Critical perspectives in public health

National Research Council Canada - National Science Library

Green, Judith; Labonte, Ronald N

2008-01-01

... the contemporary roles of 'critical voices' in public health research and practice from a range of disciplines and contexts. The book covers many of the pressing concerns for public health practitioners and researchers, including: * * * * * the implications of new genetic technologies for public health; the impact of globalisation on local practice...

Constructing critical thinking in health professional education.

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Kahlke, Renate; Eva, Kevin

2018-04-04

Calls for enabling 'critical thinking' are ubiquitous in health professional education. However, there is little agreement in the literature or in practice as to what this term means and efforts to generate a universal definition have found limited traction. Moreover, the variability observed might suggest that multiplicity has value that the quest for universal definitions has failed to capture. In this study, we sought to map the multiple conceptions of critical thinking in circulation in health professional education to understand the relationships and tensions between them. We used an inductive, qualitative approach to explore conceptions of critical thinking with educators from four health professions: medicine, nursing, pharmacy, and social work. Four participants from each profession participated in two individual in-depth semi-structured interviews, the latter of which induced reflection on a visual depiction of results generated from the first set of interviews. Three main conceptions of critical thinking were identified: biomedical, humanist, and social justice-oriented critical thinking. 'Biomedical critical thinking' was the dominant conception. While each conception had distinct features, the particular conceptions of critical thinking espoused by individual participants were not stable within or between interviews. Multiple conceptions of critical thinking likely offer educators the ability to express diverse beliefs about what 'good thinking' means in variable contexts. The findings suggest that any single definition of critical thinking in the health professions will be inherently contentious and, we argue, should be. Such debates, when made visible to educators and trainees, can be highly productive.

Integrating critical pedagogy, feminist pedagogy, and standpoint theory;connecting classroom learning with democratic citizenship

OpenAIRE

Ganote, Cynthia

2012-01-01

In this paper, I argue that processes stemming from feminist pedagogy and feminist standpoint theory can be used to enact two central goals of critical pedagogy in the classroom, those of creating a co-intentional educational space and of pursuing conscientização. Further, this integration of critical and feminist pedagogies and standpoint theory allows educators to model multicultural democracy and hone the tools of democratic citizenry with students in an emergent process that connects poli...

The Mind-Body Connection - Emotions and Health

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... Current Issue Past Issues The Mind-Body Connection Emotions and Health Past Issues / Winter 2008 Table of ... for centuries. Until the 1800s, most believed that emotions were linked to disease and advised patients to ...

Family Health and Financial Literacy--Forging the Connection

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Braun, Bonnie; Kim, Jinhee; Anderson, Elaine A.

2009-01-01

Families are at-risk of or experiencing a diminished quality of living and life in current economic times and difficult decisions are required. Health and financial literacy are the basis for wise personal and public decision making. Family and consumer sciences (FCS) professionals can forge connections between health and financial literacy to…

Multiscale connectivity and graph theory highlight critical areas for conservation under climate change.

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Dilt, Thomas E; Weisberg, Peter J; Leitner, Philip; Matocq, Marjorie D; Inman, Richard D; Nussear, Kenneth E; Esque, Todd C

2016-06-01

Conservation planning and biodiversity management require information on landscape connectivity across a range of spatial scales from individual home ranges to large regions. Reduction in landscape connectivity due changes in land use or development is expected to act synergistically with alterations to habitat mosaic configuration arising from climate change. We illustrate a multiscale connectivity framework to aid habitat conservation prioritization in the context of changing land use and climate. Our approach, which builds upon the strengths of multiple landscape connectivity methods, including graph theory, circuit theory, and least-cost path analysis, is here applied to the conservation planning requirements of the Mohave ground squirrel. The distribution of this threatened Californian species, as for numerous other desert species, overlaps with the proposed placement of several utility-scale renewable energy developments in the American southwest. Our approach uses information derived at three spatial scales to forecast potential changes in habitat connectivity under various scenarios of energy development and climate change. By disentangling the potential effects of habitat loss and fragmentation across multiple scales, we identify priority conservation areas for both core habitat and critical corridor or stepping stone habitats. This approach is a first step toward applying graph theory to analyze habitat connectivity for species with continuously distributed habitat and should be applicable across a broad range of taxa.

A missing ethical competency? A review of critical reflection in health promotion.

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Tretheway, Rebecca; Taylor, Jane; O'Hara, Lily; Percival, Nikki

2015-12-01

There is increasing emphasis in the health promotion literature on the ethical imperative for the profession to move towards critical practice. A key challenge for health promotion is that critical practice appears both under-developed and under-practiced. This is evident in the omission of critical reflection from Australian and international competencies for health promotion practitioners. A narrative literature review was undertaken to explore the current use of critical reflection in health promotion. Critical reflection models relevant to health promotion were identified and critiqued. There was a dearth of literature on critical reflection within health promotion, despite recognition of its potential to support critical practice. The discipline of critical social work provided literature on the use, effect and outcome of critical reflection in practice. The interdisciplinary critical reflection model was identified as the model most applicable to health promotion. Underpinned by critical theory, this model emphasises both critical and ethical practice. Critical reflection is a core competency for health promotion practitioners to address the ethical imperative to move towards critical practice. There is a need to explore the application of a critical reflection model in health promotion to determine how it may support critical and ethical practice. So what? If health promotion is to meet its ethical responsibilities, then critical reflection needs to be articulated as a core health promotion competency and a model for its application in health promotion developed.

Deafferentation-Induced Plasticity of Visual Callosal Connections: Predicting Critical Periods and Analyzing Cortical Abnormalities Using Diffusion Tensor Imaging

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Jaime F. Olavarria

2012-01-01

Full Text Available Callosal connections form elaborate patterns that bear close association with striate and extrastriate visual areas. Although it is known that retinal input is required for normal callosal development, there is little information regarding the period during which the retina is critically needed and whether this period correlates with the same developmental stage across species. Here we review the timing of this critical period, identified in rodents and ferrets by the effects that timed enucleations have on mature callosal connections, and compare it to other developmental milestones in these species. Subsequently, we compare these events to diffusion tensor imaging (DTI measurements of water diffusion anisotropy within developing cerebral cortex. We observed that the relationship between the timing of the critical period and the DTI-characterized developmental trajectory is strikingly similar in rodents and ferrets, which opens the possibility of using cortical DTI trajectories for predicting the critical period in species, such as humans, in which this period likely occurs prenatally. Last, we discuss the potential of utilizing DTI to distinguish normal from abnormal cerebral cortical development, both within the context of aberrant connectivity induced by early retinal deafferentation, and more generally as a potential tool for detecting abnormalities associated with neurodevelopmental disorders.

Promoting critical perspectives in mental health nursing education.

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McKie, A; Naysmith, S

2014-03-01

This paper explores themes relevant to mental health nursing using the example of one educational module of a nursing degree. The authors argue that the educational preparation of mental health nursing students in higher education must address certain contested philosophical, conceptual, social and ethical dimensions of contemporary mental health care practice. These themes are discussed within the context of a third-year mental health nursing module within a Scottish nursing degree programme. By interlinking epistemology and ontology, the notion of student as 'critical practitioner', involving the encouragement of 'critical thinking', is developed. This is shown via engagement with parallel perspectives of the sciences and the humanities in mental health. Narratives of student nurse engagement with selected literary texts demonstrate the extent to which issues of knowledge, self-awareness and personal development are central to a student's professional journey as they progress through an academic course. The paper concludes by suggesting that these 'critical perspectives' have important wider implications for curriculum design in nursing education. Insights from critical theory can equip nurse educators to challenge consumerist tendencies within contemporary higher education by encouraging them to remain knowledgeable, critical and ethically sensitive towards the needs of their students. © 2013 John Wiley & Sons Ltd.

All roads lead to Iran: Predicting landscape connectivity of the last stronghold for the critically endangered Asiatic cheetah

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E. M. Moqanaki; Samuel Cushman

2016-01-01

Effective conservation solutions for small and isolated wildlife populations depend on identifying and preserving critical biological corridors and dispersal routes. With a worldwide population of ≤70 individuals, the critically endangered Asiatic cheetah Acinonyx jubatus venaticus persists in several fragmented nuclei in Iran. Connectivity between nuclei is...

Mapping a Careflow Network to assess the connectedness of Connected Health.

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Carroll, Noel; Richardson, Ita

2017-04-01

Connected Health is an emerging and rapidly developing field which has the potential to transform healthcare service systems by increasing its safety, quality and overall efficiency. From a healthcare perspective, process improvement models have mainly focused on the static workflow viewpoint. The objective of this article is to study and model the dynamic nature of healthcare delivery, allowing us to identify where potential issues exist within the service system and to examine how Connected Health technological solutions may support service efficiencies. We explore the application of social network analysis (SNA) as a modelling technique which captures the dynamic nature of a healthcare service. We demonstrate how it can be used to map the 'Careflow Network' and guide Connected Health innovators to examine specific opportunities within the healthcare service. Our results indicate that healthcare technology must be correctly identified and implemented within the Careflow Network to enjoy improvements in service delivery. Oftentimes, prior to making the transformation to Connected Health, researchers use various modelling techniques that fail to identify where Connected Health innovation is best placed in a healthcare service network. Using SNA allows us to develop an understanding of the current operation of healthcare system within which they can effect change. It is important to identify and model the resource exchanges to ensure that the quality and safety of care are enhanced, efficiencies are increased and the overall healthcare service system is improved. We have shown that dynamic models allow us to study the exchange of resources. These are often intertwined within a socio-technical context in an informal manner and not accounted for in static models, yet capture a truer insight on the operations of a Careflow Network.

Multi-scale connectivity and graph theory highlight critical areas for conservation under climate change

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Dilts, Thomas E.; Weisberg, Peter J.; Leitner, Phillip; Matocq, Marjorie D.; Inman, Richard D.; Nussear, Ken E.; Esque, Todd C.

2016-01-01

Conservation planning and biodiversity management require information on landscape connectivity across a range of spatial scales from individual home ranges to large regions. Reduction in landscape connectivity due changes in land-use or development is expected to act synergistically with alterations to habitat mosaic configuration arising from climate change. We illustrate a multi-scale connectivity framework to aid habitat conservation prioritization in the context of changing land use and climate. Our approach, which builds upon the strengths of multiple landscape connectivity methods including graph theory, circuit theory and least-cost path analysis, is here applied to the conservation planning requirements of the Mohave ground squirrel. The distribution of this California threatened species, as for numerous other desert species, overlaps with the proposed placement of several utility-scale renewable energy developments in the American Southwest. Our approach uses information derived at three spatial scales to forecast potential changes in habitat connectivity under various scenarios of energy development and climate change. By disentangling the potential effects of habitat loss and fragmentation across multiple scales, we identify priority conservation areas for both core habitat and critical corridor or stepping stone habitats. This approach is a first step toward applying graph theory to analyze habitat connectivity for species with continuously-distributed habitat, and should be applicable across a broad range of taxa.

Beyond Techno-Utopia: Critical Approaches to Digital Health Technologies

Directory of Open Access Journals (Sweden)

Deborah Lupton

2014-12-01

Full Text Available This editorial presents an overview of digital health technologies, discusses previous research and introduces the contributions to the special issue “Beyond Techno-Utopia: Critical Approaches to Digital Health Technologies”. It is argued that thus far, few critical analyses of digital health technologies have been published in the social science literature, particularly in relation to the newest technologies. While the articles collected here in this special issue have gone some way in offering a critical response to digital health technologies, they represent only a beginning. Many more compelling topics remain to be investigated. The editorial ends with outlining directions for future research in this area.

