alcohol 2007–10. Results Alcohol producers and retailers adopted a long-term, relationship-building approach to policy influence, in which personal contacts with key policymakers were established and nurtured, including when they were not in government. The alcohol industry was successful in achieving access to UK policymakers at the highest levels of government and at all stages of the policy process. Within the United Kingdom, political devolution and the formation for the first time of a Scottish National Party (SNP) government disrupted the existing long-term strategy of alcohol industry actors and created the conditions for evidence-based policy innovations such as MUP. Conclusions Comparisons between policy communities within the United Kingdom and elsewhere are useful to the understanding of how different policy environments are amenable to influence through lobbying. Greater transparency in how policy is made is likely to lead to more effective alcohol and other public policies globally by constraining the influence of vested interests. PMID:24261642

  20. Vested interests in addiction research and policy. The challenge corporate lobbying poses to reducing society's alcohol problems: insights from UK evidence on minimum unit pricing.

    Science.gov (United States)

    McCambridge, Jim; Hawkins, Benjamin; Holden, Chris

    2014-02-01

    There has been insufficient research attention to alcohol industry methods of influencing public policies. With the exception of the tobacco industry, there have been few studies of the impact of corporate lobbying on public health policymaking more broadly. We summarize here findings from documentary analyses and interview studies in an integrative review of corporate efforts to influence UK policy on minimum unit pricing (MUP) of alcohol 2007-10. Alcohol producers and retailers adopted a long-term, relationship-building approach to policy influence, in which personal contacts with key policymakers were established and nurtured, including when they were not in government. The alcohol industry was successful in achieving access to UK policymakers at the highest levels of government and at all stages of the policy process. Within the United Kingdom, political devolution and the formation for the first time of a Scottish National Party (SNP) government disrupted the existing long-term strategy of alcohol industry actors and created the conditions for evidence-based policy innovations such as MUP. Comparisons between policy communities within the United Kingdom and elsewhere are useful to the understanding of how different policy environments are amenable to influence through lobbying. Greater transparency in how policy is made is likely to lead to more effective alcohol and other public policies globally by constraining the influence of vested interests. ©2013 The Authors. Addiction published by John Wiley & Sons Ltd on behalf of The Society for the Study of Addiction.

  1. Evaluation of the pollution and human health risks posed by heavy metals in the atmospheric dust in Ebinur Basin in Northwest China.

    Science.gov (United States)

    Abuduwailil, Jilili; Zhaoyong, Zhang; Fengqing, Jiang

    2015-09-01

    Recently, a large amount of research assessing pollution levels and the related health risks posed by atmosphere dust has been undertaken worldwide. However, little work has been done in the oases of the arid regions of Northwest China. In this paper, we studied the pollution and health risks over a year of seven heavy metals in the atmospheric dust of Ebinur Basin, a typical oasis in Northwest China. The results showed the following: (1) The annual amount of atmospheric deposition in Ebinur Basin was 298.23 g m(-2) and the average monthly atmospheric deposition was 25.06 g m(-2). The average and maximum values of the seven heavy metals measured were all below the National Soil Environmental Quality Standards (2nd). (2) Heavy metals of Cu, Cr, and As in the atmospheric deposition mainly originated from the natural geological background, while Zn came from human activity. This study also showed that among the seven measured heavy metals, the ratios of the no-pollution status of Pb, Cd, and Hg were higher than those of others with moderate degrees of pollution also accounting for a certain ratio. (3) The carcinogenic risks from As, Cd, and Cr were all lower than the corresponding standard limit values, and these metals are considered not harmful to the health of the basin. However, there is a relatively high risk of exposure for children from hand-to-mouth intake, which is worthy of attention. This research showed that both human activity and natural factors, such as wind and altitude, influenced the heavy metal contents in the atmospheric dust of the study area. Furthermore, recent human activity in the study area had the most negative influence on the accumulation of the heavy metals and the corresponding health risks, especially for Hg, Pb, and Cd, which is worthy of attention.

  2. Challenges towards Realization of Health Care Sector Goals of ...

    African Journals Online (AJOL)

    Background: Human resource for health (HRH) is an essential building block for effective and efficient health care system. In Tanzania this component is faced by many challenges which in synergy with others make the health care system inefficient. In vision 2025 the country recognizes the importance of the health care ...

  3. Policy challenges in modern health care

    National Research Council Canada - National Science Library

    Mechanic, David

    2005-01-01

    ... for the Obesity Epidemic KENNETH E. WARNER 99 8 Patterns and Causes of Disparities in Health DAVID R. WILLIAMS 115 9 Addressing Racial Inequality in Health Care SARA ROSENBAUM AND JOEL TEITELBAU...

  4. Mobile mental health: a challenging research agenda

    NARCIS (Netherlands)

    Olff, Miranda

    2015-01-01

    The field of mobile health ("m-Health'') is evolving rapidly and there is an explosive growth of psychological tools on the market. Exciting high-tech developments may identify symptoms, help individuals manage their own mental health, encourage help seeking, and provide both preventive and

  5. National health inequality monitoring: current challenges and opportunities.

    Science.gov (United States)

    Hosseinpoor, Ahmad Reza; Bergen, Nicole; Schlotheuber, Anne; Boerma, Ties

    National health inequality monitoring needs considerably more investment to realize equity-oriented health improvements in countries, including advancement towards the Sustainable Development Goals. Following an overview of national health inequality monitoring and the associated resource requirements, we highlight challenges that countries may encounter when setting up, expanding or strengthening national health inequality monitoring systems, and discuss opportunities and key initiatives that aim to address these challenges. We provide specific proposals on what is needed to ensure that national health inequality monitoring systems are harnessed to guide the reduction of health inequalities.

  6. Collective work: a challenge for health management.

    Science.gov (United States)

    Scherer, Magda Duarte Dos Anjos; Pires, Denise; Schwartz, Yves

    2009-08-01

    Based on ergology and work process theorization, the study aims to contribute to reflections on health collective work, emphasizing its specificity and difficulties in building and managing groups of workers. It deals with work as a human activity that dialectically comprises the application of a prescribed protocol and a unique and historical perspective. Health work involves a relationship among individuals who act in the drama of using themselves and manage their own work; it is influenced by the history of health professions and macro-political determinations. In conclusion, this health work complexity needs to be considered in the process of management of professional teams/groups of workers, in a way that actions can interact and enable the implementation of a new health care project in the perspective of comprehensiveness.

  7. Challenging the Conceptual Limits in Health Psychology

    DEFF Research Database (Denmark)

    Kristensen, Kasper Andreas

    2015-01-01

    This contribution explores the connection between health and subjectivity. Up until recently a marginally discussed topic in health theories, recent critical research in health psychology introduces notions of subjectivity to theories of health. These notions can be linked to phenomenology......, embodied subjectivity, and psychosocial theories that have moved away from a partial, internal understanding of subjectivity. These recent theories tend to define subjectivity as a coherence of concrete, embodied and situated subjectivity that extends capabilities and activities towards a world of social....... Hence, I will argue for the concept of conduct of life as an important concept for health psychology. The concept of conduct of life enables an analysis of how people conduct their activities and of their access to life possibilities, within social settings and societal power systems. The concept can...

  8. Plain language: a strategic response to the health literacy challenge.

    Science.gov (United States)

    Stableford, Sue; Mettger, Wendy

    2007-01-01

    Low health literacy is a major challenge confronting American and international health organizations. Research in the past decade has documented the prevalence of limited literacy and limited health literacy skills among adults worldwide. This creates a major policy challenge: how to create text-based health information - a common method of health communication - that is accessible to the public. Plain language is a logical, flexible response. While touted by American, Canadian, and European health policy makers, adoption and promotion of plain language standards and skills in health-focused organizations have lagged. Most text-based health information continues to be too hard for most adults to read. Barriers to more rapid diffusion of plain language are reflected in a set of myths perpetuated by critics. These myths are identified and refuted. While plain language is only one of many broad-based solutions needed to address low health literacy, the benefits to everyone demand increased use by health organizations.

  9. idrc on tackling global challenges health

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

    Efforts to control the spread of viru- lent strains of ... network of government ministries and research ... how future disease outbreaks are likely to ... HIV epidemic: 5.7 million of its .... collaboration with the Ministry of Health and Social Work,.

  10. Health Concern and Challenges Among School Adolescents

    African Journals Online (AJOL)

    The result showed that the majority of the male adolescent students (53.6 %) age lies in the age ... of adolescents behavioral, social and physical health problems should be given high priority ..... in which depression and anxiety can occur.

  11. Mental health challenges of LGBT forced migrants

    Directory of Open Access Journals (Sweden)

    Ariel Shidlo

    2013-04-01

    Full Text Available Many LGBT forced migrants have significant and sometimesincapacitating psychological scars. Mental health providers can assistin documenting the psychological impact of anti-LGBT persecutionand its impact on the ability to secure refugee status.

  12. [Health disparities: local realities and future challenges].

    Science.gov (United States)

    Bodenmann, P; Green, A R

    2012-11-28

    Since 1887, the Policlinique Médicale Universitaire (PMU) has brought care to vulnerable populations who are at risk of poor physical, mental and social health. These include marginalised Swiss natives and immigrant communities (asylum seekers, undocumented immigrants). These patients are at risk of health disparities given their poor access to the health care system and lack of adapted quality care. Clinical approach must address these potential disparities, reinforced by a research describing them in order to explain their cause, and propose possible solutions, and a medical training addressing these topics from the undergraduate to the attending level. Through those holistic clinical approach, robust research and improved medical training, health providers will contribute to give quality care to all citizens, without exception!

  13. Health insurance--a challenge in India.

    Science.gov (United States)

    Presswala, R G

    2004-01-01

    In India, indemnity health insurance started about 3 decades ago. Mediclaim was the most popular product. Indian insurers and multinational companies have not been enthusiastic about starting health insurance in spite of the availability of a good market because health insurers have historically incurred losses. Losses have been caused by poor administration. Because it is a small portion of their total businesses, insurers have never tried sincerely to improve deficiencies or taken special interest. Hospital management and medical specialists have the spirit of entrepreneurship and are prepared to learn quickly and follow managed care principles, though they are not currently practiced in India. Actuarial data from the health insurance industry is sparse, but data from alternative sources will be helpful for starting managed healthcare. In my opinion, if properly administered, a "limited" managed care product with appropriate precautions and premium levels will be successful and profitable and will compete with present indemnity products in India.

  14. The challenge of benchmarking health systems

    OpenAIRE

    Lapão, Luís Velez

    2015-01-01

    WOS:000359623300001 PMID: 26301085 The article by Catan et al. presents a benchmarking exercise comparing Israel and Portugal on the implementation of Information and Communication Technologies in the healthcare sector. Special attention was given to e-Health and m-Health. The authors collected information via a set of interviews with key stakeholders. They compared two different cultures and societies, which have reached slightly different implementation outcomes. Although the comparison ...

  15. Mobile mental health: a challenging research agenda

    OpenAIRE

    Olff, Miranda

    2015-01-01

    The field of mobile health (“m-Health”) is evolving rapidly and there is an explosive growth of psychological tools on the market. Exciting high-tech developments may identify symptoms, help individuals manage their own mental health, encourage help seeking, and provide both preventive and therapeutic interventions. This development has the potential to be an efficient cost-effective approach reducing waiting lists and serving a considerable portion of people globally (“g-Health”). However, f...

  16. Oral health in Libya: addressing the future challenges | Peeran ...

    African Journals Online (AJOL)

    Libya is a vast country situated in North Africa, having a relatively better functioning economy with a scanty population. This article is the first known attempt to review the current state of oral health care in Libya and to explore the present trends and future challenges. Libyan health system, oral health care, and human ...

  17. The health risk levels of different age groups of residents living in the vicinity of municipal solid waste incinerator posed by PCDD/Fs in atmosphere and soil.

    Science.gov (United States)

    Li, Jiafu; Zhang, Ying; Sun, Tingting; Hao, Huawei; Wu, Hao; Wang, Lili; Chen, Yuxing; Xing, Limin; Niu, Zhiguang

    2018-08-01

    In our study, health risk levels of different age groups of residents living in the vicinity of a municipal solid waste incinerator (MSWI) posed by polychlorinated dibenzo-p-dioxins and polychlorinated dibenzofurans (PCDD/Fs) in atmosphere and soil were evaluated. The toxic equivalent concentrations of PCDD/Fs (TEQ) in surrounding atmosphere and soil of studied MSWI were 0.05-0.12 pg I-TEQ Nm -3 and 7.622-15.450 ng I-TEQ kg -1 , respectively. The PCDFs/PCDDs (F/D) values of PCDD/Fs in surrounding atmosphere of studied MSWI ranged from 0.40 to 5.90 with a mean of 1.80, suggesting that the PCDD/Fs mainly came from combustion sources and studied MSWI could be a key source of PCDD/Fs in surrounding atmosphere. The F/D ratios of PCDD/Fs in surrounding soil ranged from 0.18 to 1.81 with a mean of 0.90, suggesting combustion is not the mainly sources of PCDD/Fs in surrounding soil, and studied MSWI may have limited influence on PCDD/Fs in surrounding soil. O8CDD and 2,3,4,7,8-P5CDF could be the total PCDD/Fs and TEQ indicators in surrounding atmosphere of studied MSWI, respectively. The carcinogenic risk (CR) values of PCDD/Fs in surrounding atmosphere and soil for children, teens and adults were 1.24E-06, 9.06E-07 and 4.41E-06, respectively, suggesting that the potential cancer risk occurred but the risk was at acceptable levels for both children and adults (risk for teens was negligible (risk (non-CR) values of three age groups were lower than 1, indicating that no obvious non-carcinogenic effects occurred. Inhalation of air was the largest contributor of health risk (both CR and non-CR) for three age groups. In addition, a comparison of the health risk between PCDD/Fs and other emerging contaminants and traditional pollutants in soil and atmosphere was performed, which will help us have a good view of the health risk levels of PCDD/Fs in surrounding environment of MWSI. Copyright © 2018 Elsevier B.V. All rights reserved.

  18. The Rise of Post-truth Populism in Pluralist Liberal Democracies: Challenges for Health Policy

    Science.gov (United States)

    Speed, Ewen; Mannion, Russell

    2017-01-01

    Recent years have witnessed the rise of populism and populist leaders, movements and policies in many pluralist liberal democracies, with Brexit and the election of Trump the two most recent high profile examples of this backlash against established political elites and the institutions that support them. This new populism is underpinned by a post-truth politics which is using social media as a mouthpiece for ‘fake news’ and ‘alternative facts’ with the intention of inciting fear and hatred of ‘the other’ and thereby helping to justify discriminatory health policies for marginalised groups. In this article, we explore what is meant by populism and highlight some of the challenges for health and health policy posed by the new wave of post-truth populism. PMID:28812811

  19. The Rise of Post-truth Populism in Pluralist Liberal Democracies: Challenges for Health Policy

    Directory of Open Access Journals (Sweden)

    Ewen Speed

    2017-04-01

    Full Text Available Recent years have witnessed the rise of populism and populist leaders, movements and policies in many pluralist liberal democracies, with Brexit and the election of Trump the two most recent high profile examples of this backlash against established political elites and the institutions that support them. This new populism is underpinned by a post-truth politics which is using social media as a mouthpiece for ‘fake news’ and ‘alternative facts’ with the intention of inciting fear and hatred of ‘the other’ and thereby helping to justify discriminatory health policies for marginalised groups. In this article, we explore what is meant by populism and highlight some of the challenges for health and health policy posed by the new wave of post-truth populism.

  20. Health regionalization in Amazonas: progress and challenges.

    Science.gov (United States)

    Garnelo, Luiza; Sousa, Amandia Braga Lima; Silva, Clayton de Oliveira da

    2017-04-01

    This paper analyses the health services regionalization process in the State of Amazonas through a case study covering the health sub-region Manaus Surroundings. This is a qualitative, descriptive and analytical research, which data were collected using interviews, documents and Internet reviews, oriented by the guiding concept of health regionalization. Study findings revealed a social setting dominated by asymmetry, verticality, competitiveness and fragile multilateral relations among municipalities, associated to a bureaucratic profile of local institutions operating in the region under study. The political agents have limited acknowledgement of the sociopolitical and institutional conditions in which they operate. They usually impute healthcare networks' management and operational issues to the natural and geographical characteristics of the Amazon region, but their financing, governance and technical capacity are insufficient to overcome them.

  1. Finding a balance: health promotion challenges of military women.

    Science.gov (United States)

    Agazio, Janice Griffin; Buckley, Kathleen M

    2010-09-01

    In this study, we explored what may determine, or predict, United States military women's health promotion behaviors. Using a descriptive correlational design grounded in Pender's Health Promotion model, 491 military women completed instruments measuring their demographic variables, perception of health, definition of health, self-efficacy, and interpersonal influences to determine the significant factors affecting participation in health promotion activities. The outcome indicated that self-efficacy and interpersonal influences were the most influential in determining health promotion. This research illuminates some of the challenges working women face in meeting health promotion activities and how best to support their ability to participate in healthy behaviors.

  2. Five Critical Challenges for Public Health

    Science.gov (United States)

    Kumanyika, Shiriki K.

    2014-01-01

    This article presents comments and observations given by Dr. Shiriki K. Kumanyika as the Lautenberg Award Lecture at the commencement of the University of Medicine and Dentistry of New Jersey-Rutgers School of Public Health, May 20, 2013. The award is named after Senator Frank Lautenberg, who served as a U.S. Senator from New Jersey during 1982 to…

  3. Health system challenges of NCDs in Tunisia.

    Science.gov (United States)

    Ben Romdhane, Habiba; Tlili, Faten; Skhiri, Afef; Zaman, Shahaduz; Phillimore, Peter

    2015-01-01

    The objective of this study was to present a qualitative 'situation analysis' of the healthcare system in Tunisia, as it applies to management of cardiovascular disease (CVD) and diabetes. A primary concern was the institutional capacity to manage non-communicable diseases (NCDs). Research took place during 2010 (analysis of official documents, semi-structured interviews with key informants, and case studies in four clinics). Walt and Gilson's framework (1994) for policy analysis was used: content, actors, context, and process. Problems of integration and coordination have compounded funding pressures. Despite its importance in Tunisian healthcare, primary health is ill-equipped to manage NCDs. With limited funds, and no referral or health information system, staff morale in the public sector was low. Private healthcare has been the main development filling the void. This study highlights major gaps in the implementation of a comprehensive approach to NCDs, which is an urgent task across the region. In strategic planning, research on the health system is vital; but the capacity within Ministries of Health to use research has first to be built, with a commitment to grounding policy change in evidence.

  4. Supplier challenges in health tech innovation

    DEFF Research Database (Denmark)

    Rolfstam, Max

    Suppliers, in particular small innovative firms, is an important contributor not only for innovation in health-tech, but also a component to consider in the light of the emerging policy interest for using public procurement as a means to stimulate innovation. Research on barriers preventing...

  5. Challenges in managing and sustaining urban slum health ...

    African Journals Online (AJOL)

    Challenges in managing and sustaining urban slum health programmes in Kenya. ... These were hardly implemented in the projects, according to the data gathered. ... Conclusion: Land and income were big issues according to the responses.

  6. BRIC Health Systems and Big Pharma: A Challenge for Health Policy and Management.

    Science.gov (United States)

    Rodwin, Victor G; Fabre, Guilhem; Ayoub, Rafael F

    2018-01-02

    BRIC nations - Brazil, Russia, India, and China - represent 40% of the world's population, including a growing aging population and middle class with an increasing prevalence of chronic disease. Their healthcare systems increasingly rely on prescription drugs, but they differ from most other healthcare systems because healthcare expenditures in BRIC nations have exhibited the highest revenue growth rates for pharmaceutical multinational corporations (MNCs), Big Pharma. The response of BRIC nations to Big Pharma presents contrasting cases of how governments manage the tensions posed by rising public expectations and limited resources to satisfy them. Understanding these tensions represents an emerging area of research and an important challenge for all those who work in the field of health policy and management (HPAM). © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  7. [Health education at the health workshops of Cahors: challenges].

    Science.gov (United States)

    Théry, Céline

    2013-01-01

    There have been significant developments in health education over recent years. Focusing on France, the purpose of this paper is to examine the role of health education in reducing social inequalities based on the example of the Atelier santé ville de Cahors (Cahors Health Workshop). The paper addresses the following questions: What are the results and outcomes of the workshop? What kind of health education issues are at stake in the territorial approach to policy-making in an urban context? We examined the methods underlying the health education measures taken in the Cahors Health Workshop, which involve project-based approaches and the promotion of community health. Health education aimed at improving health is central to issues such as listening and speaking, the development of autonomy and the responsibilization of urban actors. Based on a rigorous methodology and the underlying values, health education in the Cahors Health Workshop places local residents, elected representatives and health professionals at the heart of the health care process (from the diagnostic process to the assessment process) and contributes to the reduction of social inequalities in health while facilitating access to information and health care. The goal of health education is to encourage individuals to be responsible for their own health in order to empower them to make informed choices adapted to the demands of their environment.

  8. Occupational Health: Meeting the Challenges of the Next 20 Years

    Directory of Open Access Journals (Sweden)

    John Harrison

    2016-06-01

    Conclusion: The future strategic direction for occupational health will be informed by a needs analysis and a consideration of where it should be positioned within future healthcare provision. What are the occupational health workforce implications of the vision for occupational health provision? New challenges and new ways of working will necessitate a review of the competence and capacity of the occupational health workforce, with implications for future workforce planning.

  9. Key challenges of human resources for health in India

    OpenAIRE

    Priya Sinha

    2016-01-01

    Background and Objective Since independence the efforts have been to strengthen the health infrastructure, its accessibility and coverage. The human resources for health have been an important determinant for system but it has received significance recently. Even government expenditure on health has remained at not more than 1% of Gross Domestic Product which is very less as compared to world standard. Now the biggest challenge is the shortage of skilled human resource for health at all le...

  10. Adolescent mental health: Challenges with maternal noncompliance

    OpenAIRE

    Nejtek, Vicki A; Hardy, Sarah; Winter, Scott

    2010-01-01

    Vicki A Nejtek, Sarah Hardy, Scott WinterUniversity of North Texas Health Science Center, Fort Worth, TX, USAAbstract: The leading cause of suicide ideation, attempts, and completion in adolescents is persistent and unresolved parental conflict. National statistics show extremely high rates of childhood neglect and abuse are perpetrated most often by single mothers. Psychiatric disorders arising from maternal–child dysfunction are well-documented. However, resources to prevent offsp...

  11. Restaurant challenge offers healthful meal options and builds diabetes awareness.

    Science.gov (United States)

    Blair, Angela M; Drass, Janice A; Stone, Marylou; Rhoades, Deborah; Baldwin, Susan A; Russ, Kelsey M

    2011-01-01

    The Frederick Restaurant Challenge is an innovative project based on a collaborative effort among community organizations and partners designed to offer delicious healthful meal options at local restaurants during the month of November for American Diabetes Month. Local restaurants were challenged to participate and submitted recipes for healthful meals to the Frederick County Diabetes Coalition for review by registered dietitians. Diners voted on meals to determine the challenge winner(s), and were eligible to win prizes as well. Publicity prior to and during the month was effective in creating positive news about healthful meals when eating out, raised awareness about diabetes, and provided restaurants with desirable advertising opportunities. Feedback from restaurants and diners was overwhelmingly positive. The purpose of this article is to describe this successful low-budget project to encourage its replication in local communities. The Frederick Restaurant Challenge proved to be a very successful, innovative, low-budget project that met its intended goals: to develop healthful meal options for people with diabetes (or for anyone wishing to eat healthier); to demonstrate that healthful food can taste delicious; and to encourage restaurants to continue offering healthful options on their menus beyond the challenge month. Community interventions such as the Frederick Restaurant Challenge offer unique and important strategies for affecting change and raising awareness not only for people with diabetes but also for the entire community.

  12. Health care delivery in Malaysia: changes, challenges and champions

    Science.gov (United States)

    Thomas, Susan; Beh, LooSee; Nordin, Rusli Bin

    2011-01-01

    Since 1957, there has been major reorganization of health care services in Malaysia. This article assesses the changes and challenges in health care delivery in Malaysia and how the management in health care processes has evolved over the years including equitable health care and health care financing. The health care service in Malaysia is changing towards wellness service as opposed to illness service. The Malaysian Ministry of Health (MOH), being the main provider of health services, may need to manage and mobilize better health care services by providing better health care financing mechanisms. It is recommended that partnership between public and private sectors with the extension of traditional medicine complementing western medicine in medical therapy continues in the delivery of health care. PMID:28299064

  13. Mental health in India: Challenges ahead

    Directory of Open Access Journals (Sweden)

    Surekha Kishore

    2016-09-01

    Full Text Available With the advent of latest technologies and rapid industrialization human beings have made advancement to a great extent, in the materialistic world. He has mechanized his instruments in such a sophisticated way so as to carry out complicated and heavy tasks in comparatively lesser time and utilizing lesser manpower. In this pursuit of progress, he became more and more ambitious which further led him to stressful life and to make compromises with his other aspects of life intentionally and sometimes unintentionally. One has to consider all the aspects of individual’s physical, mental, social and psychological angles which play an important role in maintaining the individual’s overall personality development as well as wellbeing so that he may lead a productive life. These factors along with the environmental and surroundings influences the behavior of individual. In the present day life though human beings may have progressed socially, economically and also intellectually but somewhere he tended to neglect his emotions, feelings, tolerance and above all there is a growing concern of loneliness amongst all age groups. There is an imbalance between the amount of stress a person takes up with the amount he can cope up with, which has led to increase in behavioral and mental health problems. Burden of mental disorders had risen over last few decades in general mental health is often equated with the cognitive and emotional wellbeing - it is all about the way one thinks, feels and behaves. Mental health, can also mean an absence of a mental disorder. Various factors which has led to the rise in mental health problems are - growing population, continuous stress, over exertion, high ambition, socioeconomic conditions, loneliness, drug abuse, expectations, competitions and failures etc. The list is unending. It has been observed that there is a growing concern worldwide among developed as well as developing nations regarding the rise in behavioral

  14. South African Academic Health--the future challenge.

    Science.gov (United States)

    van Zyl, G J

    2004-02-01

    In South Africa, significant changes in Academic Health have taken place since the first democratic elections in 1994. Academic Health came from a separated academic hospital, departmental-based curriculum and research focussed on achievement, and an abundance of money, to a position of integrated service delivery with specific reference to primary health care, separation of service levels, a new integrated curriculum, research focussed according to the need and contract research, and financial constraints with limited budgets. The management of this change is a task challenging the manager in all fields of Academic Health. Leaders need to know their environment and organisation to be able to manage change. Academic Health centres are experiencing major changes as a result of the effects of managed care, reduced rate and growing expenditure on health services. In addition to restructuring of the clinical services, Academic Health centres are being challenged to sustain their academic mission and priorities in the face of resource constraints. In order to tackle these challenges, institutions need physicians in administrative positions at all levels who can provide leadership and thoughtful managerial initiatives. The future challenge for managers focuses on service delivery, research, health education and training, Academic Health management, professionalism and financial management.

  15. Pharmacogenomics and the challenge of health disparities.

    Science.gov (United States)

    Lee, S S

    2009-01-01

    This paper examines emerging technologies and recent research on population differences in pharmacogenomics and the perspectives of scientists, community advocates, policymakers, and social critics on the use of race as a proxy for genetic variation. The discussion focuses on how recent developments in genomic science impact social understandings of racial difference and the public health goal to eliminate ongoing health disparities among racially identified groups. This paper examines how factors such as governmental policies--requiring the use of racial and ethnic categories in genetic research and increasing interest in identifying untapped racial market niches by the pharmaceutical and biotechnology industries--and weak governmental oversight of race-based therapeutics converge to create an 'infrastructure of racialization' that may alter the vision of personalized medicine that has been so highly anticipated. This paper argues that significant public investment in pharmacogenomics requires careful consideration of the emerging discourse that tethers racial justice to notions of racial biology and discusses the social and ethical implications for the pendulum shift towards a geneticization of race in drug development. Copyright 2009 S. Karger AG, Basel.

  16. Adolescent mental health: Challenges with maternal noncompliance

    Directory of Open Access Journals (Sweden)

    Vicki A Nejtek

    2010-03-01

    Full Text Available Vicki A Nejtek, Sarah Hardy, Scott WinterUniversity of North Texas Health Science Center, Fort Worth, TX, USAAbstract: The leading cause of suicide ideation, attempts, and completion in adolescents is persistent and unresolved parental conflict. National statistics show extremely high rates of childhood neglect and abuse are perpetrated most often by single mothers. Psychiatric disorders arising from maternal–child dysfunction are well-documented. However, resources to prevent offspring victimization are lacking. Here, we report maternal neglect of a 15-year-old male brought to the psychiatric emergency room for suicidal ideation. An inpatient treatment plan including pharmacotherapy, family therapy and psychological testing was initiated. The patient’s mother failed to attend clinic appointments or family therapy sessions. Clinician attempts to engage the mother in the treatment plan was met with verbal assaults, aggression, and threatening behavior. The patient decompensated in relation to the mother’s actions. Child Protective Services were contacted and a follow-up assessment with the patient and mother is pending. Psychiatric treatment of the mother may be a necessary intervention and prevention regimen for both the adolescent and the mother. Without consistent Child Protective Services oversight, medical and psychosocial follow-up, the prognosis and quality of life for this adolescent is considered very poor. Stringent mental health law and institutional policies are needed to adequately intercede and protect adolescents with mental illness.Keywords: adolescent, suicide, maternal treatment noncompliance, maternal neglect

  17. Health care in China: improvement, challenges, and reform.

    Science.gov (United States)

    Wang, Chen; Rao, Keqin; Wu, Sinan; Liu, Qian

    2013-02-01

    Over the past 2 decades, significant progress has been made in improving the health-care system and people's health conditions in China. Following rapid economic growth and social development, China's health-care system is facing new challenges, such as increased health-care demands and expenditure, inefficient use of health-care resources, unsatisfying implementation of disease management guidelines, and inadequate health-care insurance. Facing these challenges, the Chinese government carried out a national health-care reform in 2009. A series of policies were developed and implemented to improve the health-care insurance system, the medical care system, the public health service system, the pharmaceutical supply system, and the health-care institution management system in China. Although these measures have shown promising results, further efforts are needed to achieve the ultimate goal of providing affordable and high-quality care for both urban and rural residents in China. This article not only covers the improvement, challenges, and reform of health care in general in China, but also highlights the status of respiratory medicine-related issues.

  18. Shared Electronic Health Record Systems: Key Legal and Security Challenges.

    Science.gov (United States)

    Christiansen, Ellen K; Skipenes, Eva; Hausken, Marie F; Skeie, Svein; Østbye, Truls; Iversen, Marjolein M

    2017-11-01

    Use of shared electronic health records opens a whole range of new possibilities for flexible and fruitful cooperation among health personnel in different health institutions, to the benefit of the patients. There are, however, unsolved legal and security challenges. The overall aim of this article is to highlight legal and security challenges that should be considered before using shared electronic cooperation platforms and health record systems to avoid legal and security "surprises" subsequent to the implementation. Practical lessons learned from the use of a web-based ulcer record system involving patients, community nurses, GPs, and hospital nurses and doctors in specialist health care are used to illustrate challenges we faced. Discussion of possible legal and security challenges is critical for successful implementation of shared electronic collaboration systems. Key challenges include (1) allocation of responsibility, (2) documentation routines, (3) and integrated or federated access control. We discuss and suggest how challenges of legal and security aspects can be handled. This discussion may be useful for both current and future users, as well as policy makers.

  19. Boneless Pose Editing and Animation

    DEFF Research Database (Denmark)

    Bærentzen, Jakob Andreas; Hansen, Kristian Evers; Erleben, Kenny

    2007-01-01

    In this paper, we propose a pose editing and animation method for triangulated surfaces based on a user controlled partitioning of the model into deformable parts and rigid parts which are denoted handles. In our pose editing system, the user can sculpt a set of poses simply by transforming...... the handles for each pose. Using Laplacian editing, the deformable parts are deformed to match the handles. In our animation system the user can constrain one or several handles in order to define a new pose. New poses are interpolated from the examples poses, by solving a small non-linear optimization...... problem in order to obtain the interpolation weights. While the system can be used simply for building poses, it is also an animation system. The user can specify a path for a given constraint and the model is animated correspondingly....

  20. Health problems raised by the elimination of radioactive wastes and nuclear accidents; Problemes sanitaires poses par l'elimination des dechets radioactifs et par les accidents nucleaires

    Energy Technology Data Exchange (ETDEWEB)

    Jammet, H; Mechali, D; Dousset, M [Commissariat a l' Energie Atomique, Fontenay-aux-Roses (France). Centre d' Etudes Nucleaires

    1964-07-01

    The rapid development of nuclear energy demands an urgent solution to the health problems arising from the discharge into the environment of radioactive residues produced by nuclear installations. - To be able to evaluate the risks run by the population and to fix tolerance limits for waste discharge, it is necessary to possess an exact knowledge of the course taken by the radioelements discharged, from their source until they reach man. The incorporation of radioelements in food cycles is the first risk to take into consideration. The factors involved in all stages of this transmission must be foreseen, whether they concern physical or biological media, because of their continuity and their interdependence. Finally, socio-economic and dietetic data must be collected in order that the risks and tolerance levels estimated are based on concrete and experimental rather than theoretical knowledge. The risk of nuclear accidents in the atomic industry, although very improbable, must be taken into consideration because of the seriousness of their consequences. The health problems arise in the field of professional hygiene on the one hand and in that of public hygiene on the other. In the first field the risk is two-fold and involves irradiation and contamination. The public sphere is reduced essentially to the risk of contamination by radioactive substances accidentally released in the surrounding medium. The health studies to be conducted in this field therefore include research not only on irradiation or contamination therapeutics but also on the transfer of radioelements from the accident site to man, mainly through food cycles, in their physical and in their biological components. Studies of this kind form the basis of decisions in the health field which would have to be taken in the case of an accident. (authors) [French] Le developpement rapide de l'energie nucleaire rend urgente la solution des problemes sanitaires poses par le rejet dans le milieu ambiant des

  1. Nutritional and health challenges of pastoralist populations in Kenya ...

    African Journals Online (AJOL)

    This paper examines nutritional and health challenges facing pastoralists who inhabit fragile rangelands and are one of the most nutritionally vulnerable population groups in Kenya. The review is based on a synthesis of literature on pastoralist food security, nutrition and health status and livelihoods in Kenya's rangelands.

  2. Psychosocial health challenges of the elderly in Nigeria: a narrative ...

    African Journals Online (AJOL)

    Background: Globally, national health systems are challenged to build successful aging models to prepare for biomedical, psychological and social changes. The integral component of psychosocial health in overall quality of life and well-being, however, is underscored and requires greater focus. Changing demographics ...

  3. Ethical issues in maternal and child health nursing: challenges ...

    African Journals Online (AJOL)

    Methods: This is a literature review on ethical issues in maternal and child health nursing, challenges faced by maternal and child health nurses and strategies for decision making. Literatures related to the topic was gathered from pertinent literature, completed research works and published articles retrieved from searches ...

  4. Women's Health – A Continuing Challenge in Developing Countries

    African Journals Online (AJOL)

    Patrick Erah

    Pharmacotherapy Group,. Faculty of Pharmacy, University of Benin,. Benin City, Nigeria. All rights reserved. Available online at http://www.tjpr.org. Editorial. Women's Health – A Continuing Challenge in. Developing Countries. For justifiable reasons, the health of women in developing countries is presently an important.

  5. Health Behavior Change Challenge: Understanding Stages of Change

    Science.gov (United States)

    Sullivan, Claire F.

    2011-01-01

    This semester-long activity requires students to reflect on their own strengths and weaknesses in attempting to take on a personally meaningful health behavior change challenge. This assignment affords them the opportunity to take a deeper look at theory and health concepts learned throughout the semester and to see how it has informed their own…

  6. Health system challenges to integration of mental health delivery in primary care in Kenya--perspectives of primary care health workers.

    Science.gov (United States)

    Jenkins, Rachel; Othieno, Caleb; Okeyo, Stephen; Aruwa, Julyan; Kingora, James; Jenkins, Ben

    2013-09-30

    Health system weaknesses in Africa are broadly well known, constraining progress on reducing the burden of both communicable and non-communicable disease (Afr Health Monitor, Special issue, 2011, 14-24), and the key challenges in leadership, governance, health workforce, medical products, vaccines and technologies, information, finance and service delivery have been well described (Int Arch Med, 2008, 1:27). This paper uses focus group methodology to explore health worker perspectives on the challenges posed to integration of mental health into primary care by generic health system weakness. Two ninety minute focus groups were conducted in Nyanza province, a poor agricultural region of Kenya, with 20 health workers drawn from a randomised controlled trial to evaluate the impact of a mental health training programme for primary care, 10 from the intervention group clinics where staff had received the training programme, and 10 health workers from the control group where staff had not received the training). These focus group discussions suggested that there are a number of generic health system weaknesses in Kenya which impact on the ability of health workers to care for clients with mental health problems and to implement new skills acquired during a mental health continuing professional development training programmes. These weaknesses include the medicine supply, health management information system, district level supervision to primary care clinics, the lack of attention to mental health in the national health sector targets, and especially its absence in district level targets, which results in the exclusion of mental health from such district level supervision as exists, and the lack of awareness in the district management team about mental health. The lack of mental health coverage included in HIV training courses experienced by the health workers was also striking, as was the intensive focus during district supervision on HIV to the detriment of other

  7. Different perspectives on the key challenges facing rural health: The challenges of power and knowledge.

    Science.gov (United States)

    Malatzky, Christina; Bourke, Lisa

    2018-05-25

    To examine the effects of dominant knowledge in rural health, including how they shape issues central to rural health. In particular, this article examines the roles of: (i) deficit knowledge of rural health workforce; (ii) dominant portrayals of generalism; and (iii) perceptions of inferiority about rural communities in maintaining health disparities between rural- and metropolitan-based Australians. A Foucauldian framework is applied to literature, evidence, case studies and key messages in rural health. Three scenarios are used to provide practical examples of specific knowledge that is prioritised or marginalised. The analysis of three areas in rural health identifies how deficit knowledge is privileged despite it undermining the purpose of rural health. First, deficit knowledge highlights the workforce shortage rather than the type of work in rural practice or the oversupply of workforce in metropolitan areas. Second, the construction of generalist practice as less skilled and more monotonous undermines other knowledge that it is diverse and challenging. Third, dominant negative stereotypes of rural communities discourage rural careers and highlight undesirable aspects of rural practice. The privileging of deficit knowledge pertaining to rural health workforce, broader dominant discourses of generalism and the nature of rural Australian communities reproduces many of the key challenges in rural health today, including persisting health disparities between rural- and metropolitan-based Australians. To disrupt the operations of power that highlight deficit knowledge and undermine other knowledge, we need to change the way in which rural health is currently constructed and understood. © 2018 National Rural Health Alliance Ltd.

  8. Open science initiatives: challenges for public health promotion.

    Science.gov (United States)

    Holzmeyer, Cheryl

    2018-03-07

    While academic open access, open data and open science initiatives have proliferated in recent years, facilitating new research resources for health promotion, open initiatives are not one-size-fits-all. Health research particularly illustrates how open initiatives may serve various interests and ends. Open initiatives not only foster new pathways of research access; they also discipline research in new ways, especially when associated with new regimes of research use and peer review, while participating in innovation ecosystems that often perpetuate existing systemic biases toward commercial biomedicine. Currently, many open initiatives are more oriented toward biomedical research paradigms than paradigms associated with public health promotion, such as social determinants of health research. Moreover, open initiatives too often dovetail with, rather than challenge, neoliberal policy paradigms. Such initiatives are unlikely to transform existing health research landscapes and redress health inequities. In this context, attunement to social determinants of health research and community-based local knowledge is vital to orient open initiatives toward public health promotion and health equity. Such an approach calls for discourses, norms and innovation ecosystems that contest neoliberal policy frameworks and foster upstream interventions to promote health, beyond biomedical paradigms. This analysis highlights challenges and possibilities for leveraging open initiatives on behalf of a wider range of health research stakeholders, while emphasizing public health promotion, health equity and social justice as benchmarks of transformation.

  9. Public health challenges and emerging diseases: the case of São Paulo

    Directory of Open Access Journals (Sweden)

    Silva Luiz Jacintho da

    2001-01-01

    Full Text Available The author discusses the challenges posed by emerging infectious diseases in 100 years of public health in the state of São Paulo, Brazil. With an advanced and organized public health system, São Paulo responded to the emergence of infectious diseases by creating research institutions and control programs. The late 19th century witnessed the first modern research institution in microbiology, in response to the bubonic plague. A changing economy led to constant changes in ecosystems. The late 20th century presents a wide array of both emerging and rapidly changing infectious diseases. The present situation calls for creative solutions. Ecosystem analysis and more agile epidemiological surveillance are seen as the best alternatives.

  10. 'Being appropriately unusual': a challenge for nurses in health-promoting conversations with families.

    Science.gov (United States)

    Benzein, Eva Gunilla; Hagberg, Margaretha; Saveman, Britt-Inger

    2008-06-01

    This study describes the theoretical assumptions and the application for health-promoting conversations, as a communication tool for nurses when talking to patients and their families. The conversations can be used on a promotional, preventive and healing level when working with family-focused nursing. They are based on a multiverse, salutogenetic, relational and reflecting approach, and acknowledge each person's experience as equally valid, and focus on families' resources, and the relationship between the family and its environment. By posing reflective questions, reflection is made possible for both the family and the nurses. Family members are invited to tell their story, and they can listen to and learn from each other. Nurses are challenged to build a co-creating partnership with families in order to acknowledge them as experts on how to lead their lives and to use their own expert knowledge in order to facilitate new meanings to surface. In this way, family health can be enhanced.

  11. Adolescent mental health: Challenges with maternal noncompliance.

    Science.gov (United States)

    Nejtek, Vicki A; Hardy, Sarah; Winter, Scott

    2010-04-07

    The leading cause of suicide ideation, attempts, and completion in adolescents is persistent and unresolved parental conflict. National statistics show extremely high rates of childhood neglect and abuse are perpetrated most often by single mothers. Psychiatric disorders arising from maternal-child dysfunction are well-documented. However, resources to prevent offspring victimization are lacking. Here, we report maternal neglect of a 15-year-old male brought to the psychiatric emergency room for suicidal ideation. An inpatient treatment plan including pharmacotherapy, family therapy and psychological testing was initiated. The patient's mother failed to attend clinic appointments or family therapy sessions. Clinician attempts to engage the mother in the treatment plan was met with verbal assaults, aggression, and threatening behavior. The patient decompensated in relation to the mother's actions. Child Protective Services were contacted and a follow-up assessment with the patient and mother is pending. Psychiatric treatment of the mother may be a necessary intervention and prevention regimen for both the adolescent and the mother. Without consistent Child Protective Services oversight, medical and psychosocial follow-up, the prognosis and quality of life for this adolescent is considered very poor. Stringent mental health law and institutional policies are needed to adequately intercede and protect adolescents with mental illness.

  12. Food technology: challenge for health promotion.

    Science.gov (United States)

    Kwon, T W; Hong, J H; Moon, G S; Song, Y S; Kim, J I; Kim, J C; Kim, M J

    2004-01-01

    The food technology has brought countless benefits to today's food supply. Despite its many positive contributions, it has also brought unintended negative consequences. It is the time to mobilize the food technology to help the food supply more secure, safer and healthier, and here three possible approaches are foreseeable: First, we should continue to improve the conventional technologies. Many wholesome foods have been prepared and preserved using natural materials simply by fermentation. Second, we have to enhance the minimal processing as much as applicable. Third, new ingredients, intelligent packaging and functional foods should be explored to improve food supply and health. Today, consumer interest in the functional foods has been increased tremendously, and the future of food lies in the functional foods. However, the situations in the developing world are different from this. As food resource is limited in this region, food technology has to be emphasized to increase food supply. To help solve such complex problems, not only new technologies, but also conventional technologies have to be mobilized. Simultaneously, even higher technical capabilities have to be built up by applying new findings from the related disciplines to allow the food technology to play its vital role.

  13. Challenges in mental health care in the Family Health Strategy

    Directory of Open Access Journals (Sweden)

    Consuelo Helena Aires de Freitas

    2011-06-01

    Full Text Available Objective: To discuss the practice of mental health care performed by healthcare professionals from the Family Health Strategy in Fortaleza-CE, Brazil. Methods: This is a critical and reflective study conducted in six Basic Health Units in Fortaleza-Ce. The study subjects were 12 health workers of the following professions: doctor, nurse, community health agents and technical and/or nursing assistant. Semi-structured interviews, systematic observationand questionnaire were used for data collection. The empirical analysis was based on an understanding of the discourses through critical hermeneutics. Results: It was evident that the mental health services are developed by some health workers in the ESF, such as, matrix support, relational technologies, home visits and community group therapy. However, there is still deficiency in training/coaching by most professionals in primary care, due to anenduring model of pathological or curative health care. Conclusion: Mental health care is still occasionally held by some workers in primary care. However, some progresses are already present as matrix support, relational technologies in health care, home visits andcommunity therapy.

  14. Contextual factors and challenges to e-health literacy

    Directory of Open Access Journals (Sweden)

    Bolanle A. Olaniran

    2015-12-01

    Full Text Available We live in a digital world or digital era. Hence, People will argue that not only do information communication technologies (ICTs make e-health possible but rather that it is an innovation advance whose time has come. Notwithstanding, e-health while hoping to create well needed improvement in health care, it is rife with certain challenges which are not limited to e-health literacy. However, this paper looks specifically at e-health literacy. The paper, in particular overviews e-health while addressing the impacts of key contextual factors that impacts e-health and e-health literacy regarding the propensity to adopt and use e-health in LEDCs.

  15. Fortification and health: challenges and opportunities.

    Science.gov (United States)

    Dwyer, Johanna T; Wiemer, Kathryn L; Dary, Omar; Keen, Carl L; King, Janet C; Miller, Kevin B; Philbert, Martin A; Tarasuk, Valerie; Taylor, Christine L; Gaine, P Courtney; Jarvis, Ashley B; Bailey, Regan L

    2015-01-01

    Fortification is the process of adding nutrients or non-nutrient bioactive components to edible products (e.g., food, food constituents, or supplements). Fortification can be used to correct or prevent widespread nutrient intake shortfalls and associated deficiencies, to balance the total nutrient profile of a diet, to restore nutrients lost in processing, or to appeal to consumers looking to supplement their diet. Food fortification could be considered as a public health strategy to enhance nutrient intakes of a population. Over the past century, fortification has been effective at reducing the risk of nutrient deficiency diseases such as beriberi, goiter, pellagra, and rickets. However, the world today is very different from when fortification emerged in the 1920s. Although early fortification programs were designed to eliminate deficiency diseases, current fortification programs are based on low dietary intakes rather than a diagnosable condition. Moving forward, we must be diligent in our approach to achieving effective and responsible fortification practices and policies, including responsible marketing of fortified products. Fortification must be applied prudently, its effects monitored diligently, and the public informed effectively about its benefits through consumer education efforts. Clear lines of authority for establishing fortification guidelines should be developed and should take into account changing population demographics, changes in the food supply, and advances in technology. This article is a summary of a symposium presented at the ASN Scientific Sessions and Annual Meeting at Experimental Biology 2014 on current issues involving fortification focusing primarily on the United States and Canada and recommendations for the development of responsible fortification practices to ensure their safety and effectiveness. © 2015 American Society for Nutrition.