How Kindergarten Students Connect and Critically Respond to Themes of Social Class in Children's Literature

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Labadie, Meredith; Pole, Kathryn; Rogers, Rebecca

2013-01-01

This study examines how critical literacy read-alouds can be facilitated in an early childhood setting. More specifically, it describes how books allow young children to connect with experiences that help them identify and challenge inequality and envision social change. A classroom teacher and two university-based researchers collaborated to…

Improving Cancer-Related Outcomes with Connected Health - Objective 4

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The full benefits of connected health cannot be achieved unless everyone in the United States who wants to participate and the organizations that support health and deliver healthcare have adequate access to high-speed Internet service. Access depends both on the availability of broadband service and the resources needed to obtain and maintain service.

Malaysia's social policies on mental health: a critical theory.

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Mubarak, A Rahamuthulla

2003-01-01

This article aims to review the social policies on mental health and mental illness in Malaysia. Using critical theory, major policy issues pertaining to mental health and mental illness such as mental health legislation, prevalence rates and quality of services available to the people with mental health problems are discussed in detail. Implications of these issues on persons with mental health problems are critically evaluated. The paper highlights that the other countries in ASEAN region also require similar review by policy literature.

Rationing in health systems: A critical review.

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Keliddar, Iman; Mosadeghrad, Ali Mohammad; Jafari-Sirizi, Mehdi

2017-01-01

Background: It is difficult to provide health care services to all those in need of such services due to limited resources and unlimited demands. Thus, priority setting and rationing have to be applied. This study aimed at critically examining the concept of rationing in health sector and identifying its purposes, influencing factors, mechanisms, and outcomes. Methods: The critical interpretive synthesis methodology was used in this study. PubMed, Cochrane, and Proquest databases were searched using the related key words to find related documents published between 1970 and 2015. In total, 161 published reports were reviewed and included in the study. Thematic content analysis was applied for data analysis. Results: Health services rationing means restricting the access of some people to useful or potentially useful health services due to budgetary limitation. The inherent features of the health market and health services, limited resources, and unlimited needs necessitate health services rationing. Rationing can be applied in 4 levels: health care policy- makers, health care managers, health care providers, and patients. Health care rationing can be accomplished through fixed budget, benefit package, payment mechanisms, queuing, copayments, and deductibles. Conclusion: This paper enriched our understanding of health services rationing and its mechanisms at various levels and contributed to the literature by broadly conceptualizing health services rationing.

Im/mobilities and dis/connectivities in medical globalisation: How global is Global Health?

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Dilger, Hansjörg; Mattes, Dominik

2018-03-01

The interdisciplinary, politically contested field of Global Health has often been described as a consequence of, and response to, an intensification of the mobilities of, and connectivities between, people, pathogens, ideas, and infrastructure across national borders and large distances. However, such global mobilities and connectivities are not as omnidirectional and unpatterned as the rhetoric of many Global Health actors suggests. Instead, we argue that they are suffused by a plethora of institutional, national, and global political agendas, and substantially shaped by transnational and postcolonial power relations. Furthermore, the configurations that are typically subsumed under the category of Global Health represent only a minor part of the range of im/mobilities and dis/connectivities that are essential for understanding transformations of epidemiological patterns, health care infrastructures, and the responses to health-related challenges in a globalising world. In order to broaden such a limiting analytical perspective, we propose to expand the analytical focus in studying Global Health phenomena by paying close attention to the myriad ways in which particular im/mobilities and dis/connectivities constitute medicine and well-being in global and transnational settings. Pursuing a conceptual shift from studies of 'Global Health' to studying 'medical globalization' may carve out new analytical ground for such an endeavour.

CHILDREN'S HEALTH PROTECTION IN INTERSECTORAL CONNECTION

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Yu.E. Lapin

2008-01-01

Full Text Available Recently discovered phenomenon of compensatory mechanism of absence of legislative durable national policy in health protection of children is described in this article. This mechanism was developed as a result of evolution of intersect oral connection for the sake of children's health protection. «National family policy», «national policy for the sake of children», «national policy in the field of circulation of narcotic, psychotropic substances and in the field of counteraction to its illegal use», «national policy of Russian federation in the field of education», «national policy in the field of labor relations» perform functions of such compensatory mechanism. Fact of regulation of social relations in the sphere of children's health protection with means of different active directions of national policy is evidence of legal assignment of a number of problems in children's health protection as real subject of policy. The negative feature of this problem is incomplete and fragmentary regulation of relationships in the field of children's health protection. This is the reason, which maintains a status of children's health protection service as passive dirigible object but not an active regulative factor.Key words: children, health, national policy.

Connected health and integrated care: Toward new models for chronic disease management.

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Chouvarda, Ioanna G; Goulis, Dimitrios G; Lambrinoudaki, Irene; Maglaveras, Nicos

2015-09-01

The increasingly aging population in Europe and worldwide brings up the need for the restructuring of healthcare. Technological advancements in electronic health can be a driving force for new health management models, especially in chronic care. In a patient-centered e-health management model, communication and coordination between patient, healthcare professionals in primary care and hospitals can be facilitated, and medical decisions can be made timely and easily communicated. Bringing the right information to the right person at the right time is what connected health aims at, and this may set the basis for the investigation and deployment of the integrated care models. In this framework, an overview of the main technological axes and challenges around connected health technologies in chronic disease management are presented and discussed. A central concept is personal health system for the patient/citizen and three main application areas are identified. The connected health ecosystem is making progress, already shows benefits in (a) new biosensors, (b) data management, (c) data analytics, integration and feedback. Examples are illustrated in each case, while open issues and challenges for further research and development are pinpointed. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

The extent to which the public health 'war on obesity' reflects the ethical values and principles of critical health promotion: a multimedia critical discourse analysis.

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O'Hara, Lily; Taylor, Jane; Barnes, Margaret

2015-12-01

The discipline of health promotion is responsible for implementing strategies within weight-related public health initiatives (WR-PHI). It is imperative that such initiatives be subjected to critical analysis through a health promotion ethics lens to help ensure ethical health promotion practice. Multimedia critical discourse analysis was used to examine the claims, values, assumptions, power relationships and ideologies within Australian WR-PHI. The Health Promotion Values and Principles Continuum was used as a heuristic to evaluate the extent to which the WR-PHI reflected the ethical values of critical health promotion: active participation of people in the initiative; respect for personal autonomy; beneficence; non-maleficence; and strong evidential and theoretical basis for practice. Ten initiatives were analysed. There was some discourse about the need for participation of people in the WR-PHI, but people were routinely labelled as 'target groups' requiring 'intervention'. Strong evidence of a coercive and paternalistic discourse about choice was identified, with minimal attention to respect for personal autonomy. There was significant emphasis on the beneficiaries of the WR-PHI but minimal attention to the health benefits, and nothing about the potential for harm. Discourse about the evidence of need was objectivist, and there was no discussion about the theoretical foundations of the WR-PHI. The WR-PHI were not reflective of the ethical values and principles of critical health promotion. So what? Health promotion researchers and practitioners engaged in WR-PHI should critically reflect on the extent to which they are consistent with the ethical aspects of critical health promotion practice.

Performance management models for public health: Public Health Accreditation Board/Baldrige connections, alignment, and distinctions.

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Gorenflo, Grace G; Klater, David M; Mason, Marlene; Russo, Pamela; Rivera, Lillian

2014-01-01

The nationally known Malcolm Baldrige Award for Excellence ("Baldrige program") recognizes outstanding performance management and is specifically cited by the Public Health Accreditation Board (PHAB) as a potential framework for PHAB's requisite performance management system. The authors developed a crosswalk that identifies alignments between the 2 programs and is a highlight of the Quest for Exceptional Performance tool that is intended to help health departments capitalize on the connections between the 2 programs. To provide deeper insight into the most robust connections between the 2 programs. The authors developed a crosswalk by listing the PHAB measures, identifying corresponding Baldrige areas to address, and assigning a rating regarding the strength of the alignment. Subsequently, they generated a matrix with numerical scores reflecting the strength of the PHAB-Baldrige alignments that were then analyzed for frequency and strength of alignment by PHAB domain and by Baldrige category. The tool developers and 3 public health leaders with experience in the Baldrige program contributed to both the design and the analyses. The measures used reflected both the frequency and strength of alignments. Of the 123 alignments identified in the crosswalk, 39 were rated as high, 40 as medium, and 44 as low. The strongest connections were in the areas of performance management, quality improvement, strategic planning, workforce development, assessment and analysis, and customer service. While the areas with the most frequent and strongest connections provide the most useful basis for health departments pursuing Baldrige recognition or using Baldrige criteria as a framework for performance management, all alignments could be considered for both purposes.

A Critical Care Societies Collaborative Statement: Burnout Syndrome in Critical Care Health-care Professionals. A Call for Action.

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Moss, Marc; Good, Vicki S; Gozal, David; Kleinpell, Ruth; Sessler, Curtis N

2016-07-01

Burnout syndrome (BOS) occurs in all types of health-care professionals and is especially common in individuals who care for critically ill patients. The development of BOS is related to an imbalance of personal characteristics of the employee and work-related issues or other organizational factors. BOS is associated with many deleterious consequences, including increased rates of job turnover, reduced patient satisfaction, and decreased quality of care. BOS also directly affects the mental health and physical well-being of the many critical care physicians, nurses, and other health-care professionals who practice worldwide. Until recently, BOS and other psychological disorders in critical care health-care professionals remained relatively unrecognized. To raise awareness of BOS, the Critical Care Societies Collaborative (CCSC) developed this call to action. The present article reviews the diagnostic criteria, prevalence, causative factors, and consequences of BOS. It also discusses potential interventions that may be used to prevent and treat BOS. Finally, we urge multiple stakeholders to help mitigate the development of BOS in critical care health-care professionals and diminish the harmful consequences of BOS, both for critical care health-care professionals and for patients.

Social Connection Dynamics in a Health Promotion Network

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Fernandes de Mello Araujo, Eric; Klein, Michel; van Halteren, Aart

2016-01-01

The influence of social connections on human behaviour has been demonstrated in many occasions. This paper presents the analysis of the dynamic properties of longitudinal (335 days) community data (n=3,375 participants) from an online health promotion program. The community data is unique as it

Health Activism Targeting Corporations: A Critical Health Communication Perspective.

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Zoller, Heather M

2017-02-01

Health activists and health social movements have transformed medical treatment, promoted public health policies, and extended civil rights for people with illness and disability. This essay explores health activism that targets corporate-generated illness and risk in order to understand the unique communicative challenges involved in this area of contention. Arguing for greater critical engagement with policy, the article integrates policy research with social movements, subpolitics, and issue management literature. Drawing from activist discourse and multidisciplinary research, the article describes how a wide array of groups groups build visibility for corporate health effects, create the potential for networking and collaboration, and politicize health by attributing illness to corporate behaviors. The discussion articulates the implications of this activism for health communication theory, research, and practice.