  16. Meeting global health challenges through operational research and management science.

    Science.gov (United States)

    Royston, Geoff

    2011-09-01

    This paper considers how operational research and management science can improve the design of health systems and the delivery of health care, particularly in low-resource settings. It identifies some gaps in the way operational research is typically used in global health and proposes steps to bridge them. It then outlines some analytical tools of operational research and management science and illustrates how their use can inform some typical design and delivery challenges in global health. The paper concludes by considering factors that will increase and improve the contribution of operational research and management science to global health.

  17. Mental health challenges among adolescents living with HIV.

    Science.gov (United States)

    Vreeman, Rachel C; McCoy, Brittany M; Lee, Sonia

    2017-05-16

    Mental health is a critical and neglected global health challenge for adolescents infected with HIV. The prevalence of mental and behavioural health issues among HIV-infected adolescents may not be well understood or addressed as the world scales up HIV prevention and treatment for adolescents. The objective of this narrative review is to assess the current literature related to mental health challenges faced by adolescents living with HIV, including access to mental health services, the role of mental health challenges during transition from paediatric to adult care services and responsibilities, and the impact of mental health interventions. For each of the topics included in this review, individual searches were run using Medline and PubMed, accompanied by scans of bibliographies of relevant articles. The topics on which searches were conducted for HIV-infected adolescents include depression and anxiety, transition from paediatric to adult HIV care and its impact on adherence and mental health, HIV-related, mental health services and interventions, and the measurement of mental health problems. Articles were included if the focus was consistent with one of the identified topics, involved HIV-infected adolescents, and was published in English. Mental and behavioural health challenges are prevalent in HIV-infected adolescents, including in resource-limited settings where most of them live, and they impact all aspects of HIV prevention and treatment. Too little has been done to measure the impact of mental health challenges for adolescents living with HIV, to evaluate interventions to best sustain or improve the mental health of this population, or to create healthcare systems with personnel or resources to promote mental health. Mental health issues should be addressed proactively during adolescence for all HIV-infected youth. In addition, care systems need to pay greater attention to how mental health support is integrated into the care management for HIV

  18. Nursing challenges for universal health coverage: a systematic review

    Directory of Open Access Journals (Sweden)

    Mariana Cabral Schveitzer

    2016-01-01

    Full Text Available Objectives to identify nursing challenges for universal health coverage, based on the findings of a systematic review focused on the health workforce' understanding of the role of humanization practices in Primary Health Care. Method systematic review and meta-synthesis, from the following information sources: PubMed, CINAHL, Scielo, Web of Science, PsycInfo, SCOPUS, DEDALUS and Proquest, using the keyword Primary Health Care associated, separately, with the following keywords: humanization of assistance, holistic care/health, patient centred care, user embracement, personal autonomy, holism, attitude of health personnel. Results thirty studies between 1999-2011. Primary Health Care work processes are complex and present difficulties for conducting integrative care, especially for nursing, but humanizing practices have showed an important role towards the development of positive work environments, quality of care and people-centered care by promoting access and universal health coverage. Conclusions nursing challenges for universal health coverage are related to education and training, to better working conditions and clear definition of nursing role in primary health care. It is necessary to overcome difficulties such as fragmented concepts of health and care and invest in multidisciplinary teamwork, community empowerment, professional-patient bond, user embracement, soft technologies, to promote quality of life, holistic care and universal health coverage.

  19. The art of problem posing

    CERN Document Server

    Brown, Stephen I

    1990-01-01

    Updated and expanded, this second edition satisfies the same philosophical objective as the first -- to show the importance of problem posing. Although interest in mathematical problem solving increased during the past decade, problem posing remained relatively ignored. The Art of Problem Posing draws attention to this equally important act and is the innovator in the field. Special features include: * an exploration ofthe logical relationship between problem posing and problem solving * a special chapter devoted to teaching problem posing as a separate course * sketches, drawings, diagrams, and cartoons that illustrate the schemes proposed * a special section on writing in mathematics.

  20. “Do your homework…and then hope for the best”: the challenges that medical tourism poses to Canadian family physicians’ support of patients’ informed decision-making

    Science.gov (United States)

    2013-01-01

    Background Medical tourism—the practice where patients travel internationally to privately access medical care—may limit patients’ regular physicians’ abilities to contribute to the informed decision-making process. We address this issue by examining ways in which Canadian family doctors’ typical involvement in patients’ informed decision-making is challenged when their patients engage in medical tourism. Methods Focus groups were held with family physicians practicing in British Columbia, Canada. After receiving ethics approval, letters of invitation were faxed to family physicians in six cities. 22 physicians agreed to participate and focus groups ranged from two to six participants. Questions explored participants’ perceptions of and experiences with medical tourism. A coding scheme was created using inductive and deductive codes that captured issues central to analytic themes identified by the investigators. Extracts of the coded data that dealt with informed decision-making were shared among the investigators in order to identify themes. Four themes were identified, all of which dealt with the challenges that medical tourism poses to family physicians’ abilities to support medical tourists’ informed decision-making. Findings relevant to each theme were contrasted against the existing medical tourism literature so as to assist in understanding their significance. Results Four key challenges were identified: 1) confusion and tensions related to the regular domestic physician’s role in decision-making; 2) tendency to shift responsibility related to healthcare outcomes onto the patient because of the regular domestic physician’s reduced role in shared decision-making; 3) strains on the patient-physician relationship and corresponding concern around the responsibility of the foreign physician; and 4) regular domestic physicians’ concerns that treatments sought abroad may not be based on the best available medical evidence on treatment

  1. Health technology assessment in Iran: challenges and views

    Science.gov (United States)

    Olyaeemanesh, Alireza; Doaee, Shila; Mobinizadeh, Mohammadreza; Nedjati, Mina; Aboee, Parisa; Emami-Razavi, Seyed Hassan

    2014-01-01

    Background: Various decisions have been made on technology application at all levels of the health system in different countries around the world. Health technology assessment is considered as one of the best scientific tools at the service of policy- makers. This study attempts to investigate the current challenges of Iran’s health technology assessment and provide appropriate strategies to establish and institutionalize this program. Methods: This study was carried out in two independent phases. In the first, electronic databases such as Medline (via Pub Med) and Scientific Information Database (SID) were searched to provide a list of challenges of Iran’s health technology assessment. The views and opinions of the experts and practitioners on HTA challenges were studied through a questionnaire in the second phase which was then analyzed by SPSS Software version 16. This has been an observational and analytical study with a thematic analysis. Results: In the first phase, seven papers were retrieved; from which, twenty- two HTA challenges in Iran were extracted by the researchers; and they were used as the base for designing a structured questionnaire of the second phase. The views of the experts on the challenges of health technology assessment were categorized as follows: organizational culture, stewardship, stakeholders, health system management, infrastructures and external pressures which were mentioned in more than 60% of the cases and were also common in the views. Conclusion: The identification and prioritization of HTA challenges which were approved by those experts involved in the strategic planning of the Department of Health Technology Assessment will be a step forward in the promotion of an evidence- based policy- making and in the production of comprehensive scientific evidence. PMID:25695015

  2. Deliberative democracy in health care: current challenges and future prospects.

    Science.gov (United States)

    Safaei, Jalil

    2015-01-01

    There is a vast body of literature on deliberative, participative, or engaged democracy. In the area of health care there is a rapidly expanding literature on deliberative democracy as embodied in various notions of public engagement, shared decision-making (SDM), patient-centered care, and patient/care provider autonomy over the past few decades. It is useful to review such literature to get a sense of the challenges and prospects of introducing deliberative democracy in health care. This paper reviews the key literature on deliberative democracy and SDM in health care settings with a focus on identifying the main challenges of promoting this approach in health care, and recognizing its progress so far for mapping out its future prospects in the context of advanced countries. Several databases were searched to identify the literature pertinent to the subject of this study. A total of 56 key studies in English were identified and reviewed carefully for indications and evidence of challenges and/or promising avenues of promoting deliberative democracy in health care. Time pressure, lack of financial motivation, entrenched professional interests, informational imbalance, practical feasibility, cost, diversity of decisions, and contextual factors are noted as the main challenges. As for the prospects, greater clarity on conception of public engagement and policy objectives, real commitment of the authorities to public input, documenting evidence of the effectiveness of public involvement, development of patient decision supports, training of health professionals in SDM, and use of multiple and flexible methods of engagement leadership suited to specific contexts are the main findings in the reviewed literature. Seeking deliberative democracy in health care is both challenging and rewarding. The challenges have been more or less identified. However, its prospects are potentially significant. Such prospects are more likely to materialize if deliberative democracy is

  3. The health and health system of South Africa: historical roots of current public health challenges.

    Science.gov (United States)

    Coovadia, Hoosen; Jewkes, Rachel; Barron, Peter; Sanders, David; McIntyre, Diane

    2009-09-05

    The roots of a dysfunctional health system and the collision of the epidemics of communicable and non-communicable diseases in South Africa can be found in policies from periods of the country's history, from colonial subjugation, apartheid dispossession, to the post-apartheid period. Racial and gender discrimination, the migrant labour system, the destruction of family life, vast income inequalities, and extreme violence have all formed part of South Africa's troubled past, and all have inexorably affected health and health services. In 1994, when apartheid ended, the health system faced massive challenges, many of which still persist. Macroeconomic policies, fostering growth rather than redistribution, contributed to the persistence of economic disparities between races despite a large expansion in social grants. The public health system has been transformed into an integrated, comprehensive national service, but failures in leadership and stewardship and weak management have led to inadequate implementation of what are often good policies. Pivotal facets of primary health care are not in place and there is a substantial human resources crisis facing the health sector. The HIV epidemic has contributed to and accelerated these challenges. All of these factors need to be addressed by the new government if health is to be improved and the Millennium Development Goals achieved in South Africa.

  4. Challenges for Multilevel Health Disparities Research in a Transdisciplinary Environment

    Science.gov (United States)

    Holmes, John H.; Lehman, Amy; Hade, Erinn; Ferketich, Amy K.; Sarah, Gehlert; Rauscher, Garth H.; Abrams, Judith; Bird, Chloe E.

    2008-01-01

    Numerous factors play a part in health disparities. Although health disparities are manifested at the level of the individual, other contexts should be considered when investigating the associations of disparities with clinical outcomes. These contexts include families, neighborhoods, social organizations, and healthcare facilities. This paper reports on health disparities research as a multilevel research domain from the perspective of a large national initiative. The Centers for Population Health and Health Disparities (CPHHD) program was established by the NIH to examine the highly dimensional, complex nature of disparities and their effects on health. Because of its inherently transdisciplinary nature, the CPHHD program provides a unique environment in which to perform multilevel health disparities research. During the course of the program, the CPHHD centers have experienced challenges specific to this type of research. The challenges were categorized along three axes: sources of subjects and data, data characteristics, and multilevel analysis and interpretation. The CPHHDs collectively offer a unique example of how these challenges are met; just as importantly, they reveal a broad range of issues that health disparities researchers should consider as they pursue transdisciplinary investigations in this domain, particularly in the context of a large team science initiative. PMID:18619398

  5. Patient monitoring in mobile health: opportunities and challenges.

    Science.gov (United States)

    Mohammadzadeh, Niloofar; Safdari, Reza

    2014-01-01

    In most countries chronic diseases lead to high health care costs and reduced productivity of people in society. The best way to reduce costs of health sector and increase the empowerment of people is prevention of chronic diseases and appropriate health activities management through monitoring of patients. To enjoy the full benefits of E-health, making use of methods and modern technologies is very important. This literature review articles were searched with keywords like Patient monitoring, Mobile Health, and Chronic Disease in Science Direct, Google Scholar and Pub Med databases without regard to the year of publications. Applying remote medical diagnosis and monitoring system based on mobile health systems can help significantly to reduce health care costs, correct performance management particularly in chronic disease management. Also some challenges are in patient monitoring in general and specific aspects like threats to confidentiality and privacy, technology acceptance in general and lack of system interoperability with electronic health records and other IT tools, decrease in face to face communication between doctor and patient, sudden interruptions of telecommunication networks, and device and sensor type in specific aspect. It is obvious identifying the opportunities and challenges of mobile technology and reducing barriers, strengthening the positive points will have a significant role in the appropriate planning and promoting the achievements of the health care systems based on mobile and helps to design a roadmap for improvement of mobile health.

  6. Leadership survey. An evaluation of health care executives' challenges.

    Science.gov (United States)

    Thrall, T H; Hoppszallern, S

    2001-01-01

    Locating and keeping employees represents one of the greatest challenges facing health care leaders today. This is a key finding of the third Leadership Survey of executives in physician practices, managed care organizations and hospitals. The survey is sponsored by the Medical Group Management Association and Hospitals & Health Networks magazine. Other significant results: Practices put the most emphasis on teamwork, training and staff development as methods to combat labor shortages; practice executives count adequacy of reimbursements and physician productivity as top leadership challenges, along with the availability of qualified workers; practices choose print advertising and the addition of new products and services as the best ways for them to build market share.

  7. Opportunities and challenges to promoting oral health in primary schools.

    Science.gov (United States)

    Gill, P; Chestnutt, I G; Channing, D

    2009-09-01

    Inequalities in oral health in areas of socio-economic disadvantage are well recognised. As children spend a considerable proportion of their lives in education, schools can play a significant role in promoting children's health and oral health. However, to what extent schools are able to do this is unclear. The aim of this study was therefore to investigate opportunities and challenges to promoting oral health in primary schools. A purposive sample of 20 primary schools from socially and economically disadvantaged areas of Cardiff, UK were selected to participate in this qualitative study. Data were collected through semi-structured interviews conducted with head teachers or their nominated deputies. General awareness of health and oral health was good, with all schools promoting the consumption of fruit, water and milk and discouraging products such as carbonated drinks and confectionaries. Health promotion schemes wereimplemented primarily to improve the health of the children, although schools felt they also offered the potential to improve classroom behaviour and attendance. However, oral health was viewed as a separate entity to general health and perceived to be inadequately promoted. Successful health promotion schemes were also influenced by the attitudes of headteachers. Most schools had no or limited links with local dental services and, or oral health educators, although such input, when it occurred, was welcomed and highly valued. Knowledge of how to handle dental emergencies was limited and only two schools operated toothbrushing schemes, although all expressed an interest in such programmes. This study identified a positive predisposition to promoting health in primary schools. The challenge for the dental team, however, is to promote and integrate oral health into mainstream health promotion activities in schools. The paper also makes recommendations for further research.

  8. Health policy making for street children: challenges and strategies.

    Science.gov (United States)

    Abdi, Fatemeh; Saeieh, Sara Esmaelzadeh; Roozbeh, Nasibeh; Yazdkhasti, Mansoureh

    2017-08-17

    Background The phenomenon of street children is a bio-psychological and social issue that not only harms children, but also endangers the health of a society. In line with the national programs for the development and promotion of street children's health in Iran, health policy making and essential strategies for this group of children will be presented in this paper. This paper will discuss the main issues and challenges of street children's health and, also, health policy and guidelines for this population. Methods In this review study, the keywords; street children, health, challenges, policy, and health policy making were searched through PubMed, SID, Iranmedex, World Health Organization (WHO), Emro, the Cochran Library, Medline and Google scholar to collect data. The search resulted in 84 related resources from which 48 cases that were more relevant to this research and covered the issue more comprehensively, were used. All data published during 2002-2015 have been included in this paper. Results Key concepts including street children and their health, health policy, strategies to improve the health of street children, health policy approaches for street children, the WHO's strategies, and social support program for street children must be considered in the health policy making processes for street children, as precise identification of the relevant information makes planning more effective in health policy making for this group of children. Conclusion The phenomenon of street children is a growing problem in the world and it has turned into a serious concern in many countries including Iran. The findings of this study can be used for identifying necessary measures in order to use research outcomes more effectively in policy making processes and reforming street children's health policies in Iran.

  9. Remote sensing of ecosystem health: opportunities, challenges, and future perspectives.

    Science.gov (United States)

    Li, Zhaoqin; Xu, Dandan; Guo, Xulin

    2014-11-07

    Maintaining a healthy ecosystem is essential for maximizing sustainable ecological services of the best quality to human beings. Ecological and conservation research has provided a strong scientific background on identifying ecological health indicators and correspondingly making effective conservation plans. At the same time, ecologists have asserted a strong need for spatially explicit and temporally effective ecosystem health assessments based on remote sensing data. Currently, remote sensing of ecosystem health is only based on one ecosystem attribute: vigor, organization, or resilience. However, an effective ecosystem health assessment should be a comprehensive and dynamic measurement of the three attributes. This paper reviews opportunities of remote sensing, including optical, radar, and LiDAR, for directly estimating indicators of the three ecosystem attributes, discusses the main challenges to develop a remote sensing-based spatially-explicit comprehensive ecosystem health system, and provides some future perspectives. The main challenges to develop a remote sensing-based spatially-explicit comprehensive ecosystem health system are: (1) scale issue; (2) transportability issue; (3) data availability; and (4) uncertainties in health indicators estimated from remote sensing data. However, the Radarsat-2 constellation, upcoming new optical sensors on Worldview-3 and Sentinel-2 satellites, and improved technologies for the acquisition and processing of hyperspectral, multi-angle optical, radar, and LiDAR data and multi-sensoral data fusion may partly address the current challenges.

  10. Remote Sensing of Ecosystem Health: Opportunities, Challenges, and Future Perspectives

    Directory of Open Access Journals (Sweden)

    Zhaoqin Li

    2014-11-01

    Full Text Available Maintaining a healthy ecosystem is essential for maximizing sustainable ecological services of the best quality to human beings. Ecological and conservation research has provided a strong scientific background on identifying ecological health indicators and correspondingly making effective conservation plans. At the same time, ecologists have asserted a strong need for spatially explicit and temporally effective ecosystem health assessments based on remote sensing data. Currently, remote sensing of ecosystem health is only based on one ecosystem attribute: vigor, organization, or resilience. However, an effective ecosystem health assessment should be a comprehensive and dynamic measurement of the three attributes. This paper reviews opportunities of remote sensing, including optical, radar, and LiDAR, for directly estimating indicators of the three ecosystem attributes, discusses the main challenges to develop a remote sensing-based spatially-explicit comprehensive ecosystem health system, and provides some future perspectives. The main challenges to develop a remote sensing-based spatially-explicit comprehensive ecosystem health system are: (1 scale issue; (2 transportability issue; (3 data availability; and (4 uncertainties in health indicators estimated from remote sensing data. However, the Radarsat-2 constellation, upcoming new optical sensors on Worldview-3 and Sentinel-2 satellites, and improved technologies for the acquisition and processing of hyperspectral, multi-angle optical, radar, and LiDAR data and multi-sensoral data fusion may partly address the current challenges.

  11. Remote Sensing of Ecosystem Health: Opportunities, Challenges, and Future Perspectives

    Science.gov (United States)

    Li, Zhaoqin; Xu, Dandan; Guo, Xulin

    2014-01-01

    Maintaining a healthy ecosystem is essential for maximizing sustainable ecological services of the best quality to human beings. Ecological and conservation research has provided a strong scientific background on identifying ecological health indicators and correspondingly making effective conservation plans. At the same time, ecologists have asserted a strong need for spatially explicit and temporally effective ecosystem health assessments based on remote sensing data. Currently, remote sensing of ecosystem health is only based on one ecosystem attribute: vigor, organization, or resilience. However, an effective ecosystem health assessment should be a comprehensive and dynamic measurement of the three attributes. This paper reviews opportunities of remote sensing, including optical, radar, and LiDAR, for directly estimating indicators of the three ecosystem attributes, discusses the main challenges to develop a remote sensing-based spatially-explicit comprehensive ecosystem health system, and provides some future perspectives. The main challenges to develop a remote sensing-based spatially-explicit comprehensive ecosystem health system are: (1) scale issue; (2) transportability issue; (3) data availability; and (4) uncertainties in health indicators estimated from remote sensing data. However, the Radarsat-2 constellation, upcoming new optical sensors on Worldview-3 and Sentinel-2 satellites, and improved technologies for the acquisition and processing of hyperspectral, multi-angle optical, radar, and LiDAR data and multi-sensoral data fusion may partly address the current challenges. PMID:25386759

  12. Health problems raised by the elimination of radioactive wastes and nuclear accidents; Problemes sanitaires poses par l'elimination des dechets radioactifs et par les accidents nucleaires

    Energy Technology Data Exchange (ETDEWEB)

    Jammet, H.; Mechali, D.; Dousset, M. [Commissariat a l' Energie Atomique, Fontenay-aux-Roses (France). Centre d' Etudes Nucleaires

    1964-07-01

    The rapid development of nuclear energy demands an urgent solution to the health problems arising from the discharge into the environment of radioactive residues produced by nuclear installations. - To be able to evaluate the risks run by the population and to fix tolerance limits for waste discharge, it is necessary to possess an exact knowledge of the course taken by the radioelements discharged, from their source until they reach man. The incorporation of radioelements in food cycles is the first risk to take into consideration. The factors involved in all stages of this transmission must be foreseen, whether they concern physical or biological media, because of their continuity and their interdependence. Finally, socio-economic and dietetic data must be collected in order that the risks and tolerance levels estimated are based on concrete and experimental rather than theoretical knowledge. The risk of nuclear accidents in the atomic industry, although very improbable, must be taken into consideration because of the seriousness of their consequences. The health problems arise in the field of professional hygiene on the one hand and in that of public hygiene on the other. In the first field the risk is two-fold and involves irradiation and contamination. The public sphere is reduced essentially to the risk of contamination by radioactive substances accidentally released in the surrounding medium. The health studies to be conducted in this field therefore include research not only on irradiation or contamination therapeutics but also on the transfer of radioelements from the accident site to man, mainly through food cycles, in their physical and in their biological components. Studies of this kind form the basis of decisions in the health field which would have to be taken in the case of an accident. (authors) [French] Le developpement rapide de l'energie nucleaire rend urgente la solution des problemes sanitaires poses par le rejet dans le milieu ambiant des

  13. Global Health Governance Challenges 2016 - Are We Ready?

    Science.gov (United States)

    Kickbusch, Ilona

    2016-02-29

    The year 2016 could turn out to be a turning point for global health, new political realities and global insecurities will test governance and financing mechanisms in relation to both people and planet. But most importantly political factors such as the global power shift and "the rise of the rest" will define the future of global health. A new mix of health inequity and security challenges has emerged and the 2015 humanitarian and health crises have shown the limits of existing systems. The global health as well as the humanitarian system will have to prove their capacity to respond and reform. The challenge ahead is deeply political, especially for the rising political actors. They are confronted with the consequences of a model of development that has neglected sustainability and equity, and was built on their exploitation. Some direction has been given by the path breaking international conferences in 2015. Especially the agreement on the Sustainable Development Goals (SDGs) and the Paris agreement on climate change will shape action. Conceptually, we will need a different understanding of global health and its ultimate goals - the health of people can no longer be seen separate from the health of the planet and wealth measured by parameters of growth will no longer ensure health. © 2016 by Kerman University of Medical Sciences.

  14. Electronic health records challenges in design and implementation

    CERN Document Server

    Sittig, Dean F

    2013-01-01

    This book provides an overview of the challenges in electronic health records (EHR) design and implementation along with an introduction to the best practices that have been identified over the past several years. The book examines concerns surrounding EHR use and proposes eight examples of proper EHR use. It discusses the complex strategic planning that accompanies the systemic organizational changes associated with EHR programs and highlights key lessons learned regarding health information-including technology errors and risk management concerns.

  15. Potential and challenges of body area networks for personal health.

    Science.gov (United States)

    Penders, Julien; van de Molengraft, Jef; Brown, Lindsay; Grundlehner, Bernard; Gyselinckx, Bert; Van Hoof, Chris

    2009-01-01

    This paper illustrates how body area network technology may enable new personal health concepts. A BAN technology platform is presented, which integrates technology building blocks from the Human++ research program on autonomous wireless sensors. Technology evaluation for the case of wireless sleep staging and real-time arousal monitoring is reported. Key technology challenges are discussed. The ultimate target is the development of miniaturized body sensor nodes powered by body-energy, anticipating the needs of emerging personal health applications.

  16. Profile of men's health in Malaysia: problems and challenges

    Science.gov (United States)

    Tong, Seng Fah; Low, Wah Yun; Ng, Chirk Jenn

    2011-01-01

    Men's health concerns have evolved from the traditional andrology and male sexual health to a more holistic approach that encompasses male psychological, social and physical health. The poor state of health in men compared to their female counterparts is well documented. A review of the epidemiological data from Malaysia noted a similar trend in which men die at higher rates in under 1 and above 15 years old groups and most disease categories compared to women. In Malaysia, the main causes of death in men are non-communicable diseases and injuries. Risk factors, such as risk-taking behaviour, smoking and hypertension, are prevalent and amenable to early interventions. Erectile dysfunction, premature ejaculation and prostate disorders are also prevalent. However, many of these morbidities go unreported and are not diagnosed early; therefore, opportunities for early intervention are missed. This reflects poor health knowledge and inadequate health-care utilisation among Malaysian men. Their health-seeking behaviour has been shown to be strongly influenced by family members and friends. However, more research is needed to identify men's unmet health-care needs and to develop optimal strategies for addressing them. Because the Malaysian population is aging and there is an increase in sedentary lifestyles, optimizing men's health will remain a challenge unless effective measures are implemented. The existing male-unfriendly health-care system and the negative influence of masculinity on men's health behaviour must be addressed. A national men's health policy based on a male-friendly approach to health-care delivery is urgently needed to provide a framework for addressing these challenges. PMID:21358664

  17. Profile of men's health in Malaysia: problems and challenges.

    Science.gov (United States)

    Tong, Seng Fah; Low, Wah Yun; Ng, Chirk Jenn

    2011-07-01

    Men's health concerns have evolved from the traditional andrology and male sexual health to a more holistic approach that encompasses male psychological, social and physical health. The poor state of health in men compared to their female counterparts is well documented. A review of the epidemiological data from Malaysia noted a similar trend in which men die at higher rates in under 1 and above 15 years old groups and most disease categories compared to women. In Malaysia, the main causes of death in men are non-communicable diseases and injuries. Risk factors, such as risk-taking behaviour, smoking and hypertension, are prevalent and amenable to early interventions. Erectile dysfunction, premature ejaculation and prostate disorders are also prevalent. However, many of these morbidities go unreported and are not diagnosed early; therefore, opportunities for early intervention are missed. This reflects poor health knowledge and inadequate health-care utilisation among Malaysian men. Their health-seeking behaviour has been shown to be strongly influenced by family members and friends. However, more research is needed to identify men's unmet health-care needs and to develop optimal strategies for addressing them. Because the Malaysian population is aging and there is an increase in sedentary lifestyles, optimizing men's health will remain a challenge unless effective measures are implemented. The existing male-unfriendly health-care system and the negative influence of masculinity on men's health behaviour must be addressed. A national men's health policy based on a male-friendly approach to health-care delivery is urgently needed to provide a framework for addressing these challenges.

  18. Methods for the economic evaluation of changes to the organisation and delivery of health services: principal challenges and recommendations.

    Science.gov (United States)

    Meacock, Rachel

    2018-04-20

    There is a requirement for economic evaluation of health technologies seeking public funding across Europe. Changes to the organisation and delivery of health services, including changes to health policy, are not covered by such appraisals. These changes also have consequences for National Health Service (NHS) funds, yet undergo no mandatory cost-effectiveness assessment. The focus on health technologies may have occurred because larger-scale service changes pose more complex challenges to evaluators. This paper discusses the principal challenges faced when performing economic evaluations of changes to the organisation and delivery of health services and provides recommendations for overcoming them. The five principal challenges identified are as follows: undertaking ex-ante evaluation; evaluating impacts in terms of quality-adjusted life years; assessing costs and opportunity costs; accounting for spillover effects; and generalisability. Of these challenges, methods for estimating the impact on costs and quality-adjusted life years are those most in need of development. Methods are available for ex-ante evaluation, assessing opportunity costs and examining generalisability. However, these are rarely applied in practice. The general principles of assessing the cost-effectiveness of interventions should be applied to all NHS spending, not just that involving health technologies. Advancements in this area have the potential to improve the allocation of scarce NHS resources.

  19. Health transition and immigration: a new challenge for Public Health.

    Science.gov (United States)

    Di Nicola, A; Geraci, S

    2015-01-01

    Immigration has been one of the most relevant phenomena characterizing Italy's social history of the past 30 years. Currently, there are almost 5 million non-Italian citizens in Italy, representing about 8.2% of the country's population. At the beginning of the 80s, a small health clinic, set-up by a no-profit Catholic organization called Caritas, was thus opened in Rome - managed by medical doctors and volunteer workers - aimed at providing the new migrants (often without any social rights) the sanitary support that was unavailable or difficult to find. In time, this health clinic progressively became an observatory of migrants' general health conditions, with a particular focus on the part of this population found in marginal social and legal conditions (without a residence permit). Data recorded in Roman Caritas Health Clinic database, belonging to patient admitted to the medical centre for the first time in 1986-1987, 2003-2004 and 2013-2014, were selected and compared. Only patients from Africa, Asia, Central and Eastern Europe and Central and Southern America were included. In addition to vital statistics, both diagnosis and prescriptions are filed according to the ICD-9.CM, 1997 in the database. Only codes 001 to 999 have been taken into consideration. The resulting sample is composed of 10741 patients. Of these, 3602 relate to 1986-1987, 4341 to 2003-2004 and 2798 to 2013-2014. The total diagnostical data processed was of 12662 (2777 in 1986-1987, 5704 in 2003-2004, 4181 in 2013-2014). Over the last 30 years the most significant variable for the public health scenario is the progressively ageing population, a variable that does not occur homogeneously. Starting from 2003-2004 an upward trend for non-communicable diseases was observed, that, as suggested by this study, have patterns and determinants varying according to ethnicity. The progressive modification of the socio-demographic profile of the migrant population determined the health transition already

  20. Lessons Learned and Challenges in Building a Filipino Health Coalition

    Science.gov (United States)

    Aguilar, David E.; Abesamis-Mendoza, Noilyn; Ursua, Rhodora; Divino, Lily Ann M.; Cadag, Kara; Gavin, Nicholas P.

    2010-01-01

    In recent years, community-based coalitions have become an effective channel to addressing various health problems within specific ethnic communities. The purpose of this article is twofold: (a) to describe the process involved in building the Kalusugan Coalition (KC), a Filipino American health coalition based in New York City, and (b) to highlight the lessons learned and the challenges from this collaborative venture. The challenges described also offer insights on how the coalition development process can be greatly affected by the partnership with an academic institution on a community-based research project. Because each cultural group has unique issues and concerns, the theoretical framework used by KC offers creative alternatives to address some of the challenges regarding coalition infrastructures, leadership development, unexpected change of coalition dynamics, and cultural nuances. PMID:19098260

  1. Ethical Issues in Maternal and Child Health Nursing: Challenges ...

    African Journals Online (AJOL)

    2016-06-28

    Jun 28, 2016 ... and neonatal nurses, face ethical issues possibly because of their ... Aim: To identify the ethical issues related to maternal and child care, the challenges faced by ...... Lucas V.A. The business of women's health care. In: E.T. ...

  2. Challenges in conducting qualitative research in health: A conceptual paper

    Science.gov (United States)

    Khankeh, Hamidreza; Ranjbar, Maryam; Khorasani-Zavareh, Davoud; Zargham-Boroujeni, Ali; Johansson, Eva

    2015-01-01

    Background: Qualitative research focuses on social world and provides the tools to study health phenomena from the perspective of those experiencing them. Identifying the problem, forming the question, and selecting an appropriate methodology and design are some of the initial challenges that researchers encounter in the early stages of any research project. These problems are particularly common for novices. Materials and Methods: This article describes the practical challenges of using qualitative inquiry in the field of health and the challenges of performing an interpretive research based on professional experience as a qualitative researcher and on available literature. Results: One of the main topics discussed is the nature of qualitative research, its inherent challenges, and how to overcome them. Some of those highlighted here include: identification of the research problem, formation of the research question/aim, and selecting an appropriate methodology and research design, which are the main concerns of qualitative researchers and need to be handled properly. Insights from real-life experiences in conducting qualitative research in health reveal these issues. Conclusions: The paper provides personal comments on the experiences of a researcher in conducting pure qualitative research in the field of health. It offers insights into the practical difficulties encountered when performing qualitative studies and offers solutions and alternatives applied by these authors, which may be of use to others. PMID:26793245

  3. Challenges confronting health care workers in government's ARV ...

    African Journals Online (AJOL)

    Challenges confronting health care workers in government's ARV rollout: rights and responsibilities. ... Potchefstroom Electronic Law Journal/Potchefstroomse Elektroniese Regsblad ... Unless the rights of HCWs are recognised and their needs adequately addressed, the best laid plans of government will be at risk.

  4. special article child health: past, present and future challenges

    African Journals Online (AJOL)

    among other things at ... in the planning of the new extensions to Korle Bu ... one ward (ward M) housed all the paediatric pa- ... Health Care Delivery to children by the Women Medi- .... Street, London to try to learn some paediatrics. ... career. Times indeed have changed, but there will al- ways be personal challenges for ...

  5. Effect of economic and security challenges on the Nigerian health ...

    African Journals Online (AJOL)

    Effect of economic and security challenges on the Nigerian health sector. Folashade T Alloh1, Pramod R Regmi1,2. 1. ... oil accounts for 75% of Nigeria's economy, so the fall in oil prices, therefore, has a significant impact on ... corruption surrounding many of the country's lawmakers in different scandals over the years have ...

  6. Oral Health Challenges for Sub-Saharan Africa | Danfillo | Nigerian ...

    African Journals Online (AJOL)

    Oral Health Challenges for Sub-Saharan Africa. IS Danfillo. Abstract. No Abstract. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors · FAQ's · More about AJOL · AJOL's ...

  7. Challenges of monitoring reproductive health services: a case study ...

    African Journals Online (AJOL)

    Challenges of monitoring reproductive health services: a case study of antenatal clinics in Kinondoni municipality, Dar Es Salaam. ... was descriptive cross sectional employing both qualitative and quantitative methods. The sample population included nurse-midwives who manage ANC clinics in Kinondoni Municipality.

  8. Food, Populations and Health — global Patterns and Challenges

    DEFF Research Database (Denmark)

    2016-01-01

    The present volume is based on presentations at a symposium at the Royal Danish Academy of Sciences and Letters in September 2014 with the title Food, Population and Health – global Patterns and Challenges. Food has played a fundamental role in the history of all societies over the World. Availab...

  9. CHALLENGES IN REPRODUCTIVE HEALTH CARE OF ADOLESCENTS IN SLOVENIA

    Directory of Open Access Journals (Sweden)

    Bojana Pinter

    2018-02-01

    Full Text Available Background: Slovenia is one of the most successful European countries in the prevention of adolescent pregnancy and the country with a relative early sexual engagement of adolescents. Every year new generations of adolescents are entering puberty, thus reproductive health care of adolescents should be our continuous priority. Methods: The most important challenges in reproductive health care of adolescents in Slovenia are early sexual engagement of adolescents, low double method use at sexual intercourse and inadequate detection of sexually transmitted infections. Possible responses should be found on a micro-level of physician (recognition of a new role of physician, promotion of ABC ap- proach and on a macro-level of society (development of national strategy of reproductive health care, introduction of systematic sexuality education in the schools. Conclusions: Challenges in reproductive health care of adolescents are several and possible responses are integral. A response on challenges demand that every physician recognizes his/her new role and develops his/her competency. Responses on challenges will be feasible with inter- connection of physicians with other physicians and professionals and with collaboration of profession and politics.

  10. Living with HIV: Challenges in Reproductive Health Care in South ...

    African Journals Online (AJOL)

    Women in Africa are facing discrimination and challenges in relation to HIV/AIDS, particularly regarding their sexual and reproductive health care. This includes a lack of information regarding HIV and pregnancy, difficulties with contraceptive use, negative attitudes towards childbearing, and problems in accessing safe legal ...

  11. Human capital flight challenges within an Equitable Health System ...

    African Journals Online (AJOL)

    Human capital flight challenges within an Equitable Health System. N E Udonwa. Abstract. No Abstract Nigerian Journal of Medicine Vol. 16 (4) 2007: pp. 307-311. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/njm.v16i4.37327 · AJOL African ...

  12. Six challenges in modelling for public health policy.

    Science.gov (United States)

    Metcalf, C J E; Edmunds, W J; Lessler, J

    2015-03-01

    The World Health Organisation's definition of public health refers to all organized measures to prevent disease, promote health, and prolong life among the population as a whole (World Health Organization, 2014). Mathematical modelling plays an increasingly important role in helping to guide the most high impact and cost-effective means of achieving these goals. Public health programmes are usually implemented over a long period of time with broad benefits to many in the community. Clinical trials are seldom large enough to capture these effects. Observational data may be used to evaluate a programme after it is underway, but have limited value in helping to predict the future impact of a proposed policy. Furthermore, public health practitioners are often required to respond to new threats, for which there is little or no previous data on which to assess the threat. Computational and mathematical models can help to assess potential threats and impacts early in the process, and later aid in interpreting data from complex and multifactorial systems. As such, these models can be critical tools in guiding public health action. However, there are a number of challenges in achieving a successful interface between modelling and public health. Here, we discuss some of these challenges. Copyright © 2014 The Authors. Published by Elsevier B.V. All rights reserved.

  13. Six challenges in modelling for public health policy

    Directory of Open Access Journals (Sweden)

    C.J.E. Metcalf

    2015-03-01

    Full Text Available The World Health Organisation's definition of public health refers to all organized measures to prevent disease, promote health, and prolong life among the population as a whole (World Health Organization, 2014. Mathematical modelling plays an increasingly important role in helping to guide the most high impact and cost-effective means of achieving these goals. Public health programmes are usually implemented over a long period of time with broad benefits to many in the community. Clinical trials are seldom large enough to capture these effects. Observational data may be used to evaluate a programme after it is underway, but have limited value in helping to predict the future impact of a proposed policy. Furthermore, public health practitioners are often required to respond to new threats, for which there is little or no previous data on which to assess the threat. Computational and mathematical models can help to assess potential threats and impacts early in the process, and later aid in interpreting data from complex and multifactorial systems. As such, these models can be critical tools in guiding public health action. However, there are a number of challenges in achieving a successful interface between modelling and public health. Here, we discuss some of these challenges.

  14. Health Promotion Challenges at Sea - a Danish Case

    DEFF Research Database (Denmark)

    Hjarnø, Lulu

    HEALTH PROMOTOIN CHALLENGES AT SEA - A DANISH CASE L Hjarnoe, Centre for Maritime Health and Safety, Institute of Public Health, University of Southern Denmark INTRODUCTION: For the past 15 years the need for health promotion initiatives in the maritime sector has become more and more evident. Thus...... previous studies have documented increased mortality and morbidity (incidences) among seafarers, not only due to accidents but also to lifestyle like cardiovascular disease, lung cancer and diseases related to alcohol. These diseases are related to factors like alcohol consumption, obesity, physical...... inactivity and smoking, which for the latter three are factors highly represented in the maritime industry. The aim of this study is to identify the current health status of seafarers and to detect, strengths and weaknesses of health promotion interventions implemented in this target group. METHODS: A 1 year...

  15. NETWORKS OF HEALTH CARE: A CHALLENGE TO SUS MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Camila Dubow

    2013-09-01

    Full Text Available The article proposes a critical reflection, based on national law, scholarly, scientific, on the current development of Networks of Health Care, as a strategy for strengthening the Single Health System (SUS. Are weighted inefficiency of traditional ways of organizing care and management, the challenge of Network Health Care for comprehensive care and management mechanisms used in this process. The work provides subsidies for the care practices and health management are reflected, pointing strategies that result in disruptions of paradigms through a refocusing of attention in existing models. For networks of health care can be consolidated, is fundamental to political sensitivity of health managers with a commitment to build a new model of care, through the struggle to consolidate the SUS and the realization of the principles of universality, comprehensiveness and equity.

  16. [Human resources for health in Chile: the reform's pending challenge].

    Science.gov (United States)

    Méndez, Claudio A

    2009-09-01

    Omission of human resources from health policy development has been identified as a barrier in the health sector reform's adoption phase. Since 2002, Chile's health care system has been undergoing a transformation based on the principles of health as a human right, equity, solidarity, efficiency, and social participation. While the reform has set forth the redefinition of the medical professions, continuing education, scheduled accreditation, and the introduction of career development incentives, it has not considered management options tailored to the new setting, a human resources strategy that has the consensus of key players and sector policy, or a process for understanding the needs of health care staff and professionals. However, there is still time to undo the shortcomings, in large part because the reform's implementation phase only recently has begun. Overcoming this challenge is in the hands of the experts charged with designing public health strategies and policies.

  17. Reproductive, maternal, newborn, and child health in Pakistan: challenges and opportunities.

    Science.gov (United States)

    Bhutta, Zulfiqar A; Hafeez, Assad; Rizvi, Arjumand; Ali, Nabeela; Khan, Amanullah; Ahmad, Faatehuddin; Bhutta, Shereen; Hazir, Tabish; Zaidi, Anita; Jafarey, Sadequa N

    2013-06-22

    Globally, Pakistan has the third highest burden of maternal, fetal, and child mortality. It has made slow progress in achieving the Millennium Development Goals (MDGs) 4 and 5 and in addressing common social determinants of health. The country also has huge challenges of political fragility, complex security issues, and natural disasters. We undertook an in-depth analysis of Pakistan's progress towards MDGs 4 and 5 and the principal determinants of health in relation to reproductive, maternal, newborn, and child health and nutrition. We reviewed progress in relation to new and existing public sector programmes and the challenges posed by devolution in Pakistan. Notwithstanding the urgent need to tackle social determinants such as girls' education, empowerment, and nutrition in Pakistan, we assessed the effect of systematically increasing coverage of various evidence-based interventions on populations at risk (by residence or poverty indices). We specifically focused on scaling up interventions using delivery platforms to reach poor and rural populations through community-based strategies. Our model indicates that with successful implementation of these strategies, 58% of an estimated 367,900 deaths (15,900 maternal, 169,000 newborn, 183,000 child deaths) and 49% of an estimated 180,000 stillbirths could be prevented in 2015. Copyright © 2013 Elsevier Ltd. All rights reserved.

  18. Smoking Health Professional Student: An Attitudinal Challenge for Health Promotion?

    Directory of Open Access Journals (Sweden)

    Daniel Cauchi

    2012-07-01

    Full Text Available Tobacco is a major preventable cause of premature morbidity and mortality. Health professionals are uniquely positioned to provide targeted interventions and should be empowered to provide cessation counselling that influence patient smoking. A cross-sectional national survey was administered to all third year students in four disciplines at the University of Malta. The Global Health Professional Student Survey (GHPSS questionnaire was distributed to collect standardised demographic, smoking prevalence, behavioural, and attitudinal data. 81.9% completed the questionnaire (n = 173/211. A positive significant association between tobacco smoke exposure at home and current smoking status was identified. Non-smokers regarded anti-tobacco policies more favourably than smokers, being more likely to agree with banning of tobacco sales to adolescents (OR 3.6; 95% CI: 2.5–5.3; p ≤ 0.001; and with a smoking ban in all public places (OR 8.9; 95% CI: 6.1–13.1; p ≤ 0.001. Non-smokers favoured a role for health professionals in promoting smoking cessation (OR 5.1; 95% CI: 3.1–8.5; p ≤ 0.001. Knowledge of antidepressants as tools for smoking cessation was also associated with a perceived role for skilled health professionals in cessation counselling (OR 4.9; 95% CI: 1.8–13.3; p = 0.002. Smoking negatively influences beliefs and attitudes of students toward tobacco control. There is a need to adopt a standard undergraduate curriculum containing comprehensive tobacco prevention and cessation training to improve their effectiveness as role models.

  19. Diagnostic performance of magnetic resonance imaging and pre-surgical evaluation in the assessment of traumatic intra-articular knee disorders in children and adolescents: what conditions still pose diagnostic challenges?

    Energy Technology Data Exchange (ETDEWEB)

    Gans, Itai; Ganley, Theodore J. [The Children' s Hospital of Philadelphia, Division of Orthopaedics, 34th and Civic Center Boulevard, Philadelphia, PA (United States); Bedoya, Maria A.; Ho-Fung, Victor [The Children' s Hospital of Philadelphia, Department of Radiology, Philadelphia, PA (United States)

    2014-08-31

    -surgical evaluation was quite high. The traumatic intra-articular knee lesions that still pose a diagnostic challenge for MRI and pre-surgical evaluation are lateral discoid meniscus, lateral meniscal tears, intra-articular loose bodies and osteochondral injuries. Special attention should be given to those diagnoses when evaluating a pediatric knee MRI. In children with multiple intra-articular injuries, there is significantly more inaccuracy in pre-arthroscopic diagnosis of lateral meniscal tears on both MRI and pre-surgical evaluation. (orig.)

  20. Diagnostic performance of magnetic resonance imaging and pre-surgical evaluation in the assessment of traumatic intra-articular knee disorders in children and adolescents: what conditions still pose diagnostic challenges?

    International Nuclear Information System (INIS)

    Gans, Itai; Ganley, Theodore J.; Bedoya, Maria A.; Ho-Fung, Victor

    2015-01-01

    -surgical evaluation was quite high. The traumatic intra-articular knee lesions that still pose a diagnostic challenge for MRI and pre-surgical evaluation are lateral discoid meniscus, lateral meniscal tears, intra-articular loose bodies and osteochondral injuries. Special attention should be given to those diagnoses when evaluating a pediatric knee MRI. In children with multiple intra-articular injuries, there is significantly more inaccuracy in pre-arthroscopic diagnosis of lateral meniscal tears on both MRI and pre-surgical evaluation. (orig.)

  1. From mobile mental health to mobile wellbeing: opportunities and challenges.

    Science.gov (United States)

    Gaggioli, Andrea; Riva, Giuseppe

    2013-01-01

    The combination of smart phones, wearable sensor devices and social media offer new ways of monitoring and promoting mental and physical wellbeing. In this contribution, we describe recent developments in the field of mobile healthcare (or mHealth), by focusing in particular on mobile mental health applications. First, we examine the potential benefits associated with this approach, providing examples from existing projects. Next, we identify and explain possible differences in focus between mobile mental health and mobile wellbeing applications. Finally, we discuss some open challenges associated with the implementation of this vision, ranging from the lack of evidence-based validation to privacy, security and ethical concerns.

  2. THE ENVIRONMENTAL CHALLENGE AND HEALTH SECURITY IN CHINA

    Directory of Open Access Journals (Sweden)

    Wang Wuyi

    2010-01-01

    Full Text Available China has achieved impressive rapid development over the past 30 years. But China also faces the challenge of environmental change resulting from rapid economic growth and the attendant risks to human health. In this paper we described the environmental change and health risk in China from evident fluctuation of China’s climate, major changes in natural hydrological condition, raw materials and energy demand, changes of disease epidemic pattern related to climate change and ecosystem damage, new health risk raised by rapid urbanization and rural environmental quality degradation. The suggestion and countermeasures were discussed.

  3. Employee health services integration: meeting the challenge. Successful program.

    Science.gov (United States)

    Lang, Y C

    1998-02-01

    1. The first step of a successful Employee Health Service integration is to have a plan supported by management. The plan must be presented to the employees prior to implementation in a "user friendly" manner. 2. Prior to computerization of employee health records, a record order system must be developed to prevent duplication and to enhance organization. 3. Consistency of services offered must be maintained. Each employee must have the opportunity to receive the same service. Complexity of services will determine the site of delivery. 4. Integration is a new and challenging development for the health care field. Flexibility and brainstorming are necessary in an attempt to meet both employee and employer needs.

  4. [Reflections on Occupational Health Nursing in Taiwan: Challenges and Perspectives].

    Science.gov (United States)

    Wu, Fei-Ling; Tsai, Hsiu-Min; Liou, Yiing-Mei; Chou, Yen-Fang; Chang, Tsai-Hsiu; Shiao, Shu-Chu Judith

    2018-04-01

    The development of the occupational health nursing profession has promoted stable and healthy human resources in Taiwan. In order to improve the occupational safety, health, and healthcare of workers, the professional core competencies and role functions of occupational health nursing is of utmost importance. This article investigated the current status of occupational health nursing education, role functions, practice scope, and the development and responsibilities of professional associations and proposed the challenges to and the future prospects of the development of occupational health nursing in Taiwan. The key findings include: (1) the role functions and practice scope of occupational health nursing; (2) occupational health nursing courses should be included in the required credits of Department of Nursing and master and doctor programs in occupational health nursing should be established; (3) a certification system of occupational health nursing should be established as soon as possible; (4) the professional associations for occupational health nursing should take responsibility for continuing education and training; and (5) interdisciplinary collaborations among relevant occupational health professionals should be strengthened.

  5. Transportability of tertiary qualifications and CPD: A continuing challenge for the global health workforce

    Directory of Open Access Journals (Sweden)

    Saltman Deborah C

    2012-07-01

    Full Text Available Abstract Background In workforces that are traditionally mobile and have long lead times for new supply, such as health, effective global indicators of tertiary education are increasingly essential. Difficulties with transportability of qualifications and cross-accreditation are now recognised as key barriers to meeting the rapidly shifting international demands for health care providers. The plethora of mixed education and service arrangements poses challenges for employers and regulators, let alone patients; in determining equivalence of training and competency between individuals, institutions and geographical locations. Discussion This paper outlines the shortfall of the current indicators in assisting the process of global certification and competency recognition in the health care workforce. Using Organisation for Economic Cooperation and Development (OECD data we highlight how International standardisation in the tertiary education sector is problematic for the global health workforce. Through a series of case studies, we then describe a model which enables institutions to compare themselves internally and with others internationally using bespoke or prioritised parameters rather than standards. Summary The mobility of the global health workforce means that transportability of qualifications is an increasing area of concern. Valid qualifications based on workplace learning and assessment requires at least some variables to be benchmarked in order to judge performance.

  6. Genomics as public health? Community genetics and the challenge of personalised medicine in Cuba.

    Science.gov (United States)

    Gibbon, Sahra

    2009-08-01

    Making use of a comparative perspective on the emergence of 'breast cancer genetics' in the different cultural context of the UK and Cuba, this article examines the tensions between the modern promise of genomics as personalised medicine and a commitment to public health. Focusing primarily on the Cuba context and drawing on ethnographic research as part of a collaborative project working with genetic professionals and publics, the article examines the particular technologies, identities and socialities at stake in an emerging and evolving field of genetic medicine. It highlights how long-standing continuities in the commitment to the equitable provision of public health, particularly as this relates to 'family medicine', are central to understanding the scope and expansion of 'community genetics' interventions, even when at the level of local practice, public health is also now subject to the unequal dynamics of economic necessity through the working out of 'lo informal'. Illuminating the different ways agency, risk, responsibility, citizenship and activism get configured by and between publics and health professionals in Cuba, the article reveals the challenges and opportunities posed by predictive genomic medicine in relation to the dynamic and shifting terrain of public health.

  7. Viral hepatitis in Latin America and the Caribbean: a public health challenge

    Directory of Open Access Journals (Sweden)

    Núria Díez-Padrisa

    2013-10-01

    Full Text Available Viral hepatitis (VH is an emergent concern in public health agendas worldwide. More than one million people die annually from hepatitis and 57% and 78% of global cirrhosis and hepatocellular carcinoma cases, respectively, are caused by VH. The burden of disease caused by hepatitis in Latin America and the Caribbean (LAC is high. Data on hepatitis has been collected in several countries, but more accurate and comparable studies are needed. Hepatitis B vaccination and screening of donated blood are routine practices in the region. However, integrated policies covering prevention and control of disease caused by all types of hepatitis viruses are scarce. Existing preventive measures need to be reinforced. Attention must be paid to at-risk populations, awareness campaigns, and water and food safety. Affordable access to diagnosis and treatment, population screening, referral to health services and monitoring of positive cases are among the main challenges currently posed by VH in LAC. The World Health Organization framework and Pan American Health Organization regional strategy, defined in response to resolution WHA63.18 of the World Health Assembly, may help to overcome these difficulties. Successful experiences in the fight against hepatitis in some LAC countries may also provide very interesting solutions for the region.

  8. Challenges of Health Games in the Social Network Environment.

    Science.gov (United States)

    Paredes, Hugo; Pinho, Anabela; Zagalo, Nelson

    2012-04-01

    Virtual communities and their benefits have been widely exploited to support patients, caregivers, families, and healthcare providers. The complexity of the social organization evolved the concept of virtual community to social networks, exploring the establishment of ties and relations between people. These technological platforms provide a way to keep up with one's connections network, through a set of communication and interaction tools. Games, as social interactive technologies, have great potential, ensuring a supportive community and thereby reducing social isolation. Serious social health games bring forward several research challenges. This article examines the potential benefits of the triad "health-serious games-social networks" and discusses some research challenges and opportunities of the liaison of serious health games and social networks.

  9. Electronic health systems: challenges faced by hospital-based providers.

    Science.gov (United States)

    Agno, Christina Farala; Guo, Kristina L

    2013-01-01

    The purpose of this article is to discuss specific challenges faced by hospitals adopting the use of electronic medical records and implementing electronic health record (EHR) systems. Challenges include user and information technology support; ease of technical use and software interface capabilities; compliance; and financial, legal, workforce training, and development issues. Electronic health records are essential to preventing medical errors, increasing consumer trust and use of the health system, and improving quality and overall efficiency. Government efforts are focused on ways to accelerate the adoption and use of EHRs as a means of facilitating data sharing, protecting health information privacy and security, quickly identifying emerging public health threats, and reducing medical errors and health care costs and increasing quality of care. This article will discuss physician and nonphysician staff training before, during, and after implementation; the effective use of EHR systems' technical features; the selection of a capable and secure EHR system; and the development of collaborative system implementation. Strategies that are necessary to help health care providers achieve successful implementation of EHR systems will be addressed.

  10. Mental health in Asia: social improvements and challenges.

    Science.gov (United States)

    Tseng, W S; Ebata, K; Kim, K I; Krahl, W; Kua, E H; Lu, Q; Shen, Y; Tan, E S; Yang, M J

    2001-01-01

    Remarkable improvements in economic conditions and a considerable upgrade in the quality of life have been observed in many parts of Asia during the past several decades. At the same time, many mental health challenges face the people of Asia. Various social mental health indexes are reviewed here, with available data from China, Japan, Korea, Singapore, Malaysia, and other Asian societies. The data are compared with data from the United States, Australia in the Pacific Rim, and some other Western countries to examine patterns of similarity or difference between East and West in the process of modernization. Common trends in mental health issues associated with rapid sociocultural change observed in different Asian societies are discussed, as well as the relative shortage of mental health personnel available in many Asian societies. It is emphasized that, in addition to expanding psychiatric services, there is an even more urgent need to promote mental health knowledge and concern through education in the general population. Mental health needs to be cultivated and maintained by social forces and cultural strengths. It is stressed that there is a challenge for Asian people to advance mental health beyond economic development in the 21st century.

  11. Integrating an Academic Electronic Health Record: Challenges and Success Strategies.

    Science.gov (United States)

    Herbert, Valerie M; Connors, Helen

    2016-08-01

    Technology is increasing the complexity in the role of today's nurse. Healthcare organizations are integrating more health information technologies and relying on the electronic health record for data collection, communication, and decision making. Nursing faculty need to prepare graduates for this environment and incorporate an academic electronic health record into a nursing curriculum to meet student-program outcomes. Although the need exists for student preparation, some nursing programs are struggling with implementation, whereas others have been successful. To better understand these complexities, this project was intended to identify current challenges and success strategies of effective academic electronic health record integration into nursing curricula. Using Rogers' 1962 Diffusion of Innovation theory as a framework for technology adoption, a descriptive survey design was used to gain insights from deans and program directors of nursing schools involved with the national Health Informatics & Technology Scholars faculty development program or Cerner's Academic Education Solution Consortium, working to integrate an academic electronic health record in their respective nursing schools. The participants' experiences highlighted approaches used by these schools to integrate these technologies. Data from this project provide nursing education with effective strategies and potential challenges that should be addressed for successful academic electronic health record integration.

  12. Human Resources for Health Challenges in Nigeria and Nurse Migration.

    Science.gov (United States)

    Salami, Bukola; Dada, Foluke O; Adelakun, Folake E

    2016-05-01

    The emigration of sub-Saharan African health professionals to developed Western nations is an aspect of increasing global mobility. This article focuses on the human resources for health challenges in Nigeria and the emigration of nurses from Nigeria as the country faces mounting human resources for health challenges. Human resources for health issues in Nigeria contribute to poor population health in the country, alongside threats from terrorism, infectious disease outbreaks, and political corruption. Health inequities within Nigeria mirror the geographical disparities in human resources for health distribution and are worsened by the emigration of Nigerian nurses to developed countries such as the United States and the United Kingdom. Nigerian nurses are motivated to emigrate to work in healthier work environments, improve their economic prospects, and advance their careers. Like other migrant African nurses, they experience barriers to integration, including racism and discrimination, in receiving countries. We explore the factors and processes that shape this migration. Given the forces of globalization, source countries and destination countries must implement policies to more responsibly manage migration of nurses. This can be done by implementing measures to retain nurses, promote the return migration of expatriate nurses, and ensure the integration of migrant nurses upon arrival in destination countries. © The Author(s) 2016.

  13. Health claims on foods: challenge for clinical research companies

    Directory of Open Access Journals (Sweden)

    Essi Sarkkinen

    2012-06-01

    Full Text Available Background The Nutrition and Health Claim Regulation 1924/2006/EC, together with EFSA guidances on the scientific requirements for different type of health claims, is setting the basis for health claim substantiation in the EU. Aim The aim of this presentation is to bring up the key challenges that the food industry and clinical research organizations are facing when meeting these requirements. Results and discussion Key issues in clinical research planning to meet the requirements set for the health claim substantiation are: (1 Selection of right outcome markers since the selection of outcome marker defines actually the formulation of the health claim to be used on food or food ingredient. (2 Selection of right target population since that determines the target consumer group for the food with a health claim. (3 Selection of dose regime and food matrices used since these largely determine the conditions set for the use of the health claim. One of the major challenges in health claim substantiation is the deviant approach to risk factors or biomarkers. From the regulation point of view, a single risk factor approach is emphasized, but from the clinical and scientific point of view the pattern of different risk markers or biomarkers could, in some cases, be a more relevant choice to reflect the final health outcome. This is especially the case in the nutrition and health area because we are often dealing with weak but multiple health effects of certain food items or ingredients. Also the lack of validated well-established biomarkers potent to be affected by diet is a challenge in health claim substantiation.The selection of right target population is often a compromise between choosing a more potential target group to obtain efficacy (i.e. risk factors elevated vs. patient groups and choosing a rationale to generalize the results to wider population (target consumer group.The selection of optimal dosing regime and matrices for a clinical study is

  14. Technologies for HIV prevention and care: challenges for health services.

    Science.gov (United States)

    Maksud, Ivia; Fernandes, Nilo Martinez; Filgueiras, Sandra Lucia

    2015-09-01

    This article aims to consider some relevant challenges to the provision of "new prevention technologies" in health services in a scenario where the "advances" in the global response to AIDS control are visible. We take as material for analysis the information currently available on the HIV post-exposure prophylaxis (PEP) and pre-exposure prophylaxis (PrEP), treatment as prevention (TASP) and over the counter. The methodology consisted of the survey and analysis of the Biblioteca Virtual em Saúde (BVS: MEDLINE, LILACS, WHOLIS, PAHO, SciELO) articles that addressed the issue of HIV prevention and care in the context of so-called new prevention technologies. The results of the studies show that there is assistance on the ground of clinics for the treatment of disease responses, but there are several challenges related to the sphere of prevention. The articles list some challenges regarding to management, organization of services and the attention given by health professionals to users. The current context shows evidence of the effectiveness of antiretroviral therapy in reducing the risk of HIV transmission, but the challenges for the provision of preventive technologies in health services permeate health professionals and users in their individual dimensions and health services in organizational and structural dimension. Interventions should be made available in a context of community mobilization; there should be no pressure on people to make HIV testing, antiretroviral treatment or for prevention. In the management is responsible for the training of health professionals to inform, clarify and make available to users, partners and family information about the new antiretroviral use strategies.

  15. National health insurance policy in Nepal: challenges for implementation

    Directory of Open Access Journals (Sweden)

    Shiva Raj Mishra

    2015-08-01

    Full Text Available The health system in Nepal is characterized by a wide network of health facilities and community workers and volunteers. Nepal's Interim Constitution of 2007 addresses health as a fundamental right, stating that every citizen has the right to basic health services free of cost. But the reality is a far cry. Only 61.8% of the Nepalese households have access to health facilities within 30 min, with significant urban (85.9% and rural (59% discrepancy. Addressing barriers to health services needs urgent interventions at the population level. Recently (February 2015, the Government of Nepal formed a Social Health Security Development Committee as a legal framework to start implementing a social health security scheme (SHS after the National Health Insurance Policy came out in 2013. The program has aimed to increase the access of health services to the poor and the marginalized, and people in hard to reach areas of the country, though challenges remain with financing. Several aspects should be considered in design, learning from earlier community-based health insurance schemes that suffered from low enrollment and retention of members as well as from a pro-rich bias. Mechanisms should be built for monitoring unfair pricing and unaffordable copayments, and an overall benefit package be crafted to include coverage of major health services including non-communicable diseases. Regulations should include such issues as accreditation mechanisms for private providers. Health system strengthening should move along with the roll-out of SHS. Improving the efficiency of hospital, motivating the health workers, and using appropriate technology can improve the quality of health services. Also, as currently a constitution drafting is being finalized, careful planning and deliberation is necessary about what insurance structure may suit the proposed future federal structure in Nepal.

  16. Deliberative democracy in health care: current challenges and future prospects

    Directory of Open Access Journals (Sweden)

    Safaei J

    2015-12-01

    Full Text Available Jalil Safaei Department of Economics, University of Northern British Columbia, Prince George, BC, CanadaBackground: There is a vast body of literature on deliberative, participative, or engaged democracy. In the area of health care there is a rapidly expanding literature on deliberative democracy as embodied in various notions of public engagement, shared decision-making (SDM, patient-centered care, and patient/care provider autonomy over the past few decades. It is useful to review such literature to get a sense of the challenges and prospects of introducing deliberative democracy in health care.Objective: This paper reviews the key literature on deliberative democracy and SDM in health care settings with a focus on identifying the main challenges of promoting this approach in health care, and recognizing its progress so far for mapping out its future prospects in the context of advanced countries.Method: Several databases were searched to identify the literature pertinent to the subject of this study. A total of 56 key studies in English were identified and reviewed carefully for indications and evidence of challenges and/or promising avenues of promoting deliberative democracy in health care.Results: Time pressure, lack of financial motivation, entrenched professional interests, informational imbalance, practical feasibility, cost, diversity of decisions, and contextual factors are noted as the main challenges. As for the prospects, greater clarity on conception of public engagement and policy objectives, real commitment of the authorities to public input, documenting evidence of the effectiveness of public involvement, development of patient decision supports, training of health professionals in SDM, and use of multiple and flexible methods of engagement leadership suited to specific contexts are the main findings in the reviewed literature.Conclusion: Seeking deliberative democracy in health care is both challenging and rewarding. The

  17. [Employees health education--challenges according to the educational level].

    Science.gov (United States)

    Korzeniowska, Elzbieta; Puchalski, Krzysztof

    2012-01-01

    Article addresses the problem of increasing Polish employees health education effectiveness according to the differences in educational level. Research model assume that effective method of developing recommendations improving the health education will synthesise scientific findings regarding methodology of conducting such education and knowledge about needs of two target groups: low and high educated employees. Educational solutions were searched in publications related to: health education, andragogy, propaganda and direct marketing. The empirical material used to characterize two target groups came from four research (qualitative and quantitative) conducted by the National Centre for Workplace Health Promotion (Nofer Institute of Occupational Medicine) in 2007-2010. Low educated employees' health education should be focused on increasing responsibility for health and strengthening their self-confidence according to the introduction of healthy lifestyle changes. To achieve these goals, important issue is to build their motivation to develop knowledge about taking care of health. In providing such information we should avoid the methods associated with school. Another important issue is creating an appropriate infrastructure and conditions facilitating the change of harmful behaviors undertaken at home and in the workplace. According to high-educated employees a challenge is to support taking health behaviors--although they are convinced it is important for their health, such behaviors are perceived as a difficult and freedom restriction. Promoting behavior change techniques, avoiding prohibitions in the educational messages and creating favorable climate for taking care of health in groups they participate are needed.

  18. Managing the pursuit of health and wealth: the key challenges.

    Science.gov (United States)

    Fidler, David P; Drager, Nick; Lee, Kelley

    2009-01-24

    This article forms part of a six-part Series on trade and health, and sets the stage for this Series by analysing key aspects of the relationship between trade and health. The Series takes stock of this relation and provides timely analysis of the key challenges facing efforts to achieve an appropriate balance between trade and health across a diverse range of issues. This introductory article reviews how trade and health have risen and expanded on global policy agendas in the past decade in unprecedented ways, describes how trade and health issues are respectively governed in international relations, examines the ongoing search for policy coherence between the two policy spheres, and highlights the topics of the remaining articles in the Series.

  19. Overcoming Family Planning Challenges in Africa: Toward Meeting ...

    African Journals Online (AJOL)

    USER

    Overcoming Family Planning Challenges in Africa: Toward Meeting. Unmet Need ... The challenges posed are greater in ... Gaps in meeting women's needs persist especially ..... WHO. Everybody's business: Strengthening health systems to.

  20. Human action recognition based on estimated weak poses

    Science.gov (United States)

    Gong, Wenjuan; Gonzàlez, Jordi; Roca, Francesc Xavier

    2012-12-01

    We present a novel method for human action recognition (HAR) based on estimated poses from image sequences. We use 3D human pose data as additional information and propose a compact human pose representation, called a weak pose, in a low-dimensional space while still keeping the most discriminative information for a given pose. With predicted poses from image features, we map the problem from image feature space to pose space, where a Bag of Poses (BOP) model is learned for the final goal of HAR. The BOP model is a modified version of the classical bag of words pipeline by building the vocabulary based on the most representative weak poses for a given action. Compared with the standard k-means clustering, our vocabulary selection criteria is proven to be more efficient and robust against the inherent challenges of action recognition. Moreover, since for action recognition the ordering of the poses is discriminative, the BOP model incorporates temporal information: in essence, groups of consecutive poses are considered together when computing the vocabulary and assignment. We tested our method on two well-known datasets: HumanEva and IXMAS, to demonstrate that weak poses aid to improve action recognition accuracies. The proposed method is scene-independent and is comparable with the state-of-art method.

  1. Immigrants and health system challenges to TB control in Oman

    Directory of Open Access Journals (Sweden)

    Fochsen Grethe

    2010-07-01

    Full Text Available Abstract Background During the past three decades, Oman has made significant progress in controlling TB within it's borders. However, the national TB control program elimination target has yet to be reached. This study aims to explore the perceived roles played by the immigrant population and the private health sector in relation to TB control in Oman. Methods We conducted seventeen interviews with different health care providers. The verbatim transcripts were processed using content analysis. Results Three main themes emerged. Firstly the threat of repatriation faced by underprivileged expatriates, secondly the criticized and forgotten private health sector as a key player and thirdly the user and provider barriers faced by Omani patients in the Omani public health system. Conclusions The study has identified some of the challenges and barriers to TB control in Oman. These challenges are mainly related to unintended negative consequences arising from the current repatriation policy of immigrants and to and the lack of involvement of the private sector in TB control. TB control strategies designed to address these challenges are needed, for Oman to reach its TB elimination targets.

  2. [Mental health in Chile and Finland: Challenges and lessons].

    Science.gov (United States)

    Retamal C, Pedro; Markkula, Niina; Peña, Sebastián

    2016-07-01

    This article analyses and compares the epidemiology of mental disorders and relevant public policies in Chile and Finland. In Chile, a specific mental health law is still lacking. While both countries highlight the role of primary care, Finland places more emphasis on participation and recovery of service users. Comprehensive mental health policies from Finland, such as a successful suicide prevention program, are presented. Both countries have similar prevalence of mental disorders, high alcohol consumption and high suicide rates. In Chile, the percentage of total disease burden due to psychiatric disorders is 13% and in Finland 14%. However, the resources to address these issues are very different. Finland spends 4.5% of its health budget on mental health, while in Chile the percentage is 2.2%. This results in differences in human resources and service provision. Finland has five times more psychiatric outpatient visits, four times more psychiatrists, triple antidepressant use and twice more clinical guidelines for different psychiatric conditions. In conclusion, both countries have similar challenges but differing realities. This may help to identify gaps and potential solutions for public health challenges in Chile. Finland’s experience demonstrates the importance of political will and long-term vision in the construction of mental health policies.

  3. Examining the Links between Challenging Behaviors in Youth with ASD and Parental Stress, Mental Health, and Involvement: Applying an Adaptation of the Family Stress Model to Families of Youth with ASD

    Science.gov (United States)

    Schiltz, Hillary K.; McVey, Alana J.; Magnus, Brooke; Dolan, Bridget K.; Willar, Kirsten S.; Pleiss, Sheryl; Karst, Jeffrey; Carson, Audrey M.; Caiozzo, Christina; Vogt, Elisabeth; Van Hecke, Amy Vaughan

    2018-01-01

    Raising a child with autism spectrum disorder (ASD) poses unique challenges that may impact parents' mental health and parenting experiences. The current study analyzed self-report data from 77 parents of youth with ASD. A serial multiple mediation model revealed that parenting stress (SIPA) and parental mental health (BAI and BDI-II) appears to…

  4. Problem posing reflections and applications

    CERN Document Server

    Brown, Stephen I

    2014-01-01

    As a result of the editors' collaborative teaching at Harvard in the late 1960s, they produced a ground-breaking work -- The Art Of Problem Posing -- which related problem posing strategies to the already popular activity of problem solving. It took the concept of problem posing and created strategies for engaging in that activity as a central theme in mathematics education. Based in part upon that work and also upon a number of articles by its authors, other members of the mathematics education community began to apply and expand upon their ideas. This collection of thirty readings is a tes

  5. Challenging machismo: promoting sexual and reproductive health with Nicaraguan men.

    Science.gov (United States)

    Sternberg, P

    2000-03-01

    This article presents the results of a participatory exploration of male attitudes towards sexual and reproductive health issues in Nicaragua. Nicaraguan culture views men in a machismo concept. The study examined the knowledge, attitudes and behavior of men in relation to the social construction of masculinity: sexuality, reproduction, and fatherhood. Employing 90 men from both rural and urban communities, attitudes towards sexuality, reproduction, abortion and fatherhood were discussed. Several insights were gathered from the research, which explains men's behavior. Thus, it was deemed imperative that in empowering women by promoting sexual and reproductive health among men would require challenging male hegemony and persuading men to participate in health promotion. However, the setting and application of a men's agenda for sexual health promotion should not result in the curtailment of services for women because funds are being reallocated to men, nor should it give men the opportunity to more subtle forms of domination and exploitation.

  6. Monitoring health spending increases: incremental budget analyses reveal challenging tradeoffs.

    Science.gov (United States)

    Hartman, Micah; Smith, Cynthia; Heffler, Stephen; Freeland, Mark

    2006-01-01

    With each passing decade, health care has consumed a larger share of gross domestic product (GDP) and Federal budgets. By the 2000-2004 period, society was willing to devote over 20 percent of the cumulative increase in GDP and the cumulative increase in Federal outlays towards health care. The financing challenges are expected to become more acute for private payers as well as Federal, State, and local budgets. With the implementation of Part D in 2006, the U.S. Office of Management and Budget projects that Federal budget pressures will heighten, bringing increased attention to Medicare's long-term fiscal outlook.

  7. Application of GIS technology in public health: successes and challenges.

    Science.gov (United States)

    Fletcher-Lartey, Stephanie M; Caprarelli, Graziella

    2016-04-01

    The uptake and acceptance of Geographic Information Systems (GIS) technology has increased since the early 1990s and public health applications are rapidly expanding. In this paper, we summarize the common uses of GIS technology in the public health sector, emphasizing applications related to mapping and understanding of parasitic diseases. We also present some of the success stories, and discuss the challenges that still prevent a full scope application of GIS technology in the public health context. Geographical analysis has allowed researchers to interlink health, population and environmental data, thus enabling them to evaluate and quantify relationships between health-related variables and environmental risk factors at different geographical scales. The ability to access, share and utilize satellite and remote-sensing data has made possible even wider understanding of disease processes and of their links to the environment, an important consideration in the study of parasitic diseases. For example, disease prevention and control strategies resulting from investigations conducted in a GIS environment have been applied in many areas, particularly in Africa. However, there remain several challenges to a more widespread use of GIS technology, such as: limited access to GIS infrastructure, inadequate technical and analytical skills, and uneven data availability. Opportunities exist for international collaboration to address these limitations through knowledge sharing and governance.

  8. Getting Australia more active: challenges and opportunities for health promotion.

    Science.gov (United States)

    Hills, A P; Street, S J; Harris, N

    2014-04-01

    A growing body of evidence demonstrates that regular physical activity promotes health and assists in the prevention of non-communicable diseases but this is presently curtailed by low and unhealthy participation rates in Australia and comparable industrialised countries. Compounding the problem is knowledge that physical inactivity is independently associated with poor health outcomes. Despite physical activity being described as public health's 'best bet' or 'best buy', motivating individuals and groups to adopt and maintain physical activity continues to be a major challenge for health professionals. Global advocacy for prevention efforts must be operationalised through national to local strategies to promote and support physical activity in multiple settings including the home, schools and workplace. The Australian health promotion community has and continues to play a leadership role in physical activity promotion. However, there is an urgent need to continue to promote the importance of physical activity, along with its pivotal role in the prevention of non-communicable diseases, alongside related agendas including healthy diets, tobacco control and environmental sustainability. This commentary overviews the contemporary status of physical activity promotion in Australia and identifies key challenges and opportunities moving forward.

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

    Science.gov (United States)

    Lee, Kelley; Brumme, Zabrina L

    2013-10-01

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

  10. mHealth For Aging China: Opportunities and Challenges.

    Science.gov (United States)

    Sun, Jing; Guo, Yutao; Wang, Xiaoning; Zeng, Qiang

    2016-01-01

    The aging population with chronic and age-related diseases has become a global issue and exerted heavy burdens on the healthcare system and society. Neurological diseases are the leading chronic diseases in the geriatric population, and stroke is the leading cause of death in China. However, the uneven distribution of caregivers and critical healthcare workforce shortages are major obstacles to improving disease outcome. With the advancement of wearable health devices, cloud computing, mobile technologies and Internet of Things, mobile health (mHealth) is rapidly developing and shows a promising future in the management of chronic diseases. Its advantages include its ability to improve the quality of care, reduce the costs of care, and improve treatment outcomes by transferring in-hospital treatment to patient-centered medical treatment at home. mHealth could also enhance the international cooperation of medical providers in different time zones and the sharing of high-quality medical service resources between developed and developing countries. In this review, we focus on trends in mHealth and its clinical applications for the prevention and treatment of diseases, especially aging-related neurological diseases, and on the opportunities and challenges of mHealth in China. Operating models of mHealth in disease management are proposed; these models may benefit those who work within the mHealth system in developing countries and developed countries.

  11. Pilot Implementation of Health Information Systems: Issues and challenges

    DEFF Research Database (Denmark)

    Bansler, Jørgen Peter; Havn, Erling C.

    2010-01-01

    Objectives: This study aims to explore the issues and challenges involved in designing and organizing pilot implementations of health information systems (HIS). Pilot implementations are a widely used approach for identifying design flaws and implementation issues before full-scale deployment...... of conventional implementations; they are fundamentally different and they have their own complications and issues to deal with that make them hard to design and manage....

  12. Emerging arboviruses and public health challenges in Brazil

    OpenAIRE

    Lima-Camara,Tamara Nunes

    2016-01-01

    ABSTRACT Environmental modification by anthropogenic actions, disordered urban growth, globalization of international exchange and climate change are some factors that help the emergence and dissemination of human infectious diseases transmitted by vectors. This review discusses the recent entry of three arboviruses in Brazil: Chikungunya, West Nile, and Zika virus, focusing on the challenges for the Country’s public health. The Brazilian population is exposed to infections caused by th...

  13. Health sector reform in South Asia: new challenges and constraints.

    Science.gov (United States)

    Islam, Anwar; Tahir, M Zaffar

    2002-05-01

    In early 1990s, Jamison, Mosley and others concluded that a profound demographic and consequent epidemiological transition is taking place in developing countries. According to this classical model, by the year 2015, infectious diseases will account for only about 20% of deaths in developing countries as chronic diseases become more pronounced. These impending demographic and epidemiological transitions were to dominate the health sector reform agenda in developing countries. Following an analysis of fertility, mortality and other demographic and epidemiological data from South Asian and other developing countries, the paper argues that the classical model is in need of re-evaluation. A number of new 'challenges' have complicated the classical interplay of demographic and epidemiological factors. These new challenges include continuing population growth in some countries, rapid unplanned urbanization, the HIV/AIDS pandemic in Sub-Saharan Africa (and its impending threat in South Asia), and globalization and increasing marginalisation of developing countries. While the traditional lack of investment in human development makes the developing countries more vulnerable to the vicissitudes of globalization, increasing economic weakness of their governments forces them to retreat further from the social sector. Pockets of poverty and deprivation, therefore, persist giving rise to three simultaneous burdens for South Asia and much of the rest of the developing world: continuing communicable diseases, increasing burden of chronic diseases, and increasing demand for both primary and tertiary levels of health care services. While these complex factors, on the one hand, underscore the need for health sector reform, on the other, they make the task much more difficult and challenging. The paper emphasizes the need to revisit the classical model of demographic and epidemiological transition. It is argued that the health sector in developing countries must be aware of and

  14. Public Health Achievements and Challenges: Symposium of the University of Mostar Faculty of Health Studies.

    Science.gov (United States)

    Ravlija, Jelena; Vasilj, Ivan; Babic, Dragan; Marijanovic, Inga

    2017-05-01

    Public health is an important area of health care that reflects the readiness of the state and society to provide the welfare of all citizens through the promotion of health and the preservation of a healthy environment - factors that directly affect the health of the population. The field of public health is very broad and its concept is changing over time, being defined in a narrower and wider sense. In short, public health is a science and practice that aims at ensuring the conditions in which people can preserve and improve their health and prevent health damage. The third millennium brings its specifics, needs and priorities according to challenges public health is faced by in the twenty-first century: the economic crisis, rising inequality, population aging, rising rates of chronic diseases, migration, urbanization, ecosystem change, climate change, etc. The role of public health is to protect, improve health, prevent diseases and injuries. Such a public health approach implies a multisectoral work focusing on "wider health determinants", and within this activity experts from various medical and non-medical profiles, whose field of public health is concerned, can be found. The development of inter-departmental co-operation skills contributes to a better understanding of health professionals and professionals of other profiles, and facilitates common, synergistic actions in addressing public health problems in the community. Symposium on Public Health Achievements and Challenges organized by the University of Mostar Faculty of Health Studies is just another indication of the obligation, the need and the desire for professional and scientific contribution to the fight for better health. Our faculty has so far organized other numerous symposia, and the aim of this symposium is to present public health achievements and challenges in our surrounding in order to protect, improve health, prevent diseases and injuries in a modern way.

  15. Key challenges of human resources for health in India

    Directory of Open Access Journals (Sweden)

    Priya Sinha

    2016-01-01

    Full Text Available Background and Objective Since independence the efforts have been to strengthen the health infrastructure, its accessibility and coverage. The human resources for health have been an important determinant for system but it has received significance recently. Even government expenditure on health has remained at not more than 1% of Gross Domestic Product which is very less as compared to world standard. Now the biggest challenge is the shortage of skilled human resource for health at all levels in the healthcare delivery system. The article aimed at understanding the current status of human resources for health and initiatives adopted to deal with existing shortage and to highlight factors leading to further shortage and to bring to notice the use of talent management strategy as a retention tool. Review Methodology The review used descriptive research design using secondary sources from journals-articles using key words. The study also used exclusion and inclusion criteria to select the articles. The study was done using extensive review of literature on health sector, health workforce, its availability and scarcity due to attrition/emigration in India. The critical review helped in setting objective for the study. Findings The review of articles provided insight into the current status of health workforce in India. The earlier studies emphasized that gap between demand and supply of human resource for health is mainly due to increasing population and burden of diseases. Studies have now identified other factors leading to further shortage as attrition/emigration of skilled health workforce. Most of the initiatives are mainly directed towards increasing supply of human resources for health to deal with the scarcity and less emphasis to control attrition. Few studies highlighted the use of talent management strategy to deal with the challenges of attrition and emigration that helps in retention and controlling further shortage. Recommendations

  16. eHealth and Global Health: Investments Opportunities and Challenges for Industry in Developing Countries

    Science.gov (United States)

    Iluyemi, Adesina; Briggs, Jim

    eHealth investments from developed countries to developing countries are expected to follow the emerging trend of eHealth for meeting global health problems. However, eHealth industry from developed countries will need to learn to make this impending venture a ‘win-win’ situation with profitable return on investments. This short paper highlights some of these challenges that must be overcome in order to achieve these objectives.

  17. [The other inequities in health care: A challenge for bioethics].

    Science.gov (United States)

    Bórquez Polloni, B

    2014-01-01

    Contrary to what one may think health and equity are not issues that have always gone hand in hand following the formal recognition of the former by the Universal Declaration of Human Rights (1948). It was not until the Alma Ata Declaration in 1978 when the close ties between both began to be seriously considered, and in 2000 this led to several international organizations formalizing their concern for the factors that determine whether a health system is fair or not. Since then, the term «equity in health» has taken on a special meaning when weighing up the strength or weaknesses of certain health systems. However, over the years, equity in health has gradually been identified almost exclusively with a financial issue that focuses on distributing health resources. As a result, one often forgets to provide the necessary care for those in other unfair situations, which, as regards access to and providing health care, leads to unfair situations that are not directly related to financial reasons and do not require investments, but consensus and the honest determination to make changes. This leads the Bioethics of the 21st century to face two challenges: to warn of these inequities and to promote initiatives that are able to make effective changes. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

  18. Group Health Coaching: Strengths, Challenges, and Next Steps

    Science.gov (United States)

    Wolever, Ruth Q.; Manning, Linda; Elam, Roy; Moore, Margaret; Frates, Elizabeth Pegg; Duskey, Heidi; Anderson, Chelsea; Curtis, Rebecca L.; Masemer, Susan; Lawson, Karen

    2013-01-01

    There is great need for cost effective approaches to increase patient engagement and improve health and well-being. Health and wellness coaching has recently demonstrated great promise, but the majority of studies to date have focused on individual coaching (ie, one coach with one client). Newer initiatives are bringing a group coaching model from corporate leadership development and educational settings into the healthcare arena. A group approach potentially increases cost-effective access to a larger number of clients and brings the possible additional benefit of group support. This article highlights some of the group coaching approaches currently being conducted across the United States. The group coaching interventions included in this overview are offered by a variety of academic and private sector institutions, use both telephonic and in-person coaching, and are facilitated by professionally trained health and wellness coaches as well as trained peer coaches. Strengths and challenges experienced in these efforts are summarized, as are recommendations to address those challenges. A working definition of “Group Health and Wellness Coaching” is proposed, and important next steps for research and for the training of group coaches are presented. PMID:24416678

  19. Group health coaching: strengths, challenges, and next steps.

    Science.gov (United States)

    Armstrong, Colin; Wolever, Ruth Q; Manning, Linda; Elam, Roy; Moore, Margaret; Frates, Elizabeth Pegg; Duskey, Heidi; Anderson, Chelsea; Curtis, Rebecca L; Masemer, Susan; Lawson, Karen

    2013-05-01

    There is great need for cost effective approaches to increase patient engagement and improve health and well-being. Health and wellness coaching has recently demonstrated great promise, but the majority of studies to date have focused on individual coaching (ie, one coach with one client). Newer initiatives are bringing a group coaching model from corporate leadership development and educational settings into the healthcare arena. A group approach potentially increases cost-effective access to a larger number of clients and brings the possible additional benefit of group support. This article highlights some of the group coaching approaches currently being conducted across the United States. The group coaching interventions included in this overview are offered by a variety of academic and private sector institutions, use both telephonic and in-person coaching, and are facilitated by professionally trained health and wellness coaches as well as trained peer coaches. Strengths and challenges experienced in these efforts are summarized, as are recommendations to address those challenges. A working definition of "Group Health and Wellness Coaching" is proposed, and important next steps for research and for the training of group coaches are presented.

  20. Bangladesh Midlife Women's Health Study (BMWHS): methods, challenges and experiences.

    Science.gov (United States)

    Islam, Rakibul M; Bell, Robin J; Hossain, Mohammad B; Davis, Susan R

    2015-01-01

    To understand the challenges and experiences encountered during data collection for Bangladesh Midlife Women's Health Study (BMWHS) that investigated the low uptake of cervical cancer (CCa) screening barriers, understanding of breast cancer (BCa) knowledge and practices, the prevalence of urinary and fecal incontinence and menopausal symptoms. A multistage cluster sampling technique was used to recruit women from the 32 districts of Bangladesh that had offered CCa screening. Female interviewers were trained to undertake structured face-to-face interviews that incorporated both non-validated and several validated questionnaires, such as Question for Urinary Incontinence Diagnosis, Pelvic Organ Prolapse Distress Inventory, Colorectal-Anal Distress Inventory and Menopause-Specific Quality of Life. We completed surveys of 1590 women, estimated age 30-59 years, between September 2013 and March 2014. We implemented several strategies to deal with low literacy and used the temporal relationship between marriage and childbirth, and the average age of onset of menarche, to estimate age. Cultural and religious sensitivities and personal security were managed by engaging community leaders, limiting activities to daylight hours, adopting local codes of dress, such as the wearing of head scarves. Our major challenges and experiences included difficulties in age determination, selection of and access to households, interview privacy, lack of basic and health literacy, transportation, political unrest and security of the interviewers. By anticipating challenges, we have been able to comprehensively survey a representative sample of Bangladeshi women. Disseminating information about the field challenges and experiences from the BMWHS should assist other researchers planning to conduct surveys about women's health issues in similar context. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  1. Responding to Public Health Emergencies on Tribal Lands: Jurisdictional Challenges and Practical Solutions.

    Science.gov (United States)

    Barnard, Justin B

    2015-01-01

    Response to public health emergencies on tribal lands poses a unique challenge for state and tribal public health officials. The complexity and intensely situation-specific nature of federal Indian jurisprudence leaves considerable question as to which government entity, state or tribal, has jurisdiction on tribal lands to undertake basic emergency measures such as closure of public spaces, quarantine, compulsory medical examination, and investigation. That jurisdictional uncertainty, coupled with cultural differences and an often troubled history of tribal-state relations, threatens to significantly impede response to infectious disease outbreaks or other public health emergencies on tribal lands. Given that tribal communities may be disproportionately impacted by public health emergencies, it is critical that tribal, state, and local governments engage with each other in coordinated planning for public health threats. This Article is offered as a catalyst for such planning efforts. The Article identifies some of the most pressing jurisdictional issues that may confront governments responding to a public health emergency on tribal lands, with the aim of highlighting the nature of the problem and the need for action. The Article goes on to examine the most promising means of addressing jurisdictional uncertainty: intergovernmental agreements. Already utilized in many areas of shared interest between tribe and state, intergovernmental agreements offer neighboring state, local, and tribal governments a vehicle for delineating roles and authorities in an emergency, and may lay the groundwork for sharing resources. The Article surveys various representative tribal public health intergovernmental agreements, and concludes with suggestions for tribes and state or local governments looking to craft their own agreements.

  2. Worksite health promotion research: challenges, current state and future directions

    Directory of Open Access Journals (Sweden)

    Georg F. Bauer

    2007-12-01

    Full Text Available

    Background: Worksite health promotion (WHP addresses diverse individual and work-related health determinants. Thus, multiple, non-standardized interventions as well as company outcomes other than health have to be considered in WHP research.

    Methods: The article builds primarily on published research reviews in WHP and related fields. It discusses key practical and research challenges of the workplace setting. The evidence available on the effectiveness of WHP is summarised and conclusions are drawn for future WHP practice and research.

    Results: WHP research on health-oriented, behavioural interventions shows that the level of evidence ranges from suggestive to acceptable for key prevention areas such as physical activity, nutrition, fitness, smoking, alcohol and stress. Such interventions are effective if key conditions are met. Future research is needed on long-term effects, on multi-component programs and on programs, which address environmental determinants of health behaviour as well. Research on work-related determinants of health shows the economic and public health relevance of WHP interventions. Reviews of work-oriented, organisational interventions show that they produce a range of individual and organisational outcomes. However, due to the complexity of the organisational context, the generalisability and predictability of such outcomes remain limited.

    Conclusions: WHP research shows success factors of WHP and provides evidence of its effectiveness. In future, the evidence base should be expanded by developing adaptive, company-driven intervention approaches which allow for continuous optimisation of companies from a health perspective. Also, approaches for active dissemination of such a systemic-salutogenic occupational health management approach should be developed to increase the public health impact of WHP.

  3. Health and Human Rights: New challenges for social responsiveness

    Directory of Open Access Journals (Sweden)

    Leslie London

    2009-11-01

    Full Text Available South Africa’s struggle against apartheid discrimination, including struggles in the health sector, laid the basis for a vibrant engagement of staff and students in human rights research, teaching and outreach in the Health Sciences Faculty at the University of Cape Town (UCT. This article provides a brief overview of this background context, then shows how this engagement has continued with new challenges emerging in the post-apartheid democratic period. Teaching at undergraduate and postgraduate levels has been complemented by a programme of ‘Training the Trainers’ in health and human rights. The programme targets teachers of health professionals at institutions in South and Southern Africa, resulting in national adoption of human rights competencies as an essential component of health professionals’ skills base. Research has also extended lessons learnt from the apartheid period into work with vulnerable groups, such as rural farm workers and the deaf, and seeks to build the capacity of marginal populations to change the conditions of their vulnerability in order to realize their rights. Partnerships with civil society organisations have been a strong thread, creating new knowledge and new ways of joint work towards realizing the right to health, including advocacy engagement in civil society movements and regional networks. Further, a focus on health professionals’ practice, in terms of dealing with potential dual loyalty conflicts and their role as gatekeepers in the health services on matters of patients’ rights, has shaped the research agenda. This article illustrates how knowledge production for the public good extends beyond notions of enhancing economic productivity for national development and provides a base for transdisciplinary and transinstitutional engagement. Additionally, non-traditional forms of knowledge networking and transfer have also been explored, including engagement with policy-makers and health managers

  4. Mobile health data collection at primary health care in Ethiopia: a feasible challenge.

    Science.gov (United States)

    Medhanyie, Araya Abrha; Moser, Albine; Spigt, Mark; Yebyo, Henock; Little, Alex; Dinant, GeertJan; Blanco, Roman

    2015-01-01

    Feasibility assessment of mobile health (mHealth) data collection at primary health care in Ethiopia. A total of 14 health workers were recruited from 12 primary health care facilities to use smartphones, installed with customized data collection application and electronic maternal health care forms for assessing pregnant women's health for 6 months. Qualitative approaches comprising in-depth interviews and field notes were used to document the users' perception and experience in using the application and forms. All health workers had never had previous exposure to smartphones and electronic forms, but they got used to them easily. Over 6 months, all health workers completed a total of 952 patient records using the forms on smartphones. Health workers' acceptability and demand for the application and forms were high. In introducing the application, nontechnical challenges were more difficult to solve than technical challenges. Introducing an mHealth application at primary health care for routine collection of health data relevant to maternal health at a small scale was feasible. Nonetheless, implementing a system of assigning unique and consistent patient identifier, standardization of health services, and improving mobile network coverage would be prerequisites for scaled-up usage of such an application. Copyright © 2015 Elsevier Inc. All rights reserved.

  5. Challenges to neurology residency education in today's health care environment.

    Science.gov (United States)

    Bega, Danny; Krainc, Dimitri

    2016-09-01

    Residency training has had to adapt to higher patient volumes, increased complexity of medical care, and the commercialized system of health care. These changes have led to a concerning culture shift in neurology. We review the relationship between the emerging health care delivery system and residency training, highlighting issues related to duty hours and work-life balance, the changing technological landscape, high patient volumes, and complex service obligations. We propose that the current challenges in health care delivery offer the opportunity to improve neurology residency through faculty development programs, bringing teaching back to the bedside, increasing resident autonomy, utilizing near-peer teaching, and rewarding educators who facilitate an environment of inquiry and scholarship, with the ultimate goal of better alignment between education and patient care. Ann Neurol 2016;80:315-320. © 2016 American Neurological Association.

  6. Mobile Network Data for Public-Health: Opportunities and Challenges

    Directory of Open Access Journals (Sweden)

    Nuria eOliver

    2015-08-01

    Full Text Available The ubiquity of mobile phones worldwide is generating an unprecedented amount of human behavioral data both at an individual and aggregated levels. The study of this data as a rich source of information about human behavior emerged almost a decade ago. Since then it has grown into a fertile area of research named computational social sciences with a wide variety of applications in different fields such as social networks, urban and transport planning, economic development, emergency relief and, recently, public health. In this paper we briefly describe the state of the art on using mobile phone data for public health, and present the opportunities and challenges that this kind of data presents for public health.