Criticism of health researches: why and how

Directory of Open Access Journals (Sweden)

Hasan Ashrafi-rizi

2016-04-01

Full Text Available Research is one of the most important ways of science production (1. The purpose of research is exploring the unknown and explaining the variables that affect the human life. In the health sciences the purpose of which is health promotion, research is valued as much as human life (2. In many scientific texts, there is an emphasis on the importance of health researches in the quality of human life; the lack of attention to the quality of the publishing process is considered as the cause of much damage (3-10. The result of health researches is usually published as a paper, thesis, research project and book, the contents of all needs to be assessed. This process is named Research Review or Research Critique (2. Research critique is done during publishing process or after it, and in this paper we deal with it after publishing health texts. The broker chain between information producer and consumers who is the critic (Reviewer and critique journals has been less attended. In short, Soltani indicates that the purpose of critique as a defense of society’s cultural rights is to help the reader to choose the appropriate work, help the writer identify his weak points and his strengths (11, and also prevent damage to the society, especially people’s health. In the critique of health researches, there are two essential stages: in the first stage, the work is studied quickly by the critic (Survey study. The aim of this study is gaining knowledge of the text and usually the bibliographic information of work like title, writer, incentive of work, headings and so on is assessed briefly (12. In the second stage, a critical study is done. The critical study is the most important and most critical step in the reviewing the texts. “In this study, the critic judges as to the accuracy, reliability, or value of the text based on criteria or standards. This type of study is the key to the appropriate understanding. This method is necessary to determine the truth

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

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Maglaveras, Nicos; Kilintzis, Vassilis; Koutkias, Vassilis; Chouvarda, Ioanna

2016-01-01

Integrated care and connected health are two fast evolving concepts that have the potential to leverage personalised health. From the one side, the restructuring of care models and implementation of new systems and integrated care programs providing coaching and advanced intervention possibilities, enable medical decision support and personalized healthcare services. From the other side, the connected health ecosystem builds the means to follow and support citizens via personal health systems in their everyday activities and, thus, give rise to an unprecedented wealth of data. These approaches are leading to the deluge of complex data, as well as in new types of interactions with and among users of the healthcare ecosystem. The main challenges refer to the data layer, the information layer, and the output of information processing and analytics. In all the above mentioned layers, the primary concern is the quality both in data and information, thus, increasing the need for filtering mechanisms. Especially in the data layer, the big biodata management and analytics ecosystem is evolving, telemonitoring is a step forward for data quality leverage, with numerous challenges still left to address, partly due to the large number of micro-nano sensors and technologies available today, as well as the heterogeneity in the users' background and data sources. This leads to new R&D pathways as it concerns biomedical information processing and management, as well as to the design of new intelligent decision support systems (DSS) and interventions for patients. In this paper, we illustrate these issues through exemplar research targeting chronic patients, illustrating the current status and trends in PHS within the integrated care and connected care world.

Optimizing network connectivity for mobile health technologies in sub-Saharan Africa.

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Siedner, Mark J; Lankowski, Alexander; Musinga, Derrick; Jackson, Jonathon; Muzoora, Conrad; Hunt, Peter W; Martin, Jeffrey N; Bangsberg, David R; Haberer, Jessica E

2012-01-01

Mobile health (mHealth) technologies hold incredible promise to improve healthcare delivery in resource-limited settings. Network reliability across large catchment areas can be a major challenge. We performed an analysis of network failure frequency as part of a study of real-time adherence monitoring in rural Uganda. We hypothesized that the addition of short messaging service (SMS+GPRS) to the standard cellular network modality (GPRS) would reduce network disruptions and improve transmission of data. Participants were enrolled in a study of real-time adherence monitoring in southwest Uganda. In June 2011, we began using Wisepill devices that transmit data each time the pill bottle is opened. We defined network failures as medication interruptions of >48 hours duration that were transmitted when network connectivity was re-established. During the course of the study, we upgraded devices from GPRS to GPRS+SMS compatibility. We compared network failure rates between GPRS and GPRS+SMS periods and created geospatial maps to graphically demonstrate patterns of connectivity. One hundred fifty-seven participants met inclusion criteria of seven days of SMS and seven days of SMS+GPRS observation time. Seventy-three percent were female, median age was 40 years (IQR 33-46), 39% reported >1-hour travel time to clinic and 17% had home electricity. One hundred one had GPS coordinates recorded and were included in the geospatial maps. The median number of network failures per person-month for the GPRS and GPRS+SMS modalities were 1.5 (IQR 1.0-2.2) and 0.3 (IQR 0-0.9) respectively, (mean difference 1.2, 95%CI 1.0-1.3, p-valueImprovements in network connectivity were notable throughout the region. Study costs increased by approximately $1USD per person-month. Addition of SMS to standard GPRS cellular network connectivity can significantly reduce network connection failures for mobile health applications in remote areas. Projects depending on mobile health data in resource

Mobile health messaging service and helpdesk for South African mothers (MomConnect): history, successes and challenges

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Barron, Peter; Peter, Joanne; Sebidi, Jane; Bekker, Marcha; Allen, Robert; Parsons, Annie Neo; Benjamin, Peter; Pillay, Yogan

2018-01-01

MomConnect is a flagship programme of the South African National Department of Health that has reached over 1.5 million pregnant women. Using mobile technology, MomConnect provides pregnant and postpartum women with twice-weekly health information text messages as well as access to a helpdesk for patient queries and feedback. In just 3 years, MomConnect has been taken to scale to reach over 95% of public health facilities and has reached 63% of all pregnant women attending their first antenatal appointment. The helpdesk has received over 300 000 queries at an average of 250 per day from 6% of MomConnect users. The service is entirely free to its users. The rapid deployment of MomConnect has been facilitated by strong government leadership, and an ecosystem of mobile health implementers who had experience of much of the content and technology required. An early decision to design MomConnect for universal coverage has required the use of text-based technologies (short messaging service and Unstructured Supplementary Service Data) that are accessible via even the most basic mobile phones, but cumbersome to use and costly at scale. Unlike previous mobile messaging services in South Africa, MomConnect collects the user’s identification number and facility code during registration, enabling future linkages with other health and population databases and geolocated feedback. MomConnect has catalysed additional efforts to strengthen South Africa’s digital health architecture. The rapid growth in smartphone penetration presents new opportunities to reduce costs, increase real-time data collection and expand the reach and scope of MomConnect to serve health workers and other patient groups. PMID:29713503

Connected health and multiple sclerosis.

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Cohen, M

2018-04-18

There is as yet no consensual definition of "connected health". In general, the term refers to the growing use of technology and, in particular, mobile technology in medicine. Over the past 10 years, there have been an increasing number of published reports on the wide-ranging and heterogeneous fields involving the application of technology in medicine, ranging from telemedicine to tools to improve patients' evaluation and monitoring by physicians, as well as a multitude of patient-centered applications. They also represent promising tools in the field of clinical research. This report is a review of the importance of using this technology in the management of multiple sclerosis patients. Copyright © 2018 Elsevier Masson SAS. All rights reserved.

A uniqueness-and-anonymity-preserving remote user authentication scheme for connected health care.

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Chang, Ya-Fen; Yu, Shih-Hui; Shiao, Ding-Rui

2013-04-01

Connected health care provides new opportunities for improving financial and clinical performance. Many connected health care applications such as telecare medicine information system, personally controlled health records system, and patient monitoring have been proposed. Correct and quality care is the goal of connected heath care, and user authentication can ensure the legality of patients. After reviewing authentication schemes for connected health care applications, we find that many of them cannot protect patient privacy such that others can trace users/patients by the transmitted data. And the verification tokens used by these authentication schemes to authenticate users or servers are only password, smart card and RFID tag. Actually, these verification tokens are not unique and easy to copy. On the other hand, biometric characteristics, such as iris, face, voiceprint, fingerprint and so on, are unique, easy to be verified, and hard to be copied. In this paper, a biometrics-based user authentication scheme will be proposed to ensure uniqueness and anonymity at the same time. With the proposed scheme, only the legal user/patient himself/herself can access the remote server, and no one can trace him/her according to transmitted data.

Family caregivers' health in connection with providing care.

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Erlingsson, Christen L; Magnusson, Lennart; Hanson, Elizabeth

2012-05-01

Our aim was to investigate connections between Swedish family caregivers' health and providing care for an ill relative by conducting a systematic search and synthesis of previous research. We analyzed 31 articles using first qualitative content analysis then hermeneutic analysis. Analysis resulted in three derived themes-sliding sideways into caregiving, caregiving in reciprocity, and caregiving in disintegration-and a main interpretation and conceptual model of Swedish family caregivers' health-caregiving in a sphere of beliefs. Results indicated that Swedish family caregivers' beliefs, experiences of reciprocity, or nonsupport, together with quality of interpersonal relationships and feelings of responsibility and guilt, have a profound impact on their health. These results point to the value and importance of nurses gaining an understanding of family caregivers' beliefs and experiences of reciprocity or nonsupport to effectively promote family caregivers' health.

An Official Critical Care Societies Collaborative Statement-Burnout Syndrome in Critical Care Health-care Professionals: A Call for Action.

Science.gov (United States)

Moss, Marc; Good, Vicki S; Gozal, David; Kleinpell, Ruth; Sessler, Curtis N

2016-07-01

Burnout syndrome (BOS) occurs in all types of health-care professionals and is especially common in individuals who care for critically ill patients. The development of BOS is related to an imbalance of personal characteristics of the employee and work-related issues or other organizational factors. BOS is associated with many deleterious consequences, including increased rates of job turnover, reduced patient satisfaction, and decreased quality of care. BOS also directly affects the mental health and physical well-being of the many critical care physicians, nurses, and other health-care professionals who practice worldwide. Until recently, BOS and other psychological disorders in critical care health-care professionals remained relatively unrecognized. To raise awareness of BOS, the Critical Care Societies Collaborative (CCSC) developed this call to action. The present article reviews the diagnostic criteria, prevalence, causative factors, and consequences of BOS. It also discusses potential interventions that may be used to prevent and treat BOS. Finally, we urge multiple stakeholders to help mitigate the development of BOS in critical care health-care professionals and diminish the harmful consequences of BOS, both for critical care health-care professionals and for patients. Copyright © 2016 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

Designing for scale: optimising the health information system architecture for mobile maternal health messaging in South Africa (MomConnect).

Science.gov (United States)

Seebregts, Christopher; Dane, Pierre; Parsons, Annie Neo; Fogwill, Thomas; Rogers, Debbie; Bekker, Marcha; Shaw, Vincent; Barron, Peter

2018-01-01

MomConnect is a national initiative coordinated by the South African National Department of Health that sends text-based mobile phone messages free of charge to pregnant women who voluntarily register at any public healthcare facility in South Africa. We describe the system design and architecture of the MomConnect technical platform, planned as a nationally scalable and extensible initiative. It uses a health information exchange that can connect any standards-compliant electronic front-end application to any standards-compliant electronic back-end database. The implementation of the MomConnect technical platform, in turn, is a national reference application for electronic interoperability in line with the South African National Health Normative Standards Framework. The use of open content and messaging standards enables the architecture to include any application adhering to the selected standards. Its national implementation at scale demonstrates both the use of this technology and a key objective of global health information systems, which is to achieve implementation scale. The system's limited clinical information, initially, allowed the architecture to focus on the base standards and profiles for interoperability in a resource-constrained environment with limited connectivity and infrastructural capacity. Maintenance of the system requires mobilisation of national resources. Future work aims to use the standard interfaces to include data from additional applications as well as to extend and interface the framework with other public health information systems in South Africa. The development of this platform has also shown the benefits of interoperability at both an organisational and technical level in South Africa.