  7. Mobile Network Data for Public Health: Opportunities and Challenges

    Science.gov (United States)

    Oliver, Nuria; Matic, Aleksandar; Frias-Martinez, Enrique

    2015-01-01

    The ubiquity of mobile phones worldwide is generating an unprecedented amount of human behavioral data both at an individual and aggregated levels. The study of this data as a rich source of information about human behavior emerged almost a decade ago. Since then, it has grown into a fertile area of research named computational social sciences with a wide variety of applications in different fields such as social networks, urban and transport planning, economic development, emergency relief, and, recently, public health. In this paper, we briefly describe the state of the art on using mobile phone data for public health, and present the opportunities and challenges that this kind of data presents for public health. PMID:26301211

  8. The Rise of Post-truth Populism in Pluralist Liberal Democracies: Challenges for Health Policy.

    Science.gov (United States)

    Speed, Ewen; Mannion, Russell

    2017-02-12

    Recent years have witnessed the rise of populism and populist leaders, movements and policies in many pluralist liberal democracies, with Brexit and the election of Trump the two most recent high profile examples of this backlash against established political elites and the institutions that support them. This new populism is underpinned by a post-truth politics which is using social media as a mouthpiece for 'fake news' and 'alternative facts' with the intention of inciting fear and hatred of 'the other' and thereby helping to justify discriminatory health policies for marginalised groups. In this article, we explore what is meant by populism and highlight some of the challenges for health and health policy posed by the new wave of post-truth populism. © 2017 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  9. Health literacy, health communication challenges, and cancer screening among rural Native Hawaiian and Filipino Women

    Science.gov (United States)

    Sentell, Tetine; Cruz, May Rose Dela; Heo, Hyun Hee; Braun, Kathryn

    2013-01-01

    Native Hawaiians and Filipinos are disproportionately impacted by cancer, and are less likely to participate in cancer screening than whites. Limited information exists about health information pathways and health communication challenges as they relate to cancer screening in these groups. Six focus groups (n=77) of Native Hawaiian and Filipino women age 40+ years were conducted to investigate these research gaps. Participants noted many health information challenges. Challenges were both practical and interpersonal and included both written and oral health communication. Practical challenges included “big” words, complexity of terms, and lack of plain English. Interpersonal issues included doctors rushing, doctors not assessing comprehension, and doctors treating respondents as patients not people. Women noted that they would often not ask questions even when they knew they did not understand because they did not want the provider to think negatively of them. Overarching themes to improve cancer communication gaps included: (1) the importance of family and community in health information dissemination; (2) the key role women play in interpreting health information for others; (3) the importance of personal experience and relationships to the salience of health information; and (4) the desire for local cultural relevance in health communication. Findings are discussed in light of the 2010 National Action Plan for Health Literacy. PMID:23536194

  10. Public health education in Saudi Arabia: Needs and challenges.

    Science.gov (United States)

    Mahmoud, Mahmoud Abdulrahman; Al-Zalabani, Abdulmohsen H; Bin Abdulrahman, Khalid A

    2016-01-01

    In the last decade, public health (PH) has come to the frontlines in Saudi Arabia. The recent outbreak of a novel corona virus (MERS-CoV) highlighted the importance of PH services and the need for a competent PH workforce. The urgency and panic induced by infectious disease outbreaks explain the heightened interest. Decision makers' interest in public health was observed through a series of decisions, including creating a position for Deputy Minister for Public Health, changing the name of "Directorate of Primary Healthcare Centers" to "Directorate of Public Health" in all health regions and initiating a special scholarship program to prepare health administration professionals in collaboration with US-based universities. A distinguished group of PH leaders in Saudi Arabia was gathered in a structured workshop that was organized by the Al Imam Mohammad Ibn Saud Islamic University, college of medicine to discuss the current status and future needs of PH education in the Kingdom of Saudi Arabia. The workshop highlighted the need for PH education development and outlined the challenges ahead. The main challenges laid out by participants in the workshop were the development of an appropriate PH curriculum, appropriate training spots for practical placement, the development of research priorities for PH to satisfy the needs of PH programs and agencies, attracting the most qualified academic staff, the enrolment of highly motivated students and finally, the establishment of a quality assurance program to ensure the quality of PH education programs. The development of a framework for graduate competencies in PH was perceived to be a top priority. Moreover, setting a PH workforce surveillance system, building partnership between PH academic institutions and PH services providers, implementing national campaigns to explain what PH is about and illuminating the role of PH workers were also of utmost importance.

  11. Challenges of mainstreaming: Ayurvedic practice in Delhi Government health institutions

    Directory of Open Access Journals (Sweden)

    Sharmistha Mallick

    2016-03-01

    Full Text Available This paper is an attempt to understand the project of mainstreaming in India's health care system that has started with an aim to bring marginalized and alternative systems of medicine in mainstream. The project has gained much attention with the establishment of Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy (AYUSH in the year 2003, which is now a ministry. It has ushered some positive results in terms of growth of AYUSH hospitals and dispensaries. However, it has also raised challenges around the theory and practice of mainstreaming. With an emphasis on Ayurvedic practice in Delhi Government Health Institutions, this article has tried to analyze some of those challenges and intricacies. Drawing on Weber's theory of bureaucratization and Giddens's theory of structuration, the paper asks what happens to an alternative medical system when it becomes part of the bureaucratic set-up. Along with the questions of structures, it also tries to combine the question of the agency of both patients and doctors considered to be the cornerstone of the Ayurvedic medical system. Although our study recognizes some of the successes of the mainstreaming project, it also underlines the challenges and problems it faces by analyzing three points of view (institutions, doctors, and patients.

  12. Challenges of mainstreaming: Ayurvedic practice in Delhi Government health institutions.

    Science.gov (United States)

    Mallick, Sharmistha

    2016-03-01

    This paper is an attempt to understand the project of mainstreaming in India's health care system that has started with an aim to bring marginalized and alternative systems of medicine in mainstream. The project has gained much attention with the establishment of Department of Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy (AYUSH) in the year 2003, which is now a ministry. It has ushered some positive results in terms of growth of AYUSH hospitals and dispensaries. However, it has also raised challenges around the theory and practice of mainstreaming. With an emphasis on Ayurvedic practice in Delhi Government Health Institutions, this article has tried to analyze some of those challenges and intricacies. Drawing on Weber's theory of bureaucratization and Giddens's theory of structuration, the paper asks what happens to an alternative medical system when it becomes part of the bureaucratic set-up. Along with the questions of structures, it also tries to combine the question of the agency of both patients and doctors considered to be the cornerstone of the Ayurvedic medical system. Although our study recognizes some of the successes of the mainstreaming project, it also underlines the challenges and problems it faces by analyzing three points of view (institutions, doctors, and patients). Copyright © 2016 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Published by Elsevier B.V. All rights reserved.

  13. Journalists and public health professionals: challenges of a symbiotic relationship.

    Science.gov (United States)

    Lubens, Pauline

    2015-02-01

    Journalists and health professionals share a symbiotic relationship during a disease outbreak as both professions play an important role in informing the public's perceptions and the decisions of policy makers. Although critics in the United States have focused on US reporters and media outlets whose coverage has been sensationalist and alarmist, the discussion in this article is based on the ideal--gold standard--for US journalists. Journalists perform three primary functions during times of health crises: disseminating accurate information to the public, medical professionals, and policy makers; acting as the go-between for the public and decision makers and health and science experts; and monitoring the performance of institutions responsible for the public health response. A journalist's goal is to responsibly inform the public in order to optimize the public health goals of prevention while minimizing panic. The struggle to strike a balance between humanizing a story and protecting the dignity of patients while also capturing the severity of an epidemic is harder in the era of the 24-7 news cycle. Journalists grapple with dueling pressures: confirming that their information is correct while meeting the demand for rapid updates. Just as health care professionals triage patients, journalists triage information. The challenge going forward will be how to get ahead of the story from the onset, racing against the pace of digital dissemination of misinformation by continuing to refine the media-science relationship.

  14. Women and health consequences of natural disasters: Challenge or opportunity?

    Science.gov (United States)

    Sohrabizadeh, Sanaz; Tourani PhD, Sogand; Khankeh, Hamid Reza

    2016-01-01

    Disasters do not affect people equally; the impact of disasters on the lives of women is different from other groups of a community. Women's fundamental rights to health and safety are violated after disasters. The authors of this study aimed to explore various factors of women's health with reference to previous natural disasters in Iran. A qualitative approach using in-depth unstructured interviews and field observations was employed to explore women's health factors in the affected regions. A total of 22 participants affected by disasters, as well as key informants, were interviewed applying the purposeful sampling method. Data were collected in 2014 in three provinces, including East Azerbaijan, Bushehr, and Mazandaran. A content analysis using the Graneheim approach was performed for analyzing the transcribed interviews. Two themes and four categories were extracted from the data. The themes that emerged included psycho-physical effects and women's health status. Physical and psycho-emotional effects and reproductive and environmental health effects were the four emergent categories. The findings implied that managing women's health challenges may result in reducing the distressing effects of disaster. These findings support identification and application of the mechanisms by which women's well-being in physical, mental, reproductive, and environmental aspects can be protected after disasters.

  15. Implementing electronic health care predictive analytics: considerations and challenges.

    Science.gov (United States)

    Amarasingham, Ruben; Patzer, Rachel E; Huesch, Marco; Nguyen, Nam Q; Xie, Bin

    2014-07-01

    The use of predictive modeling for real-time clinical decision making is increasingly recognized as a way to achieve the Triple Aim of improving outcomes, enhancing patients' experiences, and reducing health care costs. The development and validation of predictive models for clinical practice is only the initial step in the journey toward mainstream implementation of real-time point-of-care predictions. Integrating electronic health care predictive analytics (e-HPA) into the clinical work flow, testing e-HPA in a patient population, and subsequently disseminating e-HPA across US health care systems on a broad scale require thoughtful planning. Input is needed from policy makers, health care executives, researchers, and practitioners as the field evolves. This article describes some of the considerations and challenges of implementing e-HPA, including the need to ensure patients' privacy, establish a health system monitoring team to oversee implementation, incorporate predictive analytics into medical education, and make sure that electronic systems do not replace or crowd out decision making by physicians and patients. Project HOPE—The People-to-People Health Foundation, Inc.

  16. Measuring health: a practical challenge with a philosophical solution?

    Science.gov (United States)

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

    2011-03-01

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

  17. Improving local health through community health workers in Cambodia: challenges and solutions.

    Science.gov (United States)

    Ozano, Kim; Simkhada, Padam; Thann, Khem; Khatri, Rose

    2018-01-06

    Volunteer community health workers (CHWs) are an important link between the public health system and the community. The 'Community Participation Policy for Health' in Cambodia identifies CHWs as key to local health promotion and as a critical link between district health centres and the community. However, research on the challenges CHWs face and identifying what is required to optimise their performance is limited in the Cambodian context. This research explores the views of CHWs in rural Cambodia, on the challenges they face when implementing health initiatives. Qualitative methodology was used to capture the experiences of CHWs in Kratie and Mondulkiri provinces. Two participatory focus groups with CHWs in Mondulkiri and ten semi-structured interviews in Kratie were conducted. Results from both studies were used to identify common themes. Participants were CHWs, male and female, from rural Khmer and Muslim communities and linked with seven different district health centres. Findings identify that CHWs regularly deliver health promotion to communities. However, systemic, personal and community engagement challenges hinder their ability to function effectively. These include minimal leadership and support from local government, irregular training which focuses on verticalised health programmes, inadequate resources, a lack of professional identity and challenges to achieving behaviour change of community members. In addition, the CHW programme is delivered in a fragmented way that is largely influenced by external aid objectives. When consulted, however, CHWs demonstrate their ability to develop realistic practical solutions to challenges and barriers. The fragmented delivery of the CHW programme in Cambodia means that government ownership is minimal. This, coupled with the lack of defined core training programme or adequate resources, prevents CHWs from reaching their potential. CHWs have positive and realistic ideas on how to improve their role and, subsequently

  18. Maternal and child health in Brazil: progress and challenges.

    Science.gov (United States)

    Victora, Cesar G; Aquino, Estela M L; do Carmo Leal, Maria; Monteiro, Carlos Augusto; Barros, Fernando C; Szwarcwald, Celia L

    2011-05-28

    (coverage of which expanded to reach the poorest areas of the country through the Family Health Program in the mid-1990s); and implementation of many national and state-wide programmes to improve child health and child nutrition and, to a lesser extent, to promote women's health. Nevertheless, substantial challenges remain, including overmedicalisation of childbirth (nearly 50% of babies are delivered by caesarean section), maternal deaths caused by illegal abortions, and a high frequency of preterm deliveries. Copyright © 2011 Elsevier Ltd. All rights reserved.

  19. Head pose estimation algorithm based on deep learning

    Science.gov (United States)

    Cao, Yuanming; Liu, Yijun

    2017-05-01

    Head pose estimation has been widely used in the field of artificial intelligence, pattern recognition and intelligent human-computer interaction and so on. Good head pose estimation algorithm should deal with light, noise, identity, shelter and other factors robustly, but so far how to improve the accuracy and robustness of attitude estimation remains a major challenge in the field of computer vision. A method based on deep learning for pose estimation is presented. Deep learning with a strong learning ability, it can extract high-level image features of the input image by through a series of non-linear operation, then classifying the input image using the extracted feature. Such characteristics have greater differences in pose, while they are robust of light, identity, occlusion and other factors. The proposed head pose estimation is evaluated on the CAS-PEAL data set. Experimental results show that this method is effective to improve the accuracy of pose estimation.

  20. Challenges faced by public health nursing leaders in hyperturbulent times.

    Science.gov (United States)

    Reyes, David J; Bekemeier, Betty; Issel, L Michele

    2014-01-01

    This study discusses the challenges and characteristics of effective public health nursing leaders in local health departments and barriers to effective leadership during the hyperturbulent conditions of 2008-2010. Participants were drawn from a purposive sample of seven directors of nursing (DON) in six county LHDs in two states for this qualitative study using inductive methods. Semistructured telephone interviews were conducted, using open-ended questions. Data analysis consisted of coding, pattern identification, and theme development, assisted by the use of ATLAS.ti™. Credibility was achieved through intercoder agreement and resonance of the findings with participants. Two underlying challenges emerged: leadership dissonance and leading through ambiguity. Three key effective leadership attributes identified were as follows: collaborative change management, life-long learning, and being visionary. DONs identified extrinsic and intrinsic barriers to leadership effectiveness and leading change in public health systems and PHN practice. Results suggest ways to support PHN leaders in order to overcome barriers to effective leadership such as defined leadership competencies, continuing education, and mentorship opportunities. © 2013 Wiley Periodicals, Inc.

  1. Male reproductive health challenges: appraisal of wives coping strategies.

    Science.gov (United States)

    Amoo, Emmanuel O; Omideyi, Adekunbi K; Fadayomi, Theophilus O; Ajayi, Mofoluwake P; Oni, Gbolahan A; Idowu, Adenike E

    2017-07-28

    Systematic studies on the association between men's sexual dysfunction (low sexual desire, ejaculation disorders, erectile dysfunctions, genital ulcers, testicular disorders, prostate cancer or sexually transmitted infections) and marital conflict are emerging. However, the coping strategies adopted by wives in such circumstances are not commonly reported in the literature. Male sexual functioning is vital to the marital relationship, lack of it can result in intolerable cohabitation or relationship breakdown, and could also cause infertility, infidelity, and arouse stigma in Nigeria. The understanding of coping strategies by female partners could guide in the counselling and treatment of men's sexual health problems. Effective coping has the potential to lessen or prevent negative outcomes, and thereby could reduce marital conflict. This study examined the coping strategies adopted by women whose husbands have reproductive health challenges in two of the five states with the highest proportion of divorce/separation in Nigeria. Four focus group discussions were conducted in two local government areas. The women were recruited from a quantitative couple-study for men with sexual health problems. Focus group responses were transcribed and analysed using systematic-content-analysis with thematic organisation of the summaries and systematic typologies of participants' responses. The results revealed the coping strategies employed by women in this environment: seeking guidance from their religious leaders and family doctors, physical-sexual-therapy, abstinence and concubinage. The participants indicated that they encountered difficulties in discussing their husbands' sexual health problems with a third party. The study concludes that husband's sexual ability is crucial to the sustenance of the marital relationship. Religious leaders and family doctors often serve as mediators to husband-wife conflict management. Counselling is recommended in cases of sexual health

  2. Health seeking behaviour and challenges in utilising health facilities in Wakiso district, Uganda.

    Science.gov (United States)

    Musoke, David; Boynton, Petra; Butler, Ceri; Musoke, Miph Boses

    2014-12-01

    The health seeking behaviour of a community determines how they use health services. Utilisation of health facilities can be influenced by the cost of services, distance to health facilities, cultural beliefs, level of education and health facility inadequacies such as stock-out of drugs. To assess the health seeking practices and challenges in utilising health facilities in a rural community in Wakiso district, Uganda. The study was a cross sectional survey that used a structured questionnaire to collect quantitative data among 234 participants. The sample size was obtained using the formula by Leslie Kish. While 89% of the participants were aware that mobile clinics existed in their community, only 28% had received such services in the past month. The majority of participants (84%) did not know whether community health workers existed in their community. The participants' health seeking behaviour the last time they were sick was associated with age (p = 0.028) and occupation (p = 0.009). The most significant challenges in utilising health services were regular stock-out of drugs, high cost of services and long distance to health facilities. There is potential to increase access to health care in rural areas by increasing the frequency of mobile clinic services and strengthening the community health worker strategy.

  3. Parasites and other infectious agents in marine finfish and shellfish species posing a hazard to human health (ToR b)

    DEFF Research Database (Denmark)

    Alfjorden, A.; Podolska, M.; Karaseva, T.

    2015-01-01

    Several parasites and other infectious agents frequently reported by the WGPDMO in the annual update of disease trends (ICES WGPDMO reports 1999–2015) have the potential to be harmful to human health if ingested in unprocessed or inadequate-ly/partly processed seafood. These include, but are not ...

  4. Predictive analytics in mental health: applications, guidelines, challenges and perspectives.

    Science.gov (United States)

    Hahn, T; Nierenberg, A A; Whitfield-Gabrieli, S

    2017-01-01

    The emerging field of 'predictive analytics in mental health' has recently generated tremendous interest with the bold promise to revolutionize clinical practice in psychiatry paralleling similar developments in personalized and precision medicine. Here, we provide an overview of the key questions and challenges in the field, aiming to (1) propose general guidelines for predictive analytics projects in psychiatry, (2) provide a conceptual introduction to core aspects of predictive modeling technology, and (3) foster a broad and informed discussion involving all stakeholders including researchers, clinicians, patients, funding bodies and policymakers.

  5. Which US States Pose the Greatest Threats to Military Readiness and Public Health? Public Health Policy Implications for a Cross-sectional Investigation of Cardiorespiratory Fitness, Body Mass Index, and Injuries Among US Army Recruits.

    Science.gov (United States)

    Bornstein, Daniel B; Grieve, George L; Clennin, Morgan N; McLain, Alexander C; Whitsel, Laurie P; Beets, Michael W; Hauret, Keith G; Jones, Bruce H; Sarzynski, Mark A

    2018-01-09

    Many states in the southern region of the United States are recognized for higher rates of obesity, physical inactivity, and chronic disease. These states are therefore recognized for their disproportionate public health burden. The purpose of this study was to investigate state-level distributions of cardiorespiratory fitness, body mass index (BMI), and injuries among US Army recruits in order to determine whether or not certain states may also pose disproportionate threats to military readiness and national security. Sex-specific state-level values for injuries and fitness among 165 584 Army recruits were determined. Next, the relationship between median cardiorespiratory fitness and injury incidence at the state level was examined using Spearman correlations. Finally, multivariable Poisson regression models stratified by sex examined state-level associations between fitness and injury incidence, while controlling for BMI, and other covariates. Cardiorespiratory fitness and training-related injury incidence. A cluster of 10 states from the south and southeastern regions (Alabama, Arkansas, Florida, Georgia, Louisiana, Mississippi, North Carolina, South Carolina, Tennessee, and Texas) produced male or female recruits who were significantly less fit and/or more likely to become injured than recruits from other US states. Compared with the "most fit states," the incidence of injuries increased by 22% (95% CI, 17-28; P < .001) and 28% (95% CI, 19-36; P < .001) in male and female recruits from the "least fit states," respectively. The impact of policies, systems, and environments on physical activity behavior, and subsequently fitness and health, has been clearly established. Advocacy efforts aimed at active living policies, systems, and environmental changes to improve population health often fail. However, advocating for active living policies to improve national security may prove more promising, particularly with legislators. Results from this study demonstrate

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

    Science.gov (United States)

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

    2016-01-01

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

  7. Health impact assessment in China: Emergence, progress and challenges

    Energy Technology Data Exchange (ETDEWEB)

    Huang Zheng, E-mail: huangzhg@mails.tjmu.edu.cn

    2012-01-15

    The values, concepts and approaches of health impact assessment (HIA) were outlined in the Gothenburg consensus paper and some industrialized countries have implemented HIA for many years. HIA has played an important role in environmental protection in China, however, the emergence, progress and challenges of HIA in China have not been well described. In this paper, the evolution of HIA in China was analyzed and the challenges of HIA were presented based on the author's experiences. HIA contributed to decision-making for large capital construction projects, such as the Three Gorges Dam project, in its emergence stage. Increasing attention has been given to HIA in recent years due to supportive policies underpinning development of the draft HIA guidelines in 2008. However enormous challenges lie ahead in ensuring the institutionalization of HIA into project, program and policy decision-making process due to limited scope, immature tools and insufficient professionals in HIA practice. HIA should broaden its horizons by encompassing physical, chemical, biological and socio-economic aspects and constant attempts should be made to integrate HIA into the decision-making process, not only for projects and programs but also for policies as well.

  8. Hand hygiene management among nurses: collective health challenges

    Directory of Open Access Journals (Sweden)

    João Manuel Graveto

    Full Text Available ABSTRACT Objective: To describe the determining factors in hand hygiene management among nurses and identify associated collective health challenges. Method: Cross-sectional descriptive study. Data were collected using a questionnaire that was applied in four internal medicine units of a hospital of reference in Portugal. Results: The sample was composed of 50 nurses aged 26 to 55 years (mean age of 34.88 years; 80% were women, 58% had a Bachelor’s degree, and had 5-30 years of nursing practice (X̄ =11.94;±5.92. The vast majority of nurses (90% reported complying with the existing recommendations on hand hygiene in pre-established moments. However, none of the nurses were able to identify all the moments for hand hygiene using water and soap or alcohol-based handrub. Conclusion: This study shows that continuous training, adequate materials/structures in the units, and redesigned administration/supervision practices are determining factors to achieve higher levels of adherence to hand hygiene among nurses, as well as increased quality and safety in care delivery, which is a current collective health challenge.

  9. The contemporary refugee crisis: an overview of mental health challenges.

    Science.gov (United States)

    Silove, Derrick; Ventevogel, Peter; Rees, Susan

    2017-06-01

    There has been an unprecedented upsurge in the number of refugees worldwide, the majority being located in low-income countries with limited resources in mental health care. This paper considers contemporary issues in the refugee mental health field, including developments in research, conceptual models, social and psychological interventions, and policy. Prevalence data yielded by cross-sectional epidemiological studies do not allow a clear distinction to be made between situational forms of distress and frank mental disorder, a shortcoming that may be addressed by longitudinal studies. An evolving ecological model of research focuses on the dynamic inter-relationship of past traumatic experiences, ongoing daily stressors and the background disruptions of core psychosocial systems, the scope extending beyond the individual to the conjugal couple and the family. Although brief, structured psychotherapies administered by lay counsellors have been shown to be effective in the short term for a range of traumatic stress responses, questions remain whether these interventions can be sustained in low-resource settings and whether they meet the needs of complex cases. In the ideal circumstance, a comprehensive array of programs should be provided, including social and psychotherapeutic interventions, generic mental health services, rehabilitation, and special programs for vulnerable groups. Sustainability of services, ensuring best practice, evidence-based approaches, and promoting equity of access must remain the goals of future developments, a daunting challenge given that most refugees reside in settings where skills and resources in mental health care are in shortest supply. © 2017 World Psychiatric Association.

  10. Mentoring health researchers globally: Diverse experiences, programmes, challenges and responses.

    Science.gov (United States)

    Cole, Donald C; Johnson, Nancy; Mejia, Raul; McCullough, Hazel; Turcotte-Tremblay, Anne-Marie; Barnoya, Joaquin; Falabella Luco, María Soledad

    2016-10-01

    Mentoring experiences and programmes are becoming increasingly recognised as important by those engaged in capacity strengthening in global health research. Using a primarily qualitative study design, we studied three experiences of mentorship and eight mentorship programmes for early career global health researchers based in high-income and low- and middle-income countries. For the latter, we drew upon programme materials, existing unpublished data and more formal mixed-method evaluations, supplemented by individual email questionnaire responses. Research team members wrote stories, and the team assembled and analysed them for key themes. Across the diverse experiences and programmes, key emergent themes included: great mentors inspire others in an inter-generational cascade, mentorship is transformative in personal and professional development and involves reciprocity, and finding the right balance in mentoring relationships and programmes includes responding creatively to failure. Among the challenges encountered were: struggling for more level playing fields for new health researchers globally, changing mindsets in institutions that do not have a culture of mentorship and building collaboration not competition. Mentoring networks spanning institutions and countries using multiple virtual and face-to-face methods are a potential avenue for fostering organisational cultures supporting quality mentorship in global health research.

  11. [Women, health, and labor in Brazil: challenges for new action].

    Science.gov (United States)

    Aquino, E M; Menezes, G M; Marinho, L F

    1995-01-01

    Despite the remarkable rise in women's participation in the labor market in Brazil, its consequences on health are still virtually unknown. This study aims to identify theoretical and methodological problems in the relationship between labor and women's health from a gender perspective. Characteristics of women's occupational placement are described and analyzed as resulting from their role in social reproduction. The study examines the development of several conciliatory strategies between paid work and housework which are discussed as potential determinants of health problems and support the need for a critical reappraisal of theoretical and methodological strategies to reach a better understanding of the complexity and specificities of women's living and working conditions. The author also stresses the role of women's recent participation in the trade union movements in defense of health, body rights, and women's issues in the workplace, as well as the need for a new framework embodied in the women's social movement. The study thus points to the challenge to produce knowledge on this subject in order to unveil the uniqueness of the national scenario marked by unemployment, informal jobs, low salaries, weak trade unions and other civil organizations, and traditional domestic and marriage relationships.

  12. Energy and Fructose From Beverages Sweetened With Sugar or High-Fructose Corn Syrup Pose a Health Risk for Some People 1 2

    OpenAIRE

    Bray, George A.

    2013-01-01

    Sugar intake in the United States has increased by >40 fold since the American Revolution. The health concerns that have been raised about the amounts of sugar that are in the current diet, primarily as beverages, are the subject of this review. Just less than 50% of the added sugars (sugar and high-fructose corn syrup) are found in soft drinks and fruit drinks. The intake of soft drinks has increased 5-fold between 1950 and 2000. Most meta-analyses have shown that the risk of obesity, diabet...

  13. Public health hazards in Poland posed by foodstuffs contaminated with [i]E.Coli[/i] O104:H4 bacterium from the recent European out break

    Directory of Open Access Journals (Sweden)

    Przemysław Biliński

    2012-03-01

    Full Text Available Shiga toxin producing [i]Escherichia coli[/i] (STEC are the most virulent diarrhoeagenic [i]E. coli [/i]known to date. They can spread with alarming ease via the food chain, as recently demonstrated by the large outbreak of STEC O104:H4 borne by sprouted seeds in 2011, clustered in northern Germany, and subsequently affecting other countries. Indeed, a significant number of infections to verocytotoxin producing [i]Escherichia coli[/i] O104:H4 have been reported from the WHO European Region resulting in many cases of bloody diarrhoea and haemolytic uraemic syndrome in Germany, 15 other European countries and North America. Eventually, the European Food Standards Agency, (EFSA, identified the likely source to a single consignment of fenugreek seeds from an Egyptian exporter as being linked to the two outbreaks in Germany and France. The situation was closely monitored by the Chief Sanitary Inspectorate public health authority in Poland where actions undertaken ensured that the public was well informed about the dangers of STEC contamination of food, how to avoid infection, and what to do if infected. Tracing the fenugreek distributors also enabled the identification of suspected batches and their isolation. As a result, there were very few reported cases of STEC infection in Poland. Effective control over such outbreaks is therefore a vital public health task. This should include early detection and rapid identification of the contagion mode, followed by removing the foodstuff(s from the market, providing consumer advice, and preventing secondary spreading. As a mitigation measure, screening/monitoring those involved in food handling is also warranted to exclude carriers who can be asymptomatic.

  14. Energy and fructose from beverages sweetened with sugar or high-fructose corn syrup pose a health risk for some people.

    Science.gov (United States)

    Bray, George A

    2013-03-01

    Sugar intake in the United States has increased by >40 fold since the American Revolution. The health concerns that have been raised about the amounts of sugar that are in the current diet, primarily as beverages, are the subject of this review. Just less than 50% of the added sugars (sugar and high-fructose corn syrup) are found in soft drinks and fruit drinks. The intake of soft drinks has increased 5-fold between 1950 and 2000. Most meta-analyses have shown that the risk of obesity, diabetes, cardiovascular disease, and metabolic syndrome are related to consumption of beverages sweetened with sugar or high-fructose corn syrup. Calorically sweetened beverage intake has also been related to the risk of nonalcoholic fatty liver disease, and, in men, gout. Calorically sweetened beverages contribute to obesity through their caloric load, and the intake of beverages does not produce a corresponding reduction in the intake of other food, suggesting that beverage calories are "add-on" calories. The increase in plasma triglyceride concentrations by sugar-sweetened beverages can be attributed to fructose rather than glucose in sugar. Several randomized trials of sugar-containing soft drinks versus low-calorie or calorie-free beverages show that either sugar, 50% of which is fructose, or fructose alone increases triglycerides, body weight, visceral adipose tissue, muscle fat, and liver fat. Fructose is metabolized primarily in the liver. When it is taken up by the liver, ATP decreases rapidly as the phosphate is transferred to fructose in a form that makes it easy to convert to lipid precursors. Fructose intake enhances lipogenesis and the production of uric acid. By worsening blood lipids, contributing to obesity, diabetes, fatty liver, and gout, fructose in the amounts currently consumed is hazardous to the health of some people.

  15. Health system challenges to integration of mental health delivery in primary care in Kenya- perspectives of primary care health workers

    OpenAIRE

    Jenkins, Rachel; Othieno, Caleb; Okeyo, Stephen; Aruwa, Julyan; Kingora, James; Jenkins, Ben

    2013-01-01

    Background Health system weaknesses in Africa are broadly well known, constraining progress on reducing the burden of both communicable and non-communicable disease (Afr Health Monitor, Special issue, 2011, 14-24), and the key challenges in leadership, governance, health workforce, medical products, vaccines and technologies, information, finance and service delivery have been well described (Int Arch Med, 2008, 1:27). This paper uses focus group methodology to explore health worker perspecti...

  16. In-the-wild facial expression recognition in extreme poses

    Science.gov (United States)

    Yang, Fei; Zhang, Qian; Zheng, Chi; Qiu, Guoping

    2018-04-01

    In the computer research area, facial expression recognition is a hot research problem. Recent years, the research has moved from the lab environment to in-the-wild circumstances. It is challenging, especially under extreme poses. But current expression detection systems are trying to avoid the pose effects and gain the general applicable ability. In this work, we solve the problem in the opposite approach. We consider the head poses and detect the expressions within special head poses. Our work includes two parts: detect the head pose and group it into one pre-defined head pose class; do facial expression recognize within each pose class. Our experiments show that the recognition results with pose class grouping are much better than that of direct recognition without considering poses. We combine the hand-crafted features, SIFT, LBP and geometric feature, with deep learning feature as the representation of the expressions. The handcrafted features are added into the deep learning framework along with the high level deep learning features. As a comparison, we implement SVM and random forest to as the prediction models. To train and test our methodology, we labeled the face dataset with 6 basic expressions.

  17. U.S. health care: a conundrum and a challenge.

    Science.gov (United States)

    Ciric, Ivan S

    2013-12-01

    This report was conceived as a contribution to the national debate regarding U.S. health care (HC) and as a means of explaining the challenges facing U.S. HC to the international readers of WORLD NEUROSURGERY. The basic economic concepts pertinent to health care, including fundamentals of economic theories, gross domestic product (GDP), U.S. revenues and expenditures and the U.S. federal deficit and national debt, are discussed at the outset of this study. This is followed by a review of the U.S. health insurance paradigms and a detailed analysis of the escalating cost of U.S. health care. Finally, the efforts designed to reverse the paradigm of escalating health care costs will be discussed. This study reveals that should the U.S. HC cost continue to escalate at the same rate, HC would consume the entire gross domestic product by 2070. The root causes for this trend are overutilization of HC, inappropriate allocation of HC costs at the end of life, defensive medicine, high-end technology and prescription drugs, failure of competitive market forces, and administrative costs, inefficiency, and waste. The proposed means of reversing this paradigm, including the Patient Protection and Affordable Care Act, are discussed in light of their economic and social impact. The reversal of the current paradigm of escalating cost of U.S. HC will require extraordinary leadership across the entire spectrum of HC delivery. It is concluded that neither the Affordable Care Act nor the Path to Prosperity will succeed unless the escalating cost of U.S. HC is reversed. It is hoped that this report contributes to that end. Copyright © 2013 Elsevier Inc. All rights reserved.

  18. UK community health visiting: challenges faced during lean implementation

    Directory of Open Access Journals (Sweden)

    Carr SM

    2012-01-01

    Full Text Available Susan M Carr1,2, Pauline Pearson1, Lesley Young-Murphy3, Barbara Cleghorn41Centre for Community Health & Education Studies Research & Enterprise, Northumbria University, Newcastle upon Tyne, UK; 2School of Health, University of New England, Armidale, New South Wales, Australia; 3NHS North of Tyne, Newcastle upon Tyne, UK, 4Newcastle PCT, Newcastle upon Tyne, UKAbstract: This paper presents an overview of the challenges and potential of lean implementation for the health visiting service in England and examines the rhetoric and the reality of the situation. It is coauthored by academic researchers and senior service providers so as to embrace the multidimensional issues impacting on this subject. If lean thinking is to be implemented in relation to health visiting, it is important to understand how it is likely to be viewed by practitioners and line managers in settings where it is used. In order to contextualize the discussion, an introduction to the roles, systems, and structures of health visiting are provided. The literature on what lean implementation is, what it means, and in particular the application and potential of the approach to primary care and public health services is reviewed. The process and findings from a focus group convened within a large primary care organization in the National Health Service during their lean implementation is reported. The paper concludes that it is important for staff at all levels to see a clear link between strategic aims and objectives and the planning processes operated by providers and commissioners. It appears that the successful introduction of lean thinking should focus more on productive working and thereby reducing waste. This has the potential to refresh workforce models to ensure that health visiting and other practitioners liberate the use of their specialist knowledge and skills. In a context of enhanced partnership working, the stage is then set for providers to add value to the whole

  19. Current challenges in health economic modeling of cancer therapies: a research inquiry.

    Science.gov (United States)

    Miller, Jeffrey D; Foley, Kathleen A; Russell, Mason W

    2014-05-01

    The demand for economic models that evaluate cancer treatments is increasing, as healthcare decision makers struggle for ways to manage their budgets while providing the best care possible to patients with cancer. Yet, after nearly 2 decades of cultivating and refining techniques for modeling the cost-effectiveness and budget impact of cancer therapies, serious methodologic and policy challenges have emerged that question the adequacy of economic modeling as a sound decision-making tool in oncology. We sought to explore some of the contentious issues associated with the development and use of oncology economic models as informative tools in current healthcare decision-making. Our objective was to draw attention to these complex pharmacoeconomic concerns and to promote discussion within the oncology and health economics research communities. Using our combined expertise in health economics research and economic modeling, we structured our inquiry around the following 4 questions: (1) Are economic models adequately addressing questions relevant to oncology decision makers; (2) What are the methodologic limitations of oncology economic models; (3) What guidelines are followed for developing oncology economic models; and (4) Is the evolution of oncology economic modeling keeping pace with treatment innovation? Within the context of each of these questions, we discuss issues related to the technical limitations of oncology modeling, the availability of adequate data for developing models, and the problems with how modeling analyses and results are presented and interpreted. There is general acceptance that economic models are good, essential tools for decision-making, but the practice of oncology and its rapidly evolving technologies present unique challenges that make assessing and demonstrating value especially complex. There is wide latitude for improvement in oncology modeling methodologies and how model results are presented and interpreted. Complex technical and

  20. Is supergravity well-posed?

    International Nuclear Information System (INIS)

    Isenberg, J.; Bao, D.; Yasskin, P.B.

    1983-01-01

    One rather fundamental question concerning supergravity remains unresolved: Is supergravity a well-posed field theory? That is, does a set of certain (Cauchy) data specified on some initial spacelike surface determine a unique, causally propagating spacetime solution of the supergravity field equations (at least in some finite neighborhood of the initial surface)? In this paper, the authors give a very brief report on work directed towards answering this question. (Auth.)

  1. Universal health coverage and the health Sustainable Development Goal: achievements and challenges for Sri Lanka.

    Science.gov (United States)

    de Silva, Amala; Ranasinghe, Thushara; Abeykoon, Palitha

    2016-09-01

    With state-funded health care that is free at the point of delivery, a sound primary health-care policy and widespread health-care services, Sri Lanka seems a good example of universal health coverage. Yet, health transition and disparities in provision and financing threaten this situation. Sri Lanka did well on the Millennium Development Goal health indicators, but the Sustainable Development Goal (SDG) for health has a wider purview, which is to "ensure healthy lives and promote well-being for all at all ages". The gender gap in life expectancy and the gap between life expectancy and healthy life expectancy make achievement of the health SDG more challenging. Although women and children do well overall, the comparative health disadvantage for men in Sri Lanka is a cause for concern. From a financing perspective, high out-of-pocket expenditure and high utilization of the private sector, even by those in the lowest income quintile, are concerns, as is the emerging "third tier", where some individuals accessing state health care that is free at the point of delivery actually bear some of the costs of drugs, investigations and surgery. This cost sharing is resulting in catastrophic health expenditure for individuals, and delays in and non-compliance with treatment. These concerns about provision and financing must be addressed, as health transition will intensify the morbidity burden and loss of well-being, and could derail plans to achieve the health SDG.

  2. Challenges for Game Addiction as a Mental Health Diagnosis

    DEFF Research Database (Denmark)

    Nielsen, Rune K.L.; Aarseth, Espen; Poulsen, Arne

    2014-01-01

    In this paper, we outline the proposed PhD project: "Challenges for Game Addiction as a Mental Health Diagnosis". The project aims to bridge gaps between the perspectives, theories and data of current research trajectories that engage with the concept of game addiction; from psychology, psychiatry......, cognitive neuroscience to media and game studies. The project has several proposed outcomes. Based on a review of the literature, the adequacy of 'game addiction' as a concept is questioned. The concept is further discussed in a historical perspective of game related pathologies and media/moral panics....... The validity of the prevalent instruments used to assess the prevalence of computer game addiction is examined in a cross-disciplinary context. The argument of the project is that research on computer game addiction is limited by mono-disciplinary approaches that fail to capture significant nuances at the cost...

  3. Big Data and Health Economics: Opportunities, Challenges and Risks

    Directory of Open Access Journals (Sweden)

    Diego Bodas-Sagi

    2018-03-01

    Full Text Available Big Data offers opportunities in many fields. Healthcare is not an exception. In this paper we summarize the possibilities of Big Data and Big Data technologies to offer useful information to policy makers. In a world with tight public budgets and ageing populations we feel necessary to save costs in any production process. The use of outcomes from Big Data could be in the future a way to improve decisions at a lower cost than today. In addition to list the advantages of properly using data and technologies from Big Data, we also show some challenges and risks that analysts could face. We also present an hypothetical example of the use of administrative records with health information both for diagnoses and patients.

  4. Emerging arboviruses and public health challenges in Brazil

    Directory of Open Access Journals (Sweden)

    Tamara Nunes Lima-Camara

    2016-01-01

    Full Text Available ABSTRACT Environmental modification by anthropogenic actions, disordered urban growth, globalization of international exchange and climate change are some factors that help the emergence and dissemination of human infectious diseases transmitted by vectors. This review discusses the recent entry of three arboviruses in Brazil: Chikungunya, West Nile, and Zika virus, focusing on the challenges for the Country’s public health. The Brazilian population is exposed to infections caused by these three arboviruses widely distributed on the national territory and associated with humans. Without effective vaccine and specific treatment, the maintainance and integration of a continuos entomological and epidemiological surveillance are important so we can set methods to control and prevent these arboviruses in the Country.

  5. Emerging and Reemerging Diseases in the World Health Organization (WHO) Eastern Mediterranean Region-Progress, Challenges, and WHO Initiatives.

    Science.gov (United States)

    Buliva, Evans; Elhakim, Mohamed; Tran Minh, Nhu Nguyen; Elkholy, Amgad; Mala, Peter; Abubakar, Abdinasir; Malik, Sk Md Mamunur Rahman

    2017-01-01

    The Eastern Mediterranean Region (EMR) of the World Health Organization (WHO) continues to be a hotspot for emerging and reemerging infectious diseases and the need to prevent, detect, and respond to any infectious diseases that pose a threat to global health security remains a priority. Many risk factors contribute in the emergence and rapid spread of epidemic diseases in the Region including acute and protracted humanitarian emergencies, resulting in fragile health systems, increased population mobility, rapid urbanization, climate change, weak surveillance and limited laboratory diagnostic capacity, and increased human-animal interaction. In EMR, several infectious disease outbreaks were detected, investigated, and rapidly contained over the past 5 years including: yellow fever in Sudan, Middle East respiratory syndrome in Bahrain, Oman, Qatar, Saudi Arabia, United Arab Emirates, and Yemen, cholera in Iraq, avian influenza A (H5N1) infection in Egypt, and dengue fever in Yemen, Sudan, and Pakistan. Dengue fever remains an important public health concern, with at least eight countries in the region being endemic for the disease. The emergence of MERS-CoV in the region in 2012 and its continued transmission currently poses one of the greatest threats. In response to the growing frequency, duration, and scale of disease outbreaks, WHO has worked closely with member states in the areas of improving public health preparedness, surveillance systems, outbreak response, and addressing critical knowledge gaps. A Regional network for experts and technical institutions has been established to facilitate support for international outbreak response. Major challenges are faced as a result of protracted humanitarian crises in the region. Funding gaps, lack of integrated approaches, weak surveillance systems, and absence of comprehensive response plans are other areas of concern. Accelerated efforts are needed by Regional countries, with the continuous support of WHO, to

  6. Emerging and Reemerging Diseases in the World Health Organization (WHO Eastern Mediterranean Region—Progress, Challenges, and WHO Initiatives

    Directory of Open Access Journals (Sweden)

    Evans Buliva

    2017-10-01

    Full Text Available The Eastern Mediterranean Region (EMR of the World Health Organization (WHO continues to be a hotspot for emerging and reemerging infectious diseases and the need to prevent, detect, and respond to any infectious diseases that pose a threat to global health security remains a priority. Many risk factors contribute in the emergence and rapid spread of epidemic diseases in the Region including acute and protracted humanitarian emergencies, resulting in fragile health systems, increased population mobility, rapid urbanization, climate change, weak surveillance and limited laboratory diagnostic capacity, and increased human–animal interaction. In EMR, several infectious disease outbreaks were detected, investigated, and rapidly contained over the past 5 years including: yellow fever in Sudan, Middle East respiratory syndrome in Bahrain, Oman, Qatar, Saudi Arabia, United Arab Emirates, and Yemen, cholera in Iraq, avian influenza A (H5N1 infection in Egypt, and dengue fever in Yemen, Sudan, and Pakistan. Dengue fever remains an important public health concern, with at least eight countries in the region being endemic for the disease. The emergence of MERS-CoV in the region in 2012 and its continued transmission currently poses one of the greatest threats. In response to the growing frequency, duration, and scale of disease outbreaks, WHO has worked closely with member states in the areas of improving public health preparedness, surveillance systems, outbreak response, and addressing critical knowledge gaps. A Regional network for experts and technical institutions has been established to facilitate support for international outbreak response. Major challenges are faced as a result of protracted humanitarian crises in the region. Funding gaps, lack of integrated approaches, weak surveillance systems, and absence of comprehensive response plans are other areas of concern. Accelerated efforts are needed by Regional countries, with the continuous

  7. Singing for respiratory health: theory, evidence and challenges.

    Science.gov (United States)

    Gick, Mary L; Nicol, Jennifer J

    2016-09-01

    The premise that singing is a health promoting activity for people with respiratory conditions of chronic obstructive pulmonary disease (COPD) and asthma is a growing area of interest being investigated by researchers from various disciplines. The preliminary evidence, a theoretical framework and identification of methodological challenges are discussed in this perspective article with an eye to recommendations for further research to advance knowledge. After a brief summary of main research findings on singing in healthy people to provide background context, research is reviewed on singing in people with COPD and asthma. Studies include published research and as yet unpublished work by the authors. Methodological challenges arising from the reviewed studies are identified such as attrition from singing or control groups based on weak and strong, respectively, beliefs about singing's effectiveness. Potential solutions for these problems are considered with further recommendations made for other singing research. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. [Challenges of an integrative and personalised health care for health economics and the insurance system].

    Science.gov (United States)

    Schoch, Goentje-Gesine; Würdemann, E

    2014-11-01

    "Stratifying medicine" is a topic of increasing importance in the public health system. There are several questions related to "stratifying medicine". This paper reconsiders definitions, opportunities and risks related to "stratifying medicine" as well as the main challenges of "stratifying medicine" from the perspective of a public health insurance. The application of the term and the definition are important points to discuss. Terms such as "stratified medicine", "personalised medicine" or "individualised medicine" are used. The Techniker Krankenkasse prefers "stratifying medicine", because it usually means a medicine that tailors therapy to specific groups of patients by biomarkers. OPPORTUNITIES AND RISKS: "Stratifying medicine" is associated with various hopes, e. g., the avoidance of ineffective therapies and early detection of diseases. But "stratifying medicine" also carries risks, such as an increase in the number of cases by treatment of disease risks, a duty for health and the weakening of the criteria of evidence-based medicine. The complexity of "stratifying medicine" is a big challenge for all involved parties in the health system. A lot of interrelations are still not completely understood. So the statutory health insurance faces the challenge of making innovative therapy concepts accessible in a timely manner to all insured on the one hand but on the other hand also to protect the community from harmful therapies. Information and advice to patients related to "stratifying medicine" is of particular importance. The equitable distribution of fees for diagnosis and counselling presents a particular challenge. The solidarity principle of public health insurance may be challenged by social and ethical issues of "stratifying medicine". "Stratifying medicine" offers great potential to improve medical care. However, false hopes must be avoided. Providers and payers should measure chances and risks of "stratifying medicine" together for the welfare of the

  9. Policy challenges for the pediatric rheumatology workforce: Part II. Health care system delivery and workforce supply.

    Science.gov (United States)

    Henrickson, Michael

    2011-01-01

    The United States pediatric population with chronic health conditions is expanding. Currently, this demographic comprises 12-18% of the American child and youth population. Affected children often receive fragmented, uncoordinated care. Overall, the American health care delivery system produces modest outcomes for this population. Poor, uninsured and minority children may be at increased risk for inferior coordination of services. Further, the United States health care delivery system is primarily organized for the diagnosis and treatment of acute conditions. For pediatric patients with chronic health conditions, the typical acute problem-oriented visit actually serves as a barrier to care. The biomedical model of patient education prevails, characterized by unilateral transfer of medical information. However, the evidence basis for improvement in disease outcomes supports the use of the chronic care model, initially proposed by Dr. Edward Wagner. Six inter-related elements distinguish the success of the chronic care model, which include self-management support and care coordination by a prepared, proactive team. United States health care lacks a coherent policy direction for the management of high cost chronic conditions, including rheumatic diseases. A fundamental restructure of United States health care delivery must urgently occur which places the patient at the center of care. For the pediatric rheumatology workforce, reimbursement policies and the actions of health plans and insurers are consistent barriers to chronic disease improvement. United States reimbursement policy and overall fragmentation of health care services pose specific challenges for widespread implementation of the chronic care model. Team-based multidisciplinary care, care coordination and self-management are integral to improve outcomes. Pediatric rheumatology demand in the United States far exceeds available workforce supply. This article reviews the career choice decision-making process

  10. Policy challenges for the pediatric rheumatology workforce: Part II. Health care system delivery and workforce supply

    Directory of Open Access Journals (Sweden)

    Henrickson Michael

    2011-08-01

    Full Text Available Abstract The United States pediatric population with chronic health conditions is expanding. Currently, this demographic comprises 12-18% of the American child and youth population. Affected children often receive fragmented, uncoordinated care. Overall, the American health care delivery system produces modest outcomes for this population. Poor, uninsured and minority children may be at increased risk for inferior coordination of services. Further, the United States health care delivery system is primarily organized for the diagnosis and treatment of acute conditions. For pediatric patients with chronic health conditions, the typical acute problem-oriented visit actually serves as a barrier to care. The biomedical model of patient education prevails, characterized by unilateral transfer of medical information. However, the evidence basis for improvement in disease outcomes supports the use of the chronic care model, initially proposed by Dr. Edward Wagner. Six inter-related elements distinguish the success of the chronic care model, which include self-management support and care coordination by a prepared, proactive team. United States health care lacks a coherent policy direction for the management of high cost chronic conditions, including rheumatic diseases. A fundamental restructure of United States health care delivery must urgently occur which places the patient at the center of care. For the pediatric rheumatology workforce, reimbursement policies and the actions of health plans and insurers are consistent barriers to chronic disease improvement. United States reimbursement policy and overall fragmentation of health care services pose specific challenges for widespread implementation of the chronic care model. Team-based multidisciplinary care, care coordination and self-management are integral to improve outcomes. Pediatric rheumatology demand in the United States far exceeds available workforce supply. This article reviews the career

  11. Environmental, health, and safety effects of engineered nanomaterials: challenges and research needs

    Science.gov (United States)

    Fairbrother, Howard

    2010-04-01

    The number of technologies and consumer products that incorporate engineered nanomaterials (ENMs) has grown rapidly. Indeed, ENMs such as carbon nanotubes and nano-silver, are revolutionizing many commercial technologies and have already been incorporated into more than 800 commercial products, including polymer composites, cell phone batteries, sporting equipment and cosmetics. The global market for ENMs has grown steadily from 7.5 billion in 2003 to 12.7 billion in 2008. Over the next five years, their market value is expected to exceed $27 billion. This surge in demand has been responsible for a corresponding increase in the annual production rates of ENMs. For example, Bayer anticipates that single and multi-walled carbon nanotubes (SWNT and MWNT) production rates will reach 3,000 tons/yr by 2012. Inevitably, some of these synthetic materials will enter the environment either from incidental release during manufacture and transport, or following use and disposal. Consequently, intense scientific research is now being directed towards understanding the environmental, health and safety (EHS) risks posed by ENMs. I will highlight some of the key research challenges and needs in this area, include (i) developing structure-property relationships that will enable physicochemical properties of ENMs to be correlated with environmentally relevant behavior (e.g. colloidal properties, toxicity), (ii) determining the behavior of nanoproducts, and (iii) developing analytical techniques capable of detecting and quantifying the concentration of ENMs in the environment.

  12. Reporting Qualitative Research: Standards, Challenges, and Implications for Health Design.

    Science.gov (United States)

    Peditto, Kathryn

    2018-04-01

    This Methods column describes the existing reporting standards for qualitative research, their application to health design research, and the challenges to implementation. Intended for both researchers and practitioners, this article provides multiple perspectives on both reporting and evaluating high-quality qualitative research. Two popular reporting standards exist for reporting qualitative research-the Consolidated Criteria for Reporting Qualitative Research (COREQ) and the Standards for Reporting Qualitative Research (SRQR). Though compiled using similar procedures, they differ in their criteria and the methods to which they apply. Creating and applying reporting criteria is inherently difficult due to the undefined and fluctuating nature of qualitative research when compared to quantitative studies. Qualitative research is expansive and occasionally controversial, spanning many different methods of inquiry and epistemological approaches. A "one-size-fits-all" standard for reporting qualitative research can be restrictive, but COREQ and SRQR both serve as valuable tools for developing responsible qualitative research proposals, effectively communicating research decisions, and evaluating submissions. Ultimately, tailoring a set of standards specific to health design research and its frequently used methods would ensure quality research and aid reviewers in their evaluations.

  13. Gender-based violence: a crucial challenge for public health.

    Science.gov (United States)

    Sanjel, S

    2013-01-01

    This article attempts to summarize the situations of gender-based violence, a major public health issue. Due to the unequal power relations between men and women, women are violated either in family, in the community or in the State. Gender-based violence takes different forms like physical, sexual or psychological/ emotional violence. The causes of gender-based violence are multidimensional including social, economic, cultural, political and religious. The literatures written in relation to the gender-based violence are accessed using electronic databases as PubMed, Medline and Google scholar, Google and other Internet Websites between 1994 and first quarter of 2013 using an internet search from the keywords such as gender-based violence, women violence, domestic violence, wife abuse, violence during pregnancy, women sexual abuse, political gender based violence, cultural gender-based violence, economical gender-based violence, child sexual abuse and special forms of gender-based violence in Nepal. As GBVs remain one of the most rigorous challenges of women's health and well-being, it is one of the indispensable issues of equity and social justice. To create a gender-based violence free environment, a lot works has to be done. Hence, it is suggested to provide assistance to the victims of violence developing the mechanism to support them.

  14. Mental health literacy as theory: current challenges and future directions.

    Science.gov (United States)

    Spiker, Douglas A; Hammer, Joseph H

    2018-02-13

    Mental health literacy (MHL) is one increasingly researched factor thought to influence mental health behaviors. Researchers have argued for expanding the definition of MHL to include additional constructs, but no consensus has yet been reached on what constructs should be included as part of MHL. The purpose of this paper is to (i) elucidate how the expansion of the MHL construct has impeded the growth of MHL research and (ii) through the lens of construct and theory development, highlight how these challenges might be remedied. An inclusive search of the literature was undertaken to identify MHL studies. The principles of construct and theory development guided a critical analysis of MHL. The review of the literature found that MHL violates many principles of what constitutes an acceptable construct definition. To address these concerns, we proposed conceptualizing MHL as a theory and recommended principles of theory development that should be taken into consideration. A theory of MHL can guide future researchers to clearly delineate important constructs and their interrelationships. For practitioners, a theory of MHL can help inform how to improve MHL at both the individual and community level.

  15. Opportunities and challenges in conducting secondary analysis of HIV programmes using data from routine health information systems and personal health information.

    Science.gov (United States)

    Gloyd, Stephen; Wagenaar, Bradley H; Woelk, Godfrey B; Kalibala, Samuel

    2016-01-01

    HIV programme data from routine health information systems (RHIS) and personal health information (PHI) provide ample opportunities for secondary data analysis. However, these data pose unique opportunities and challenges for use in health system monitoring, along with process and impact evaluations. Analyses focused on retrospective case reviews of four of the HIV-related studies published in this JIAS supplement. We identify specific opportunities and challenges with respect to the secondary analysis of RHIS and PHI data. Challenges working with both HIV-related RHIS and PHI included missing, inconsistent and implausible data; rapidly changing indicators; systematic differences in the utilization of services; and patient linkages over time and different data sources. Specific challenges among RHIS data included numerous registries and indicators, inconsistent data entry, gaps in data transmission, duplicate registry of information, numerator-denominator incompatibility and infrequent use of data for decision-making. Challenges specific to PHI included the time burden for busy providers, the culture of lax charting, overflowing archives for paper charts and infrequent chart review. Many of the challenges that undermine effective use of RHIS and PHI data for analyses are related to the processes and context of collecting the data, excessive data requirements, lack of knowledge of the purpose of data and the limited use of data among those generating the data. Recommendations include simplifying data sources, analysis and reporting; conducting systematic data quality audits; enhancing the use of data for decision-making; promoting routine chart review linked with simple patient tracking systems; and encouraging open access to RHIS and PHI data for increased use.

  16. Climate change and health: new challenges for epidemiology and public health

    International Nuclear Information System (INIS)

    Pascal, Mathilde; Beaudeau, Pascal; Laaidi, Karine; Pirard, Philippe; Vautard, Robert

    2015-01-01

    Climate change contributes to a rapid and deep modification of the environment. In the same time, other factors such as population increase, ageing or urbanization increase the vulnerability to various environmental and health risks. Chains of complex interactions are impacting populations' health and well-being. Developing prevention measures is an asset to reduce the health impacts of present climate change (through adaptation measures) and to limit the intensity of future impacts (through mitigation measures). Mitigation will result in major changes in several sectors, for instance housing, transports or agriculture. Taking into account the potential health impacts is important to avoid choices impairing human health, and to maximize health co-benefits. In this paper we propose a reflection on how present and future climate change in France challenges epidemiology and public health in the next few years. While many questions remain unanswered, there is a consensus on the importance of the links between climate change and human health, that can be summarized into three points: 1) climate change already impacts human health, 2) adaptation and mitigation are needed to reduce those impacts, 3) adaptation and mitigation can rely on immediate measures that would be beneficial for health and for climate. An integrated and interdisciplinary approach is essential to tackle the complexity of the issue, of its implications for public health, for research, surveillance and intervention. (authors)

  17. Promoting better integration of health information systems: best practices and challenges

    NARCIS (Netherlands)

    Michelsen, K.; Brand, H.; Achterberg, P.; Wilkinson, J.

    2015-01-01

    Health Evidence Network Synthesis Report [Promoting better integration of health information systems: best practices and challenges K Michelsen, H Brand, P Achterberg, J Wilkinson - 2015 ... Authors Kai Michelsen Department of International Health, Maastricht University Maastricht,

  18. Challenges, health implications, and advocacy opportunities for lesbian, gay, bisexual, and transgender global health providers.

    Science.gov (United States)

    Nagata, Jason M

    2017-01-01

    In this commentary, I reflect on challenges with conducting global health research internationally as a lesbian, gay, bisexual, and transgender (LGBT) person, grapple with decisions related to coming out in regions with anti-LGBT laws, and outline the risks and benefits of different advocacy options related to the promotion of LGBT health globally. Despite significant advances in LGBT rights in many countries, homosexuality remains illegal in many others. Using a critical medical anthropology framework, I argue that anti-LGBT laws constitute structural violence and have many detrimental consequences including discrimination and violence; poorer mental and physical health outcomes; and risky sexual behaviors. As a global health provider, there are many options for the promotion of LGBT health worldwide.

  19. Challenges to studying the health effects of early life environmental chemical exposures on children's health.

    Science.gov (United States)

    Braun, Joseph M; Gray, Kimberly

    2017-12-01

    Epidemiological studies play an important role in quantifying how early life environmental chemical exposures influence the risk of childhood diseases. These studies face at least four major challenges that can produce noise when trying to identify signals of associations between chemical exposure and childhood health. Challenges include accurately estimating chemical exposure, confounding from causes of both exposure and disease, identifying periods of heightened vulnerability to chemical exposures, and determining the effects of chemical mixtures. We provide recommendations that will aid in identifying these signals with more precision.

  20. Human resources for health in southeast Asia: shortages, distributional challenges, and international trade in health services.

    Science.gov (United States)

    Kanchanachitra, Churnrurtai; Lindelow, Magnus; Johnston, Timothy; Hanvoravongchai, Piya; Lorenzo, Fely Marilyn; Huong, Nguyen Lan; Wilopo, Siswanto Agus; dela Rosa, Jennifer Frances

    2011-02-26

    In this paper, we address the issues of shortage and maldistribution of health personnel in southeast Asia in the context of the international trade in health services. Although there is no shortage of health workers in the region overall, when analysed separately, five low-income countries have some deficit. All countries in southeast Asia face problems of maldistribution of health workers, and rural areas are often understaffed. Despite a high capacity for medical and nursing training in both public and private facilities, there is weak coordination between production of health workers and capacity for employment. Regional experiences and policy responses to address these challenges can be used to inform future policy in the region and elsewhere. A distinctive feature of southeast Asia is its engagement in international trade in health services. Singapore and Malaysia import health workers to meet domestic demand and to provide services to international patients. Thailand attracts many foreign patients for health services. This situation has resulted in the so-called brain drain of highly specialised staff from public medical schools to the private hospitals. The Philippines and Indonesia are the main exporters of doctors and nurses in the region. Agreements about mutual recognition of professional qualifications for three groups of health workers under the Association of Southeast Asian Nations Framework Agreement on Services could result in increased movement within the region in the future. To ensure that vital human resources for health are available to meet the needs of the populations that they serve, migration management and retention strategies need to be integrated into ongoing efforts to strengthen health systems in southeast Asia. There is also a need for improved dialogue between the health and trade sectors on how to balance economic opportunities associated with trade in health services with domestic health needs and equity issues. Copyright © 2011

  1. Digital Technology and Mental Health Interventions: Opportunities and Challenges

    Directory of Open Access Journals (Sweden)

    Aguilera, Adrian

    2015-02-01

    Full Text Available The growth of the Internet, mobile phones, social media and other digital technologies has changed our world in many ways. It has provided individuals with information that was previously only available to a select few. An example of the reach of technology is data that as of October 2012, there are over 6 billion phones worldwide (BBC, 2012. The availability of data in real time has presented hopes of intervening more efficiently and managing health problems by leveraging limited human resources. It also has an impact in changing the roles of providers and patients and in legal and ethical issues including privacy in digital health interactions. This paper will discuss why digital technology has received recent attention in the area of mental health, present some applications of technology for mental health to date, explore the challenges to full implementation in clinical settings, and present future opportunities for digital technologies.El crecimiento del Internet, los teléfonos móviles, las redes sociales y otras tecnologías digitales ha cambiado nuestro mundo de muchas maneras. Ha proporcionado a las personas con la información que antes sólo estaba disponible para un grupo selecto, por ejemplo a partir de octubre de 2012. Un ejemplo del alcance de la tecnología son los datos que dicen que hay más de 6 millones de teléfonos en todo el mundo (BBC, 2012. La disponibilidad de los datos en tiempo real a presentado la esperanza de intervenir de manera más eficiente y manejar los problemas de salud los recursos humanos limitados. También tiene un impacto en el cambio de los roles de los proveedores y los pacientes y en aspectos legales y éticos, incluyendo la privacidad en las interacciones de salud digital. Este artículo discutirá unas razones por cual la tecnología digital ha recibido atención recientemente en el área de salud mental, presentará algunas aplicaciones de la tecnología para mejorar la salud mental hasta la fecha

  2. Integration of community health workers into health systems in developing countries: Opportunities and challenges

    Directory of Open Access Journals (Sweden)

    Collins Otieno Asweto

    2016-02-01

    Full Text Available Background: Developing countries have the potential to reach vulnerable and underserved populations marginalized by the country’s health care systems by way of community health workers (CHWs. It is imperative that health care systems focus on improving access to quality continuous primary care through the use of CHWs while paying attention to the factors that impact on CHWs and their effectiveness. Objective: To explore the possible opportunities and challenges of integrating CHWs into the health care systems of developing countries. Methods: Six databases were examined for quantitative, qualitative, and mixed-methods studies that included the integration of CHWs, their motivation and supervision, and CHW policy making and implementation in developing countries. Thirty-three studies met the inclusion criteria and were double read to extract data relevant to the context of CHW programs. Thematic coding was conducted and evidence on the main categories of contextual factors influencing integration of CHWs into the health system was synthesized. Results: CHWs are an effective and appropriate element of a health care team and can assist in addressing health disparities and social determinants of health. Important facilitators of integration of CHWs into health care teams are support from other health workers and inclusion of CHWs in case management meetings. Sustainable integration of CHWs into the health care system requires the formulation and implementation of polices that support their work, as well as financial and nonfinancial incentives, motivation, collaborative and supportive supervision, and a manageable workload. Conclusions: For sustainable integration of CHWs into health care systems, high-performing health systems with sound governance, adequate financing, well-organized service delivery, and adequate supplies and equipment are essential. Similarly, competent communities could contribute to better CHW performance through sound

  3. Reproductive health care for asylum-seeking women - a challenge for health professionals

    Directory of Open Access Journals (Sweden)

    Zemp Elisabeth

    2010-11-01

    Full Text Available Abstract Background Dealing with pregnancy, childbirth and the care of newborn babies is a challenge for female asylum seekers and their health care providers. The aim of our study was to identify reproductive health issues in a population of women seeking asylum in Switzerland, and to examine the care they received. The women were insured through a special Health Maintenance Organisation (HMO and were attending the Women's Clinic of the University Hospital in Basel. We also investigated how the health professionals involved perceived the experience of providing health care for these patients. Methods A mixed methods approach combined the analysis of quantitative descriptive data and qualitative data obtained from semi-structured interviews with health care providers and from patients' files. We analysed the records of 80 asylum-seeking patients attending the Women's Clinic insured through an HMO. We conducted semi-structured interviews with 10 care providers from different professional groups. Quantitative data were analysed descriptively. Qualitative data analysis was guided by Grounded Theory. Results The principal health problems among the asylum seekers were a high rate of induced abortions (2.5 times higher than in the local population, due to inadequate contraception, and psychosocial stress due to the experience of forced migration and their current difficult life situation. The language barriers were identified as a major difficulty for health professionals in providing care. Health care providers also faced major emotional challenges when taking care of asylum seekers. Additional problems for physicians were that they were often required to act in an official capacity on behalf of the authorities in charge of the asylum process, and they also had to make decisions about controlling expenditure to fulfil the requirements of the HMO. They felt that these decisions sometimes conflicted with their duty towards the patient. Conclusion

  4. The ethics of health service delivery: a challenge to public health leadership.

    Science.gov (United States)

    DeLuca, D M

    1989-01-01

    The ethical distribution of health care is a central issue now that AIDS has started to be a drain on health care resources. If the worst predictions are true, the next half century will be capitalized by a great stress of the health care delivery system in the Pacific. The critical challenges that face the current leadership are: sustaining commitment to all levels of administration to reduce social and health inequities; making sound decisions on policies, priorities and goals that are based on valid information; strengthen health infrastructure, based on the principle of primary health care, including appropriate distribution of staffing, skills, technology and resources. The goals of the Pacific Health Promotion and Development center must not focus exclusively on AIDs. Hepatitis B control measures, hypertension and diabetes, primary care in remote areas, and rehabilitation initiatives must be kept in place. Humanitarian interests for AIDs patients must be balanced with the pragmatic reality of saving children's hearing, or extending useful lives. The attributes of respect, accountability, leadership, judgement, fairness, integrity and honesty controlled by principles of social justice must be part of the administrative decision making process. The 2 major issues facing public health professional are: (1) the financial considerations involved with increasingly expensive technology, services and research, contrasted against the need to prioritize their use and development; (2) pragmatic and ideological needs must be balanced to maximize preventative and curative services and make them available to those who can benefit from them.

  5. The Far Right Challenge Comment on "The Rise of Post-truth Populism in Pluralist Liberal Democracies: Challenges for Health Policy".

    Science.gov (United States)

    Halikiopoulou, Daphne

    2017-07-11

    Speed and Mannion make a good case that the rise of populism poses significant challenges for health policy. This commentary suggests that the link between populism and health policy should be further nuanced in four ways. First, a deconstruction of the term populism itself and a focus on the far right dimension of populist politics; second, a focus on the supply side and more specifically the question of nationalism and the 'national preference'; third, the dynamics of party competition during economic crisis; and fourth the question of policy, and more specifically the extent to which certain labour market policies are able to mediate demand for the far right. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  6. Revisiting Public Health Challenges in the New Millennium | Anish ...

    African Journals Online (AJOL)

    Positive Health of the communities could only be brought out through the interrelationship between conventional health sector and other development sectors. It was a dream that came true when World Health Organization (WHO) accepted Primary Health Care (PHC) as the major tool to achieve its proposed goal of Health ...

  7. Statistical Model-Based Face Pose Estimation

    Institute of Scientific and Technical Information of China (English)

    GE Xinliang; YANG Jie; LI Feng; WANG Huahua

    2007-01-01

    A robust face pose estimation approach is proposed by using face shape statistical model approach and pose parameters are represented by trigonometric functions. The face shape statistical model is firstly built by analyzing the face shapes from different people under varying poses. The shape alignment is vital in the process of building the statistical model. Then, six trigonometric functions are employed to represent the face pose parameters. Lastly, the mapping function is constructed between face image and face pose by linearly relating different parameters. The proposed approach is able to estimate different face poses using a few face training samples. Experimental results are provided to demonstrate its efficiency and accuracy.

  8. THE CHALLENGES OF SCHOOL-BASED YOUTH SUICIDE PREVENTION: EXPERIENCES AND PERCEPTIONS OF MENTAL HEALTH PROFESSIONALS IN SOUTH AFRICAN SCHOOLS.

    Science.gov (United States)

    Woolf, Maryke; Bantjes, Jason; Kagee, Ashraf

    2015-01-01

    Youth suicidal behaviour poses a significant public health concern. Mental health care professionals working in schools have an important role to play in youth suicide prevention initiatives, although little is known of the experiences of this group of professionals in the developing world. The aim of this study was to explore the experiences of mental health professionals working in South African schools and document their insights, attitudes and beliefs regarding youth suicidal behaviour. In-depth semi-structured interviews were conducted with seven school-based mental health care professionals and data were analysed using Thematic Analysis. Participants reported that they relied on a reactive strategy by responding to youths who were in crisis. They were challenged by a lack of support from faculty staff, lack of access to resources, and heavy caseloads. Findings highlight the need for a proactive and collaborative approach to suicide prevention among mental health care professionals, teachers and parents in South African schools and improved training and supervision.

  9. Pose estimation of industrial objects towards robot operation

    Science.gov (United States)

    Niu, Jie; Zhou, Fuqiang; Tan, Haishu; Cao, Yu

    2017-10-01

    With the advantages of wide range, non-contact and high flexibility, the visual estimation technology of target pose has been widely applied in modern industry, robot guidance and other engineering practices. However, due to the influence of complicated industrial environment, outside interference factors, lack of object characteristics, restrictions of camera and other limitations, the visual estimation technology of target pose is still faced with many challenges. Focusing on the above problems, a pose estimation method of the industrial objects is developed based on 3D models of targets. By matching the extracted shape characteristics of objects with the priori 3D model database of targets, the method realizes the recognition of target. Thus a pose estimation of objects can be determined based on the monocular vision measuring model. The experimental results show that this method can be implemented to estimate the position of rigid objects based on poor images information, and provides guiding basis for the operation of the industrial robot.

  10. The right to health, health systems development and public health policy challenges in Chad.

    Science.gov (United States)

    Azétsop, Jacquineau; Ochieng, Michael

    2015-02-15

    There is increasing consensus that the right to health can provide ethical, policy and practical groundings for health systems development. The goals of the right to health are congruent with those of health systems development, which are about strengthening health promotion organizations and actions so as to improve public health. The poor shape and performance of health systems in Chad question the extent of realization of the right to health. Due to its comprehensiveness and inclusiveness, the right to health has the potential of being an organizational and a normative backbone for public health policy and practice. It can then be understood and studied as an integral component of health systems development. This paper uses a secondary data analysis of existing documents by the Ministry of Public Health, Institut National de la Statistique, des Etudes Economiques et Démographiques (INSEED), the Ministry of Economy and Agence Française de Cooperation to analyze critically the shape and performance of health systems in Chad based on key concepts and components of the right to health contained in article 12 of the International Covenant on Economic, Social and Cultural Rights, and on General Comment 14. The non-realization of the right to health, even in a consistently progressive manner, raises concerns about the political commitment of state officials to public health, about the justice of social institutions in ensuring social well-being and about individual and public values that shape decision-making processes. Social justice, democratic rule, transparency, accountability and subsidiarity are important groundings for ensuring community participation in public affairs and for monitoring the performance of public institutions. The normative ideals of health systems development are essentially democratic in nature and are rooted in human rights and in ethical principles of human dignity, equality, non-discrimination and social justice. These ideals are grounded

  11. Animated pose templates for modeling and detecting human actions.

    Science.gov (United States)

    Yao, Benjamin Z; Nie, Bruce X; Liu, Zicheng; Zhu, Song-Chun

    2014-03-01

    family of optimization methods known as the Concave-Convex Procedure (CCCP) that converge to a local optimal solution. The inference algorithm consists of two components: 1) Detecting top candidates for the pose templates, and 2) computing the sequence of pose templates. Both are done by dynamic programming or, more precisely, beam search. In experiments, we demonstrate that this method is capable of discovering salient poses of actions as well as interactions with contextual objects. We test our method on several public action data sets and a challenging outdoor contextual action data set collected by ourselves. The results show that our model achieves comparable or better performance compared to state-of-the-art methods.

  12. Thailand's Health Workforce : A Review of Challenges and Experiences

    OpenAIRE

    Pagaiya, Nonglak; Noree, Thinakorn

    2009-01-01

    Thailand's health system is a dynamic entity that continues to change and grow. The country's health policies greatly affect the health workforce, the choices they make, their numbers and their availability. This paper explores the relationship between Thai health workers and the policies that affect them.

  13. Oral health in Libya: addressing the future challenges

    African Journals Online (AJOL)

    2014-03-24

    Mar 24, 2014 ... Keywords: oral health; oral health research; oral health care; dental research; dental education; Libya ... Libyan Journal of Medicine 2014. © 2014 Syed Wali Peeran ..... Clinical examination for dental erosion .... International health conference, ... (MIH) in a group of school-aged children in Benghazi, Libya.

  14. Incorporating intersectionality theory into population health research methodology: challenges and the potential to advance health equity.

    Science.gov (United States)

    Bauer, Greta R

    2014-06-01

    Intersectionality theory, developed to address the non-additivity of effects of sex/gender and race/ethnicity but extendable to other domains, allows for the potential to study health and disease at different intersections of identity, social position, processes of oppression or privilege, and policies or institutional practices. Intersectionality has the potential to enrich population health research through improved validity and greater attention to both heterogeneity of effects and causal processes producing health inequalities. Moreover, intersectional population health research may serve to both test and generate new theories. Nevertheless, its implementation within health research to date has been primarily through qualitative research. In this paper, challenges to incorporation of intersectionality into population health research are identified or expanded upon. These include: 1) confusion of quantitative terms used metaphorically in theoretical work with similar-sounding statistical methods; 2) the question of whether all intersectional positions are of equal value, or even of sufficient value for study; 3) distinguishing between intersecting identities, social positions, processes, and policies or other structural factors; 4) reflecting embodiment in how processes of oppression and privilege are measured and analysed; 5) understanding and utilizing appropriate scale for interactions in regression models; 6) structuring interaction or risk modification to best convey effects, and; 7) avoiding assumptions of equidistance or single level in the design of analyses. Addressing these challenges throughout the processes of conceptualizing and planning research and in conducting analyses has the potential to improve researchers' ability to more specifically document inequalities at varying intersectional positions, and to study the potential individual- and group-level causes that may drive these observed inequalities. A greater and more thoughtful incorporation

  15. When health systems are barriers to health care: challenges faced by uninsured Mexican kidney patients.

    Science.gov (United States)

    Kierans, Ciara; Padilla-Altamira, Cesar; Garcia-Garcia, Guillermo; Ibarra-Hernandez, Margarita; Mercado, Francisco J

    2013-01-01

    Chronic Kidney Disease disproportionately affects the poor in Low and Middle Income Countries (LMICs). Mexico exemplifies the difficulties faced in supporting Renal Replacement Therapy (RRT) and providing equitable patient care, despite recent attempts at health reform. The objective of this study is to document the challenges faced by uninsured, poor Mexican families when attempting to access RRT. The article takes an ethnographic approach, using interviewing and observation to generate detailed accounts of the problems that accompany attempts to secure care. The study, based in the state of Jalisco, comprised interviews with patients, their caregivers, health and social care professionals, among others. Observations were carried out in both clinical and social settings. In the absence of organised health information and stable pathways to renal care, patients and their families work extraordinarily hard and at great expense to secure care in a mixed public-private healthcare system. As part of this work, they must navigate challenging health and social care environments, negotiate treatments and costs, resource and finance healthcare and manage a wide range of formal and informal health information. Examining commonalities across pathways to adequate healthcare reveals major failings in the Mexican system. These systemic problems serve to reproduce and deepen health inequalities. A system, in which the costs of renal care are disproportionately borne by those who can least afford them, faces major difficulties around the sustainability and resourcing of RRTs. Attempts to increase access to renal therapies, therefore, need to take into account the complex social and economic demands this places on those who need access most. This paper further shows that ethnographic studies of the concrete ways in which healthcare is accessed in practice provide important insights into the plight of CKD patients and so constitute an important source of evidence in that effort.

  16. Polycentrism in Global Health Governance Scholarship Comment on "Four Challenges That Global Health Networks Face".

    Science.gov (United States)

    Tosun, Jale

    2017-05-23

    Drawing on an in-depth analysis of eight global health networks, a recent essay in this journal argued that global health networks face four challenges to their effectiveness: problem definition, positioning, coalition-building, and governance. While sharing the argument of the essay concerned, in this commentary, we argue that these analytical concepts can be used to explicate a concept that has implicitly been used in global health governance scholarship for quite a few years. While already prominent in the discussion of climate change governance, for instance, global health governance scholarship could make progress by looking at global health governance as being polycentric. Concisely, polycentric forms of governance mix scales, mechanisms, and actors. Drawing on the essay, we propose a polycentric approach to the study of global health governance that incorporates coalitionbuilding tactics, internal governance and global political priority as explanatory factors. © 2018 The Author(s); Published by Kerman University of Medical Sciences. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

  17. Accessibility to health services in the prison population in Colombia: a public health challenge

    Directory of Open Access Journals (Sweden)

    Luz Mery Mejía O

    2010-08-01

    Full Text Available This article is the result of a product of a study elaborated with the aim of systematizing the available information related to the accessibility to the health services of the prison population in the penitentiary centers. To this end, we reviewed the literature and systematic collection of the academic available material in the principal university libraries in the city of Medellin, scientific databases and the web pages of national and international organizations that have dealt with this topic. The information was systematized considering some historical references to prisons and health, the record of experiences in some countries and the current regulations for health care in the prison population in the Colombian case. We conclude that although significant progress has been made to ensure health care for the prison population, in the prison there are still obstacles and limitations that infringe the right to health of this population. Likewise, it is evidenced that it has not been considered a public health problem in the country, which it is considered a challenge to incorporate it as such.

  18. Pose-Invariant Face Recognition via RGB-D Images.

    Science.gov (United States)

    Sang, Gaoli; Li, Jing; Zhao, Qijun

    2016-01-01

    Three-dimensional (3D) face models can intrinsically handle large pose face recognition problem. In this paper, we propose a novel pose-invariant face recognition method via RGB-D images. By employing depth, our method is able to handle self-occlusion and deformation, both of which are challenging problems in two-dimensional (2D) face recognition. Texture images in the gallery can be rendered to the same view as the probe via depth. Meanwhile, depth is also used for similarity measure via frontalization and symmetric filling. Finally, both texture and depth contribute to the final identity estimation. Experiments on Bosphorus, CurtinFaces, Eurecom, and Kiwi databases demonstrate that the additional depth information has improved the performance of face recognition with large pose variations and under even more challenging conditions.

  19. Public health informatics in India: the potential and the challenges.

    Science.gov (United States)

    Athavale, A V; Zodpey, Sanjay P

    2010-01-01

    Public health informatics is emerging as a new and distinct specialty area in the global scenario within the broader discipline of health informatics. The potential role of informatics in reducing health disparities in underserved populations has been identified by a number of reports from all over the world. The article discusses the scope, the limitations, and future perspective of this novice discipline in context to India. It also highlights information and technology related tools namely Geographical Information Systems, Telemedicine and Electronic Medical Record/Electronic Health Record. India needs to leverage its "technology" oriented growth until now (e.g., few satellite-based telemedicine projects, etc.) simultaneously toward development of "information"-based public health informatics systems in future. Under the rapidly evolving scenario of global public health, the future of the public health governance and population health in India would depend upon building and integrating the comprehensive and responsive domain of public health informatics.

  20. Healthcare-associated infections: challenges to public health in Brazil.

    Science.gov (United States)

    Padoveze, Maria Clara; Fortaleza, Carlos Magno Castelo Branco

    2014-12-01

    This study presents a critical evaluation of the scientific literature related to this subject, aiming to assess the policies and administrative issues regarding the prevention and magnitude of healthcare-associated infections and discuss the challenges for their prevention in Brazil. The topics discussed included historical and administrative issues, challenges imposed by the characteristics of the healthcare system and the territorial dimension, laboratorial support limitations, costs, institutional culture, professional qualification, and patient engagement. It is urgent to hold a nationwide discussion among government representatives, institutions, and healthcare workers and users to overcome these challenges.

  1. Emerging arboviruses and public health challenges in Brazil.

    Science.gov (United States)

    Lima-Camara, Tamara Nunes

    2016-06-27

    Environmental modification by anthropogenic actions, disordered urban growth, globalization of international exchange and climate change are some factors that help the emergence and dissemination of human infectious diseases transmitted by vectors. This review discusses the recent entry of three arboviruses in Brazil: Chikungunya, West Nile, and Zika virus, focusing on the challenges for the Country's public health. The Brazilian population is exposed to infections caused by these three arboviruses widely distributed on the national territory and associated with humans. Without effective vaccine and specific treatment, the maintainance and integration of a continuos entomological and epidemiological surveillance are important so we can set methods to control and prevent these arboviruses in the Country. RESUMO A modificação do ambiente por ações antrópicas, o crescimento urbano desordenado, o processo de globalização do intercâmbio internacional e as mudanças climáticas são alguns fatores que vêm facilitando a emergência e disseminação de doenças infecciosas humanas transmitidas por vetores. Este comentário aborda a recente entrada de três arbovírus no Brasil, Chikungunya (CHIKV), West Nile (WNV) e Zika (ZIKV), com enfoque nos desafios para a Saúde Pública do País. Transmitidos por mosquitos vetores amplamente distribuídos no território nacional e associados ao homem, a população brasileira encontra-se exposta à infecção por esses três arbovírus. Na ausência de vacina eficaz e tratamento específico, são importantes a manutenção e integração de uma vigilância entomológica e epidemiológica contínua, a fim de direcionarmos métodos de controle e prevenção contra essas arboviroses no País.

  2. Full Body Pose Estimation During Occlusion using Multiple Cameras

    DEFF Research Database (Denmark)

    Fihl, Preben; Cosar, Serhan

    people is a very challenging problem for methods based on pictorials structure as for any other monocular pose estimation method. In this report we present work on a multi-view approach based on pictorial structures that integrate low level information from multiple calibrated cameras to improve the 2D...

  3. Administrative Challenges to the Integration of Oral Health With Primary Care

    Science.gov (United States)

    Maxey, Hannah L.; Randolph, Courtney; Gano, Laura; Kochhar, Komal

    2017-01-01

    Inadequate access to preventive oral health services contributes to oral health disparities and is a major public health concern in the United States. Federally Qualified Health Centers play a critical role in improving access to care for populations affected by oral health disparities but face a number of administrative challenges associated with implementation of oral health integration models. We conducted a SWOT (strengths, weaknesses, opportunities, and threats) analysis with health care executives to identify strengths, weaknesses, opportunities, and threats of successful oral health integration in Federally Qualified Health Centers. Four themes were identified: (1) culture of health care organizations; (2) operations and administration; (3) finance; and (4) workforce. PMID:27218701

  4. 76 FR 66306 - Announcement of Requirements and Registration for Leading Health Indicators App Challenge

    Science.gov (United States)

    2011-10-26

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Announcement of Requirements and Registration for Leading... People 2020 leading health indicators (LHIs). The LHIs were developed to communicate high-priority health... , 240-453-6113. SUPPLEMENTARY INFORMATION: Subject of Challenge Competition: Leading Health Indicators...

  5. Challenges and Opportunities for Advancing Work on Climate Change and Public Health.

    Science.gov (United States)

    Gould, Solange; Rudolph, Linda

    2015-12-09

    Climate change poses a major threat to public health. Strategies that address climate change have considerable potential to benefit health and decrease health inequities, yet public health engagement at the intersection of public health, equity, and climate change has been limited. This research seeks to understand the barriers to and opportunities for advancing work at this nexus. We conducted semi-structured in-depth interviews (N = 113) with public health and climate change professionals and thematic analysis. Barriers to public health engagement in addressing climate change include individual perceptions that climate change is not urgent or solvable and insufficient understanding of climate change's health impacts and programmatic connections. Institutional barriers include a lack of public health capacity, authority, and leadership; a narrow framework for public health practice that limits work on the root causes of climate change and health; and compartmentalization within and across sectors. Opportunities include integrating climate change into current public health practice; providing inter-sectoral support for climate solutions with health co-benefits; and using a health frame to engage and mobilize communities. Efforts to increase public health sector engagement should focus on education and communications, building leadership and funding, and increasing work on the shared root causes of climate change and health inequities.

  6. Challenges and Opportunities for Advancing Work on Climate Change and Public Health

    Science.gov (United States)

    Gould, Solange; Rudolph, Linda

    2015-01-01

    Climate change poses a major threat to public health. Strategies that address climate change have considerable potential to benefit health and decrease health inequities, yet public health engagement at the intersection of public health, equity, and climate change has been limited. This research seeks to understand the barriers to and opportunities for advancing work at this nexus. We conducted semi-structured in-depth interviews (N = 113) with public health and climate change professionals and thematic analysis. Barriers to public health engagement in addressing climate change include individual perceptions that climate change is not urgent or solvable and insufficient understanding of climate change’s health impacts and programmatic connections. Institutional barriers include a lack of public health capacity, authority, and leadership; a narrow framework for public health practice that limits work on the root causes of climate change and health; and compartmentalization within and across sectors. Opportunities include integrating climate change into current public health practice; providing inter-sectoral support for climate solutions with health co-benefits; and using a health frame to engage and mobilize communities. Efforts to increase public health sector engagement should focus on education and communications, building leadership and funding, and increasing work on the shared root causes of climate change and health inequities. PMID:26690194

  7. Overcoming eHealth challenges with social and technical innovations

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

    2018-01-29

    Jan 29, 2018 ... ... Lebanon, Peru, and Vietnam, involved local research teams working closely ... Women in Burkina Faso are now empowered to make informed decisions ... Enhancing health worker performance in Ethiopia with mHealth.

  8. The challenges of human resources in mental health in Kenya

    African Journals Online (AJOL)

    Adele

    University of Nairobi, Kenya & Director, Africa Mental Health Foundation. (AMHF) ... The ratios decline further when psychiatrists available for clinical work in public facilities are ..... health problems at the level they are trained to handle medical.

  9. Health care achievement and challenges in the Western Cape

    African Journals Online (AJOL)

    our citizens: (I) the introduction of free primary health care. (PHC) services has made ... Representatives, House of Delegates, House of Assembly. (which operated ... produce the Provincial Health Plan with its 26 task team reports, which have ...

  10. Profile of men's health in Malaysia: problems and challenges

    OpenAIRE

    Tong, Seng Fah; Low, Wah Yun; Ng, Chirk Jenn

    2011-01-01

    Men's health concerns have evolved from the traditional andrology and male sexual health to a more holistic approach that encompasses male psychological, social and physical health. The poor state of health in men compared to their female counterparts is well documented. A review of the epidemiological data from Malaysia noted a similar trend in which men die at higher rates in under 1 and above 15 years old groups and most disease categories compared to women. In Malaysia, the main causes of...

  11. The Promise and Challenge of eHealth Interventions.

    Science.gov (United States)

    Atkinson, Nancy L.; Gold, Robert S.

    2002-01-01

    Discusses how health education researchers can use the Internet to both intervene in health behavior and evaluate the effects of interventions (eHealth), describing the potential of computer technology for behavior interventions via message tailoring, intervention tailoring, simulations, games, and online communities, and noting implementation…

  12. Poverty and elimination of urban health disparities: challenge and opportunity.

    Science.gov (United States)

    Thomas, Stephen B; Quinn, Sandra Crouse

    2008-01-01

    The aim of this article is to examine the intersection of race and poverty, two critical factors fueling persistent racial and ethnic health disparities among urban populations. From the morass of social determinants that shape the health of racial and ethnic communities in our urban centers, we will offer promising practices and potential solutions to eliminating racial and ethnic health disparities.

  13. Obesity and Depression : An Intertwined Public Health Challenge

    NARCIS (Netherlands)

    Nigatu, Yeshambel Tesfa

    2015-01-01

    Obesity and depression are widespread public health problems. Both problems often coexist, and can affect an individual’s health and productivity. We examine in this thesis the prospective association between obesity and depression, and their separate and combined effects on work and health

  14. [The modern international public health and globalization challenges].

    Science.gov (United States)

    2012-01-01

    The article deals with the issues of impact of globalization on population health and public health. The positive and negative aspects of this process are analyzed. The role of international organizations (UN, WHO, UNESCO, ILO, UNISEF) is demonstrated in the area of management of globalization impact on public health of different countries, Russia included.

  15. The barriers and challenges to Health Promotion in Africa ...

    African Journals Online (AJOL)

    Health promotion is the process of enabling people to increase control over and to improve their health so as to reach a state of complete physical, mental and social well being. The World Health Organisation which was created in 1948, where some 190 countries exchange their knowledge and experience with the aim of ...

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

    Directory of Open Access Journals (Sweden)

    A. Sukumaran

    2015-05-01

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

  17. [Mental health and primary care in Mexico. Opportunities and challenges].

    Science.gov (United States)

    Saavedra Solano, Nayelhi; Berenzon Gorn, Shoshana; Galván Reyes, Jorge

    2016-04-01

    To present the conditions that favour or limit the integration of mental health into health centres, based on the perceptions of health workers and on observations made by researchers. A study was conducted between April 2012 and February 2014 using a non-participant observation technique plus interviews with health professionals. Descriptive exploratory study conducted in 19 health centres in Mexico City. The selection of centres and participants was intentional, followed by the snowball technique in order to reach data saturation. Two guides were use, one for collecting information during the observation and the other one for interviews. The observations were registered in field notes, while the interviews were audio recorded. All collected information was stored in Word files. The analysis of field notes consisted of three levels of reading, and the interview analysis was based on "categorisation of meanings" proposed by Kvale (1996). The aspects that favour or limit the integration of mental health services involve three broad categories: a) programs and methods that organise services, b) infrastructure and material resources and, c) human and information resources. Actions targeted at including mental health into productivity reports and into already established goals, would contribute to the integration of mental health care, as well as promoting the idea that mental health is part of overall health, and to increase the public investment in health. Copyright © 2015 Elsevier España, S.L.U. All rights reserved.

  18. Perspective projection for variance pose face recognition from camera calibration

    Science.gov (United States)

    Fakhir, M. M.; Woo, W. L.; Chambers, J. A.; Dlay, S. S.

    2016-04-01

    Variance pose is an important research topic in face recognition. The alteration of distance parameters across variance pose face features is a challenging. We provide a solution for this problem using perspective projection for variance pose face recognition. Our method infers intrinsic camera parameters of the image which enable the projection of the image plane into 3D. After this, face box tracking and centre of eyes detection can be identified using our novel technique to verify the virtual face feature measurements. The coordinate system of the perspective projection for face tracking allows the holistic dimensions for the face to be fixed in different orientations. The training of frontal images and the rest of the poses on FERET database determine the distance from the centre of eyes to the corner of box face. The recognition system compares the gallery of images against different poses. The system initially utilises information on position of both eyes then focuses principally on closest eye in order to gather data with greater reliability. Differentiation between the distances and position of the right and left eyes is a unique feature of our work with our algorithm outperforming other state of the art algorithms thus enabling stable measurement in variance pose for each individual.

  19. Robust head pose estimation via supervised manifold learning.

    Science.gov (United States)

    Wang, Chao; Song, Xubo

    2014-05-01

    Head poses can be automatically estimated using manifold learning algorithms, with the assumption that with the pose being the only variable, the face images should lie in a smooth and low-dimensional manifold. However, this estimation approach is challenging due to other appearance variations related to identity, head location in image, background clutter, facial expression, and illumination. To address the problem, we propose to incorporate supervised information (pose angles of training samples) into the process of manifold learning. The process has three stages: neighborhood construction, graph weight computation and projection learning. For the first two stages, we redefine inter-point distance for neighborhood construction as well as graph weight by constraining them with the pose angle information. For Stage 3, we present a supervised neighborhood-based linear feature transformation algorithm to keep the data points with similar pose angles close together but the data points with dissimilar pose angles far apart. The experimental results show that our method has higher estimation accuracy than the other state-of-art algorithms and is robust to identity and illumination variations. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Qualitative Assessment of Challenges in Tuberculosis Control in West Gojjam Zone, Northwest Ethiopia: Health Workers’ and Tuberculosis Control Program Coordinators’ Perspectives

    Directory of Open Access Journals (Sweden)

    Senedu B. Gebreegziabher

    2016-01-01

    Full Text Available Background. Weak health systems pose many barriers to effective tuberculosis (TB control. This study aimed at exploring health worker’s and TB control program coordinator’s perspectives on health systems challenges facing TB control in West Gojjam Zone, Amhara Region, Ethiopia. Methods. This was a qualitative descriptive study. Eight in-depth interviews with TB control program coordinators and two focus group discussions among 16 health workers were conducted. Purposive sampling was used to recruit study participants. Thematic analysis was used to identify and analyse main themes. Results. We found that intermittent interruptions of laboratory reagents and anti-TB drugs supplies, absence of trained and motivated health workers, poor TB data documentation, lack of adherence to TB treatment guideline, and lack of access to TB diagnostic tools at peripheral health institutions were challenges facing the TB control program performance in the study zone. Conclusions. Ensuring uninterrupted supply of anti-TB drugs and laboratory reagents to all health institutions is essential. Continuous refresher training of health workers on standard TB care and data handling and developing and implementing a sound retention strategy to attract and motivate health professionals to work in rural areas are necessary interventions to improve the TB control program performance in the study zone.

  1. Analysis of the mass media coverage of the Gates Foundation grand challenges in global health initiative.

    Science.gov (United States)

    Verma, G

    2009-03-01

    The Grand Challenges were launched in 2003 by the Gates Foundation and other collaborators to address the health needs of developing countries. This paper outlines the current problem with health research and development in the context of inequality as conveyed by the 90/10 divide. The paper then looks at the focus and nature of press reporting of global health issues by analysing how press articles have portrayed the Grand Challenges in Global Health initiative. Analysis of the mass media illustrates that the focus of reporting on the Grand Challenges tends to be on utilitarian themes, leaving issues related to justice and equity comparatively under-reported.

  2. Challenges and Opportunities of Implementing District-based Health Information System in Ethiopia

    DEFF Research Database (Denmark)

    Mengiste, Shegaw Anagaw

    2005-01-01

    This paper has analyzed the challenges of sustainability and scalability of HIS. The empirical analysis was conducted in a backward and disadvantaged region of Ethiopia. An ongoing process of HISP (Health Information System Program) was addressed and the main challenges in the implementation...... of sustainable and scalable district-based health information system in the context of Primary Health Care (PHC) sector in Ethiopia were identified. Human resource, infrastructure, and HIS related problems are the main challenges hindering the implementation of sustainable and scalable district-based health...... information systems in the region....

  3. Global trade and health: key linkages and future challenges.

    Science.gov (United States)

    Bettcher, D W; Yach, D; Guindon, G E

    2000-01-01

    Globalization of trade, marketing and investment has important implications for public health, both negative and positive. This article considers the implications of the single package of World Trade Organization (WTO) agreements for public health research and policy, focusing on three themes: commodities, intellectual property rights, and health services. The main aims of the analysis are as follows: to identify how trade issues are associated with the transnationalization of health risks and possible benefits; to identify key areas of research; and to suggest policy-relevant advice and interventions on trade and health issues. The next wave of international trade law will need to take more account of global public health issues. However, to become more engaged in global trade debates, the public health community must gain an understanding of the health effects of global trade agreements. It must also ensure that its own facts are correct, so that public health is not blindly used for political ends, such as justifying unwarranted economic protectionism. "Healthy trade" policies, based on firm empirical evidence and designed to improve health status, are an important step towards reaching a more sustainable form of trade liberalization.