A Renormalization-Group Interpretation of the Connection between Criticality and Multifractals

Science.gov (United States)

Chang, Tom

2014-05-01

Turbulent fluctuations in space plasmas beget phenomena of dynamic complexity. It is known that dynamic renormalization group (DRG) may be employed to understand the concept of forced and/or self-organized criticality (FSOC), which seems to describe certain scaling features of space plasma turbulence. But, it may be argued that dynamic complexity is not just a phenomenon of criticality. It is therefore of interest to inquire if DRG may be employed to study complexity phenomena that are distinctly more complicated than dynamic criticality. Power law scaling generally comes about when the DRG trajectory is attracted to the vicinity of a fixed point in the phase space of the relevant dynamic plasma parameters. What happens if the trajectory lies within a domain influenced by more than one single fixed point or more generally if the transformation underlying the DRG is fully nonlinear? The global invariants of the group under such situations (if they exist) are generally not power laws. Nevertheless, as we shall argue, it may still be possible to talk about local invariants that are power laws with the nonlinearity of transformation prescribing a specific phenomenon as crossovers. It is with such concept in mind that we may provide a connection between the properties of dynamic criticality and multifractals from the point of view of DRG (T. Chang, Chapter VII, "An Introduction to Space Plasma Complexity", Cambridge University Press, 2014). An example in terms of the concepts of finite-size scaling (FSS) and rank-ordered multifractal analysis (ROMA) of a toy model shall be provided. Research partially supported by the US National Science Foundation and the European Community's Seventh Framework Programme (FP7/ 2007-2013) under Grant agreement no. 313038/STORM.

Wireless connectivity for health and sports monitoring: a review.

Science.gov (United States)

Armstrong, S

2007-05-01

This is a review of health and sports monitoring research that uses or could benefit from wireless connectivity. New, enabling wireless connectivity standards are evaluated for their suitability, and an assessment of current exploitation of these technologies is summarised. An example of the application is given, highlighting the capabilities of a network of wireless sensors. Issues of timing and power consumption in a battery-powered system are addressed to highlight the benefits networking can provide, and a suggestion of how monitoring different biometric signals might allow one to gain additional information about an athlete or patient is made.

The Mind-Body Connection - Complementary and Alternative Approaches to Health

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... Navigation Bar Home Current Issue Past Issues The Mind-Body Connection Complementary and Alternative Approaches to Health ... Also, a 2007 study found that Tai Chi boosts resistance to the shingles virus in older adults." ...

School Climate, Deployment, and Mental Health among Students in Military-Connected Schools

Science.gov (United States)

De Pedro, Kris Tunac; Astor, Ron Avi; Gilreath, Tamika D.; Benbenishty, Rami; Berkowitz, Ruth

2018-01-01

Research has found that when compared with civilian students, military-connected students in the United States have more negative mental health outcomes, stemming from the stress of military life events (i.e., deployment). To date, studies on military-connected youth have not examined the role of protective factors within the school environment,…

Faculty Perceptions of Critical Thinking at a Health Sciences University

Science.gov (United States)

Rowles, Joie; Morgan, Christine; Burns, Shari; Merchant, Christine

2013-01-01

The fostering of critical thinking skills has become an expectation of faculty, especially those teaching in the health sciences. The manner in which critical thinking is defined by faculty impacts how they will address the challenge to promote critical thinking among their students. This study reports the perceptions of critical thinking held by…

Critical interactionism: an upstream-downstream approach to health care reform.

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Martins, Diane Cocozza; Burbank, Patricia M

2011-01-01

Currently, per capita health care expenditures in the United States are more than 20% higher than any other country in the world and more than twice the average expenditure for European countries, yet the United States ranks 37th in life expectancy. Clearly, the health care system is not succeeding in improving the health of the US population with its focus on illness care for individuals. A new theoretical approach, critical interactionism, combines symbolic interactionism and critical social theory to provide a guide for addressing health care problems from both an upstream and downstream approach. Concepts of meaning from symbolic interactionism and emancipation from critical perspective move across system levels to inform and reform health care for individuals, organizations, and societies. This provides a powerful approach for health care reform, moving back and forth between the micro and macro levels. Areas of application to nursing practice with several examples (patients with obesity; patients who are lesbian, gay, bisexual, and transgender; workplace bullying and errors), nursing education, and research are also discussed.

Community mental health nurses speak out: the critical relationship between emotional wellbeing and satisfying professional practice.

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Rose, Jayln; Glass, Nel

2006-10-01

The article reports on selected findings of a research study concerning emotional wellbeing and professional nursing practice (Rose 2002). It highlights the relationship between community mental health nurses' and emotional wellbeing, and their capacity to provide satisfying professional nursing practice (Rose 2002). The notion of emotional wellbeing, factors that impacted upon the participants' emotional wellbeing, and the relationship of emotional wellbeing to professional practice were revealed in the study. These findings were based on a qualitative critical feminist research inquiry and specifically, interviews with five women community mental health nurses in Australia. Whilst complex, emotional wellbeing was found to be both implicitly and explicitly linked to the participants intertwined personal and professional experiences. Four key components were identified: the nebulous notion; the stress relationship; the mind, body, spirit connection; and, inner sense of balance. In terms of emotional wellbeing and professional practice, three themes were revealed. These were: being able to speak out (or not); being autonomous (or not) and being satisfied (or not). The authors argue that the emotional wellbeing of nurses working in community mental health settings is critical to satisfying professional practice. Furthermore nursing work involves emotional work which impacts on one's emotional wellbeing and emotional wellbeing is integrally linked to professional practice. It is recommended that health organisations must be pro-active in addressing the emotional needs of nurses to ensure the delivery of health care that is aligned to professional practice. This approach will ensure nurses will feel more recognised and validated in terms of their nursing practice.

Circadian Rhythm Connections to Oxidative Stress: Implications for Human Health

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Wilking, Melissa; Ndiaye, Mary; Mukhtar, Hasan

2013-01-01

Abstract Significance: Oxygen and circadian rhythmicity are essential in a myriad of physiological processes to maintain homeostasis, from blood pressure and sleep/wake cycles, down to cellular signaling pathways that play critical roles in health and disease. If the human body or cells experience significant stress, their ability to regulate internal systems, including redox levels and circadian rhythms, may become impaired. At cellular as well as organismal levels, impairment in redox regulation and circadian rhythms may lead to a number of adverse effects, including the manifestation of a variety of diseases such as heart diseases, neurodegenerative conditions, and cancer. Recent Advances: Researchers have come to an understanding as to the basics of the circadian rhythm mechanism, as well as the importance of the numerous species of oxidative stress components. The effects of oxidative stress and dysregulated circadian rhythms have been a subject of intense investigations since they were first discovered, and recent investigations into the molecular mechanisms linking the two have started to elucidate the bases of their connection. Critical Issues: While much is known about the mechanics and importance of oxidative stress systems and circadian rhythms, the front where they interact has had very little research focused on it. This review discusses the idea that these two systems are together intricately involved in the healthy body, as well as in disease. Future Directions: We believe that for a more efficacious management of diseases that have both circadian rhythm and oxidative stress components in their pathogenesis, targeting both systems in tandem would be far more successful. Antioxid. Redox Signal. 19, 192–208 PMID:23198849

Prospective Health: Duke's Approach to Improving Employee Health and Managing Health Care Costs

Science.gov (United States)

Davidson, H. Clint, Jr.

2004-01-01

If developing a healthy workforce is critical to reining in the skyrocketing cost of health care, then why have so many attempts at preventive health or disease management fallen short? How can employers connect with employees to engage them in changing unhealthy habits or lifestyles? Duke University has launched an innovative new approach called…

Robust Actor-Critic Contextual Bandit for Mobile Health (mHealth) Interventions

OpenAIRE

Zhu, Feiyun; Guo, Jun; Li, Ruoyu; Huang, Junzhou

2018-01-01

We consider the actor-critic contextual bandit for the mobile health (mHealth) intervention. State-of-the-art decision-making algorithms generally ignore the outliers in the dataset. In this paper, we propose a novel robust contextual bandit method for the mHealth. It can achieve the conflicting goal of reducing the influence of outliers while seeking for a similar solution compared with the state-of-the-art contextual bandit methods on the datasets without outliers. Such performance relies o...

The Social Determinants of Refugee Mental Health in the Post-Migration Context: A Critical Review.

Science.gov (United States)

Hynie, Michaela

2018-05-01

With the global increase in the number of refugees and asylum seekers, mental health professionals have become more aware of the need to understand and respond to the mental health needs of forced migrants. This critical review summarizes the findings of recent systematic reviews and primary research on the impact of post-migration conditions on mental disorders and PTSD among refugees and asylum seekers. Historically, the focus of mental health research and interventions with these populations has been on the impact of pre-migration trauma. Pre-migration trauma does predict mental disorders and PTSD, but the post-migration context can be an equally powerful determinant of mental health. Moreover, post-migration factors may moderate the ability of refugees to recover from pre-migration trauma. The importance of post-migration stressors to refugee mental health suggests the need for therapeutic interventions with psychosocial elements that address the broader conditions of refugee and asylum seekers' lives. However, there are few studies of multimodal interventions with refugees, and even fewer with control conditions that allow for conclusions about their effectiveness. These findings are interpreted using a social determinants of health framework that connects the risk and protective factors in the material and social conditions of refugees' post-migration lives to broader social, economic and political factors.

Developing Students' Critical Reasoning About Online Health Information: A Capabilities Approach

Science.gov (United States)

Wiblom, Jonna; Rundgren, Carl-Johan; Andrée, Maria

2017-11-01

The internet has become a main source for health-related information retrieval. In addition to information published by medical experts, individuals share their personal experiences and narratives on blogs and social media platforms. Our increasing need to confront and make meaning of various sources and conflicting health information has challenged the way critical reasoning has become relevant in science education. This study addresses how the opportunities for students to develop and practice their capabilities to critically approach online health information can be created in science education. Together with two upper secondary biology teachers, we carried out a design-based study. The participating students were given an online retrieval task that included a search and evaluation of health-related online sources. After a few lessons, the students were introduced to an evaluation tool designed to support critical evaluation of health information online. Using qualitative content analysis, four themes could be discerned in the audio and video recordings of student interactions when engaging with the task. Each theme illustrates the different ways in which critical reasoning became practiced in the student groups. Without using the evaluation tool, the students struggled to overview the vast amount of information and negotiate trustworthiness. Guided by the evaluation tool, critical reasoning was practiced to handle source subjectivity and to sift out scientific information only. Rather than a generic skill and transferable across contexts, students' critical reasoning became conditioned by the multi-dimensional nature of health issues, the blend of various contexts and the shift of purpose constituted by the students.

Community Interagency Connections for Immigrant Worker Health Interventions, King County, Washington State, 2012-2013.