  4. [Problems and ethical challenges in public health communication].

    Science.gov (United States)

    Loss, J; Nagel, E

    2009-05-01

    Health communication, e.g., mass media campaigns, patient information leaflets or websites, plays an important role in public health. It contributes to citizen empowerment and helps them make informed decisions in health matters. However, public health communication can lead to adverse effects on both individual and societal level, e.g., by inaccurate or partial information, discriminatory messages, scandalizing coverage or inadequate tailoring to relevant target groups. It seems important to suggest ethical criteria for health information, e.g., (1) accuracy, completeness and balance, (2) transparency, (3) participation of the target group, (4) respect for human dignity, (5) social justice and equity, (6) appropriateness. Thoughtfulness is important in order not to stigmatize population subgroups. In addition, it is laborious to comprehensively and correctly present benefits and risks of a certain health behavior. Marketing principles guide how to 'sell' a certain health behavior, but health campaigns should not manipulate target persons for the sake of a population health aim. It remains unclear, however, how the different providers of health information can be held ethically responsible.

  5. Health in All (Foreign) Policy: challenges in achieving coherence.

    Science.gov (United States)

    Labonté, Ronald

    2014-06-01

    Health in All Policies (HiAP) approach is generally perceived as an intersectoral approach to national or sub-national public policy development, such that health outcomes are given full consideration by non-health sectors. Globalization, however, has created numerous 'inherently global health issues' with cross-border causes and consequences, requiring new forms of global governance for health. Although such governance often includes both state and non-state (private, civil society) actors in agenda setting and influence, different actors have differing degrees of power and authority and, ultimately, it is states that ratify intergovernmental covenants or normative declarations that directly or indirectly affect health. This requires public health and health promotion practitioners working within countries to give increased attention to the foreign policies of their national governments. These foreign policies include those governing national security, foreign aid, trade and investment as well as the traditional forms of diplomacy. A new term has been coined to describe how health is coming to be positioned in governments' foreign policies: global health diplomacy. To become adept at this nuanced diplomatic practice requires familiarity with the different policy frames by which health might be inserted into the foreign policy deliberations, and thence intergovernmental/global governance negotiations. This article discusses six such frames (security, trade, development, global public goods, human rights, ethical/moral reasoning) that have been analytically useful in assessing the potential for greater and more health-promoting foreign policy coherence: a 'Health in All (Foreign) Policies' approach. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  6. Health Behaviour Change Support Systems: Past Research and Future Challenges

    OpenAIRE

    Mettler, Tobias

    2015-01-01

    The emergence of mobile devices and social technologies has opened up new possibilities for health promotion and disease prevention. By means of emotional stimuli, motivation, and persuasion health behaviour change support systems (HBCSS) aim at influencing users to improve their health and wellbeing. This article presents the results of a bibliometric analysis related to the existing HBCSS body of knowledge. A total of 51 research studies were analysed with a look at their topical and theore...

  7. Health workforce governance and oral health: Diversity and challenges in Europe.

    Science.gov (United States)

    Gallagher, Jennifer E; Eaton, Kenneth A

    2015-12-01

    Throughout the life course, oral diseases are some of the most common non-communicable diseases globally, and in Europe. Human resources for oral health are fundamental to healthcare systems in general and dentistry is no exception. As political and healthcare systems change, so do forms of governance. The aim of this paper is to examine human resources for oral health in Europe, against a workforce governance framework, using England as a case study. The findings suggest that neo-liberalist philosophies are leading to multiple forms of soft governance at professional, system, organisational and individual levels, most notably in England, where there is no longer professional self-regulation. Benefits include professional regulation of a wider cadre of human resources for oral health, reorientation of care towards evidence-informed practice including prevention, and consideration of care pathways for patients. Across Europe there has been significant professional collaboration in relation to quality standards in the education of dentists, following transnational policies permitting freedom of movement of health professionals; however, the distribution of dentists is inequitable. Challenges include facilitating employment of graduates to serve the needs and demands of the population in certain countries, together with governance of workforce production and migration across Europe. Integrated trans-European approaches to monitoring mobility and governance are urgently required. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. Ethnic and cultural diversity: challenges and opportunities for health law.

    Science.gov (United States)

    Hendriks, Aart

    2008-09-01

    Guaranteeing equal health care of appropriate quality implies taking ethnic and cultural diversity into account, without over- or underestimating the importance of these grounds. Besides awareness of its relevance, it is essential to have disaggregated data to better understand the relationship between ethnicity and culture on the one hand and health and health care on the other hand. From a health law perspective, it is a prerequisite to understand the conceptual and normative meaning of equality and non-discrimination, also in relation to the right to privacy, and to be aware of the need to collaborate with other legal and non-legal disciplines.

  9. Using foresight to prepare animal health today for tomorrow's challenges.

    Science.gov (United States)

    Willis, Norman G; Munroe, Fonda A; Empringham, R Edward; Renwick, Shane A; Van der Linden, Ingrid W M; Dunlop, James R

    2011-06-01

    Foresight has been introduced in Canada in the area of animal health as a process to broaden thinking about the future and inform policy development. Its initial use and evolution through projects and studies over the past decade are described, demonstrating real action in animal health. Despite positive, continuing, and exciting results in animal health policy development, foresight's widespread acceptance and use thus far have been limited. Critical components for success, drawn from the Canadian experience, are described, and recommendations are offered for further action in animal health.

  10. Challenges in Developing Health Promoting Schools’ Project: Application of Global Traits in Local Realm

    OpenAIRE

    Behrouz Fathi; Hamid Allahverdipour; Abdolreza Shaghaghi; Ahmad Kousha; Ali Jannati

    2014-01-01

    Background: Despite the importance of student health and school hygiene as an aspect of the infrastructure of community health, few feasibility studies have been conducted on school health programs in developing countries. This study examined possible barriers to and challenges of such programs from the executive perspective in East Azerbaijan Province in Iran. Methods: This qualitative study used the content analysis approach to recognize barriers to and challenges of healt...

  11. Ghana's National Health Insurance Scheme: an assessment of problems and challenges

    OpenAIRE

    Danquah, Jones Kwame Adom

    2017-01-01

    Despite impressive progress since 2003, huge challenges remain in the effort to improve health outcomes in Ghana and achieve related goals concerning universal coverage, basic needs, equity, inclusion, risk protection and reaching poor and marginalized groups. One of these challenges is how health should be financed – who should pay how much and through what arrangements, given the reality that the services and other actions needed to attain desired health results inevitably involve costs tha...

  12. Knowledge and understanding of health insurance: challenges and remedies.

    Science.gov (United States)

    Barnes, Andrew J; Hanoch, Yaniv

    2017-07-13

    As coverage is expanded in health systems that rely on consumers to choose health insurance plans that best meet their needs, interest in whether consumers possess sufficient understanding of health insurance to make good coverage decisions is growing. The recent IJHPR article by Green and colleagues-examining understanding of supplementary health insurance (SHI) among Israeli consumers-provides an important and timely answer to the above question. Indeed, their study addresses similar problems to the ones identified in the US health care market, with two notable findings. First, they show that overall-regardless of demographic variables-there are low levels of knowledge about SHI, which the literature has come to refer to more broadly as "health insurance literacy." Second, they find a significant disparity in health insurance literacy between different SES groups, where Jews were significantly more knowledgeable about SHI compared to their Arab counterparts.The authors' findings are consistent with a growing body of literature from the U.S. and elsewhere, including our own, presenting evidence that consumers struggle with understanding and using health insurance. Studies in the U.S. have also found that difficulties are generally more acute for populations considered the most vulnerable and consequently most in need of adequate and affordable health insurance coverage.The authors' findings call attention to the need to tailor communication strategies aimed at mitigating health insurance literacy and, ultimately, access and outcomes disparities among vulnerable populations in Israel and elsewhere. It also raises the importance of creating insurance choice environments in health systems relying on consumers to make coverage decisions that facilitate the decision process by using "choice architecture" to, among other things, simplify plan information and highlight meaningful differences between coverage options.

  13. The creation of the health consumer: challenges on health sector regulation after managed care era.

    Science.gov (United States)

    Iriart, Celia; Franco, Tulio; Merhy, Emerson E

    2011-02-24

    We utilized our previous studies analyzing the reforms affecting the health sector developed in the 1990s by financial groups to frame the strategies implemented by the pharmaceutical industry to regain market positions and to understand the challenges that regulatory agencies are confronting. We followed an analytical approach for analyzing the process generated by the disputes between the financial groups and the pharmaceutical corporations and the challenges created to governmental regulation. We analyzed primary and secondary sources using situational and discourse analyses. We introduced the concepts of biomedicalization and biopedagogy, which allowed us to analyze how medicalization was radicalized. In the 1990s, structural adjustment policies facilitated health reforms that allowed the entrance of multinational financial capital into publicly-financed and employer-based insurance. This model operated in contraposition to the interests of the medical industrial complex, which since the middle of the 1990s had developed silent reforms to regain authority in defining the health-ill-care model. These silent reforms radicalized the medicalization. Some reforms took place through deregulatory processes, such as allowing direct-to-consumer advertisements of prescription drugs in the United States. In other countries different strategies were facilitated by the lack of regulation of other media such as the internet. The pharmaceutical industry also has had a role in changing disease definitions, rebranding others, creating new ones, and pressuring for approval of treatments to be paid by public, employer, and private plans. In recent years in Brazil there has been a substantial increase in the number of judicial claims demanding that public administrations pay for new treatments. We found that the dispute for the hegemony of the health sector between financial and pharmaceutical companies has deeply transformed the sector. Patients converted into consumers are

  14. The creation of the health consumer: challenges on health sector regulation after managed care era

    Directory of Open Access Journals (Sweden)

    Merhy Emerson E

    2011-02-01

    Full Text Available Abstract Background We utilized our previous studies analyzing the reforms affecting the health sector developed in the 1990s by financial groups to frame the strategies implemented by the pharmaceutical industry to regain market positions and to understand the challenges that regulatory agencies are confronting. Methods We followed an analytical approach for analyzing the process generated by the disputes between the financial groups and the pharmaceutical corporations and the challenges created to governmental regulation. We analyzed primary and secondary sources using situational and discourse analyses. We introduced the concepts of biomedicalization and biopedagogy, which allowed us to analyze how medicalization was radicalized. Results In the 1990s, structural adjustment policies facilitated health reforms that allowed the entrance of multinational financial capital into publicly-financed and employer-based insurance. This model operated in contraposition to the interests of the medical industrial complex, which since the middle of the 1990s had developed silent reforms to regain authority in defining the health-ill-care model. These silent reforms radicalized the medicalization. Some reforms took place through deregulatory processes, such as allowing direct-to-consumer advertisements of prescription drugs in the United States. In other countries different strategies were facilitated by the lack of regulation of other media such as the internet. The pharmaceutical industry also has had a role in changing disease definitions, rebranding others, creating new ones, and pressuring for approval of treatments to be paid by public, employer, and private plans. In recent years in Brazil there has been a substantial increase in the number of judicial claims demanding that public administrations pay for new treatments. Conclusions We found that the dispute for the hegemony of the health sector between financial and pharmaceutical companies has deeply

  15. Contemporary issues and challenges of health sector in Nigeria ...

    African Journals Online (AJOL)

    The paper utilised primary data by interacting with randomly selected medical doctors, pharmacists, image scientists and nurses to elicit facts and information on issues, challenges and problems they experience in their hospitals. The findings of their experiences revealed that constellation of social, economic and ...

  16. The ebola crisis : challenges for global health law

    NARCIS (Netherlands)

    Toebes, Brigit

    2015-01-01

    he recent Ebola crisis has caused approximately 20.000 deaths so far. Compared to other global health crises, including the deaths caused by armed conflicts and chronic diseases, this is still a small amount. Yet, from a global and domestic health law and governance perspective, this crisis raises a

  17. Challenging homeostasis to define biomarkers for nutrition related health

    NARCIS (Netherlands)

    Ommen, van B.; Keijer, J.; Heil, S.G.; Kaput, J.

    2009-01-01

    A primary goal of nutrition research is to optimize health and prevent or delay disease. Biomarkers to quantify health optimization are needed since many if not most biomarkers are developed for diseases. Quantifying normal homeostasis and developing validated biomarkers are formidable tasks because

  18. Interdisciplinary career full of challenges and opportunities. Health physics

    Energy Technology Data Exchange (ETDEWEB)

    Van As, D. (Nuclear Development Corp. of South Africa (Pty.) Ltd., Pelindaba, Pretoria)

    1982-09-01

    South Africa is one of the largest uranium producers in the world. Because of this nuclear energy must be used to its full extent. The development of the nuclear industry and uranium enrichment led to a greater demand for health physics. The career of a health physicist is discussed.

  19. FAMILY HEALTH PROGRAM: CHALLENGES AND POTENTIALITIES REGARDING DRUGS USE

    Directory of Open Access Journals (Sweden)

    Marcelle Aparecida de Barros

    2006-04-01

    Full Text Available ABSTRACT: Epidemiological studies on drugs use point towards this phenomenon as a public health problem. Nowadays, the Family Health Program (FHP is presented by the Health Ministry as a model to restructure primary health care and aims to offer family-centered care, permeated by integrality, problem solving and community bonds. This article aims to discuss action possibilities of Family Health Care professionals involving drugs patients. It is evident that, as opposed to other actions already developed by FHP professionals in other health care areas, which has appeared clearly and objectively. This fact is observed in the daily activities of FHP professionals, which give little attention to drugs-related problems. However, research emphasizes that there exists a broad range of action possibilities for FHP professionals. Although other studies evidence this team’s fragilities in terms of care for drugs users, these can be overcome by investing in the training and valuation of these professionals. KEY WORDS: Family Health Program; Street drugs; Health Knowledge, Attitudes, Practice.

  20. Curriculum challenges faced by rural-origin health science students ...

    African Journals Online (AJOL)

    This article is one of a series of investigations into various aspects of university life and career choices of health science students. Data were collected at three South African universities by the Collaboration for Health Equity through Education and Research (CHEER) collaborators. Ethical permission was sought from each ...

  1. Challenges and opportunities in building health research capacity in ...

    African Journals Online (AJOL)

    Capacity building is considered a priority for health research institutions in developing countries to achieve the Millennium Development Goals by 2015. However, in many countries including Tanzania, much emphasis has been directed towards human resources for health with the total exclusion of human resources for ...

  2. Challenges of Secondary Traumatic Stress in Mental Health Nurses ...

    African Journals Online (AJOL)

    Rwanda Journal Series F: Medicine and Health Sciences Vol. 2 No. 2, 2015 ... can be serious and permanent in mental health workers working with traumatized clients (Satkunanayagam,. Tunariu & Tribe, 2010). ... research approach. The study focused on developing a sense of self-care and wellness using personal and.

  3. Austerity and the challenges of health for all in Nigeria

    Directory of Open Access Journals (Sweden)

    Ogundana Folakemi

    2012-09-01

    Full Text Available The economic downturn experienced by Nigeria and many sub-Saharan African countries led to the adoption of austerity to restore the country’s economy since the 1980s. Since austerity emphasizes privatization and commercialization, instead of restoration, it had, however, impacted especially the Nigerian health sector negatively. Nigeria has indeed continued to bear witness to some of the worst health and healthcare statistics in the world. Evidence from key health indicators in Nigeria also clearly shows that the country’s health situation has experienced massive deterioration. Given the above, the paper argues that austerity constitutes a major impediment to the attainment of a good state of health as well as effective and viable healthcare delivery to all in Nigeria. The paper, therefore suggests: (1 reframing and recognizing health as a human right issue; (2 integration of indigenous medicine into the Nigerian national health delivery systems; (3 recognition of State investment in social services as quite necessary and important such that budget allocation to health is increased as ways forward.

  4. Health in South Africa: changes and challenges since 2009.

    Science.gov (United States)

    Mayosi, Bongani M; Lawn, Joy E; van Niekerk, Ashley; Bradshaw, Debbie; Abdool Karim, Salim S; Coovadia, Hoosen M

    2012-12-08

    Since the 2009 Lancet Health in South Africa Series, important changes have occurred in the country, resulting in an increase in life expectancy to 60 years. Historical injustices together with the disastrous health policies of the previous administration are being transformed. The change in leadership of the Ministry of Health has been key, but new momentum is inhibited by stasis within the health management bureaucracy. Specific policy and programme changes are evident for all four of the so-called colliding epidemics: HIV and tuberculosis; chronic illness and mental health; injury and violence; and maternal, neonatal, and child health. South Africa now has the world's largest programme of antiretroviral therapy, and some advances have been made in implementation of new tuberculosis diagnostics and treatment scale-up and integration. HIV prevention has received increased attention. Child mortality has benefited from progress in addressing HIV. However, more attention to postnatal feeding support is needed. Many risk factors for non-communicable diseases have increased substantially during the past two decades, but an ambitious government policy to address lifestyle risks such as consumption of salt and alcohol provide real potential for change. Although mortality due to injuries seems to be decreasing, high levels of interpersonal violence and accidents persist. An integrated strategic framework for prevention of injury and violence is in progress but its successful implementation will need high-level commitment, support for evidence-led prevention interventions, investment in surveillance systems and research, and improved human-resources and management capacities. A radical system of national health insurance and re-engineering of primary health care will be phased in for 14 years to enable universal, equitable, and affordable health-care coverage. Finally, national consensus has been reached about seven priorities for health research with a commitment to

  5. Opportunities and challenges in the use of personal health data for health research.

    Science.gov (United States)

    Bietz, Matthew J; Bloss, Cinnamon S; Calvert, Scout; Godino, Job G; Gregory, Judith; Claffey, Michael P; Sheehan, Jerry; Patrick, Kevin

    2016-04-01

    Understand barriers to the use of personal health data (PHD) in research from the perspective of three stakeholder groups: early adopter individuals who track data about their health, researchers who may use PHD as part of their research, and companies that market self-tracking devices, apps or services, and aggregate and manage the data that are generated. A targeted convenience sample of 465 individuals and 134 researchers completed an extensive online survey. Thirty-five hour-long semi-structured qualitative interviews were conducted with a subset of 11 individuals and 9 researchers, as well as 15 company/key informants. Challenges to the use of PHD for research were identified in six areas: data ownership; data access for research; privacy; informed consent and ethics; research methods and data quality; and the unpredictable nature of the rapidly evolving ecosystem of devices, apps, and other services that leave "digital footprints." Individuals reported willingness to anonymously share PHD if it would be used to advance research for the good of the public. Researchers were enthusiastic about using PHD for research, but noted barriers related to intellectual property, licensing, and the need for legal agreements with companies. Companies were interested in research but stressed that their first priority was maintaining customer relationships. Although challenges exist in leveraging PHD for research, there are many opportunities for stakeholder engagement, and experimentation with these data is already taking place. These early examples foreshadow a much larger set of activities with the potential to positively transform how health research is conducted. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  6. Missing Midwifery: Relevance for Contemporary Challenges in Maternal Health

    Directory of Open Access Journals (Sweden)

    Rupa Prasad

    2013-01-01

    Full Text Available Midwifery is rooted in public health, and most of its history has been community oriented. In India, midwifery evolved during the British rule; but over the years with changes in political and program priorities, the role and the capacity of midwives has changed substantially. The verticalization of national health programs has obscured the midwives′ community focus and inhibited its contribution to the wider public health. There is a global acceptance and recognition of the midwifery model of care and skilled delivery for ensuring effective maternal health outcomes. The approaches are in line with local needs and have proved its effectiveness in resource-constrained settings. It is important to recognize the substantial contribution they make to public health, working to promote the long-term well-being of women, their babies and families, by offering information and advice on nutrition, supplementation, breastfeeding, and immunization. There is considerable scope for developing the midwifery model through enhancing the extent of their involvement in assessing health needs of local populations, designing, managing and evaluating maternal and health services, making timely and effective referrals and developing family-centered care.

  7. Missing midwifery: relevance for contemporary challenges in maternal health.

    Science.gov (United States)

    Prasad, Rupa; Dasgupta, Rajib

    2013-01-01

    Midwifery is rooted in public health, and most of its history has been community oriented. In India, midwifery evolved during the British rule; but over the years with changes in political and program priorities, the role and the capacity of midwives has changed substantially. The verticalization of national health programs has obscured the midwives' community focus and inhibited its contribution to the wider public health. There is a global acceptance and recognition of the midwifery model of care and skilled delivery for ensuring effective maternal health outcomes. The approaches are in line with local needs and have proved its effectiveness in resource-constrained settings. It is important to recognize the substantial contribution they make to public health, working to promote the long-term well-being of women, their babies and families, by offering information and advice on nutrition, supplementation, breastfeeding, and immunization. There is considerable scope for developing the midwifery model through enhancing the extent of their involvement in assessing health needs of local populations, designing, managing and evaluating maternal and health services, making timely and effective referrals and developing family-centered care.

  8. Pengenalan Pose Tangan Menggunakan HuMoment

    Directory of Open Access Journals (Sweden)

    Dina Budhi Utami

    2017-02-01

    Full Text Available Computer vision yang didasarkan pada pengenalan bentuk memiliki banyak potensi dalam interaksi manusia dan komputer. Pose tangan dapat dijadikan simbol interaksi manusia dengan komputer seperti halnya pada penggunaan berbagai pose tangan pada bahasa isyarat. Berbagai pose tangan dapat digunakan untuk menggantikan fungsi mouse, untuk mengendalikan robot, dan sebagainya. Penelitian ini difokuskan pada pembangunan sistem pengenalan pose tangan menggunakan HuMoment. Proses pengenalan pose tangan dimulai dengan melakukan segmentasi citra masukan untuk menghasilkan citra ROI (Region of Interest yaitu area telapak tangan. Selanjutnya dilakukan proses deteksi tepi. Kemudian dilakukan ekstraksi nilai HuMoment. Nilai HuMoment dikuantisasikan ke dalam bukukode yang dihasilkan dari proses pelatihan menggunakan K-Means. Proses kuantisasi dilakukan dengan menghitung nilai Euclidean Distance terkecil antara nilai HuMomment citra masukan dan bukukode. Berdasarkan hasil penelitian, nilai akurasi sistem dalam mengenali pose tangan adalah 88.57%.

  9. Vulnerable participants in health research: methodological and ethical challenges

    DEFF Research Database (Denmark)

    Nordentoft, Helle Merete; Kappel, Nanna

    2011-01-01

    , leaving both professionals and researchers in ethical and moral dilemmas. In this article, we specifically focus on the methodological challenges of obtaining informed consent from drug users and terminally ill cancer patients in our PhD research. The question is how to illuminate the needs and problems......Ethical guidelines for conducting research are embedded in the Helsinki Declaration of 1964. We contend that these abstract and intentionally universal guidelines need to be appropriated for social and healthcare research, in which purpose and methods often deviate from medical research....... The guidelines appear to be instrumental and over-simplistic representations of the often ‘messy’ realities surrounding the research process that is often guided by relational and local negotiations of ethical solutions. Vulnerable participants, for instance, challenge both professional and research ethics...

  10. Energy and public health: the challenge of peak petroleum.

    Science.gov (United States)

    Frumkin, Howard; Hess, Jeremy; Vindigni, Stephen

    2009-01-01

    Petroleum is a unique and essential energy source, used as the principal fuel for transportation, in producing many chemicals, and for numerous other purposes. Global petroleum production is expected to reach a maximum in the near future and to decline thereafter, a phenomenon known as "peak petroleum." This article reviews petroleum geology and uses, describes the phenomenon of peak petroleum, and reviews the scientific literature on the timing of this transition. It then discusses how peak petroleum may affect public health and health care, by reference to four areas: medical supplies and equipment, transportation, energy generation, and food production. Finally, it suggests strategies for anticipating and preparing for peak petroleum, both general public health preparedness strategies and actions specific to the four expected health system impacts.

  11. The challenge of achieving health equity in Africa | IDRC ...

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

    2011-02-01

    Feb 1, 2011 ... Global health professionals have struggled with a definition for some time. ... That group, which became EQUINET, has grown today to a steering committee ... portrays a burgeoning youth-owned business landscape in Africa, ...

  12. Health system challenges: An obstacle to the success of isoniazid ...

    African Journals Online (AJOL)

    TB a global public health emergency because of 7 - 8 million recor- ded cases, the spread .... deliver, including the procurement of drugs to ensure the availability of IPT. ... research design and instrument development, data interpretation and.

  13. Climate change: challenges and opportunities for global health.

    Science.gov (United States)

    Patz, Jonathan A; Frumkin, Howard; Holloway, Tracey; Vimont, Daniel J; Haines, Andrew

    2014-10-15

    Health is inextricably linked to climate change. It is important for clinicians to understand this relationship in order to discuss associated health risks with their patients and to inform public policy. To provide new US-based temperature projections from downscaled climate modeling and to review recent studies on health risks related to climate change and the cobenefits of efforts to mitigate greenhouse gas emissions. We searched PubMed and Google Scholar from 2009 to 2014 for articles related to climate change and health, focused on governmental reports, predictive models, and empirical epidemiological studies. Of the more than 250 abstracts reviewed, 56 articles were selected. In addition, we analyzed climate data averaged over 13 climate models and based future projections on downscaled probability distributions of the daily maximum temperature for 2046-2065. We also compared maximum daily 8-hour average ozone with air temperature data taken from the National Oceanic and Atmospheric Administration, National Climate Data Center. By 2050, many US cities may experience more frequent extreme heat days. For example, New York and Milwaukee may have 3 times their current average number of days hotter than 32°C (90°F). High temperatures are also strongly associated with ozone exceedance days, for example, in Chicago, Illinois. The adverse health aspects related to climate change may include heat-related disorders, such as heat stress and economic consequences of reduced work capacity; respiratory disorders, including those exacerbated by air pollution and aeroallergens, such as asthma; infectious diseases, including vectorborne diseases and waterborne diseases, such as childhood gastrointestinal diseases; food insecurity, including reduced crop yields and an increase in plant diseases; and mental health disorders, such as posttraumatic stress disorder and depression, that are associated with natural disasters. Substantial health and economic cobenefits could be

  14. Opportunities and challenges within urban health and sustainable development

    DEFF Research Database (Denmark)

    Fisher, Jack E.; Andersen, Zorana J.; Loft, Steffen

    2017-01-01

    The United Nations’ Sustainable Development Goals mark aunique window of opportunity for both human and planetaryhealth. With rising life expectancy and rapidly expanding urbanpopulations exposed to pollution and sedentary lifestyles, thereis a greater focus on reducing the gap between life...... expectancyand number of healthy years lived, whilst limiting anthropogenicactivities contributing to pollution and climate change. Thus,urban development and policies, which can create win–winsituations for our planet and human health, falls into the realmand expertise of public health. However, some...

  15. Social media as a platform for science and health engagement: challenges and opportunities.

    Science.gov (United States)

    Dixon, Graham

    2016-01-01

    Social media has become a major platform for debates on science and health. This commentary argues that while social media can present challenges to communicating important health matters, it can also provide health experts a unique opportunity to engage with and build trust among members of the public.

  16. Nutritional challenges and health implications of takeaway and fast food.

    Science.gov (United States)

    Jaworowska, Agnieszka; Blackham, Toni; Davies, Ian G; Stevenson, Leonard

    2013-05-01

    Consumption of takeaway and fast food continues to increase in Western societies and is particularly widespread among adolescents. Since food is known to play an important role in both the development and prevention of many diseases, there is no doubt that the observed changes in dietary patterns affect the quality of the diet as well as public health. The present review examines the nutritional characteristics of takeaway and fast food items, including their energy density, total fat, and saturated and trans fatty acid content. It also reports on the association between the consumption of such foods and health outcomes. While the available evidence suggests the nutrient profiles of takeaway and fast foods may contribute to a variety of negative health outcomes, findings on the specific effects of their consumption on health are currently limited and, in recent years, changes have been taking place that are designed to improve them. Therefore, more studies should be directed at gaining a firmer understanding of the nutrition and health consequences of eating takeaway and fast foods and determining the best strategy to reduce any negative impact their consumption may have on public health. © 2013 International Life Sciences Institute.

  17. India-EU relations in health services: prospects and challenges

    Science.gov (United States)

    2011-01-01

    Background India and the EU are currently negotiating a Trade and Investment Agreement which also covers services. This paper examines the opportunities for and constraints to India-EU relations in health services in the context of this agreement, focusing on the EU as a market for India's health services exports and collaboration. The paper provides an overview of key features of health services in the EU and India and their bearing on bilateral relations in this sector. Methods Twenty six semi-structured, in-person, and telephonic interviews were conducted in 2007-2008 in four Indian cities. The respondents included management and practitioners in a variety of healthcare establishments, health sector representatives in Indian industry associations, health sector officials in the Indian government, and official representatives of selected EU countries and the European Commission based in New Delhi. Secondary sources were used to supplement and corroborate these findings. Results The interviews revealed that India-EU relations in health services are currently very limited. However, several opportunity segments exist, namely: (i) Telemedicine; (ii) Clinical trials and research in India for EU-based pharmaceutical companies; (iii) Medical transcriptions and back office support; (iv) Medical value travel; and (v) Collaborative ventures in medical education, research, training, staff deployment, and product development. However, various factors constrain India's exports to the EU. These include data protection regulations; recognition requirements; insurance portability restrictions; discriminatory conditions; and cultural, social, and perception-related barriers. The interviews also revealed several constraints in the Indian health care sector, including disparity in domestic standards and training, absence of clear guidelines and procedures, and inadequate infrastructure. Conclusions The paper concludes that although there are several promising areas for India

  18. India-EU relations in health services: prospects and challenges

    Directory of Open Access Journals (Sweden)

    Chanda Rupa

    2011-02-01

    Full Text Available Abstract Background India and the EU are currently negotiating a Trade and Investment Agreement which also covers services. This paper examines the opportunities for and constraints to India-EU relations in health services in the context of this agreement, focusing on the EU as a market for India's health services exports and collaboration. The paper provides an overview of key features of health services in the EU and India and their bearing on bilateral relations in this sector. Methods Twenty six semi-structured, in-person, and telephonic interviews were conducted in 2007-2008 in four Indian cities. The respondents included management and practitioners in a variety of healthcare establishments, health sector representatives in Indian industry associations, health sector officials in the Indian government, and official representatives of selected EU countries and the European Commission based in New Delhi. Secondary sources were used to supplement and corroborate these findings. Results The interviews revealed that India-EU relations in health services are currently very limited. However, several opportunity segments exist, namely: (i Telemedicine; (ii Clinical trials and research in India for EU-based pharmaceutical companies; (iii Medical transcriptions and back office support; (iv Medical value travel; and (v Collaborative ventures in medical education, research, training, staff deployment, and product development. However, various factors constrain India's exports to the EU. These include data protection regulations; recognition requirements; insurance portability restrictions; discriminatory conditions; and cultural, social, and perception-related barriers. The interviews also revealed several constraints in the Indian health care sector, including disparity in domestic standards and training, absence of clear guidelines and procedures, and inadequate infrastructure. Conclusions The paper concludes that although there are several

  19. The mental health system in Brazil: Policies and future challenges

    Directory of Open Access Journals (Sweden)

    Razzouk Denise

    2008-09-01

    Full Text Available Abstract Background The aim of this paper is to assess the mental health system in Brazil in relation to the human resources and the services available to the population. Methods The World Health Organization Assessment Instrument for Mental Health Systems (WHO AIMS was recently applied in Brazil. This paper will analyse data on the following sections of the WHO-AIMS: a mental health services; and b human resources. In addition, two more national datasets will be used to complete the information provided by the WHO questionnaire: a the Executive Bureau of the Department of Health (Datasus; and b the National Register of Health Institutions (CNS. Results There are 6003 psychiatrists, 18,763 psychologists, 1985 social workers, 3119 nurses and 3589 occupational therapists working for the Unified Health System (SUS. At primary care level, there are 104,789 doctors, 184, 437 nurses and nurse technicians and 210,887 health agents. The number of psychiatrists is roughly 5 per 100,000 inhabitants in the Southeast region, and the Northeast region has less than 1 psychiatrist per 100,000 inhabitants. The number of psychiatric nurses is insufficient in all geographical areas, and psychologists outnumber other mental health professionals in all regions of the country. The rate of beds in psychiatric hospitals in the country is 27.17 beds per 100,000 inhabitants. The rate of patients in psychiatric hospitals is 119 per 100,000 inhabitants. The average length of stay in mental hospitals is 65.29 days. In June 2006, there were 848 Community Psychosocial Centers (CAPS registered in Brazil, a ratio of 0.9 CAPS per 200,000 inhabitants, unequally distributed in the different geographical areas: the Northeast and the North regions having lower figures than the South and Southeast regions. Conclusion The country has opted for innovative services and programs, such as the expansion of Psychosocial Community Centers and the Return Home program to deinstitutionalize

  20. Health Challenges in Refugee Reception: Dateline Europe 2016.

    Science.gov (United States)

    Blitz, Brad K; d'Angelo, Alessio; Kofman, Eleonore; Montagna, Nicola

    2017-11-30

    The arrival of more than one million migrants, many of them refugees, has proved a major test for the European Union. Although international relief and monitoring agencies have been critical of makeshift camps in Calais and Eidomeni where infectious disease and overcrowding present major health risks, few have examined the nature of the official reception system and its impact on health delivery. Drawing upon research findings from an Economic and Social Research Council (ESRC) funded project, this article considers the physical and mental health of asylum-seekers in transit and analyses how the closure of borders has engendered health risks for populations in recognised reception centres in Sicily and in Greece. Data gathered by means of a survey administered in Greece (300) and in Sicily (400), and complemented by in-depth interviews with migrants (45) and key informants (50) including representatives of government offices, humanitarian and relief agencies, NGOs and activist organisations, are presented to offer an analysis of the reception systems in the two frontline states. We note that medical provision varies significantly from one centre to another and that centre managers play a critical role in the transmission of vital information. A key finding is that, given such disparity, the criteria used by the UNHCR to grade health services reception do not address the substantive issue that prevent refugees from accessing health services, even when provided on site. Health provision is not as recorded in UNHCR reporting but rather there are critical gaps between provision, awareness, and access for refugees in reception systems in Sicily and in Greece. This article concludes that there is a great need for more information campaigns to direct refugees to essential services.

  1. Health Challenges in Refugee Reception: Dateline Europe 2016

    Directory of Open Access Journals (Sweden)

    Brad K. Blitz

    2017-11-01

    Full Text Available The arrival of more than one million migrants, many of them refugees, has proved a major test for the European Union. Although international relief and monitoring agencies have been critical of makeshift camps in Calais and Eidomeni where infectious disease and overcrowding present major health risks, few have examined the nature of the official reception system and its impact on health delivery. Drawing upon research findings from an Economic and Social Research Council (ESRC funded project, this article considers the physical and mental health of asylum–seekers in transit and analyses how the closure of borders has engendered health risks for populations in recognised reception centres in Sicily and in Greece. Data gathered by means of a survey administered in Greece (300 and in Sicily (400, and complemented by in-depth interviews with migrants (45 and key informants (50 including representatives of government offices, humanitarian and relief agencies, NGOs and activist organisations, are presented to offer an analysis of the reception systems in the two frontline states. We note that medical provision varies significantly from one centre to another and that centre managers play a critical role in the transmission of vital information. A key finding is that, given such disparity, the criteria used by the UNHCR to grade health services reception do not address the substantive issue that prevent refugees from accessing health services, even when provided on site. Health provision is not as recorded in UNHCR reporting but rather there are critical gaps between provision, awareness, and access for refugees in reception systems in Sicily and in Greece. This article concludes that there is a great need for more information campaigns to direct refugees to essential services.

  2. Health Challenges in Refugee Reception: Dateline Europe 2016

    Science.gov (United States)

    Blitz, Brad K.; d’Angelo, Alessio; Kofman, Eleonore; Montagna, Nicola

    2017-01-01

    The arrival of more than one million migrants, many of them refugees, has proved a major test for the European Union. Although international relief and monitoring agencies have been critical of makeshift camps in Calais and Eidomeni where infectious disease and overcrowding present major health risks, few have examined the nature of the official reception system and its impact on health delivery. Drawing upon research findings from an Economic and Social Research Council (ESRC) funded project, this article considers the physical and mental health of asylum–seekers in transit and analyses how the closure of borders has engendered health risks for populations in recognised reception centres in Sicily and in Greece. Data gathered by means of a survey administered in Greece (300) and in Sicily (400), and complemented by in-depth interviews with migrants (45) and key informants (50) including representatives of government offices, humanitarian and relief agencies, NGOs and activist organisations, are presented to offer an analysis of the reception systems in the two frontline states. We note that medical provision varies significantly from one centre to another and that centre managers play a critical role in the transmission of vital information. A key finding is that, given such disparity, the criteria used by the UNHCR to grade health services reception do not address the substantive issue that prevent refugees from accessing health services, even when provided on site. Health provision is not as recorded in UNHCR reporting but rather there are critical gaps between provision, awareness, and access for refugees in reception systems in Sicily and in Greece. This article concludes that there is a great need for more information campaigns to direct refugees to essential services. PMID:29189766

  3. Air pollution and population health: a global challenge.

    Science.gov (United States)

    Chen, Bingheng; Kan, Haidong

    2008-03-01

    "Air pollution and population health" is one of the most important environmental and public health issues. Economic development, urbanization, energy consumption, transportation/motorization, and rapid population growth are major driving forces of air pollution in large cities, especially in megacities. Air pollution levels in developed countries have been decreasing dramatically in recent decades. However, in developing countries and in countries in transition, air pollution levels are still at relatively high levels, though the levels have been gradually decreasing or have remained stable during rapid economic development. In recent years, several hundred epidemiological studies have emerged showing adverse health effects associated with short-term and long-term exposure to air pollutants. Time-series studies conducted in Asian cities also showed similar health effects on mortality associated with exposure to particulate matter (PM), sulfur dioxide (SO(2)), nitrogen dioxide (NO(2)) and ozone (O(3)) to those explored in Europe and North America. The World Health Organization (WHO) published the "WHO Air Quality Guidelines (AQGs), Global Update" in 2006. These updated AQGs provide much stricter guidelines for PM, NO(2), SO(2) and O(3). Considering that current air pollution levels are much higher than the WHO-recommended AQGs, interim targets for these four air pollutants are also recommended for member states, especially for developing countries in setting their country-specific air quality standards. In conclusion, ambient air pollution is a health hazard. It is more important in Asian developing countries within the context of pollution level and population density. Improving air quality has substantial, measurable and important public health benefits.

  4. The challenge that Confucian filial piety poses for Korean churches ...

    African Journals Online (AJOL)

    Journal Home > Vol 70, No 2 (2014) > ... Contemporary ancestor worship is currently practiced around the world in several different forms. However, the essence and practice of ancestor worship varies throughout Asia, Africa, Oceania and ...

  5. The challenge that Confucian filial piety poses for Korean churches

    African Journals Online (AJOL)

    2014-04-30

    Apr 30, 2014 ... Thus, Korean Confucians and non-Christians have criticised. Christianity as a .... The piel form is primarily a declarative meaning of 'honour or .... Confucian ancestor worship is not just the memory of the dead father and ...

  6. The challenge that Confucian filial piety poses for Korean churches

    Directory of Open Access Journals (Sweden)

    David M. Park

    2014-04-01

    Full Text Available Contemporary ancestor worship is currently practiced around the world in several different forms. However, the essence and practice of ancestor worship varies throughout Asia, Africa, Oceania and Latin America. The context of countries under the influence of Confucianism is very different from that of other countries. Confucianism teaches that ancestor worship is the most prized display of filial piety toward one’s dead ancestors. Amongst Asian countries under the influence of Confucianism – specifically China, Japan, Malaysia, Taiwan, Vietnam and Korea – ancestor worship has not only been accepted and propagated as a culture, but it is also considered to be filial piety. Especially the Korean people think that ancestor worship is a very important expression of filial piety, and it is a ritual which they practice regularly during their festive days. What does Confucianism teach about filial piety, and how is ancestor worship practiced? What does the Bible teach about filial piety? Are practical applications of biblical filial piety present in Korean society? Rather than allowing Confucian ancestor worship to take root in Korean society as a traditional Korean heritage, the conclusion is that Korean Christians must make an effort to teach and facilitate biblical filial piety.

  7. Lost in Translation? Challenges and Opportunities for Raising Health and Safety Awareness among a Multinational Workforce in the United Arab Emirates

    Science.gov (United States)

    Cooling, Robert Fletcher; Aw, Tar-Ching

    2012-01-01

    The United Arab Emirates (UAE) has experienced tremendous economic and industrial growth in the petroleum, airline, maritime and construction sectors, especially since the discovery of oil reserves. Mass recruitment of low skilled or unskilled laborers from less-developed countries has been utilized to satisfy the manpower demands of these fast paced industrial developments. Such workforce recruitment has created an unusual populace demographic, with the total UAE population estimated at 8.3 million, composed of 950,000 Emiratis, with the remainder being multinational expatriate workers, with varying educational qualifications, work experience, religious beliefs, cultural practices, and native languages. These unique characteristics pose a challenge for health and safety professionals tasked with ensuring the UAE workforce adheres to specific occupational health and safety procedures. The paper discusses two case studies that employ a novel multimedia approach to raising health and safety awareness among a multinational workforce. PMID:23251846

  8. Challenges of implementing routine health behavior change support in a children's hospital setting.

    Science.gov (United States)

    Elwell, Laura; Powell, Jane; Wordsworth, Sharon; Cummins, Carole

    2014-07-01

    Evidence indicates that health behavior change initiatives are often not implemented successfully. This qualitative study aims to understand the barriers and facilitators to implementation of health behavior change brief advice into routine practice in an acute children's hospital setting. Semi-structured interviews were conducted with health professionals working at a UK children's hospital (n=33). Participants were purposively sampled to incorporate a range of specialties, job roles and training. An inductive thematic framework analysis identified two emergent themes. These capture the challenges of implementing routine health behavior change support in a children's hospital setting: (1) 'health professional knowledge, beliefs and behaviors' and (2) 'patient and family related challenges'. This study enhances findings from previous research by outlining the challenges pediatric health professionals face in relation to supporting health behavior change. Challenges include failure to assume responsibility, low confidence, prioritization of the health provider relationship with patients and families, health provider and patient knowledge, and low patient and family motivation. Skills-based behavior change training is needed for pediatric health professionals to effectively support health behavior change. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  9. Strategies for health promotion: facing the challenge in South Africa.

    Science.gov (United States)

    Temple, Norman J

    2007-01-01

    Many health promotion intervention studies have been conducted with the goal of encouraging people to change their lifestyles. These include interventions in the community, at worksites, in a medical setting, and on patients at high risk of disease. These interventions have had, in general, a limited impact (eg, risk of heart disease is lowered by 5%-15%). These interventions were carried out in developed countries, and little is known as to their effectiveness in developing countries such as South Africa. Numerous barriers impede the success of health promotion interventions, including the cost of healthy food, advertising for unhealthy food, and food labels that are confusing. Policy measures are proposed, including government interventions using taxes and subsidies so as to manipulate prices and bring about desirable changes in eating patterns and other aspects of lifestyle. A new type of healthcare professional is suggested with a specialization in health promotion.

  10. Brain drain: a challenge to global mental health.

    Science.gov (United States)

    Oladeji, Bibilola D; Gureje, Oye

    2016-08-01

    The brain drain of medical professionals from lower-income to higher-income countries contributes to the current inequity that characterises access to mental healthcare by those in need across the world and hinders efforts to scale up mental health services in resource-constrained settings, especially in Nigeria and other West African countries. The migration of skilled workers is driven by a combination of the globalisation of the labour market and the ability of highly resourced countries to attract and retain specialists from poorer countries. If we are to ameliorate the worldwide shortage of mental health professionals, we need to find innovative ways of attracting young doctors into psychiatric training in all countries. We must also introduce measures to improve health worker retention in low- and middle-income countries.

  11. The Challenge of Behaviour Change and Health Promotion

    Directory of Open Access Journals (Sweden)

    Glenn Laverack

    2017-10-01

    Full Text Available The evidence about the effectiveness of behaviour change approaches—what works and what does not work—is unclear. What we do know is that single interventions that target a specific behavioural risk have little impact on the determinants that actually cause poor health, especially for vulnerable people. This has not prevented health promoters from continuing to invest in behaviour change interventions which are widely used in a range of programs. The future of behaviour change and health promotion is through the application of a comprehensive strategy with three core components: (1 a behaviour change approach; (2 a strong policy framework that creates a supportive environment and (3 the empowerment of people to gain more control over making healthy lifestyle decisions. This will require the better planning of policy interventions and the coordination of agencies involved in behaviour change and empowerment activities at the community level, with government to help develop policy at the national level.

  12. Epidemiology in the Era of Health Informatics: Opportunities & Challenges

    Directory of Open Access Journals (Sweden)

    Rajesh Kumar

    2016-03-01

    Full Text Available Over the years, epidemiology has played a key role in improving our understanding about the determinants of health and disease. In the 19th century epidemiological observations led to the discovery of the modes of communication of cholera much before the discovery of the causative organism responsible for it. Similarly, in the 20th century, it led to the discovery of the risks of tobacco smoking, and the modes of transmission of AIDS. In the 21st century, advancement in the computation, visualization, communication, and mhealth technologies are likely to expand the landscape of epidemiology which has now acquired the status of a core discipline of health sciences.

  13. Multi-task pose-invariant face recognition.

    Science.gov (United States)

    Ding, Changxing; Xu, Chang; Tao, Dacheng

    2015-03-01

    Face images captured in unconstrained environments usually contain significant pose variation, which dramatically degrades the performance of algorithms designed to recognize frontal faces. This paper proposes a novel face identification framework capable of handling the full range of pose variations within ±90° of yaw. The proposed framework first transforms the original pose-invariant face recognition problem into a partial frontal face recognition problem. A robust patch-based face representation scheme is then developed to represent the synthesized partial frontal faces. For each patch, a transformation dictionary is learnt under the proposed multi-task learning scheme. The transformation dictionary transforms the features of different poses into a discriminative subspace. Finally, face matching is performed at patch level rather than at the holistic level. Extensive and systematic experimentation on FERET, CMU-PIE, and Multi-PIE databases shows that the proposed method consistently outperforms single-task-based baselines as well as state-of-the-art methods for the pose problem. We further extend the proposed algorithm for the unconstrained face verification problem and achieve top-level performance on the challenging LFW data set.

  14. Bringing Wellness to Schools: Opportunities for and Challenges to Mental Health Integration in School-Based Health Centers.

    Science.gov (United States)

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

    2016-12-01

    School-based health centers (SBHCs) reduce access barriers to mental health care and improve educational outcomes for youths. This qualitative study evaluated the innovations and challenges of a unique network of SBHCs in a large, urban school district as the centers attempted to integrate health, mental health, and educational services. The 43 participants sampled included mental health providers, primary care providers, and care coordinators at 14 SBHCs. Semistructured interviews with each participant were audio recorded and transcribed. Themes were identified and coded by using Atlas.ti 5.1 and collapsed into three domains: operations, partnership, and engagement. Interviews revealed provider models ranging from single agencies offering both primary care and mental health services to colocated services. Sites where the health agency provided at least some mental health services reported more mental health screenings. Many sites used SBHC wellness coordinators and coordination team meetings to facilitate relationships between schools and health agency and community mental health clinic providers. Partnership challenges included confidentiality policies and staff turnover. Participants also highlighted student and parent engagement through culturally sensitive services, peer health advocates, and "drop-in" lunches. Staffing and operational models are critical in the success of integrating primary care, mental health care, and education. Among the provider models observed, the combined primary care and mental health provider model offered the most integrated services. Despite barriers, providers and schools have begun to implement novel solutions to operational problems and family engagement in mental health services.