Science.gov (United States)

Tsai, Jenny Hsin-Chin; Petrescu-Prahova, Miruna

2016-06-02

Cross-sector community partnerships are a potentially powerful strategy to address population health problems, including health disparities. US immigrants - commonly employed in low-wage jobs that pose high risks to their health - experience such disparities because of hazardous exposures in the workplace. Hazardous exposures contribute to chronic health problems and complicate disease management. Moreover, prevention strategies such as worksite wellness programs are not effective for low-wage immigrant groups. The purpose of this article was to describe an innovative application of social network analysis to characterize interagency connections and knowledge needed to design and deliver a comprehensive community-based chronic disease prevention program for immigrant workers. Using iterative sample expansion, we identified 42 agencies representing diverse community sectors (service agencies, faith-based organizations, unions, nonprofits, government agencies) pertinent to the health of Chinese immigrant workers. To capture data on shared information, resources, and services as well as organizational characteristics, we jointly interviewed 2 representatives from each agency. We used social network analysis to describe interagency network structure and the positions of agencies within the networks. Agency interconnections were established primarily for information sharing. In the overall interagency network, a few service-oriented agencies held central or gatekeeper positions. Strong interconnectedness occurred predominately across service, public, and nonprofit sectors. The Chinese and Pan-Asian service sectors showed the strongest interconnectedness. Network analysis yields critical understanding of community structural links and assets needed to inform decisions about actual and potential community collaborations. Alternative intervention strategies may be needed to address health disparities among immigrant workers.

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

Directory of Open Access Journals (Sweden)

Richard P. Harte

2014-06-01

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

Integrating the Principles of Socioecology and Critical Pedagogy for Health Promotion Health Literacy Interventions.

Science.gov (United States)

Dawkins-Moultin, Lenna; McDonald, Andrea; McKyer, Lisako

2016-01-01

While health literacy research has experienced tremendous growth in the last two decades, the field still struggles to devise interventions that lead to lasting change. Most health literacy interventions are at the individual level and focus on resolving clinician-patient communication difficulties. As a result, the interventions use a deficit model that treats health literacy as a patient problem that needs to be fixed or circumvented. We propose that public health health literacy interventions integrate the principles of socioecology and critical pedagogy to develop interventions that build capacity and empower individuals and communities. Socioecology operates on the premise that health outcome is hinged on the interplay between individuals and their environment. Critical pedagogy assumes education is inherently political, and the ultimate goal of education is social change. Integrating these two approaches will provide a useful frame in which to develop interventions that move beyond the individual level.

A Volunteer Program to Connect Primary Care and the Home to Support the Health of Older Adults: A Community Case Study

Directory of Open Access Journals (Sweden)

Doug Oliver

2018-02-01

Full Text Available Primary care providers are critical in providing and optimizing health care to an aging population. This paper describes the volunteer component of a program (Health TAPESTRY which aims to encourage the delivery of effective primary health care in novel and proactive ways. As part of the program, volunteers visited older adults in their homes and entered information regarding health risks, needs, and goals into an electronic application on a tablet computer. A total of 657 home visits were conducted by 98 volunteers, with 22.45% of volunteers completing at least 20 home visits over the course of the program. Information was summarized in a report and electronically sent to the health care team via clients’ electronic medical records. The report was reviewed by the interprofessional team who then plan ongoing care. Volunteer recruitment, screening, training, retention, and roles are described. This paper highlights the potential role of a volunteer in a unique connection between primary care providers and older adult patients in their homes.

Global public health today: connecting the dots

Directory of Open Access Journals (Sweden)

Marta Lomazzi

2016-02-01

Full Text Available Background: Global public health today faces new challenges and is impacted by a range of actors from within and outside state boundaries. The diversity of the actors involved has created challenges and a complex environment that requires a new context-tailored global approach. The World Federation of Public Health Associations has embarked on a collaborative consultation with the World Health Organization to encourage a debate on how to adapt public health to its future role in global health. Design: A qualitative study was undertaken. High-level stakeholders from leading universities, multilateral organizations, and other institutions worldwide participated in the study. Inductive content analyses were performed. Results: Stakeholders underscored that global public health today should tackle the political, commercial, economic, social, and environmental determinants of health and social inequalities. A multisectoral and holistic approach should be guaranteed, engaging public health in broad dialogues and a concerted decision-making process. The connection between neoliberal ideology and public health reforms should be taken into account. The WHO must show leadership and play a supervising and technical role. More and better data are required across many programmatic areas of public health. Resources should be allocated in a sustainable and accountable way. Public health professionals need new skills that should be provided by a collaborative global education system. A common framework context-tailored to influence governments has been evaluated as useful. Conclusions: The study highlighted some of the main public health challenges currently under debate in the global arena, providing interesting ideas. A more inclusive integrated vision of global health in its complexity, shared and advocated for by all stakeholders involved in decision-making processes, is crucial. This vision represents the first step in innovating public health at the

Global public health today: connecting the dots

Science.gov (United States)

Lomazzi, Marta; Jenkins, Christopher; Borisch, Bettina

2016-01-01

Background Global public health today faces new challenges and is impacted by a range of actors from within and outside state boundaries. The diversity of the actors involved has created challenges and a complex environment that requires a new context-tailored global approach. The World Federation of Public Health Associations has embarked on a collaborative consultation with the World Health Organization to encourage a debate on how to adapt public health to its future role in global health. Design A qualitative study was undertaken. High-level stakeholders from leading universities, multilateral organizations, and other institutions worldwide participated in the study. Inductive content analyses were performed. Results Stakeholders underscored that global public health today should tackle the political, commercial, economic, social, and environmental determinants of health and social inequalities. A multisectoral and holistic approach should be guaranteed, engaging public health in broad dialogues and a concerted decision-making process. The connection between neoliberal ideology and public health reforms should be taken into account. The WHO must show leadership and play a supervising and technical role. More and better data are required across many programmatic areas of public health. Resources should be allocated in a sustainable and accountable way. Public health professionals need new skills that should be provided by a collaborative global education system. A common framework context-tailored to influence governments has been evaluated as useful. Conclusions The study highlighted some of the main public health challenges currently under debate in the global arena, providing interesting ideas. A more inclusive integrated vision of global health in its complexity, shared and advocated for by all stakeholders involved in decision-making processes, is crucial. This vision represents the first step in innovating public health at the global level and should lead

Burnout and health among critical care professionals: The mediational role of resilience.

Science.gov (United States)

Arrogante, Oscar; Aparicio-Zaldivar, Eva

2017-10-01

To analyse the mediational role of resilience in relationships between burnout and health in critical care professionals; to determine relationships among resilience level, three burnout dimensions, and physical/mental health; and to establish demographic differences in psychological variables evaluated. Cross-sectional study. A total of 52 critical care professionals, mainly nurses, were recruited from an intensive care unit of Madrid (Spain). All participants were assessed with the questionnaires 10-item Connor-Davidson Resilience Scale, Maslach Burnout Inventory-Human Services Survey, and Short Form-12 Health Survey. No demographic differences were found. Three burnout dimensions were negatively associated with mental health and resilience. Mediational analyses revealed resilience mediated 1) the relationships between emotional exhaustion and depersonalisation with mental health (partial mediations) and 2) the relationship between personal accomplishment and mental health (total mediation). Resilience minimises and buffers the impact of negative outcomes of workplace stress on mental health of critical care professionals. As a result, resilience prevents the occurrence of burnout syndrome. Resilience improves not only their mental health, but also their ability to practice effectively. It is therefore imperative to develop resilience programs for critical care nurses in nursing schools, universities and health centres. Copyright © 2017 Elsevier Ltd. All rights reserved.

Connecting Patients to mHealth Applications to Enhance Self-care Management.

Science.gov (United States)

Conroy, Meghan K

2015-09-01

Smartphone use and the desire to use mHealth are growing in the population of patients who most commonly use home healthcare (HHC) services, a population with chronic conditions and complex healthcare management needs. HHC nurses are positioned to connect HHC patients with mHealth Apps to access health-related information, engage in interactive monitoring, and manage self-care activities. The challenge of finding reputable Apps is discussed and resources are presented to overcome this challenge at the business orindividual level.

Time Lapse Electrical Resistivity to Connect Evapotranspiration and Groundwater Fluxes in the Critical Zone

Science.gov (United States)

Jarvis, S. K.; Harmon, R. E.; Barnard, H. R.; Randall, J.; Singha, K.

2017-12-01

The critical zone (CZ)—an open system extending from canopy top to the base of groundwater—is a highly dynamic and heterogeneous environment. In forested terrain, trees make up a large component of the CZ. This work aims to quantify the connection between vegetation and subsurface water storage at a hillslope scale within a forested watershed in the H.J. Andrews Experimental Forest, Oregon. To identify the mechanism(s) controlling the connection at the hillslope scale, we observe patterns in electrical conductivity using 2D-time lapse-DC resistivity. To compare inversions through time a representative error model was determined using L-curve criterion. Inverted data show high spatial variability in ground electrical conductivity and variation at both diel and seasonal timescales. These changes are most pronounced in areas corresponding to dense vegetation. The diel pattern in electrical conductivity is also observed in monitored sap flow sensors, water-level gauges, tensiometers, and sediment thermal probes. To quantify the temporal connection between these data over the course of the growing season a cross correlation analysis was conducted. Preliminary data show that over the course of the growing season transpiration becomes decoupled from both groundwater and soil moisture. Further decomposition of the inverted time lapse data will highlight spatial variability in electrical conductivity providing insight into the where, when, and how(s) of tree-modified subsurface storage.

Critical health literacy in American deaf college students.

Science.gov (United States)

Kushalnagar, Poorna; Ryan, Claire; Smith, Scott; Kushalnagar, Raja

2017-05-24

This study investigates the relationship between critical health literacy (CHL) and discussion of health information among college deaf students who use American Sign Language. CHL is crucial in making appropriate health-related decisions for oneself and aiding others in making good health-choices. Research on general youth population shows that frequent health-related discussions with both friends and family is associated with higher health literacy. However, for our sample of deaf college-aged students who might have had less access to communication at home, we hypothesize that health-related discussions with same-age peers may be more important for critical health literacy. We asked two questions to assess the frequency of health-related discussions with friends and families: "How often do you discuss health-related information with your friends" and "How often do you discuss your family medical history with your family?". Participants rated their experience on a scale from 1-5 (1=never, 5=always). To assess CHL, 38 deaf and 38 hearing participants were shown a short scenario that showed a woman confiding in her friend after finding a lump in her breast. Participants were then asked what the friend should say. Responses were scored by a team of 3 raters using a CHL rubric. As predicted, results showed a strong relationship between discussion of health-related information with friends and CHL in both deaf and hearing samples. Discussion with family was linked to CHL only for hearing participants, but not deaf participants in our study. These findings underscore the importance of socializing with health-literate, accessible peers to improve the health literacy and health outcomes of all deaf people. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Relationship between Female Pre University Students' Critical Thinking Skills and Their Mental Health

Directory of Open Access Journals (Sweden)

Y. Maroofi

2012-04-01

Full Text Available Introduction & Objective: Critical thinking is simply defined as ability for analysis and evaluation of information. Today, this skill is considered as an undeniable necessity for social life. So fostering critical thinking ability is one of the basic goals of different levels of education from primary school to higher education. Each conscious behavior is related to the theoretical and intellectual foundation and origin. Therefore, the quality and types of thought play an important role in human mental health. This research studies the relationship between female pre-university students' critical thinking skills and their mental health in the academic year 2009-2010 in Hamadan city. Materials & Methods: This study is a cross sectional research and our method is based on correlation. Using random multiple stages clustering method, we selected 331 students as statistical sample. The data gathering instruments are two standard questionnaires: California form b critical thinking questionnaire and 28-question Goldberg and Hilier general health questionnaire. The data were analyzed using descriptive statistic indexes such as frequency, percent, mean and standard deviation and inferential tests such as Pearson correlation coefficient and multiple regressions. Results: Research findings show that the average point of students' critical thinking skills is (6.51 out of 34 and their average point of mental health is (31.52 .About 61 persons(18.4 percent have not any psychological disorder, about 270 person (81.6 percent seemed to have psychological disorder symptoms. There are negative and significant differences between critical thinking skills and disorder in mental health. Multiple regression analysis show that: there is negative and significant differences between critical analysis and deductive rational skills with psychological disorder symptoms, that is when students' critical thinking skills increases, the psychological disorder symptoms decrease

Health psychology in autobiography: Three Canadian critical narratives.