  15. Pilot Implementation of Health Information Systems: Issues and challenges

    DEFF Research Database (Denmark)

    Bansler, Jørgen P.; Havn, Erling C.

    2009-01-01

    Pilot implementation is a powerful and widely used approach in identifying design flaws and implementation issues before the full-scale deployment of new health information systems. However, pilot implementations often fail in the sense that they say little about the usability and usefulness...

  16. medical tourism in nigeria: challenges and remedies to health care ...

    African Journals Online (AJOL)

    DGS-FUTO

    2018-06-01

    Jun 1, 2018 ... distinct services namely: healthcare and tourism. .... Despite Nigeria‟s strategic position as the giant of Africa and her position in the .... adapted, the lost glory of the country‟s health care system would be restored and the.

  17. Human Resource Development for Health in Ethiopia: Challenges of ...

    African Journals Online (AJOL)

    Review of different documents on human resource for health was undertaken. Particular attention was given to documents from Ethiopia. Generally there is shortage in number of different groups of professionals, mal distribution of professionals between regions, urban and rural setting, and governmental and non ...

  18. Maternal health in fifty years of Tanzania independence: Challenges ...

    African Journals Online (AJOL)

    High rate of maternal death is one of the major public health concerns in Tanzania. ... had been on a downward trend from 453 to 200 per 100,000 live births. ... Current statistics indicate that maternal mortality ratio has dropped slightly in 2010 ...

  19. Psychosocial health challenges of the elderly in Nigeria: a narrative ...

    African Journals Online (AJOL)

    Objective: We aimed to review the literature that describes the current situation ... creased demand for healthcare services, increased economic stress, and decreased ... ituality,10 may not elucidate the true role of psychosocial .... al tool for this critical public health issue.28 It is important .... themselves as being fit to work.

  20. Holistic Health Care: A Challenge to Podiatric Medical Practice.

    Science.gov (United States)

    Levy, Leonard A.; Levine, Peter M.

    1980-01-01

    As the profession of podiatric medicine becomes more closely identified with the delivery of primary care, it is suggested that it is essential for practicing podiatrists and students to have more educational opportunities in the field of holistic health care, psychiatry, and the behavioral sciences. (Author/MLW)

  1. Primary health care management challenges for childhood atopic ...

    African Journals Online (AJOL)

    Kaarina Frieda Meintjes

    primary health care (PHC) management of their children's atopic eczema in a Gauteng district. A qualitative, explorative, descriptive, contextual embedded single case study design ... direct observation until saturation occurred; analysed according to Tesch's ..... needed, it was provided by the researcher as part of the pro-.

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

    Science.gov (United States)

    Mirin, Steven; Summergrad, Paul

    2011-01-01

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

  3. Global child health: challenges and goals in the 1990s.

    Science.gov (United States)

    Reid, R S

    1994-01-01

    The UNICEF message to the pediatricians and child health experts attending the Regional Pediatric Congress of the Union of National Pediatric Societies of Turkish Republics is that the way children are conceptualized in the development process has a major impact on poverty. UNICEF argues that human resource development is the safest way out of population pressure, vanishing forests, and despoiled rivers. Thailand, South Korea, Taiwan, and Singapore are examples of countries that "sacrificed, deferred consumer gratification of the elites, and disciplined themselves" in order to provide better care for their children in terms of good nutrition, good health care, and rigorous primary and secondary education for all children. Family planning was available to all parents. The emphasis was on hygiene, immunization, clean water supplies, and sanitation. Lower infant and child mortality created confidence in child survival and parental willingness to have fewer children. The working population is healthier due to the state nutrition programs and a better skilled labor force due to education and training. These countries are no longer underdeveloped because of the priority on children for over a generation and a half. Robert Heilbroner has described this strategy for development as based on social development, human development, and protection of children aged under 5 years. The Alma Ata conference in 1976 was instrumental in focusing on the health of the child by setting a standard of health for all by the year 2000. Many countries are moving in the direction proposed in these agendas. The result has been a 33% reduction in child mortality within 10 years and greater immunization in some developing countries than in Europe and North America. Immunization rates in Ankara, Turkey; Calcutta, India; Lagos, Nigeria; and Mexico City are higher than in Washington, D.C. or New York City. The 1990 World Summit for Children found that the following rules are applicable to

  4. Grandparent caregiving among rural African Americans in a community in the American South: challenges to health and wellbeing.

    Science.gov (United States)

    Clottey, Emmanuel N; Scott, Alison J; Alfonso, Moya L

    2015-01-01

    as well as their grandchildren's. Financial scarcity added to their vulnerability to poor health outcomes, especially when caregivers would forego purchase of medications or visits to the doctor because of expenses related to their grandchildren. In addition, lack of child care made health appointments and hospitalizations logistically difficult. Emotional strain was common as grandparent caregivers struggled to protect their grandchildren in communities where rates of drug use, HIV, and incarceration were high. Caregivers worried about their mortality and the related consequences for their grandchildren. Chronic stress, which is linked to a number of poor health outcomes, was self-reported by most rural grandparent caregivers. In this study, the challenges of rural grandparent caregiving among African American women posed multiple threats to health and wellbeing. Further research is needed, in different rural contexts and with different caregiver populations, to more thoroughly examine the health risks of grandparent caregiving. In addition, the development of multi-faceted interventions and programs will be critical to meeting the needs of rural grandparent caregivers. A few models for such programs exist, although resource shortfalls have often limited their impact.

  5. The emergence of precision therapeutics: New challenges and opportunities for Canada's health leaders.

    Science.gov (United States)

    Slater, Jim; Shields, Laura; Racette, Ray J; Juzwishin, Donald; Coppes, Max

    2015-11-01

    In the era of personalized and precision medicine, the approach to healthcare is quickly changing. Genetic and other molecular information are being increasingly demanded by clinicians and expected by patients for prevention, screening, diagnosis, prognosis, health promotion, and treatment of an increasing number of conditions. As a result of these developments, Canadian health leaders must understand and be prepared to lead the necessary changes associated with these disruptive technologies. This article focuses on precision therapeutics but also provides background on the concepts and terminology related to personalized and precision medicine and explores Canadian health leadership and system issues that may pose barriers to their implementation. The article is intended to inspire, educate, and mobilize Canadian health leaders to initiate dialogue around the transformative changes necessary to ready the healthcare system to realize the benefits of precision therapeutics. © 2015 Collège canadien des leaders en santé

  6. Towards Horizon 2020: challenges and advances for clinical mental health research – outcome of an expert survey

    Directory of Open Access Journals (Sweden)

    van der Feltz-Cornelis CM

    2014-06-01

    Full Text Available Christina M van der Feltz-Cornelis,1–3 Jim van Os,4,6 Susanne Knappe,5 Gunter Schumann,6 Eduard Vieta,7 Hans-Ulrich Wittchen,5 Shôn W Lewis,8 Iman Elfeddali,2,9 Kristian Wahlbeck,10,11 Donald Linszen,4 Carla Obradors-Tarragó,12,13 Josep Maria Haro12–141Trimbos Instituut, Utrecht, 2Tilburg University, Tranzo Department, Tilburg, 3GGz Breburg, Tilburg, 4Department of Psychiatry and Psychology, South Limburg Mental Health Research and Teaching Network, Euron, Maastricht University Medical Center, Maastricht, the Netherlands; 5Institute of Clinical Psychology and Psychotherapy and Center for Epidemiology and Longitudinal Studies, Technische Universität Dresden, Dresden, Germany; 6Institute of Psychiatry, King’s College London, London, UK; 7Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain; 8School of Community-Based Medicine, University of Manchester, Manchester, UK; 9Department of Health Promotion/School of Public Health and Primary Care, Maastricht University, Maastricht, the Netherlands; 10The Nordic School of Public Health, Gothenburg, Sweden; 11National Institute for Health and Welfare, Helsinki, Finland; 12Centro de Investigación Biomédica en Red de Salud Mental, Madrid, 13Research and Development Unit, Parc Sanitari Sant Joan de Déu, Fundació Sant Joan de Déu, Sant Boi de Llobregat, 14Universitat de Barcelona, Barcelona, SpainBackground: The size and increasing burden of disease due to mental disorders in Europe poses substantial challenges to its population and to the health policy of the European Union. This warrants a specific research agenda concerning clinical mental health research as one of the cornerstones of sustainable mental health research and health policy in Europe. The aim of this research was to identify the top priorities needed to address the main challenges in clinical research for mental disorders.Methods: The research was conducted as an

  7. From occupational safety and health to Workers' Health: history and challenges to the Brazilian Journal of Occupational Health.

    Science.gov (United States)

    Jackson Filho, José Marçal; Algranti, Eduardo; Saito, Cézar Akiyoshi; Garcia, Eduardo Garcia

    2015-07-01

    The Revista Brasileira de Saúde Ocupacional (RBSO) - Brazilian Journal of Occupational Health - is an academic peer-reviewed journal in the field of Workers' Health that has been published by Fundacentro since 1973. Its historical trajectory, current performance, challenges and future perspectives were approached, in this paper, from a documental analysis. The journal's history can be divided into three periods, starting during the military government. At the beginning, the journal was the official vehicle for the Brazilian occupational accidents prevention policy, in which Fundacentro played a central role. The early 1980s opens space for technical-scientific publications and the field of Workers' Health emerges on the journal's pages. In 2005-6, a restructuring process is implemented, ensuring independent editorial policy and structures. Since 2006, 139 original papers and 9 thematic issues have been published. The journal is indexed in 9 bibliographic databases, has been ranked B1 in the field of interdisciplinary studies and B2 in the field of public health by CAPES, has an upward trend in the SciELO Impact Factor, and has an h-index of 5 in Google Scholar. Nevertheless, the low scientific production in the field and the high rate of rejection of manuscripts may jeopardize the survival of the journal, which is the main locus for scientific publications in the field of Workers' Health.

  8. Nanomaterials: new challenges in environmental health and safety

    International Nuclear Information System (INIS)

    Sun, Casper; Gallaghar, Robert G.

    2008-01-01

    A follow-up of the Nano-panel discussion in the 41 st Midyear Health Physics Society (HPS) meeting, Oakland CA, 'Accelerators and Nanoparticles' have been introduced to and discussed among participants, i.e., health physicists, especially within the topic that monitoring and measurement of nano-radioactive materials. It is documented clearly that the chemistry and physical mobility and optical properties, and the monitoring and protection requirements for nano-radioactive substances vary observed from collective experiences. Soon after nanocarbon-tube discovery and use of the innovated materials expand, as nanoscience and nanotechnogy, exponential globally and revolutionized in just about every industries, for examples, agricultural, chemical, biological, pharmaceutical, medical, electronic, green-energies. To produce individual desired benefits, the engineered tiny substances could add health risk inevitably to the workers and consumers. The environmental health and safety (EH and S) research budgets and awareness programs have been steady increased in according with National Nanotechnology Initiative (NNI) report. All nanoscale materials which they have virtually invisible and yet can penetrate and deposit on cell walls of living organs and tissues without being detected once inhaled or ingested in the body, the handling and application of these materials with associated hazard in terms of occupational and environment risk must be identified, investigated, and documented before any of damage or vulnerability revealed. In the other words, be prepared then sorry. Many common properties and risk issues are identical or very similar between radioactive and nanoscale materials. Both are exist naturally and will persist. What is and is not a problem, must be clearly understood to support operational and protection decision making. The safety data must be provided in Internet transparently and voluntarily. All nanomaterials should consider as hazard before proofed. The

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

    Science.gov (United States)

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

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

  10. Great expectations: challenges for women as mental health administrators.

    Science.gov (United States)

    Scheidt, S D

    1994-01-01

    Although women have made many strides in the area of leadership, stereotypes still exist that limit their power. Traditional concepts of femininity have not typically been associated with strength and competence. This article describes an inpatient unit at San Francisco General Hospital, University of California, San Francisco, which is led by a group of women. The unit houses a women-focused treatment team specializing in treating women who have serious mental illness with histories of severe trauma, including poverty and violence. The article describes the challenges and rewards available to women leaders in this type of setting. Four areas of women's leadership are explored: the stereotypes women have about each other as leaders, the expectations and biases of staff and trainees, the projections of patients onto women leaders, and women's leadership in relation to department administration. Strategies for addressing biases in these areas and developing women's leadership conclude the article.

  11. Mental health care in Nepal: current situation and challenges for development of a district mental health care plan.

    Science.gov (United States)

    Luitel, Nagendra P; Jordans, Mark Jd; Adhikari, Anup; Upadhaya, Nawaraj; Hanlon, Charlotte; Lund, Crick; Komproe, Ivan H

    2015-01-01

    Globally mental health problems are a serious public health concern. Currently four out of five people with severe mental illness in Low and Middle Income Countries (LMIC) receive no effective treatment. There is an urgent need to address this enormous treatment gap. Changing the focus of specialist mental health workers (psychiatrists and psychologists) from only service delivery to also designing and managing mental health services; building clinical capacity of the primary health care (PHC) workers, and providing supervision and quality assurance of mental health services may help in scaling up mental health services in LMICs. Little is known however, about the mental health policy and services context for these strategies in fragile-state settings, such as Nepal. A standard situation analysis tool was developed by the PRogramme for Improving Mental health carE (PRIME) consortium to systematically analyze and describe the current gaps in mental health care in Nepal, in order to inform the development of a district level mental health care plan (MHCP). It comprised six sections; general information (e.g. population, socio-economic conditions); mental health policies and plans; mental health treatment coverage; district health services; and community services. Data was obtained from secondary sources, including scientific publications, reports, project documents and hospital records. Mental health policy exists in Nepal, having been adopted in 1997, but implementation of the policy framework has yet to begin. In common with other LMICs, the budget allocated for mental health is minimal. Mental health services are concentrated in the big cities, with 0.22 psychiatrists and 0.06 psychologists per 100,000 population. The key challenges experienced in developing a district level MHCP included, overburdened health workers, lack of psychotropic medicines in the PHC, lack of mental health supervision in the existing system, and lack of a coordinating body in the Ministry

  12. Brain drain: a challenge to global mental health

    OpenAIRE

    Oladeji, Bibilola D.; Gureje, Oye

    2016-01-01

    The brain drain of medical professionals from lower-income to higher-income countries contributes to the current inequity that characterises access to mental healthcare by those in need across the world and hinders efforts to scale up mental health services in resource-constrained settings, especially in Nigeria and other West African countries. The migration of skilled workers is driven by a combination of the globalisation of the labour market and the ability of highly resourced countries t...

  13. CLIMATE CHANGE AND HEALTHCHALLENGES FOR HUNGARY

    OpenAIRE

    Anna Paldy; Janos Bobvos

    2010-01-01

    In Hungary detailed research work has been carried out since several years to help the process of getting prepared and adapted to the impacts of climate change. The research activities concerned mainly the health impacts of heat waves (excess mortality). Based on the results of the time series statistical analysis of weather variables and daily mortality of Budapest, it was found that a 5º C increase of the daily mean temperature increases of the risk of all cause mort...

  14. Occupational Health: Meeting the Challenges of the Next 20 Years

    OpenAIRE

    Harrison, John; Dawson, Leonie

    2015-01-01

    Background: The industrial revolution that took place in the United Kingdom (UK) between 1760 and 1830 led to profound social change. Occupational medicine was concerned with the diagnosis, treatment, and prevention of occupational diseases, that is, diseases directly caused by exposure to workplace hazards. A similar pattern of development has occurred globally. Methods: A review of relevant literature. Results: The international conceptualization and development of occupational health...

  15. Air pollution and population health: a global challenge

    OpenAIRE

    Chen, Bingheng; Kan, Haidong

    2008-01-01

    “Air pollution and population health” is one of the most important environmental and public health issues. Economic development, urbanization, energy consumption, transportation/motorization, and rapid population growth are major driving forces of air pollution in large cities, especially in megacities. Air pollution levels in developed countries have been decreasing dramatically in recent decades. However, in developing countries and in countries in transition, air pollution levels are still...

  16. Physiological Health Challenges for Human Missions to Mars

    Science.gov (United States)

    Norsk, Peter

    2015-01-01

    During the next decades, manned space missions are expected to be aiming at the Lagrange points, near Earth asteroids, and Mars flyby and/or landing. The question is therefore: Are we ready to go? To answer this with a yes, we are currently using the International Space Station to develop an integrated human physiological countermeasure suite. The integrated countermeasure suite will most likely encounter: 1) Exercise devices for aerobic, dynamic and resistive exercise training; 2) sensory-motor computer training programs and anti-motion sickness medication for preparing EVAs and G-transitions; 3) lower limb bracelets for preventing and/or treating the VIIP (vision impairment and intracranial pressure) syndrome; 4) nutritional components for maintenance of bone, muscle, the cardiovascular system and preventing oxidative stress and damage and immune deficiencies (e. g. omega-3 fatty acids, PRO/K, anti-oxidants and less salt and iron); 5) bisphosphonates for preventing bone degradation.; 6) lower body compression garment and oral salt and fluid loading for landing on a planetary surface to combat orthostatic intolerance; 7) laboratory analysis equipment for individualized monitoring of biomarkers in blood, urine and saliva for estimation of health status in; 8) advanced ultrasound techniques for monitoring bone and cardiovascular health; and 9) computer modeling programs for individual health status assessments of efficiency and subsequent adjustments of countermeasures. In particular for future missions into deep space, we are concerned with the synergistic effects of weightlessness, radiation, operational constraints and other spaceflight environmental factors. Therefore, increased collaboration between physiological, behavioral, radiation and space vehicle design disciplines are strongly warranted. Another venue we are exploring in NASA's Human Research Program is the usefulness of artificial gravity for mitigating the health risks of long duration weightlessness.

  17. Zika virus: Global health challenge, threat and current situation.

    Science.gov (United States)

    Aziz, Hafsa; Zia, Aadarash; Anwer, Amania; Aziz, Muneeba; Fatima, Shazia; Faheem, Muhammad

    2017-06-01

    ZIKV has emerged as grave global health issue in the past few years. ZIKV was firstly isolated in 1947 from a rhesus sentinel monkey in the Zika forest in Uganda. It is usually transmitted by the bite of infected mosquitoes and infects skin fibroblasts, skin keratinocytes, etc. ZIKV until now was under reported because of its clinical similarity with the dengue and chikungunya. It is usually spread through the course of the sylvatic cycle. In this cycle, the virus or pathogen lifespan is spent between the wild animal and vectors. The intrinsic incubation period is not yet fully known but it is observed that the very first symptoms of ZIKV infection can appear or develop within 3-12 days of time period and usually subside within 7 days of time. There is a strong relationship between prenatal Zika virus infection and microcephaly; other serious brain anomalies to the infant or newborn are Guillain-Barré syndrome. To date no vaccines are available for ZIKV prevention hence only symptomatic treatment is recommended in infected patients. Usually ZIKV is detected by serologic (IgM ELISA), plaque reduction neutralization test (PRNT) along with in-house" molecular techniques (RT-PCR). ZIKV infection being imminent global health issue warrants strong protective measures to prevent it from becoming an epidemic. Early detection and prevention is the key to tackle this grave potential health hazard. J. Med. Virol. 89:943-951, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  18. Applying a framework for assessing the health system challenges to scaling up mHealth in South Africa

    Directory of Open Access Journals (Sweden)

    Leon Natalie

    2012-11-01

    Full Text Available Abstract Background Mobile phone technology has demonstrated the potential to improve health service delivery, but there is little guidance to inform decisions about acquiring and implementing mHealth technology at scale in health systems. Using the case of community-based health services (CBS in South Africa, we apply a framework to appraise the opportunities and challenges to effective implementation of mHealth at scale in health systems. Methods A qualitative study reviewed the benefits and challenges of mHealth in community-based services in South Africa, through a combination of key informant interviews, site visits to local projects and document reviews. Using a framework adapted from three approaches to reviewing sustainable information and communication technology (ICT, the lessons from local experience and elsewhere formed the basis of a wider consideration of scale up challenges in South Africa. Results Four key system dimensions were identified and assessed: government stewardship and the organisational, technological and financial systems. In South Africa, the opportunities for successful implementation of mHealth include the high prevalence of mobile phones, a supportive policy environment for eHealth, successful use of mHealth for CBS in a number of projects and a well-developed ICT industry. However there are weaknesses in other key health systems areas such as organisational culture and capacity for using health information for management, and the poor availability and use of ICT in primary health care. The technological challenges include the complexity of ensuring interoperability and integration of information systems and securing privacy of information. Finally, there are the challenges of sustainable financing required for large scale use of mobile phone technology in resource limited settings. Conclusion Against a background of a health system with a weak ICT environment and limited implementation capacity, it remains

  19. Transforming public health education in India through networking and collaborations: opportunities and challenges.

    Science.gov (United States)

    Sharma, Anjali; Zodpey, Sanjay P

    2013-01-01

    A competent and motivated health workforce is indispensable to achieve the best health outcomes possible through given available resources and circumstances. However, apart from the shortages and unequal distribution, the workforce has fallen short of responding to the public health challenges of 21 st century also because of primarily the traditional training of health professionals. Although, health professionals have made enormous contributions to health and development over the past century, the 20 th century educational strategies are unfit to tackle 21 st century challenges. One of the key recommendations of the Lancet Commission on Education of Health Professionals is to improve health through reforms of professional education by establishing networks and partnerships which takes advantage of information and communication linkages. The primary goal of this manuscript is to highlight the potential of networks and partnerships in advancing the agenda of educational reforms to revitalize public health education in India. It outlines the current status and expanding scope of public health education in India, existing networks of public health professionals and public health education institutions in the country, and opportunities, advantages and challenges for such networks. Although, we have networks of individuals and institutions in the country, there potential to bring about change has still not being utilized fully and effectively. Immediate collaborative efforts could be directed towards designing and adaptation of competency driven curriculum frameworks suitable of addressing public health challenges of 21 st century, shifting the current focus of curriculum to multidisciplinary public health outlook, developing accreditation mechanisms for both the programs and institutions, engaging in creating job opportunities and designing career pathways for public health professionals in public and private sector. These efforts could certainly be facilitated

  20. Environmental and human health challenges of industrial livestock and poultry farming in China and their mitigation.

    Science.gov (United States)

    Hu, Yuanan; Cheng, Hefa; Tao, Shu

    2017-10-01

    Driven by the growing demand for food products of animal origin, industrial livestock and poultry production has become increasingly popular and is on the track of becoming an important source of environmental pollution in China. Although concentrated animal feeding operations (CAFOs) have higher production efficiency and profitability with less resource consumption compared to the traditional family-based and "free range" farming, they bring significant environmental pollution concerns and pose public health risks. Gaseous pollutants and bioaerosols are emitted directly from CAFOs, which have health implications on animal producers and neighboring communities. A range of pollutants are excreted with the animal waste, including nutrients, pathogens, natural and synthetic hormones, veterinary antimicrobials, and heavy metals, which can enter local farmland soils, surface water, and groundwater, during the storage and disposal of animal waste, and pose direct and indirect human health risks. The extensive use of antimicrobials in CAFOs also contributes to the global public health concern of antimicrobial resistance (AMR). Efforts on treating the large volumes of manure generated in CAFOs should be enhanced (e.g., by biogas digesters and integrated farm systems) to minimize their impacts on the environment and human health. Furthermore, the use of veterinary drugs and feed additives in industrial livestock and poultry farming should be controlled, which will not only make the animal food products much safer to the consumers, but also render the manure more benign for treatment and disposal on farmlands. While improving the sustainability of animal farming, China also needs to promote healthy food consumption, which not only improves public health from avoiding high-meat diets, but also slows down the expansion of industrial animal farming, and thus reduces the associated environmental and public health risks. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. One Health: The global challenge of epidemic and endemic leishmaniasis

    Directory of Open Access Journals (Sweden)

    Day Michael J

    2011-10-01

    Full Text Available Abstract 'One Health' proposes the unification of medical and veterinary sciences with the establishment of collaborative ventures in clinical care, surveillance and control of cross-species disease, education, and research into disease pathogenesis, diagnosis, therapy and vaccination. The concept encompasses the human population, domestic animals and wildlife, and the impact that environmental changes ('environmental health' such as global warming will have on these populations. Visceral leishmaniasis is a perfect example of a small companion animal disease for which prevention and control might abolish or decrease the suffering of canine and human patients, and which aligns well with the One Health approach. In this review we discuss how surveillance for leishmaniases is undertaken globally through the control of anthroponootic visceral leishmaniasis (AVL and zoonotic visceral leishmaniasis (ZVL. The ZVL epidemic has been managed to date by the culling of infected dogs, treatment of human cases and control of the sandfly vector by insecticidal treatment of human homes and the canine reservoir. Recently, preventive vaccination of dogs in Brazil has led to reduction in the incidence of the canine and human disease. Vaccination permits greater dog owner compliance with control measures than a culling programme. Another advance in disease control in Africa is provided by a surveillance programme that combines remote satellite sensing, ecological modelling, vector surveillance and geo-spatial mapping of the distribution of vectors and of the animal-to-animal or animal-to-human pathogen transmission. This coordinated programme generates advisory notices and alerts on emerging infectious disease outbreaks that may impede or avoid the spreading of visceral leishmaniasis to new areas of the planet as a consequence of global warming.

  2. Computational brain connectivity mapping: A core health and scientific challenge.

    Science.gov (United States)

    Deriche, Rachid

    2016-10-01

    One third of the burden of all the diseases in Europe is due to problems caused by diseases affecting brain. Although exceptional progress have been obtained for exploring the brain during the past decades, it is still terra-incognita and calls for specific efforts in research to better understand its architecture and functioning. To take up this great challenge of modern science and to solve the limited view of the brain provided just by one imaging modality, this article advocates the idea developed in my research group of a global approach involving new generation of models for brain connectivity mapping and strong interactions between structural and functional connectivities. Capitalizing on the strengths of integrated and complementary non invasive imaging modalities such as diffusion Magnetic Resonance Imaging (dMRI) and Electro & Magneto-Encephalography (EEG & MEG) will contribute to achieve new frontiers for identifying and characterizing structural and functional brain connectivities and to provide a detailed mapping of the brain connectivity, both in space and time. Thus leading to an added clinical value for high impact diseases with new perspectives in computational neuro-imaging and cognitive neuroscience. Copyright © 2016 Elsevier B.V. All rights reserved.

  3. Second-hand smoke: a neglected public health challenge.

    Science.gov (United States)

    Singh, Rana J; Lal, Pranay G

    2011-01-01

    Exposure to secondhand smoke (SHS) causes an estimated 5% of the global burden of disease, slightly higher than the burden from direct use of tobacco. This review highlights the urgent need to address this ignored public health issue by presenting the evidence and impact of SHS on those exposed using global studies including those from the South-East Asia Region. The burden of morbidity from SHS exposure is higher in low-income countries in Southeast Asia region compared to the rest of the world. SHS exposure affects those most vulnerable, especially women and children. While several countries in the region have enacted legislation which offer protection to those exposed to SHS, most measures are partial and inadequate. As a result, implementation and compliance at national and sub-national level within the countries of the Southeast Asia region is variable. Governments must ensure that legislation mandates comprehensive smoke-free environments in order to provide public health benefit which offers universal protection to everyone and everywhere. Where comprehensive legislation exists, stringent implementation and enforcement, along with awareness building, education and monitoring through regular compliance studies must be done to sustain smokefree status of public places within jurisdictions.

  4. Human capital flight challenges within an equitable health system.

    Science.gov (United States)

    Udonwa, N E

    2007-01-01

    The issue of human capital flight has been discussed at different forums with a consensus opinion that it has its merits and demerits to equitable health system. Most often one nation becomes a substantial net exporter of talent, leaving the provider nation at risk of depleting its natural supply of talent. This paper looks into the historical perspective of human capital flight or "brain drain", and its burden. It attempts to elucidate the various causes and suggested solutions. The paper's objective is to educate colleagues on the conceptual and contextual imperatives of the issue. Using a convenient sample of key informants who were medical colleagues in Nigeria relevant information was sourced from these colleagues, documents from the postgraduate medical college of Nigeria and the internet on maters relating to human capital flight and brain drain. Every year, thousands of qualified doctors, and other professionals leave Nigeria tempted by significantly higher wages, brighter prospects for employment and education, stability, food security. It appears that the potential exposure to different working conditions, resources and professional environments can be of advantage to the country, should Nigeria be able to recall these professionals. It also appears that necessary economic reforms that make staying at home rewarding, that is--good leadership, and policy planning that seriously looks into rural development, among other issues, are keys ingredients to reversing the trend in order to ensure a more equitable health system.

  5. Urban health. A challenge for the third millennium

    International Nuclear Information System (INIS)

    Caroli, S.; Menditto, A.

    1999-01-01

    In the frame of the bilateral governmental programme for scientific and technical cooperation existing between Italy and Hungary a successful series of biennial Symposia were undertaken since the early 1980s. These were designed to provide scientists of both countries with a permanent forum for the evaluation of ongoing joint projects, the exchange of views on future priorities dealt with by these Symposia always made the participation of prominent scientists from other countries a necessary complement substantially enhancing the international characteristics of such events. Each Symposium features a specific theme of primary importance within the general context of human health and environmental protection. In this respect, the ninth edition of this series of Symposia focuses on the major concerns raised by chemical pollution on all aspects of urban life. More than one half of the world population lives today in big cities, with all the attendant problems as regards air, water and soil quality, safe disposal of urban waste, occupational exposure, in one word, the physical, mental and cultural welfare of citizens at large. All facets concurring to protect and maintain urban health will be thus taken into consideration and highlighted in about forty invited lectures, while posters will be displayed in a permanent session throughout the conference duration [it

  6. Air pollution and public health: the challenges for Delhi, India.

    Science.gov (United States)

    Sharma, Arun Kumar; Baliyan, Palak; Kumar, Prashant

    2018-03-28

    Mitigating the impact of pollution on human health worldwide is important to limit the morbidity and mortality arising from exposure to its effect. The level and type of pollutants vary in different urban and rural settings. Here, we explored the extent of air pollution and its impacts on human health in the megacity of Delhi (India) through a review of the published literature. The study aims at describing the extent of air pollution in Delhi, the magnitude of health problems due to air pollution and the risk relationship between air pollution and associated health effects. We found 234 published articles in the PubMed search. The search showed that the extent of air pollution in Delhi has been described by various researchers from about 1986 onwards. We synthesized the findings and discuss them at length with respect to reported values, their possible interpretations and any limitations of the methodology. The chemical composition of ambient air pollution is also discussed. Further, we discuss the magnitude of health problem with respect to chronic obstructive pulmonary diseases (COPD), bronchial asthma and other illnesses. The results of the literature search showed that data has been collected in last 28 years on ambient air quality in Delhi, though it lacks a scientific continuity, consistency of locations and variations in parameters chosen for reporting. As a result, it is difficult to construct a spatiotemporal picture of the air pollution status in Delhi over time. The number of sites from where data have been collected varied widely across studies and methods used for data collection is also non-uniform. Even the parameters studied are varied, as some studies focused on particulate matter ≤10 μm in aerodynamic diameter (PM10) and those ≤2.5 μm in aerodynamic diameter (PM2.5), and others on suspended particulate matter (SPM) and respirable suspended particulate matter (RSPM). Similarly, the locations of data collection have varied widely. Some of the

  7. Health in Southeast Asia 6 Health-financing reforms in southeast Asia: challenges in achieving universal coverage

    OpenAIRE

    Tangcharoensathien, V; Patcharanarumol, W; Ir, P; Aljunid, SM; Mukti, AG; Akkhavong, K; Banzon, E; Huong, DB; Thabrany, H; Mills, A

    2011-01-01

    In this sixth paper of the Series, we review health-financing reforms in seven countries in southeast Asia that have sought to reduce dependence on out-of-pocket payments, increase pooled health finance, and expand service use as steps towards universal coverage. Laos and Cambodia, both resource-poor countries, have mostly relied on donor-supported health equity funds to reach the poor, and reliable funding and appropriate identification of the eligible poor are two major challenges for natio...

  8. What Are the Professional, Political, and Ethical Challenges of Co-Creating Health Care Systems?

    Science.gov (United States)

    Singh, Guddi; Owens, John; Cribb, Alan

    2017-11-01

    Co-creation is seen by many as a means of meeting the multiple challenges facing contemporary health care systems by involving institutions, professionals, patients, and stakeholders in new roles, relationships, and collaborative practices. While co-creation has the potential to positively transform health care systems, it generates a number of political and ethical challenges that should not be overlooked. We suggest that those involved in envisioning and implementing co-creation initiatives pay close attention to significant questions of equity, power, and justice and to the fundamental challenge of securing a common vision of the aims of and agendas for health care systems. While such initiatives present significant opportunities for improvement, they need to be viewed in light of their accompanying professional, political, and ethical challenges. © 2017 American Medical Association. All Rights Reserved.

  9. Manifolds for pose tracking from monocular video

    Science.gov (United States)

    Basu, Saurav; Poulin, Joshua; Acton, Scott T.

    2015-03-01

    We formulate a simple human-pose tracking theory from monocular video based on the fundamental relationship between changes in pose and image motion vectors. We investigate the natural embedding of the low-dimensional body pose space into a high-dimensional space of body configurations that behaves locally in a linear manner. The embedded manifold facilitates the decomposition of the image motion vectors into basis motion vector fields of the tangent space to the manifold. This approach benefits from the style invariance of image motion flow vectors, and experiments to validate the fundamental theory show reasonable accuracy (within 4.9 deg of the ground truth).

  10. Referee Anxiety in Health Researches: A Challenge of Referees

    Directory of Open Access Journals (Sweden)

    Hasan Ashrafi-rizi

    2015-10-01

    Full Text Available In addition to the researchers, referees have important roles for publishing a valuable scholarly paper. A scientific work is evaluated in different phases from the beginning till it is published. In each of these phases, unpleasant experiences may happen for researchers and referees. Researchers as the producers of scientific papers experience research anxiety, library anxiety, information seeking anxiety, and referee anxiety. On the other hand, referees experience referees’ anxiety. So it is very important to recognize the effective factors causing anxiety and try to eliminate these problems. As the research area is very broad, all these mentioned concepts are parts of the research process. But one of the most critical stages of research is the review of scientific works particularly in the field of health. “The selection of the referee is the most important decision that the editors make about a scientific work” (1. Referee selection is very important in the area of health because the results of these researches have direct or indirect effects on public health (2. If the facilities are not properly provided for referees, many problems may occur including anxiety referee. Findings of Von Glinow and Novelli showed that there was an unpleasant sense for referees when they feel particular biases from the editor (3. Weller also states that there is an unpleasant sensation if the authors identify their referees (4. Other factors that cause anxiety during the referee process are: receiving several papers to review (5, selecting an inappropriate referee for a paper by the editor (6, lack of clear guidelines and standards of review (4, young and inexperienced referees and inappropriate behavior of journal staff and research centers, lack of scientific knowledge of the referee, and lack of enough ability for the referee to reject the article, all causing unpleasant feelings. In a simple definition, referee anxiety includes any discomfort of

  11. PHYSICAL AND HEALTH EDUCATION FACING THE TECHNOLOGY CHALLENGE

    Directory of Open Access Journals (Sweden)

    Cristiana Lucretia Pop

    2016-04-01

    Full Text Available Purpose: This essay aims to signal up the detrimental effects of sedentary behaviours determined by extensive use of technology. Material: The paper is a survey of the most relevant data related to physical inactivity consequences with a specific reference to the Eastern Europe countries. Results. There is no doubt that children and young people will prefer the technology and its commodities, but they need to be encouraged to practice exercise, to control their posture and weight. Physical activity favorably influences on mental health and reduces the incidence and severity of diseases and pathological conditions, such as cardiovascular disease, type II diabetes, osteoarthritis, osteoporosis and obesity. Conclusions. Promoting physical activity as a healthy life style component in schools and in universities targets the enhancement of vigour, resilience, employement and social outcomes for graduates and comunities.

  12. Rewards and challenges of community health center practice.

    Science.gov (United States)

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

    2014-04-01

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

  13. Neoliberalism and indigenous knowledge: Māori health research and the cultural politics of New Zealand's "National Science Challenges".

    Science.gov (United States)

    Prussing, Erica; Newbury, Elizabeth

    2016-02-01

    In 2012-13 the Ministry of Business, Innovation and Employment (MBIE) in New Zealand rapidly implemented a major restructuring of national scientific research funding. The "National Science Challenges" (NSC) initiative aims to promote greater commercial applications of scientific knowledge, reflecting ongoing neoliberal reforms in New Zealand. Using the example of health research, we examine the NSC as a key moment in ongoing indigenous Māori advocacy against neoliberalization. NSC rhetoric and practice through 2013 moved to marginalize participation by Māori researchers, in part through constructing "Māori" and "science" as essentially separate arenas-yet at the same time appeared to recognize and value culturally distinctive forms of Māori knowledge. To contest this "neoliberal multiculturalism," Māori health researchers reasserted the validity of culturally distinctive knowledge, strategically appropriated NSC rhetoric, and marshalled political resources to protect Māori research infrastructure. By foregrounding scientific knowledge production as an arena of contestation over neoliberal values and priorities, and attending closely to how neoliberalizing tactics can include moves to acknowledge cultural diversity, this analysis poses new questions for social scientific study of global trends toward reconfiguring the production of knowledge about health. Study findings are drawn from textual analysis of MBIE documents about the NSC from 2012 to 2014, materials circulated by Māori researchers in the blogosphere in 2014, and ethnographic interviews conducted in 2013 with 17 Māori health researchers working at 7 sites that included university-based research centers, government agencies, and independent consultancies. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Exposure to formaldehyde: a challenge of occupational health significance

    International Nuclear Information System (INIS)

    Kaonga, K.

    2009-01-01

    The use of formaldehyde as the fixative for general microscopic demonstration of tissues in medical laboratory establishments is as significant as the diagnosis of the underlying ailment. Instantaneous human exposure to formaldehyde elicits symptoms that may include watery eyes, headache, inflamed throat and dyspnea. The gaseous chemical is toxic, allergenic and carcinogenic. A study to determine the incidence of human exposure to formaldehyde was carried out at the University Teaching Hospital in Lusaka, Zambia from January to December, 2007. Anonymous questionnaires on various aspects of human exposure to formaldehyde were given to laboratory technical personnel. Exposure to formaldehyde was determined using general consideration model comprising points awarded to participants according to their responses. Five points represented the maximum level of exposure, while one point denoted the minimum encounter. There were 8 incidents of formaldehyde pollution, with five being emissions from 210-litre formalin receptacles whose stoppers were inadvertently left loose overnight, while three involved accidental breakage of Winchester bottles of formalin. A total of 115 people were exposed during the year. Fifteen (13.0 percent) participants scored one point each, while 20 (17.4 percent) participants obtained 2 points each. Thirty-five (30.4 percent) participants got 3 points each, while 30 (26.0 percent) participants received 4 points each. Twenty-five (21.7 percent) participants attained 5 points each. Human exposure to formaldehyde is an issue of occupational health concern. Participants with a score of 3 points or more need regular medical check ups in order to safeguard their health. Programs on effective management of hazardous chemicals are worth setting up.(author)

  15. CLIMATE CHANGE AND HEALTHCHALLENGES FOR HUNGARY

    Directory of Open Access Journals (Sweden)

    Anna Paldy

    2010-03-01

    Full Text Available In Hungary detailed research work has been carried out since several years to help the process of getting prepared and adapted to the impacts of climate change. The research activities concerned mainly the health impacts of heat waves (excess mortality. Based on the results of the time series statistical analysis of weather variables and daily mortality of Budapest, it was found that a 5º C increase of the daily mean temperature increases of the risk of all cause mortality by 10%; and the risk of death due to cardio-vascular diseases by 12%. The frequency of heat waves has been increasing since the nineties. The most extreme heat wave hit the country in 2007 with an excess mortality around 1100 cases. A three level heat health warning system was launched in 2005 as an action to support adaptation. A significant association was found between global radiation and the increase of melanoma cases. The incidence of melanoma morbidity increased between 2003– 2008, the number of new cases changed from 1854 to 2610. The data of the previous years support that there is an increasing risk of vector borne diseases, as the continuous increase of the incidence of Lyme diseases (15% per year showed it. Although tick-borne encephalitis is present in the country, the incidence of the disease does not show a strong correlation with climate variability. Diseases like West Nile virus and Hanta virus infection appeared and showed an increasing tendency. The vector of Leishmaniasis also appeared in Hungary. Another consequence of climate change is the temporal and spatial change of allergenic plant species. New, invasive plants will appear, the length of pollination has been increasing.

  16. Different measles outbreaks in Belgium, January to June 2016 – a challenge for public health

    Science.gov (United States)

    Grammens, Tine; Maes, Virginie; Hutse, Veronik; Laisnez, Valeska; Schirvel, Carole; Trémérie, Jean Marie; Sabbe, Martine

    2016-01-01

    During the first half of 2016, several outbreaks of measles were reported in the three regions of Belgium. Main challenges for public health were severe complications occurring in adults, nosocomial transmission and infection in healthcare workers. Here, we describe those outbreaks and lessons learnt for public health. PMID:27541858

  17. Progress and challenges of disaster health management in China: a scoping review.

    Science.gov (United States)

    Zhong, Shuang; Clark, Michele; Hou, Xiang-Yu; Zang, Yuli; FitzGerald, Gerard

    2014-01-01

    Despite the importance of an effective health system response to various disasters, relevant research is still in its infancy, especially in middle- and low-income countries. This paper provides an overview of the status of disaster health management in China, with its aim to promote the effectiveness of the health response for reducing disaster-related mortality and morbidity. A scoping review method was used to address the recent progress of and challenges to disaster health management in China. Major health electronic databases were searched to identify English and Chinese literature that were relevant to the research aims. The review found that since 2003 considerable progress has been achieved in the health disaster response system in China. However, there remain challenges that hinder effective health disaster responses, including low standards of disaster-resistant infrastructure safety, the lack of specific disaster plans, poor emergency coordination between hospitals, lack of portable diagnostic equipment and underdeveloped triage skills, surge capacity, and psychological interventions. Additional challenges include the fragmentation of the emergency health service system, a lack of specific legislation for emergencies, disparities in the distribution of funding, and inadequate cost-effective considerations for disaster rescue. One solution identified to address these challenges appears to be through corresponding policy strategies at multiple levels (e.g. community, hospital, and healthcare system level).

  18. A Lifetime of Trauma: Mental Health Challenges for Higher Education in a Conflict Environment in Afghanistan

    Science.gov (United States)

    Babury, Mohammed Osman; Hayward, Fred Manwarren

    2013-01-01

    More than 30 years of war in Afghanistan have resulted in immense policy challenges to address the resulting mental health issues. The purpose of this policy analysis is to examine the potential role of higher education in addressing the pressing mental health problems in Afghanistan's public universities and higher education institutions as a…

  19. Grand Challenges Canada: inappropriate emphasis and missed opportunities in global health research?

    Science.gov (United States)

    Larson, Charles P; Haddad, Slim; Birn, Anne-Emanuelle; Cole, Donald C; Labonte, Ronald; Roberts, Janet Hatcher; Schrecker, Ted; Sellen, Daniel; Zakus, David

    2011-01-01

    In May 2010, Grand Challenges Canada (GCC) was launched with the mandate to identify global challenges in health that could be supported through the Government of Canada's Development Innovations Fund (DIF: $225 million over five years). The GCC offers a potentially excellent mechanism for taking Canada's participation in global health challenges "to a higher level". Recent GCC announcements raise new questions about the emphasis being placed on technological discovery or "catalytic" research. Missing so far are opportunities that the Fund could offer in order to support innovative research addressing i) health systems strengthening, ii) more effective delivery of existing interventions, and iii) policies and programs that address broader social determinants of health. The Canadian Grand Challenges announced to date risk pushing to the sidelines good translational and implementation science and early career-stage scientists addressing important social, environmental and political conditions that affect disease prevalence, progress and treatment; and the many unresolved challenges faced in bringing to scale proven interventions within resource-constrained health systems. We wish to register our concern at the apparent prioritization of biotechnical innovation research and the subordination of the social, environmental, economic and political context in which human health is either protected or eroded.

  20. Health care providers under pressure: making the most of challenging times.

    Science.gov (United States)

    Davis, Scott B; Robinson, Phillip J

    2010-01-01

    Whether the slowing economic recovery, tight credit markets, increasing costs, or the uncertainty surrounding health care reform, the health care industry faces some sizeable challenges. These factors have put considerable strain on the industry's traditional financing options that the industry has relied on in the past--bonds, banks, finance companies, private equity, venture capital, real estate investment trusts, private philanthropy, and grants. At the same time, providers are dealing with rising costs, lower reimbursement rates, shrinking demand for elective procedures, higher levels of charitable care and bad debt, and increased scrutiny of tax-exempt hospitals. Providers face these challenges against a back ground of uncertainty created by health care reform.

  1. Consumer Health Insurance Shopping Behavior and Challenges: Lessons From Two State-Based Marketplaces.

    Science.gov (United States)

    Sinaiko, Anna D; Kingsdale, Jon; Galbraith, Alison A

    2017-07-01

    Selecting a health plan in a health insurance exchange is a critical decision, yet consumers are known to face challenges with health plan choice. We surveyed new enrollees in two state-based exchanges in 2015 to investigate how a nonelderly, primarily low-income population chose their health plans and the implications of shopping behavior for early experiences in their plans. Financial considerations were most important to enrollees. Prior Medicaid enrollees and the uninsured were more likely to have multiple shopping challenges (e.g., difficulty identifying the best or most affordable plan, fair/poor experience, unmet need for help) than enrollees with prior employer coverage (42.9% vs. 32.5% vs. 16.4%, respectively, p Shopping challenges were associated with difficulty finding a doctor, understanding coverage, and getting questions answered. Assistance targeting enrollees who previously had Medicaid or lacked insurance could improve both shopping experiences and downstream outcomes in plans.

  2. Sociotechnical Challenges of Developing an Interoperable Personal Health Record

    Science.gov (United States)

    Gaskin, G.L.; Longhurst, C.A.; Slayton, R.; Das, A.K.