Science.gov (United States)

Stam, Henderikus J; Murray, Michael; Lubek, Ian

2018-03-01

Three Canadian colleagues in health psychology recount their careers in a field of research and practice whose birth they witnessed and whose developments they have critiqued. By placing the development of health psychology in Canada in a context that is both institutional and personal, Stam, Murray, and Lubek raise a series of questions about health psychology and its propagation. While uniquely Canadian their professional careers were affected by international colleagues as well as others-patients and community members-whose views shaped their perspectives. This article is a plea for the continuing development of critical voices in health psychology.

The Texts of the Instruments connected with the Agency's Assistance to Finland in Establishing a Sub-Critical Assemblies Project

International Nuclear Information System (INIS)

1964-01-01

The text of the Project Agreement between the Agency and the Government of Finland in connection with the Agency's assistance to that Government in establishing a sub-critical assemblies project is reproduced in Part I of this document for the information of all Members. This Agreement entered into force on 30 July 1963

The Texts of the Instruments connected with the Agency's Assistance to Finland in Establishing a Sub-Critical Assemblies Project

Energy Technology Data Exchange (ETDEWEB)

NONE

1964-02-10

The text of the Project Agreement between the Agency and the Government of Finland in connection with the Agency's assistance to that Government in establishing a sub-critical assemblies project is reproduced in Part I of this document for the information of all Members. This Agreement entered into force on 30 July 1963.

Ecological and Political Economy Lenses for School Health Education: A Critical Pedagogy Shift

Science.gov (United States)

Martinson, Marty; Elia, John P.

2018-01-01

Purpose: The purpose of this paper is to critically examine school health education in the USA and present alternative approaches for more critical and comprehensive health education. Design/methodology/approach: An ecological model framework is used to identify the limitations and opportunities for improvement in school health education in the…

Elements for harnessing participatory action research to strengthen health managers' capacity: a critical interpretative synthesis.

Science.gov (United States)

Tetui, Moses; Zulu, Joseph Mumba; Hurtig, Anna-Karin; Ekirapa-Kiracho, Elizabeth; Kiwanuka, Suzanne N; Coe, Anna-Britt

2018-04-19

Health managers play a key role in ensuring that health services are responsive to the needs of the population. Participatory action research (PAR) is one of the approaches that have been used to strengthen managers' capacity. However, collated knowledge on elements for harnessing PAR to strengthen managers' capacity is missing. This paper bridges this gap by reviewing existing literature on the subject matter. A critical interpretive synthesis method was used to interrogate eight selected articles. These articles reported the use of PAR to strengthen health managers' capacity. The critical interpretive synthesis method's approach to analysis guided the synthesis. Here, the authors interpretively made connections and linkages between different elements identified in the literature. Finally, the Atun et al. (Heal Pol Plann, 25:104-111, 2010) framework on integration was used to model the elements synthesised in the literature into five main domains. Five elements with intricate bi-directional interactions were identified in the literature reviewed. These included a shared purpose, skilled facilitation and psychological safety, activity integration into organisational procedures, organisational support, and external supportive monitoring. A shared purpose of the managers' capacity strengthening initiative created commitment and motivation to learn. This purpose was built upon a set of facilitation skills that included promoting participation, self-efficacy and reflection, thereby creating a safe psychological space within which the managers interacted and learnt from each other and their actions. Additionally, an integrated intervention strengthened local capacity and harnessed organisational support for learning. Finally, supportive monitoring from external partners, such as researchers, ensured quality, building of local capacity and professional safety networks essential for continued learning. The five elements identified in this synthesis provide a basis upon

Online, Tuned In, Turned On: Multimedia Approaches to Fostering Critical Media Health Literacy for Adolescents

Science.gov (United States)

Begoray, Deborah L.; Banister, Elizabeth M.; Wharf Higgins, Joan; Wilmot, Robin

2014-01-01

The commercial media is an influential sociocultural force and transmitter of health information especially for adolescents. Instruction in critical media health literacy, a combination of concepts from critical health literacy and critical media literacy, is a potentially effective means of raising adolescents' awareness about commercial media…

Patient-provider connectivity and the role of e-health.

Science.gov (United States)

Holmes, Suzanne C; Kearns, Ellen Hope

2003-01-01

Patient-provider connectivity (PPC) offers innovative approaches to control costs, improve quality, and sustain a healthy workforce. The application of e-commerce to health care is one facet of PPC and provides solutions to educating, informing, and more efficiently using scarce resources to sustain the nation's health. Technology is available to provide real-time access to clinical results, medical records, health-care providers, and other time-sensitive patient information. This is the first article in a series on PPC that explores the application of e-commerce to the health-care industry from the consumers' and providers' points of view and examines and assesses trends and data from various interdisciplinary sources and studies. Two models exemplifying PPC are explored including the Science Business & Education, Inc., proof-of-concept patient demonstration project, and the emerging application of peer-to-peer (P2P) technology. PPC promises to improve efficiency, facilitate communication between physician and patient, monitor compliance with medical regimens, and positively affect the quality of health care provided and the overall health of the patient. Future articles will address the growth of telemedicine, issues of confidentiality and e-risk, and other PPC applications.

Critical thinking in health professions education: summary and consensus statements of the Millennium Conference 2011.

Science.gov (United States)

Huang, Grace C; Newman, Lori R; Schwartzstein, Richard M

2014-01-01

Critical thinking is central to the function of health care professionals. However, this topic is not explicitly taught or assessed within current programs, yet the need is greater than ever, in an era of information explosion, spiraling health care costs, and increased understanding about metacognition. To address the importance of teaching critical thinking in health professions education, the Shapiro Institute for Education and Research and the Josiah Macy Jr. Foundation jointly sponsored the Millennium Conference 2011 on Critical Thinking. Teams of physician and nurse educators were selected through an application process. Attendees proposed strategies for integrating principles of critical thinking more explicitly into health professions curricula. Working in interprofessional, multi-institutional groups, participants tackled questions about teaching, assessment, and faculty development. Deliberations were summarized into consensus statements. Educational leaders participated in a structured dialogue about the enhancement of critical thinking in health professions education and recommend strategies to teach critical thinking.

'The medical' and 'health' in a critical medical humanities.

Science.gov (United States)

Atkinson, Sarah; Evans, Bethan; Woods, Angela; Kearns, Robin

2015-03-01

As befits an emerging field of enquiry, there is on-going discussion about the scope, role and future of the medical humanities. One relatively recent contribution to this debate proposes a differentiation of the field into two distinct terrains, 'medical humanities' and 'health humanities,' and calls for a supersession of the former by the latter. In this paper, we revisit the conceptual underpinnings for a distinction between 'the medical' and 'health' by looking at the history of an analogous debate between 'medical geography' and 'the geographies of health' that has, over the last few years, witnessed a re-blurring of the distinction. Highlighting the value of this debate within the social sciences for the future development of the medical humanities, we call for scholars to take seriously the challenges of critical and cultural theory, community-based arts and health, and the counter-cultural creative practices and strategies of activist movements in order to meet the new research challenges and fulfill the radical potential of a critical medical humanities.

Turning health research into health promotion: a study of causality and 'critical insights' in a United Kingdom health campaign.

Science.gov (United States)

Piggin, Joe

2012-10-01

This article examines how important decisions about health can alter between public health policy formulation and eventual marketing implementation. Specifically, the article traces the development and production of a major United Kingdom social marketing campaign named Change4Life, and examines how ideas about the causes of and solutions to the obesity epidemic are produced in differing ways throughout the health promotion process. This study examines a variety of United Kingdom health research, policy, marketing strategy and marketing messages between 2008 and 2011. This research demonstrates that claims about causality oscillate and alter throughout the research, policy and Change4Life marketing process. These oscillations are problematic, since the Department of Health described the original consumer research as 'critical'. Given both the importance of the health issues being addressed and the amount of funding dedicated to Change4Life, that 'critical' research was directly contradicted in the campaign requires urgent review. To conclude, the article discusses the utility of social marketing when considering causal claims in health promotion. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

"Bringing the outside world in": Enriching social connection through health student placements in a teaching aged care facility.

Science.gov (United States)

Annear, Michael J; Elliott, Kate-Ellen J; Tierney, Laura T; Lea, Emma J; Robinson, Andrew

2017-10-01

Older adults living in residential aged care facilities (RACFs) often experience limited opportunities for social connection despite close proximity to peers, which has implications for mental health and quality of life (QoL). The introduction of large-scale undergraduate health student placements in RACFs may enhance opportunities for meaningful engagement through social connection, although this remains unexplored. This research explores whether interpersonal encounters between health students and RACF residents influence residents' opportunities for social connection and QoL. A mixed methods design was employed which included questionnaire data from residents, and qualitative interview data from residents, family members and RACF staff. Data were collected during and after student placements to allow for an in-depth exploration of residents, family members and staff perspectives. Forty-three participants (28 residents, 10 staff and five family members) were recruited during 2014. Overall, many residents had clinical levels of depression, mild cognitive impairment and multiple morbidities, however reported moderate-to-good QoL. Thematic analysis was undertaken on interview transcripts, and three themes emerged: (i) social isolation and loneliness fostered by residents' age-related conditions, (ii) students expand socially supportive connections beyond the RACF and (iii) meaning making by sharing health experiences, which was found to help renegotiate older adults' pervasive narrative of vulnerability. Supported and structured health student placements in RACFs enable older adults to participate in meaningful encounters with younger people. These encounters focus on sharing health experiences and address long-standing issues of isolation and loneliness by providing opportunities for social connection. © 2017 The Authors Health Expectations Published by John Wiley & Sons Ltd.

Child Care Health Connections: A Health and Safety Newsletter for California Child Care Professionals. Volume 19, Number 2, March-April 2006

Science.gov (United States)

Zamani, A. Rahman, Ed.; Calder, Judy, Ed.; Rose, Bobbie, Ed.; Leonard, Victoria, Ed.; Gendell, Mara, Ed.

2006-01-01

"Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment…

Child Care Health Connections: A Health and Safety Newsletter for California Child Care Professionals. Volume 23, Number 4, July-August 2010

Science.gov (United States)

Zamani, A. Rahman, Ed.; Rose, Bobbie, Ed.; Calder, Judy, Ed.; Garakani, Tahereh, Ed.; Leonard, Victoria, Ed.

2010-01-01

"Child Care Health Connections" is a bimonthly newsletter published by the California Childcare Health Program (CCHP), a community-based program of the University of California, San Francisco School of Nursing, Department of Family Health Care Nursing. The goals of the newsletter are to promote and support a healthy and safe environment…

Connectivity, prison environment and mental health among first-time male inmates in Mexico City.