    2011-01-01

    Objectives To analyze sociotechnical issues involved in the process of developing an interoperable commercial Personal Health Record (PHR) in a hospital setting, and to create guidelines for future PHR implementations. Methods This qualitative study utilized observational research and semi-structured interviews with 8 members of the hospital team, as gathered over a 28 week period of developing and adapting a vendor-based PHR at Lucile Packard Children’s Hospital at Stanford University. A grounded theory approach was utilized to code and analyze over 100 pages of typewritten field notes and interview transcripts. This grounded analysis allowed themes to surface during the data collection process which were subsequently explored in greater detail in the observations and interviews. Results Four major themes emerged: (1) Multidisciplinary teamwork helped team members identify crucial features of the PHR; (2) Divergent goals for the PHR existed even within the hospital team; (3) Differing organizational conceptions of the end-user between the hospital and software company differentially shaped expectations for the final product; (4) Difficulties with coordination and accountability between the hospital and software company caused major delays and expenses and strained the relationship between hospital and software vendor. Conclusions Though commercial interoperable PHRs have great potential to improve healthcare, the process of designing and developing such systems is an inherently sociotechnical process with many complex issues and barriers. This paper offers recommendations based on the lessons learned to guide future development of such PHRs. PMID:22003373

  3. The public health challenge of early growth failure in India.

    Science.gov (United States)

    Young, M F; Martorell, R

    2013-05-01

    Recent recognition of the early onset and high prevalence of wasting (30%) and stunting (20%) among infants 0-5 months in India draws attention to the need to understand the causes and develop prevention strategies. Such growth failure has dire consequences in the short (increased mortality) and long-term (loss of human capital and increased risk of chronic diseases). Food interventions before 6 months will increase morbidity/mortality through contamination in settings of poor sanitation and hygiene. Waiting to improve nutrition only after the initiation of complementary feeding at 6 months is a missed opportunity and may permanently alter life trajectory and potential. This underscores the importance of maternal nutrition. Iron and folic acid and protein energy supplementation during pregnancy are interventions that can improve maternal nutrition and birth outcomes. Maternal supplementation during lactation should be considered as a means to improve maternal and child outcomes, although the evidence needs strengthening. Support and counseling are also required to improve maternal diets and promote exclusive breastfeeding. Programs focused on improving maternal nutrition across the continuum of preconception, pregnancy and lactation are likely to have the greatest impact as mothers are central gatekeepers to the health and future of their children.

  4. Leading change: a challenge for leaders in Nordic health care.

    Science.gov (United States)

    Fagerström, Lisbeth; Salmela, Susanne

    2010-07-01

    The aim of the present study was to describe personnel's attitudes to change processes between a regional hospital and the primary health care centre as well as investigate these results with regards to theories pertaining to change and leading change. Leadership has three crucial dimensions: focusing on personnel, results/key processes and the ethical base of activities. A survey was conducted in 2003 using a comprehensive questionnaire. The total sample consisted of the personnel (n = 899) at the two organizations (answering rate was 68.8%). The data were analysed descriptively. Approximately two-thirds of the respondents understood why the merger was occurring. Only one-third expressed that they had received sufficient information regarding the merger. In total 67% felt that the merger would create conflict while approximately one-fourth expressed uncertainty. Despite such negative responses, approximately two-thirds felt there were advantages to the merger. Significant differences were seen between the groups. In times of change personnel expect leaders to focus on dialogue with their personnel and to anchor the vision of the change process amongst the personnel. By identifying the 'prison of thought' and creating an atmosphere where reflection and discussion are valued the nurse leader can help prevent resistance to change.

  5. Turning science into health solutions: KEMRI's challenges as Kenya's health product pathfinder.

    Science.gov (United States)

    Simiyu, Ken; Masum, Hassan; Chakma, Justin; Singer, Peter A

    2010-12-13

    A traditional pathway for developing new health products begins with public research institutes generating new knowledge, and ends with the private sector translating this knowledge into new ventures. But while public research institutes are key drivers of basic research in sub-Saharan Africa, the private sector is inadequately prepared to commercialize ideas that emerge from these institutes, resulting in these institutes taking on the role of product development themselves to alleviate the local disease burden. In this article, the case study method is used to analyze the experience of one such public research institute: the Kenya Medical Research Institute (KEMRI). Our analysis indicates that KEMRI's product development efforts began modestly, and a manufacturing facility was constructed with a strategy for the facility's product output which was not very successful. The intended products, HIV and Hepatitis B diagnostic kits, had a short product life cycle, and an abrupt change in regulatory requirements left KEMRI with an inactive facility. These problems were the result of poor innovation management capacity, variability in domestic markets, lack of capital to scale up technologies, and an institutional culture that lacked innovation as a priority.However, KEMRI appears to have adapted by diversifying its product line to mitigate risk and ensure continued use of its manufacturing facility. It adopted an open innovation business model which linked it with investors, research partnerships, licensing opportunities, and revenue from contract manufacturing. Other activities that KEMRI has put in place over several years to enhance product development include the establishment of a marketing division, development of an institutional IP policy, and training of its scientists on innovation management. KEMRI faced many challenges in its attempt at health product development, including shifting markets, lack of infrastructure, inadequate financing, and weak human

  6. Turning science into health solutions: KEMRI’s challenges as Kenya’s health product pathfinder

    Directory of Open Access Journals (Sweden)

    Chakma Justin

    2010-12-01

    Full Text Available Abstract Background A traditional pathway for developing new health products begins with public research institutes generating new knowledge, and ends with the private sector translating this knowledge into new ventures. But while public research institutes are key drivers of basic research in sub-Saharan Africa, the private sector is inadequately prepared to commercialize ideas that emerge from these institutes, resulting in these institutes taking on the role of product development themselves to alleviate the local disease burden. In this article, the case study method is used to analyze the experience of one such public research institute: the Kenya Medical Research Institute (KEMRI. Discussion Our analysis indicates that KEMRI’s product development efforts began modestly, and a manufacturing facility was constructed with a strategy for the facility’s product output which was not very successful. The intended products, HIV and Hepatitis B diagnostic kits, had a short product life cycle, and an abrupt change in regulatory requirements left KEMRI with an inactive facility. These problems were the result of poor innovation management capacity, variability in domestic markets, lack of capital to scale up technologies, and an institutional culture that lacked innovation as a priority. However, KEMRI appears to have adapted by diversifying its product line to mitigate risk and ensure continued use of its manufacturing facility. It adopted an open innovation business model which linked it with investors, research partnerships, licensing opportunities, and revenue from contract manufacturing. Other activities that KEMRI has put in place over several years to enhance product development include the establishment of a marketing division, development of an institutional IP policy, and training of its scientists on innovation management. Summary KEMRI faced many challenges in its attempt at health product development, including shifting markets, lack

  7. Turning science into health solutions: KEMRI’s challenges as Kenya’s health product pathfinder

    Science.gov (United States)

    2010-01-01

    Background A traditional pathway for developing new health products begins with public research institutes generating new knowledge, and ends with the private sector translating this knowledge into new ventures. But while public research institutes are key drivers of basic research in sub-Saharan Africa, the private sector is inadequately prepared to commercialize ideas that emerge from these institutes, resulting in these institutes taking on the role of product development themselves to alleviate the local disease burden. In this article, the case study method is used to analyze the experience of one such public research institute: the Kenya Medical Research Institute (KEMRI). Discussion Our analysis indicates that KEMRI’s product development efforts began modestly, and a manufacturing facility was constructed with a strategy for the facility’s product output which was not very successful. The intended products, HIV and Hepatitis B diagnostic kits, had a short product life cycle, and an abrupt change in regulatory requirements left KEMRI with an inactive facility. These problems were the result of poor innovation management capacity, variability in domestic markets, lack of capital to scale up technologies, and an institutional culture that lacked innovation as a priority. However, KEMRI appears to have adapted by diversifying its product line to mitigate risk and ensure continued use of its manufacturing facility. It adopted an open innovation business model which linked it with investors, research partnerships, licensing opportunities, and revenue from contract manufacturing. Other activities that KEMRI has put in place over several years to enhance product development include the establishment of a marketing division, development of an institutional IP policy, and training of its scientists on innovation management. Summary KEMRI faced many challenges in its attempt at health product development, including shifting markets, lack of infrastructure

  8. Qualitative analysis of national documents on health care services and pharmaceuticals` purchasing challenges: evidence from Iran.

    Science.gov (United States)

    Bastani, Peivand; Samadbeik, Mahnaz; Dinarvand, Rassoul; Kashefian-Naeeini, Sara; Vatankhah, Soudabeh

    2018-06-05

    Iranian health sector encountered many challenges in resource allocation and health service purchasing during the past decades, the aim of this study was to determine the main challenges of the present process of health service purchasing for national policymakers and other developing countries with the same setting. It was a qualitative study carried out via the complete content analysis of all relevant national documents from 2007 to 2014. In order to retrieve the related documents, we searched the official websites related to the Ministry of Health and Medical Education, four main Iranian insurance organizations, the Health Committee of the Parliament Profile, strategic vice president's site and Supreme Insurance Council. After recognition of documents, their credibility and authenticity were evaluated in terms of their publication or adjustment. For the analysis of documents, the four step-Scott method was used applying MAXQDA version 10. Findings illustrated that health service purchase challenges in the country can be classified in 6 main themes of policy-making, executive, intersectional, natural, legal and informational challenges with 26 subthemes. Furthermore, 5 themes of Basic Benefit Package, Reimbursement,Decision making, Technology and Contract are considered as the main Challenges in pharmaceutical purchasing area containing 13 relevant subthemes. It seems that according to documents, Iran has faced many structural and procedural problems with the purchase of the best health interventions. So it is highly recommended to consider consequences derived from the present challenges and try to use these evidences in their policy making process to decrease the existed problems and move to better procurement of health interventions.

  9. Urban health. A challenge for the third millennium

    Energy Technology Data Exchange (ETDEWEB)

    Caroli, S [Istituto Superiore di Sanita' , Rome (Italy). Lab. di Tossicologia Applicata; Menditto, A [Istituto Superiore di Sanita' , Rome (Italy). Lab. di Biochimica Clinica

    1999-07-01

    In the frame of the bilateral governmental programme for scientific and technical cooperation existing between Italy and Hungary a successful series of biennial Symposia were undertaken since the early 1980s. These were designed to provide scientists of both countries with a permanent forum for the evaluation of ongoing joint projects, the exchange of views on future priorities dealt with by these Symposia always made the participation of prominent scientists from other countries a necessary complement substantially enhancing the international characteristics of such events. Each Symposium features a specific theme of primary importance within the general context of human health and environmental protection. In this respect, the ninth edition of this series of Symposia focuses on the major concerns raised by chemical pollution on all aspects of urban life. More than one half of the world population lives today in big cities, with all the attendant problems as regards air, water and soil quality, safe disposal of urban waste, occupational exposure, in one word, the physical, mental and cultural welfare of citizens at large. All facets concurring to protect and maintain urban health will be thus taken into consideration and highlighted in about forty invited lectures, while posters will be displayed in a permanent session throughout the conference duration. [Italian] Nel quadro degli accordi bilaterali di collaborazione tecnica e scientifica vigenti tra Italia ed Ungheria e' stata intrapresa con successo sin dall'inizio degli anni '80 una serie di simposi a cadenza biennale. Tali manifestazioni hanno lo scopo di fornire agli studiosi di entrambi i paesi un forum permanente per la valutazione dell'andamento dei progetti comuni di ricerca, lo scambio di idee sulle priorita' future e la proposta di nuove iniziative. D'altro canto, la natura sovranazionale dei problemi oggetto di questi simposi ha reso anche necessaria la presenza di qualificati esponenti scientifici di

  10. Urban health. A challenge for the third millennium

    Energy Technology Data Exchange (ETDEWEB)

    Caroli, S. [Istituto Superiore di Sanita' , Rome (Italy). Lab. di Tossicologia Applicata; Menditto, A. [Istituto Superiore di Sanita' , Rome (Italy). Lab. di Biochimica Clinica

    1999-07-01

    In the frame of the bilateral governmental programme for scientific and technical cooperation existing between Italy and Hungary a successful series of biennial Symposia were undertaken since the early 1980s. These were designed to provide scientists of both countries with a permanent forum for the evaluation of ongoing joint projects, the exchange of views on future priorities dealt with by these Symposia always made the participation of prominent scientists from other countries a necessary complement substantially enhancing the international characteristics of such events. Each Symposium features a specific theme of primary importance within the general context of human health and environmental protection. In this respect, the ninth edition of this series of Symposia focuses on the major concerns raised by chemical pollution on all aspects of urban life. More than one half of the world population lives today in big cities, with all the attendant problems as regards air, water and soil quality, safe disposal of urban waste, occupational exposure, in one word, the physical, mental and cultural welfare of citizens at large. All facets concurring to protect and maintain urban health will be thus taken into consideration and highlighted in about forty invited lectures, while posters will be displayed in a permanent session throughout the conference duration. [Italian] Nel quadro degli accordi bilaterali di collaborazione tecnica e scientifica vigenti tra Italia ed Ungheria e' stata intrapresa con successo sin dall'inizio degli anni '80 una serie di simposi a cadenza biennale. Tali manifestazioni hanno lo scopo di fornire agli studiosi di entrambi i paesi un forum permanente per la valutazione dell'andamento dei progetti comuni di ricerca, lo scambio di idee sulle priorita' future e la proposta di nuove iniziative. D'altro canto, la natura sovranazionale dei problemi oggetto di questi simposi ha reso anche necessaria la presenza di

  11. eHealth in Saudi Arabia: Current Trends, Challenges and Recommendations.

    Science.gov (United States)

    Alsulame, Khaled; Khalifa, Mohamed; Househ, Mowafa

    2015-01-01

    The purpose of this study is to explore the current status of eHealth in Saudi Arabia from the perspective of health informatics professionals. We used a case study approach and analyzed participant data using thematic analysis. The study took place between July and August 2013. Data collection included interviews with nine senior health information professionals in Saudi Arabia. The findings describe participant views on current eHealth trends in Saudi Arabia and show differences among Saudi healthcare organizations in terms of eHealth adoption. Participants also describe the challenges relating to organizational and cultural issues, end user attitudes towards eHealth projects, and the lack of specialized human resources to implement eHealth systems. Two main recommendations made by the participants were to form a new national body for eHealth and to develop a unified plan for the implementation of Saudi eHealth initiatives.

  12. Addressing the challenges of diagnostics demand and supply: insights from an online global health discussion platform

    OpenAIRE

    Engel, Nora; Wachter, Keri; Pai, Madhukar; Gallarda, Jim; Boehme, Catharina; Celentano, Isabelle; Weintraub, Rebecca

    2016-01-01

    Several barriers challenge development, adoption and scale-up of diagnostics in low and middle income countries. An innovative global health discussion platform allows capturing insights from the global health community on factors driving demand and supply for diagnostics. We conducted a qualitative content analysis of the online discussion ?Advancing Care Delivery: Driving Demand and Supply of Diagnostics? organised by the Global Health Delivery Project (GHD) (http://www.ghdonline.org/) at H...

  13. General practitioners' views on leadership roles and challenges in primary health care: a qualitative study

    OpenAIRE

    Spehar, Ivan; Sjøvik, Hege; Karevold, Knut Ivar; Rosvold, Elin Olaug; Frich, Jan C

    2017-01-01

    Objective To explore general practitioners? (GPs) views on leadership roles and leadership challenges in general practice and primary health care. Design We conducted focus groups (FGs) with 17 GPs. Setting Norwegian primary health care. Subjects 17 GPs who attended a 5 d course on leadership in primary health care. Results Our study suggests that the GPs experience a need for more preparation and formal training for the leadership role, and that they experienced tensions between the clinical...

  14. Improving the use of economics in animal health - Challenges in research, policy and education.

    Science.gov (United States)

    Rushton, Jonathan

    2017-02-01

    The way that an economist and an animal health professional use economics differs and creates frustrations. The economist is in search of optimizing resource allocation in the management of animal health and disease problems with metrics associated with the productivity of key societal resources of labour and capital. The animal health professional have a strong belief that productivity can be improved with the removal of pathogens. These differences restrict how well economics is used in animal health, and the question posed is whether this matters. The paper explores the question by looking at the changing role of animals in society and the associated change of the animal health professional's activities. It then questions if the current allocation of scarce resources for animal health are adequately allocated for societies and whether currently available data are sufficient for good allocation. A rapid review of the data on disease impacts - production losses and costs of human reaction - indicate that the data are sparse collected in different times and geographical regions. This limits what can be understood on the productivity of the economic resources used for animal health and this needs to be addressed with more systematic collection of data on disease losses and costs of animal health systems. Ideally such a process should learn lessons from the way that human health has made estimates of the burden of diseases and their capture of data on the costs of human health systems. Once available data on the global burden of animal diseases and the costs of animal health systems would allow assessments of individual disease management processes and the productivity of wider productivity change. This utopia should be aimed at if animal health is to continue to attract and maintain adequate resources. Copyright © 2016 Elsevier B.V. All rights reserved.

  15. Body-part templates for recovery of 2D human poses under occlusion

    NARCIS (Netherlands)

    Poppe, Ronald Walter; Poel, Mannes; Perales, F.J.; Fisher, R.B.

    2008-01-01

    Detection of humans and estimation of their 2D poses from a single image are challenging tasks. This is especially true when part of the observation is occluded. However, given a limited class of movements, poses can be recovered given the visible body-parts. To this end, we propose a novel template

  16. Challenges to improving maternal health in rural Nepal.

    Science.gov (United States)

    Thapa, S

    1996-05-04

    In the remote village of Martadi, in Bajura district of western Nepal, the total fertility rate is 7. 20% of newborns die before they reach age 1. Temporary migration, mainly to India, is common due to the inability of the rugged and rocky terrain to supply enough food. The existence of temporary migration and a high frequency of remarriage suggest a high rate of sexually transmitted diseases. The relatively new hospital is very much under used (e.g., only 35 patients in 1995). The office in Kolti that supplies vaccines to Martadi has gone at least six months without receiving any new child immunization drugs, despite the presence of an air service. During and after delivery, no one, not even family members or traditional birth attendants, can touch a woman, who is confined to a cow-shed to deliver and care for her child and herself alone. Yet sick animals receive care. A new mother also is required to bathe herself, often requiring a walk of many hours. Women often identify access to water as their top priority. Pregnant or postpartum women are forbidden from eating green vegetables because of the belief that they cause diarrhea. Sanitation is better now in Martadi than in the past. Diarrhea and vomiting were once very prevalent. The international organization, CARE, along with the Ministry of Local Development operate the Remote Area Basic Needs Project, which revolves around community organization, agroforestry, rural infrastructure, and primary health care. The project has helped villagers construct low-cost toilets. It provides training in basic hygiene. Households have kitchen-gardens. Many families are now eating green vegetables regularly. Fruit trees are being introduced. Villagers recognize the value of child immunization. Some small-scale drinking water systems are operating. Villagers are trained in repair and management of these systems. About 33% of women aged 15-49 want no more children. A first-ever outreach program for female sterilization services

  17. Epidemiology of child injuries in Uganda: challenges for health policy

    Directory of Open Access Journals (Sweden)

    Renee Yuen-Jan Hsia

    2011-02-01

    Full Text Available Globally, 90% of road crash deaths occur in the developing world. Children in Africa bear the major part of this burden, with the highest unintentional injury rates in the world. Our study aims to better understand injury patterns among children living in Kampala, Uganda and provide evidence that injuries are significant in child health. Trauma registry records of injured children seen at Mulago Hospital in Kampala were analysed. This data was collected when patients were seen initially and included patient condition, demographics, clinical variables, cause, severity, as measured by the Kampala trauma score, and location of injury. Outcomes were captured on discharge from the casualty department and at two weeks for admitted patients. From August 2004 to August 2005, 872 injury visits for children <18 years old were recorded. The mean age was 11 years (95% CI 10.9–11.6; 68% (95% CI 65–72% were males; 64% were treated in casualty and discharged; 35% were admitted. The most common causes were traffic crashes (34%, falls (18% and violence (15%. Most children (87% were mildly injured; 1% severely injured. By two weeks, 6% of the patients admitted for injuries had died and, of these morbidities, 16% had severe injuries, 63% had moderate injuries and 21% had mild injuries. We concluded that, in Kampala, children bear a large burden of injury from preventable causes. Deaths in low severity patients highlight the need for improvements in facility-based care. Further studies are necessary to capture overall child injury mortality and to measure chronic morbidity owing to sequelae of injuries.

  18. Students’ Creativity: Problem Posing in Structured Situation

    Science.gov (United States)

    Amalina, I. K.; Amirudin, M.; Budiarto, M. T.

    2018-01-01

    This is a qualitative research concerning on students’ creativity on problem posing task. The study aimed at describing the students’ creative thinking ability to pose the mathematics problem in structured situations with varied condition of given problems. In order to find out the students’ creative thinking ability, an analysis of mathematics problem posing test based on fluency, novelty, and flexibility and interview was applied for categorizing students’ responses on that task. The data analysis used the quality of problem posing and categorized in 4 level of creativity. The results revealed from 29 secondary students grade 8, a student in CTL (Creative Thinking Level) 1 met the fluency. A student in CTL 2 met the novelty, while a student in CTL 3 met both fluency and novelty and no one in CTL 4. These results are affected by students’ mathematical experience. The findings of this study highlight that student’s problem posing creativity are dependent on their experience in mathematics learning and from the point of view of which students start to pose problem.

  19. Development and challenges of using web-based GIS for health applications

    DEFF Research Database (Denmark)

    Gao, Sheng; Mioc, Darka; Boley, Harold

    2011-01-01

    Web-based GIS is increasingly used in health applications. It has the potential to provide critical information in a timely manner, support health care policy development, and educate decision makers and the general public. This paper describes the trends and recent development of health...... applications using a Web-based GIS. Recent progress on the database storage and geospatial Web Services has advanced the use of Web-based GIS for health applications, with various proprietary software, open source software, and Application Programming Interfaces (APIs) available. Current challenges in applying...... care planning, and public health participation....

  20. THE CHALLENGES OF SCHOOL-BASED YOUTH SUICIDE PREVENTION: EXPERIENCES AND PERCEPTIONS OF MENTAL HEALTH PROFESSIONALS IN SOUTH AFRICAN SCHOOLS

    OpenAIRE

    Woolf, Maryke; Bantjes, Jason; Kagee, Ashraf

    2015-01-01

    Youth suicidal behaviour poses a significant public health concern. Mental health care professionals working in schools have an important role to play in youth suicide prevention initiatives, although little is known of the experiences of this group of professionals in the developing world. The aim of this study was to explore the experiences of mental health professionals working in South African schools and document their insights, attitudes and beliefs regarding youth suicidal behaviour. I...

  1. Mental health system governance in Nigeria: challenges, opportunities and strategies for improvement.

    Science.gov (United States)

    Abdulmalik, J; Kola, L; Gureje, O

    2016-01-01

    A health systems approach to understanding efforts for improving health care services is gaining traction globally. A component of this approach focuses on health system governance (HSG), which can make or mar the successful implementation of health care interventions. Very few studies have explored HSG in low- and middle-income countries, including Nigeria. Studies focusing on mental health system governance, are even more of a rarity. This study evaluates the mental HSG of Nigeria with a view to understanding the challenges, opportunities and strategies for strengthening it. This study was conducted as part of the project, Emerging Mental Health Systems in Low and Middle Income Countries (Emerald). A multi-method study design was utilized to evaluate the mental HSG status of Nigeria. A situational analysis of the health policy and legal environment in the country was performed. Subsequently, 30 key informant interviews were conducted at national, state and district levels to explore the country's mental HSG. The existing policy, legislative and institutional framework for HSG in Nigeria reveals a complete exclusion of mental health in key health sector documents. The revised mental health policy is however promising. Using the Siddiqi framework categories, we identified pragmatic strategies for mental health system strengthening that include a consideration of existing challenges and opportunities within the system. The identified strategies provide a template for the subsequent activities of the Emerald Programme (and other interventions), towards strengthening the mental health system of Nigeria.

  2. E-health: Determinants, opportunities, challenges and the way forward for countries in the WHO African Region

    Directory of Open Access Journals (Sweden)

    Gatwiri Doris

    2005-12-01

    Full Text Available Abstract Background The implementation of the 58th World Health Assembly resolution on e-health will pose a major challenge for the Member States of the World Health Organization (WHO African Region due to lack of information and communications technology (ICT and mass Internet connectivity, compounded by a paucity of ICT-related knowledge and skills. The key objectives of this article are to: (i explore the key determinants of personal computers (PCs, telephone mainline and cellular and Internet penetration/connectivity in the African Region; and (ii to propose actions needed to create an enabling environment for e-health services growth and utilization in the Region. Methods The effects of school enrolment, per capita income and governance variables on the number of PCs, telephone mainlines, cellular phone subscribers and Internet users were estimated using a double-log regression model and cross-sectional data on various Member States in the African Region. The analysis was based on 45 of the 46 countries that comprise the Region. The data were obtained from the United Nations Development Programme (UNDP, the World Bank and the International Telecommunications Union (ITU sources. Results There were a number of main findings: (i the adult literacy and total number of Internet users had a statistically significant (at 5% level in a t-distribution test positive effect on the number of PCs in a country; (ii the combined school enrolment rate and per capita income had a statistically significant direct effect on the number of telephone mainlines and cellular telephone subscribers; (iii the regulatory quality had statistically significant negative effect on the number of telephone mainlines; (iv similarly, the combined school enrolment ratio and the number of telephone mainlines had a statistically significant positive relationship with Internet usage; and (v there were major inequalities in ICT connectivity between upper-middle, lower-middle and

  3. Pose-invariant face recognition using Markov random fields.

    Science.gov (United States)

    Ho, Huy Tho; Chellappa, Rama

    2013-04-01

    One of the key challenges for current face recognition techniques is how to handle pose variations between the probe and gallery face images. In this paper, we present a method for reconstructing the virtual frontal view from a given nonfrontal face image using Markov random fields (MRFs) and an efficient variant of the belief propagation algorithm. In the proposed approach, the input face image is divided into a grid of overlapping patches, and a globally optimal set of local warps is estimated to synthesize the patches at the frontal view. A set of possible warps for each patch is obtained by aligning it with images from a training database of frontal faces. The alignments are performed efficiently in the Fourier domain using an extension of the Lucas-Kanade algorithm that can handle illumination variations. The problem of finding the optimal warps is then formulated as a discrete labeling problem using an MRF. The reconstructed frontal face image can then be used with any face recognition technique. The two main advantages of our method are that it does not require manually selected facial landmarks or head pose estimation. In order to improve the performance of our pose normalization method in face recognition, we also present an algorithm for classifying whether a given face image is at a frontal or nonfrontal pose. Experimental results on different datasets are presented to demonstrate the effectiveness of the proposed approach.

  4. Preparing students for the ethical challenges on international health electives: A systematic review of the literature on educational interventions.

    Science.gov (United States)

    Rahim, Anika; Knights Née Jones, Felicity; Fyfe, Molly; Alagarajah, Janagan; Baraitser, Paula

    2016-09-01

    International health electives pose specific ethical challenges for students travelling from to low and middle income countries. We undertook a systematic review of the literature on interventions to prepare students to identify ethical issues addressed, educational approaches and to collate evidence on the effectiveness of different strategies. We searched nine electronic databases of peer-reviewed literature and identified grey literature through key word searches; supplemented through citation mapping and expert consultation. Articles that described ethical training conducted by universities or professional bodies were included for review. We reviewed forty-four full text articles. Ten sources of published literature and seven sources of grey literature met our inclusion criteria. We identified thirteen ethical situations that students should be prepared to manage and eight generic skills to support this process. Most interventions were delivered before the elective, used case studies or guidelines. Some suggested ethical principles or a framework for analysis of ethical issues. Only two papers evaluated the intervention described. Our paper collates a small but growing body of work on education to prepare students to manage ethical issues. Ethical training should have elements that are delivered before, during and after the elective. Interventions should include case studies covering thirteen ethical issues identified here, linked to ethical principles and a process for responding to ethical issues. We suggest that evaluations of interventions are an important area for future research.

  5. Intercultural communication in health care: challenges and solutions in work rehabilitation practices and training: a comprehensive review.

    Science.gov (United States)

    Côté, Daniel

    2013-01-01

    The purpose of this comprehensive literature review it to explore cross-cultural issues in occupational rehabilitation and work disability prevention. A literature review on cross-cultural issues was performed in medicine, health sciences, and social sciences databases (PubMed, Ingenta, Canadian Centre for Occupational Health and Safety, Ergonomics Abstract, Google Scholar, OSH Update and the Quebec Workers' Compensation Board data base). A total of 27 documents published until 2010 in English or French were selected and analyzed. Cross-cultural issues in occupational rehabilitation show that representations of pain, communication and therapist-patient relationship and intercultural competence could be presented as the major topics covered in the selected literature. As for the general topic of immigrant workers and OSH, barriers were identified revealing personal, relational, contextual and structural levels that put immigrant and minority workers in situation of vulnerability (ex. linguistic and cultural barriers, lack of knowledge of the system, precarious work or exposition to higher risk hazards, etc.). Cultural issues in occupational rehabilitation put less attention to work-related contextual factors but emphasized on attitude and pain behaviours, perceptions of illness and appropriate treatment, therapist-patient relationship and cultural competences among OT professionals. The growth of immigration in countries such as Canada poses a real challenge to the delivery of health care and rehabilitation services. Despite growing concerns in providing culturally appropriate heath cares, intervention models, tools and training tools are still lacking in occupational rehabilitation and disability management. Nevertheless, cultural competence seems to be a promising concept to be implemented in work rehabilitation and disability management.

  6. Using Linked Electronic Health Records to Estimate Healthcare Costs: Key Challenges and Opportunities.

    Science.gov (United States)

    Asaria, Miqdad; Grasic, Katja; Walker, Simon

    2016-02-01

    This paper discusses key challenges and opportunities that arise when using linked electronic health records (EHR) in health economics and outcomes research (HEOR), with a particular focus on estimating healthcare costs. These challenges and opportunities are framed in the context of a case study modelling the costs of stable coronary artery disease in England. The challenges and opportunities discussed fall broadly into the categories of (1) handling and organising data of this size and sensitivity; (2) extracting clinical endpoints from datasets that have not been designed and collected with such endpoints in mind; and (3) the principles and practice of costing resource use from routinely collected data. We find that there are a number of new challenges and opportunities that arise when working with EHR compared with more traditional sources of data for HEOR. These call for greater clinician involvement and intelligent use of sensitivity analysis.

  7. Hospital management autonomy in Chile: the challenges for human resources in health.

    Science.gov (United States)

    Méndez, Claudio A; Torres A, M Cristina

    2010-04-01

    In Latin America, some health sector reforms have included steps to the implementation of autonomous hospitals. In Chile, the health system is implementing a reform that introduces a network of self-managed institutions. These organizations will be high complexity centers that involve greater technical diversity, cost centers and mechanisms to evaluate users' satisfaction. For human resources in health, the implementation of these centers creates challenges in the planning of service provision and a change from the traditional management style of the teams to one based on networks. These challenges include the estimation of gaps in medical specialists and in other professions in the health sector. In order to be successful with self-management, Chile needs to establish universal and local policies that address training and the organization of health service provisioning in these institutions.

  8. Commentary: Pediatric eHealth Interventions: Common Challenges During Development, Implementation, and Dissemination

    Science.gov (United States)

    Steele, Ric G.; Connelly, Mark A.; Palermo, Tonya M.; Ritterband, Lee M.

    2014-01-01

    Objective To provide an overview of common challenges that pediatric eHealth researchers may encounter when planning, developing, testing, and disseminating eHealth interventions along with proposed solutions for addressing these challenges. Methods The article draws on the existing eHealth literature and the authors’ collective experience in pediatric eHealth research. Results and conclusions The challenges associated with eHealth interventions and their proposed solutions are multifaceted and cut across a number of areas from eHealth program development through dissemination. Collaboration with a range of individuals (e.g., multidisciplinary colleagues, commercial entities, primary stakeholders) is the key to eHealth intervention success. To ensure adequate resources for design, development, and planning for sustainability, a number of public and private sources of funding are available. A study design that addresses ethical concerns and security issues is critical to ensure scientific integrity and intervention dissemination. Table I summarizes key issues to consider during eHealth intervention development, testing, and dissemination. PMID:24816766

  9. Commentary: pediatric eHealth interventions: common challenges during development, implementation, and dissemination.

    Science.gov (United States)

    Wu, Yelena P; Steele, Ric G; Connelly, Mark A; Palermo, Tonya M; Ritterband, Lee M

    2014-07-01

    To provide an overview of common challenges that pediatric eHealth researchers may encounter when planning, developing, testing, and disseminating eHealth interventions along with proposed solutions for addressing these challenges. The article draws on the existing eHealth literature and the authors' collective experience in pediatric eHealth research. The challenges associated with eHealth interventions and their proposed solutions are multifaceted and cut across a number of areas from eHealth program development through dissemination. Collaboration with a range of individuals (e.g., multidisciplinary colleagues, commercial entities, primary stakeholders) is the key to eHealth intervention success. To ensure adequate resources for design, development, and planning for sustainability, a number of public and private sources of funding are available. A study design that addresses ethical concerns and security issues is critical to ensure scientific integrity and intervention dissemination. Table I summarizes key issues to consider during eHealth intervention development, testing, and dissemination. © The Author 2014. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  10. Perspectives on Games, Computers, and Mental Health: Questions about Paradoxes, Evidences, and Challenges

    OpenAIRE

    Desseilles, Martin

    2016-01-01

    In the field of mental health, games and computerized games present questions about paradoxes, evidences, and challenges. This perspective article offers perspectives and personal opinion about these questions, evidences, and challenges with an objective of presenting several ideas and issues in this rapidly developing field. First, games raise some questions in the sense of the paradox between a game and an issue, as well as the paradox of using an amusing game to treat a serious pathology. ...

  11. Conventional Wisdom versus Actual Outcomes: Challenges in the Conduct of an Ebola Vaccine Trial in Liberia during the International Public Health Emergency.

    Science.gov (United States)

    Larson, Gregg S; Baseler, Beth R; Hoover, Marie L; Pierson, Jerome F; Tegli, Jemee K; Johnson, Melvin P; Kieh, Mark W S; McNay, Laura A; Njoh, Wissedi Sio

    2017-07-01

    Clinical trials are challenging endeavors. Planning and implementing an investigational vaccine trial in Liberia, in the midst of an Ebola virus disease (EVD) epidemic that World Health Organization classified a public health emergency of international concern, presented extraordinary challenges. Normally, years of preparation and a litany of tasks lay the groundwork for a successful, randomized, blinded, placebo-controlled trial focused on safety and efficacy. Difficult research settings, unpredictable events, and other unique circumstances can add complexity. The setting in Liberia was especially problematic due to an infrastructure still badly damaged following a lengthy civil war and a very fragile health-care system that was further devastated by the EVD outbreak. The Partnership for Research on Vaccines in Liberia I EVD vaccine trial was planned and implemented in less than 3 months by a Liberian and U.S. research partnership, and its Phase II substudy was fully enrolled 3 months later. Contrasting conventional wisdom with trial outcomes offers an opportunity to compare early assumptions, barriers encountered, and adaptive strategies used, with end results. Understanding what was learned can inform future trial responses when disease outbreaks, especially in resource-poor locations with minimal infrastructure, pose a significant threat to public health.

  12. Exemplar-based human action pose correction.

    Science.gov (United States)

    Shen, Wei; Deng, Ke; Bai, Xiang; Leyvand, Tommer; Guo, Baining; Tu, Zhuowen

    2014-07-01

    The launch of Xbox Kinect has built a very successful computer vision product and made a big impact on the gaming industry. This sheds lights onto a wide variety of potential applications related to action recognition. The accurate estimation of human poses from the depth image is universally a critical step. However, existing pose estimation systems exhibit failures when facing severe occlusion. In this paper, we propose an exemplar-based method to learn to correct the initially estimated poses. We learn an inhomogeneous systematic bias by leveraging the exemplar information within a specific human action domain. Furthermore, as an extension, we learn a conditional model by incorporation of pose tags to further increase the accuracy of pose correction. In the experiments, significant improvements on both joint-based skeleton correction and tag prediction are observed over the contemporary approaches, including what is delivered by the current Kinect system. Our experiments for the facial landmark correction also illustrate that our algorithm can improve the accuracy of other detection/estimation systems.

  13. Challenges and priorities for modelling livestock health and pathogens in the context of climate change

    Energy Technology Data Exchange (ETDEWEB)

    Özkan, Şeyda [Department of Animal and Aquacultural Sciences, Faculty of Veterinary Medicine and Biosciences, Norwegian University of Life Sciences (NMBU), Post Box 5003, Ås 1430 (Norway); Vitali, Andrea; Lacetera, Nicola [University of Tuscia, Department of Agriculture and Forestry Science (DAFNE), Via San Camillo De Lellis, snc, Viterbo 01100 (Italy); Amon, Barbara [Leibniz Institute for Agricultural Engineering Potsdam-Bornim (ATB), Max-Eyth-Allee 100, Potsdam 14469 (Germany); Bannink, André [Wageningen UR Livestock Research, P.O. Box 338, Wageningen 6700 AH (Netherlands); Bartley, Dave J. [Moredun Research Institute, Pentlands Science Park, Bush Loan, Penicuik EH26 0PZ (United Kingdom); Blanco-Penedo, Isabel [Animal Welfare Subprogram, IRTA, Veinat de Sies s/n, Monells, Girona 17121 (Spain); Haas, Yvette de [Wageningen UR Livestock Research, P.O. Box 338, Wageningen 6700 AH (Netherlands); Dufrasne, Isabelle [Nutrition Unit, Animal Production Department, Veterinary Faculty, University of Liège, Boulevard de Colonster 20, Bât. B43, Liège 4000 (Belgium); Elliott, John [ADAS UK Ltd, 4205 Park Approach, Thorpe Park, Leeds LS15 8GB (United Kingdom); Eory, Vera [Scotland' s Rural College (SRUC), Peter Wilson Building, Kings Buildings, West Mains Road, Edinburgh EH9 3JG (United Kingdom); Fox, Naomi J. [Scotland' s Rural College (SRUC), Animal and Veterinary Sciences, Roslin Institute Building, Easter Bush, Midlothian EH25 9RG (United Kingdom); Garnsworthy, Phil C. [University of Nottingham, School of Biosciences, Sutton Bonington Campus, Loughborough LE12 5RD (United Kingdom); and others

    2016-11-15

    Climate change has the potential to impair livestock health, with consequences for animal welfare, productivity, greenhouse gas emissions, and human livelihoods and health. Modelling has an important role in assessing the impacts of climate change on livestock systems and the efficacy of potential adaptation strategies, to support decision making for more efficient, resilient and sustainable production. However, a coherent set of challenges and research priorities for modelling livestock health and pathogens under climate change has not previously been available. To identify such challenges and priorities, researchers from across Europe were engaged in a horizon-scanning study, involving workshop and questionnaire based exercises and focussed literature reviews. Eighteen key challenges were identified and grouped into six categories based on subject-specific and capacity building requirements. Across a number of challenges, the need for inventories relating model types to different applications (e.g. the pathogen species, region, scale of focus and purpose to which they can be applied) was identified, in order to identify gaps in capability in relation to the impacts of climate change on animal health. The need for collaboration and learning across disciplines was highlighted in several challenges, e.g. to better understand and model complex ecological interactions between pathogens, vectors, wildlife hosts and livestock in the context of climate change. Collaboration between socio-economic and biophysical disciplines was seen as important for better engagement with stakeholders and for improved modelling of the costs and benefits of poor livestock health. The need for more comprehensive validation of empirical relationships, for harmonising terminology and measurements, and for building capacity for under-researched nations, systems and health problems indicated the importance of joined up approaches across nations. The challenges and priorities identified can

  14. Challenges and priorities for modelling livestock health and pathogens in the context of climate change

    International Nuclear Information System (INIS)

    Özkan, Şeyda; Vitali, Andrea; Lacetera, Nicola; Amon, Barbara; Bannink, André; Bartley, Dave J.; Blanco-Penedo, Isabel; Haas, Yvette de; Dufrasne, Isabelle; Elliott, John; Eory, Vera; Fox, Naomi J.; Garnsworthy, Phil C.

    2016-01-01

    Climate change has the potential to impair livestock health, with consequences for animal welfare, productivity, greenhouse gas emissions, and human livelihoods and health. Modelling has an important role in assessing the impacts of climate change on livestock systems and the efficacy of potential adaptation strategies, to support decision making for more efficient, resilient and sustainable production. However, a coherent set of challenges and research priorities for modelling livestock health and pathogens under climate change has not previously been available. To identify such challenges and priorities, researchers from across Europe were engaged in a horizon-scanning study, involving workshop and questionnaire based exercises and focussed literature reviews. Eighteen key challenges were identified and grouped into six categories based on subject-specific and capacity building requirements. Across a number of challenges, the need for inventories relating model types to different applications (e.g. the pathogen species, region, scale of focus and purpose to which they can be applied) was identified, in order to identify gaps in capability in relation to the impacts of climate change on animal health. The need for collaboration and learning across disciplines was highlighted in several challenges, e.g. to better understand and model complex ecological interactions between pathogens, vectors, wildlife hosts and livestock in the context of climate change. Collaboration between socio-economic and biophysical disciplines was seen as important for better engagement with stakeholders and for improved modelling of the costs and benefits of poor livestock health. The need for more comprehensive validation of empirical relationships, for harmonising terminology and measurements, and for building capacity for under-researched nations, systems and health problems indicated the importance of joined up approaches across nations. The challenges and priorities identified can

  15. Science–policy challenges for biodiversity, public health and urbanization: examples from Belgium

    International Nuclear Information System (INIS)

    Keune, H; De Blust, G; Van den Berge, K; Brosens, D; Van Herzele, A; Simoens, I; Kretsch, C; Gilbert, M; Linard, C; Flandroy, L; Versteirt, V; Hartig, T; De Keersmaecker, L; Eggermont, H; Dessein, J; Vanwambeke, S; Prieur-Richard, A H; Wittmer, H; Martens, P; Mathijs, E

    2013-01-01

    Internationally, the importance of a coordinated effort to protect both biodiversity and public health is more and more recognized. These issues are often concentrated or particularly challenging in urban areas, and therefore on-going urbanization worldwide raises particular issues both for the conservation of living natural resources and for population health strategies. These challenges include significant difficulties associated with sustainable management of urban ecosystems, urban development planning, social cohesion and public health. An important element of the challenge is the need to interface between different forms of knowledge and different actors from science and policy. We illustrate this with examples from Belgium, showcasing concrete cases of human–nature interaction. To better tackle these challenges, since 2011, actors in science, policy and the broader Belgian society have launched a number of initiatives to deal in a more integrated manner with combined biodiversity and public health challenges in the face of ongoing urbanization. This emerging community of practice in Belgium exemplifies the importance of interfacing at different levels. (1) Bridges must be built between science and the complex biodiversity/ecosystem–human/public health–urbanization phenomena. (2) Bridges between different professional communities and disciplines are urgently needed. (3) Closer collaboration between science and policy, and between science and societal practice is needed. Moreover, within each of these communities closer collaboration between specialized sections is needed. (letter)

  16. Deaf Adolescents' Learning of Cardiovascular Health Information: Sources and Access Challenges.

    Science.gov (United States)

    Smith, Scott R; Kushalnagar, Poorna; Hauser, Peter C

    2015-10-01

    Deaf individuals have more cardiovascular risks than the general population that are believed to be related to their cardiovascular health knowledge disparities. This phenomenological study describes where 20 deaf sign language-using adolescents from Rochester, New York, many who possess many positive characteristics to support their health literacy, learn cardiovascular health information and their lived experiences accessing health information. The goal is to ultimately use this information to improve the delivery of cardiovascular health education to this population and other deaf adolescents at a higher risk for weak health literacy. Deaf bilingual researchers interviewed deaf adolescents, transcribed and coded the data, and described the findings. Five major sources of cardiovascular health information were identified including family, health education teachers, healthcare providers, printed materials, and informal sources. Despite possessing advantageous characteristics contributing to stronger health literacy, study participants described significant challenges with accessing health information from each source. They also demonstrated inconsistencies in their cardiovascular health knowledge, especially regarding heart attack, stroke, and cholesterol. These findings suggest a great need for additional public funding to research deaf adolescents' informal health-related learning, develop accessible and culturally appropriate health surveys and health education programming, improve interpreter education, and disseminate information through social media. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  17. Deaf Adolescents’ Learning of Cardiovascular Health Information: Sources and Access Challenges

    Science.gov (United States)

    Smith, Scott R.; Kushalnagar, Poorna; Hauser, Peter C.

    2015-01-01

    Deaf individuals have more cardiovascular risks than the general population that are believed to be related to their cardiovascular health knowledge disparities. This phenomenological study describes where 20 deaf sign language-using adolescents from Rochester, New York, many who possess many positive characteristics to support their health literacy, learn cardiovascular health information and their lived experiences accessing health information. The goal is to ultimately use this information to improve the delivery of cardiovascular health education to this population and other deaf adolescents at a higher risk for weak health literacy. Deaf bilingual researchers interviewed deaf adolescents, transcribed and coded the data, and described the findings. Five major sources of cardiovascular health information were identified including family, health education teachers, healthcare providers, printed materials, and informal sources. Despite possessing advantageous characteristics contributing to stronger health literacy, study participants described significant challenges with accessing health information from each source. They also demonstrated inconsistencies in their cardiovascular health knowledge, especially regarding heart attack, stroke, and cholesterol. These findings suggest a great need for additional public funding to research deaf adolescents’ informal health-related learning, develop accessible and culturally appropriate health surveys and health education programming, improve interpreter education, and disseminate information through social media. PMID:26048900

  18. Pose tracking for augmented reality applications in outdoor archaeological sites

    Science.gov (United States)

    Younes, Georges; Asmar, Daniel; Elhajj, Imad; Al-Harithy, Howayda

    2017-01-01

    In recent years, agencies around the world have invested huge amounts of effort toward digitizing many aspects of the world's cultural heritage. Of particular importance is the digitization of outdoor archaeological sites. In the spirit of valorization of this digital information, many groups have developed virtual or augmented reality (AR) computer applications themed around a particular archaeological object. The problem of pose tracking in outdoor AR applications is addressed. Different positional systems are analyzed, resulting in the selection of a monocular camera-based user tracker. The limitations that challenge this technique from map generation, scale, anchoring, to lighting conditions are analyzed and systematically addressed. Finally, as a case study, our pose tracking system is implemented within an AR experience in the Byblos Roman theater in Lebanon.

  19. Pose Estimation of Interacting People using Pictorial Structures

    DEFF Research Database (Denmark)

    Fihl, Preben; Moeslund, Thomas B.

    2010-01-01

    Pose estimation of people have had great progress in recent years but so far research has dealt with single persons. In this paper we address some of the challenges that arise when doing pose estimation of interacting people. We build on the pictorial structures framework and make important...... contributions by combining color-based appearance and edge information using a measure of the local quality of the appearance feature. In this way we not only combine the two types of features but dynamically find the optimal weighting of them. We further enable the method to handle occlusions by searching...... a foreground mask for possible occluded body parts and then applying extra strong kinematic constraints to find the true occluded body parts. The effect of applying our two contributions are show through both qualitative and quantitative tests and show a clear improvement on the ability to correctly localize...

  20. Challenges in developing health promoting schools' project: application of global traits in local realm.

    Science.gov (United States)

    Fathi, Behrouz; Allahverdipour, Hamid; Shaghaghi, Abdolreza; Kousha, Ahmad; Jannati, Ali

    2014-01-01

    Despite the importance of student health and school hygiene as an aspect of the infrastructure of community health, few feasibility studies have been conducted on school health programs in developing countries. This study examined possible barriers to and challenges of such programs from the executive perspective in East Azerbaijan Province in Iran. This qualitative study used the content analysis approach to recognize barriers to and challenges of health promoting school program from the executive perspective. Fourteen experts were selected in the areas of children and adolescents and school health, physical education and school headmasters. Data were collected using semi-structured interviews and analyzed using the content analysis method. Five themes were extracted as major barriers and challenges: 1. Intraand inter-sectorial collaboration; 2. Policy and rule formulation; 3. Infrastructure and capacity; 4. Human resources; 5. Community involvement. The localized version of the current health promoting school program had major faults. If this program is considered to be a healthcare system priority, it should be revised to set effective policies for implementation and to sustain school health programs based on the capacities and objectives of each country.