Science.gov (United States)

Albertie, Ariel; Bourey, Christine; Stephenson, Rob; Bautista-Arredondo, Sergio

2017-02-01

Research from high-income countries suggests that prison populations are affected disproportionately by mental illness. However, little research has examined mental health among prisoners in low- and middle-income countries or associations between mental health and contextual factors surrounding the prison experience among susceptible first-time inmates in these settings. The current study examines associations between connectivity, prison environment and mental health (major depression and substance use) among novice male inmates (n = 593) in three Mexico City prisons. Severe depression (46.2%), any substance use (53.8%) and heavy substance use (45.7%) were prevalent. Among key co-variates, recent visitors were protective for severe depression, conjugal visits for any substance use and prison employment for heavy substance use. Physical attacks were associated with increased prevalence of depression, sentence time served with both any and heavy substance use and overcrowding with any substance use. These findings suggest the need for routine health assessments to improve identification and treatment programmes to minimise mental health burden. Addressing demographic risk factors as well as contextual determinants, by decreasing physical violence and overcrowding and supporting outside connections for prisoners, may help improve inmate mental health.

Increasing Critical Health Literacy of Roma People trough Participatory Action Research

DEFF Research Database (Denmark)

Eklund Karlsson, Leena; Crondahl, Kristine

to take a leading role in their integration process a 2-year action research was implemented in 2010-2012. The idea was to strengthen the Roma Peoples’ critical health literacy which allows them to analyze and apply health information to oppose the forces that are holding them oppressed and to take better...... control over their life situation. The objective of this paper is to discuss methodological issues based on experiences of the use of participatory research approach in increasing health literacy. Methods: The core of the intervention was ‘training of trainers’ of a group of Roma people from western....... Conclusions: The Roma participants’ strengthened critical health literacy improved their health chances and possibilities for participation in working life and decision making on Roma issues. The existing system of rules for project operations clashed with the character of the “soft” bottom-up approach...

One Health: Understanding and Improving Human, Animal, and Environmental Health as a Connected System Across NOAA

Science.gov (United States)

Giltz, S.; Trtanj, J.; Jones, H.

2017-12-01

The One Health concept recognizes that the health of humans is inextricably linked with the health of animals and the environment. With a growing world population, changing climate, and increased global travel One Health approaches are increasingly useful. The National Oceanic and Atmospheric Administration (NOAA) provides key stakeholders in the public health sector with the environmental intelligence they need to mitigate emerging health threats. The NOAA One Health Working Group's mission is to integrate and coordinate the network of observing systems and in situ sensors, detection and diagnostic capacity, research and modeling efforts, and sustained engagement with health partners to deliver useful information to public health and resource management communities. The NOAA One Health group divides its broad focus into themes: thermal extremes, water-borne disease, seafood security, Arctic, wildlife and zoonotic disease, vector-borne disease, and air quality (including wildfire). The group connects the work being done throughout NOAA to coordinate One Health related efforts, increase information sharing, promote interdisciplinary approaches, and work towards better disease prevention. We are working to enhance NOAA Science and services to deliver useful information on current and emerging health risks and benefits to health decision makers.

An integrative review of health-related quality of life in patients with critical limb ischaemia.

Science.gov (United States)

Monaro, Susan; West, Sandra; Gullick, Janice

2017-10-01

To examine the domains and the domain-specific characteristics within a peripheral arterial disease health-related quality of life framework for their usefulness in defining critical limb ischaemia health-related quality of life. Critical Limb Ischaemia presents a highly individualised set of personal and health circumstances. Treatment options include conservative management, revascularisation or amputation. However, the links between treatment decisions and quality of life require further investigation. The framework for this integrative review was the peripheral arterial disease-specific health-related quality of life domains identified by Treat-Jacobson et al. The literature expanded and refined Treat-Jacobson's framework by modifying the characteristics to better describe health-related quality of life in critical limb ischaemia. Given that critical limb ischaemia is a highly individualised situation with powerful health-related quality of life implications, further research focusing on patient and family-centred decision-making relating to therapeutic options and advanced care planning is required. A critical limb ischaemia-specific, health-related quality of life tool is required to capture both the unique characteristics of this disorder, and the outcomes for active or conservative care among this complex group of patients. © 2016 John Wiley & Sons Ltd.

Hydrological connectivity in the karst critical zone: an integrated approach

Science.gov (United States)

Chen, X.; Zhang, Z.; Soulsby, C.; Cheng, Q.; Binley, A. M.; Tao, M.

2017-12-01

Spatial heterogeneity in the subsurface is high, evidenced by specific landform features (sinkholes, caves etc.) and resulting in high variability of hydrological processes in space and time. This includes complex exchange of various flow sources (e.g. hillslope springs and depression aquifers) and fast conduit flow and slow fracture flow. In this paper we integrate various "state-of-the-art" methods to understand the structure and function of this understudied critical zone environment. Geophysical, hydrometric and hydrogeochemical tools are used to characterize the hydrological connectivity of the cockpit karst critical zone in a small catchment of Chenqi, Guizhou province, China. Geophysical surveys, using electrical resistivity tomography (ERT), identified the complex conduit networks that link flows between hillslopes and depressions. Statistical time series analysis of water tables and discharge responses at hillslope springs and in depression wells and underground channels showed different threshold responses of hillslope and depression flows. This reflected the differing relative contribution of fast and slow flow paths during rainfall events of varying magnitude in the hillslope epikarst and depression aquifer in dry and wet periods. This showed that the hillslope epikarst receives a high proportion of rainfall recharge and is thus a main water resource in the catchment during the drought period. In contrast, the depression aquifer receives fast, concentrated hillslope flows during large rainfall events during the wet period, resulting in the filling of depression conduits and frequent flooding. Hydrological tracer studies using water temperatures and stable water isotopes (δD and δ18O) corroborated this and provided quantitative information of the mixing proportions of various flow sources and insights into water travel times. This revealed how higher contributions of event "new" water (from hillslope springs and depression conduits displaces "old" pre

Bursting and critical layer frequencies in minimal turbulent dynamics and connections to exact coherent states

Science.gov (United States)

Park, Jae Sung; Shekar, Ashwin; Graham, Michael D.

2018-01-01

The dynamics of the turbulent near-wall region is known to be dominated by coherent structures. These near-wall coherent structures are observed to burst in a very intermittent fashion, exporting turbulent kinetic energy to the rest of the flow. In addition, they are closely related to invariant solutions known as exact coherent states (ECS), some of which display nonlinear critical layer dynamics (motions that are highly localized around the surface on which the streamwise velocity matches the wave speed of ECS). The present work aims to investigate temporal coherence in minimal channel flow relevant to turbulent bursting and critical layer dynamics and its connection to the instability of ECS. It is seen that the minimal channel turbulence displays frequencies very close to those displayed by an ECS family recently identified in the channel flow geometry. The frequencies of these ECS are determined by critical layer structures and thus might be described as "critical layer frequencies." While the bursting frequency is predominant near the wall, the ECS frequencies (critical layer frequencies) become predominant over the bursting frequency at larger distances from the wall, and increasingly so as Reynolds number increases. Turbulent bursts are classified into strong and relatively weak classes with respect to an intermittent approach to a lower branch ECS. This temporally intermittent approach is closely related to an intermittent low drag event, called hibernating turbulence, found in minimal and large domains. The relationship between the strong burst and the instability of the lower branch ECS is further discussed in state space. The state-space dynamics of strong bursts is very similar to that of the unstable manifolds of the lower branch ECS. In particular, strong bursting processes are always preceded by hibernation events. This precursor dynamics to strong turbulence may aid in development of more effective control schemes by a way of anticipating dynamics

Towards a Critical Health Equity Research Stance: Why Epistemology and Methodology Matter More Than Qualitative Methods.

Science.gov (United States)

Bowleg, Lisa

2017-10-01

Qualitative methods are not intrinsically progressive. Methods are simply tools to conduct research. Epistemology, the justification of knowledge, shapes methodology and methods, and thus is a vital starting point for a critical health equity research stance, regardless of whether the methods are qualitative, quantitative, or mixed. In line with this premise, I address four themes in this commentary. First, I criticize the ubiquitous and uncritical use of the term health disparities in U.S. public health. Next, I advocate for the increased use of qualitative methodologies-namely, photovoice and critical ethnography-that, pursuant to critical approaches, prioritize dismantling social-structural inequities as a prerequisite to health equity. Thereafter, I discuss epistemological stance and its influence on all aspects of the research process. Finally, I highlight my critical discourse analysis HIV prevention research based on individual interviews and focus groups with Black men, as an example of a critical health equity research approach.

The Nexus Between Health Literacy and Empowerment

Directory of Open Access Journals (Sweden)

Kristine Crondahl

2016-04-01

Full Text Available The aim of this article was to explore what is known about the assumed connection between health literacy and empowerment and how this connection is portrayed in the scientific literature. If empowerment is an outcome of health literacy, what are the mechanisms behind this process? A literature search conducted in 2013 yielded 216 hits, of which five met the inclusion criteria, and thus were read in depth and analyzed through a narrative-review approach. The findings indicate that health literacy might be regarded as a tool for empowerment but does not automatically lead to empowerment. Health literacy might be increased by health education. Crucial for empowerment is to achieve the critical level of health literacy including an ability to question and reflect on the prevailing power relations and societal conditions; increased senses of power, self-esteem, and self-efficacy; and an ability to utilize these resources to engage in social and political action for change. This article suggests that for health literacy to be critical to empowerment, there must be a focus on social health determinants and individuals’ subjective perceptions of health and health needs. The article proposes functional and interactive health literacy as a form of capacity building for health and empowerment and critical health literacy as a way to describe empowerment. This scoping review indicates a research gap and a need for future research examining the relationship between health literacy and empowerment.

[Burnout and perceived health in Critical Care nursing professionals].

Science.gov (United States)

Ríos Risquez, M I; Peñalver Hernández, F; Godoy Fernández, C

2008-01-01

To assess the level of burnout syndrome in a sample of critical care nursing professionals and analyze its relation with the perception of general health and other sociodemographic and work characteristics. Cross-sectional descriptive study. SITE: Intensive Care Unit of the University Hospital Morales Meseguer, Murcia-Spain. Three evaluation tools were used. These included a sociodemographic and work survey, the validated Maslach Burnout Inventory (MBI) questionnaires and the General Health Questionnaire (GHQ-28) in order to assess professional burnout and the general health condition perceived, respectively. Only 42 out of the 56 questionnaires included in the study were valid. This means an answering rate of 75%. The mean score obtained on the emotional tiredness dimension (25.45 6 11.15) stands out. About 42.9% of the sample presented psychological or psychosomatic symptoms that could require specialized care. Correlation between burnout and general health perception was statistically significant (r = 0.536; p burnout found was moderate to high among critical care nursing professionals. A total of 11.9% of the studied sample had a high score in the 3 dimensions of the burnout syndrome: emotional tiredness, depersonalization, and lack of personal job performance. Burnout and health levels found indicate high vulnerability in the sample studied and the need to establish prevention/intervention programs in this work context.

Setting the vision: applied patient-reported outcomes and smart, connected digital healthcare systems to improve patient-centered outcomes prediction in critical illness.

Science.gov (United States)

Wysham, Nicholas G; Abernethy, Amy P; Cox, Christopher E

2014-10-01

Prediction models in critical illness are generally limited to short-term mortality and uncommonly include patient-centered outcomes. Current outcome prediction tools are also insensitive to individual context or evolution in healthcare practice, potentially limiting their value over time. Improved prognostication of patient-centered outcomes in critical illness could enhance decision-making quality in the ICU. Patient-reported outcomes have emerged as precise methodological measures of patient-centered variables and have been successfully employed using diverse platforms and technologies, enhancing the value of research in critical illness survivorship and in direct patient care. The learning health system is an emerging ideal characterized by integration of multiple data sources into a smart and interconnected health information technology infrastructure with the goal of rapidly optimizing patient care. We propose a vision of a smart, interconnected learning health system with integrated electronic patient-reported outcomes to optimize patient-centered care, including critical care outcome prediction. A learning health system infrastructure integrating electronic patient-reported outcomes may aid in the management of critical illness-associated conditions and yield tools to improve prognostication of patient-centered outcomes in critical illness.

The Four Domains Model: Connecting Spirituality, Health and Well-Being

Directory of Open Access Journals (Sweden)

John Fisher

2011-01-01

Full Text Available At our core, or coeur, we humans are spiritual beings. Spirituality can be viewed in a variety of ways from a traditional understanding of spirituality as an expression of religiosity, in search of the sacred, through to a humanistic view of spirituality devoid of religion. Health is also multi-faceted, with increasing evidence reporting the relationship of spirituality with physical, mental, emotional, social and vocational well-being. This paper presents spiritual health as a, if not THE, fundamental dimension of people’s overall health and well-being, permeating and integrating all the other dimensions of health. Spiritual health is a dynamic state of being, reflected in the quality of relationships that people have in up to four domains of spiritual well-being: Personal domain where a person intra-relates with self; Communal domain, with in-depth inter-personal relationships; Environmental domain, connecting with nature; Transcendental domain, relating to some-thing or some‑One beyond the human level. The Four Domains Model of Spiritual Health and Well‑Being embraces all extant world-views from the ardently religious to the atheistic rationalist.

Connecting food environments and health through the relational nature of aesthetics: Gaining insight through the community gardening experience

Science.gov (United States)

Hale, James; Knapp, Corrine; Bardwell, Lisa; Buchenau, Michael; Marshall, Julie; Sancar, Fahriye; Litt, Jill S

2011-01-01

Current environmental and health challenges require us to identify ways to better align aesthetics, ecology, and health. At the local level, community gardens are increasingly praised for their therapeutic qualities. They also provide a lens through which we can explore relational processes that connect people, ecology and health. Using key-informant interview data, this research explores gardeners’ tactile, emotional, and value-driven responses to the gardening experience and how these responses influence health at various ecological levels (n=67 participants, 28 urban gardens). Our findings demonstrate that gardeners’ aesthetic experiences generate meaning that encourages further engagement with activities that may lead to positive health outcomes. Gardeners directly experience nearby nature by ‘getting their hands dirty’ and growing food. They enjoy the way vegetables taste and form emotional connections with the garden. The physical and social qualities of garden participation awaken the senses and stimulate a range of responses that influence interpersonal processes (learning, affirming, expressive experiences) and social relationships that are supportive of positive health-related behaviors and overall health. This research suggests that the relational nature of aesthetics, defined as the most fundamental connection between people and place, can help guide community designers and health planners when designing environment and policy approaches to improve health behaviors. PMID:21596466

CRITICAL WINDOWS FOR REPRODUCTIVE HEALTH IN CHILDREN AND ADOLESCENTS

Science.gov (United States)

This workgroup report addresses the central question: what are the critical windows during development (pre-conception through puberty) when exposure to xenobiotics may have the greatest adverse impact on subsequent reproductive health. The reproductive system develops in stages...

The effects of social connections on self-rated physical and mental health among internal migrant and local adolescents in Shanghai, China

Directory of Open Access Journals (Sweden)

Mao Zheng-hong

2012-02-01

Full Text Available Abstract Background China is in the midst of history's largest flow of rural-urban migration in the world; a flow that includes growing numbers of children and adolescents. Their health status is an important public health issue. This study compares self-rated physical and mental health of migrant and local adolescents in China, and examines to what extent layered social connections account for health outcomes. Methods In 2010, we conducted a cross-sectional study among middle school students in Pudong New Area, Shanghai. Information about health status, social connections, and demographic factors were collected using a questionnaire survey. After controlling for sociodemographic factors, we used the t-test, Chi-square analysis, and a series of regression models to compare differences in health outcomes and explore the effects of social connections. Results Migrant adolescents reported significantly higher rates of good physical health. However, they also had significantly fewer social connections, lower self-esteem, and higher levels of depression than their native peers. Family cohesion was associated with depressive symptoms and low self-esteem among all adolescents; peer association and social cohesion played major roles in migrants' well-being. Gender, age, and socioeconomic (SES factors also affected adolescents' self-rated physical and mental health. Conclusions Self-rated data suggest that migrant adolescents enjoy a physical health advantage and a mental health disadvantage. Layered social connections, such as peer association and social cohesion, may be particularly important for migrants. A public health effort is required to improve the health status of migrant youth.

The Texts of the Instruments connected with the Agency's Assistance to Mexico in Establishing a Sub-Critical Assembly Project

Energy Technology Data Exchange (ETDEWEB)

NONE

1967-10-25

The texts of the Supply Agreement between the Agency and the Governments of Mexico and the United States of America, and of the Project Agreement between the Agency and the Government of Mexico, connected with the Agency's assistance to the latter Government in establishing a sub-critical assembly project, are reproduced in this document for the information of all Members. Both Agreements entered into force on 23 August 1967.

The Texts of the Instruments connected with the Agency's Assistance to Mexico in Establishing a Sub-Critical Assembly Project

Energy Technology Data Exchange (ETDEWEB)

NONE

1966-07-07

The texts of the Supply Agreement between the Agency and the Governments of Mexico and the United States of America, and of the Project Agreement between the Agency and the Government of Mexico in connection with the Agency's assistance to that Government in establishing a sub-critical assembly project.. are reproduced in this document for the information of all Members. Both Agreements entered into force on 20 June 1966.

The Texts of the Instruments connected with the Agency's Assistance to Mexico in Establishing a Sub-Critical Assembly Project

International Nuclear Information System (INIS)

1966-01-01

The texts of the Supply Agreement between the Agency and the Governments of Mexico and the United States of America, and of the Project Agreement between the Agency and the Government of Mexico in connection with the Agency's assistance to that Government in establishing a sub-critical assembly project.. are reproduced in this document for the information of all Members. Both Agreements entered into force on 20 June 1966

The Texts of the Instruments connected with the Agency's Assistance to Mexico in Establishing a Sub-Critical Assembly Project

International Nuclear Information System (INIS)

1967-01-01

The texts of the Supply Agreement between the Agency and the Governments of Mexico and the United States of America, and of the Project Agreement between the Agency and the Government of Mexico, connected with the Agency's assistance to the latter Government in establishing a sub-critical assembly project, are reproduced in this document for the information of all Members. Both Agreements entered into force on 23 August 1967

Critical Incidents of Growth in Nordic eHealth Service Start-Ups

Directory of Open Access Journals (Sweden)

Martti Saarela

2017-06-01

Full Text Available Digitalisation can revolutionise healthcare delivery and provide new business opportunities for innovative start-ups. Start-up businesses in the healthcare service sector are a promising source of new employment and innovations. The start-up stage is the most critical period for the survival of a business, as decisions made during the early stages have a definitive influence on success. This study seeks to clarify the early development of eHealth service start-ups. To summarise the research problem, the authors ask the following question: What are the critical incidents related to the early development of eHealth service start-ups? The units of analysis in this study are 14 Nordic eHealth service start-ups located in Sweden and Finland. The Critical Incident Technique (CIT and semi-structured interviews were applied for data collection. The results are of interest to the public sector, which plays an essential role in healthcare as a service producer, but also as a creator of the business conditions of and opportunities for small businesses.

Integration of Mobile Health Technology in the Treatment of Chronic Pain: A Critical Review.

Science.gov (United States)

Sundararaman, Lalitha V; Edwards, Robert R; Ross, Edgar L; Jamison, Robert N

This article provides a critical overview and best-evidence synthesis of the use of mobile health (mHealth) technology among persons with chronic pain and their health care providers and examines the future benefits and barriers of implementing mHealth technology in clinical care. We critically review articles about electronic pain diaries, pain assessment programs, text messaging, and smartphone pain apps for management of persons with pain. Also presented are findings on the utility of activity trackers and use of telehealth to deliver cognitive behavioral therapy. Finally, barriers, study gaps, and future challenges of incorporating mobile technology for chronic pain are discussed. Although the future of mHealth technology and telemedicine in clinical practice is promising, this critical review highlights the need for rigorous studies to establish an association of the use of mHealth technology with improved quality of life, functional autonomy, and decreased hospital use.

Collective Health Nursing: the construction of critical thinking about the reality of health.

Science.gov (United States)

Chaves, Maria Marta Nolasco; Larocca, Liliana Müller; Peres, Aida Maris

2011-12-01

This article presents an analysis of the Collective Health Nursing teaching-learning processes and research in view of the consolidation of the Brazilian National Health System (Sistema Único de Saúde - SUS), performed with the objective to acknowledge the potentiality of the health reality of the population as a strategy to approximate the field of nursing practice and training as a way to revert undesired health situations. Thus, the authors reflect about the work of Collective Health Nursing, as they understand it is a mediator to promoting teaching, learning and knowledge development in this field. The authors believe that those processes, founded on critical thinking, permit to reflect about the contradictions between the current public policy and the actions promoted by the sector, and, this way, contribute to overcome the current health care mode, which has historically been founded on curative actions towards individuals, to assuming a model that acknowledges the health needs and intervenes in the social determination of the health-disease process.

Mobile computing in critical care.

Science.gov (United States)

Lapinsky, Stephen E

2007-03-01

Handheld computing devices are increasingly used by health care workers, and offer a mobile platform for point-of-care information access. Improved technology, with larger memory capacity, higher screen resolution, faster processors, and wireless connectivity has broadened the potential roles for these devices in critical care. In addition to the personal information management functions, handheld computers have been used to access reference information, management guidelines and pharmacopoeias as well as to track the educational experience of trainees. They can act as an interface with a clinical information system, providing rapid access to patient information. Despite their popularity, these devices have limitations related to their small size, and acceptance by physicians has not been uniform. In the critical care environment, the risk of transmitting microorganisms by such a portable device should always be considered.

Health Promotion Viewed in a Critical Perspective

DEFF Research Database (Denmark)

Mik-Meyer, Nanna

2014-01-01

The aim of this paper is to reflect critically on the current health promotion initiatives targeting overweight individuals in Western countries. The paper’s methodological approach is to draw on analytical findings from my and other sociologists’ empirical work on how the problems of overweight...... people are being defined in various settings in Denmark, England, Australia and the US. I try to illustrate how health promotion targeting overweight individuals can not only be seen as a project aimed at securing longer lives and fewer illnesses for people carrying excess fat but also a moral project...... that, in a more general sense, aims to tell people how they ought to live their lives. I link this moral aspect of health promotion to a) the medicalization tendency in current Western society (e.g. a growing pharmaceutical industry and its economic interest in transforming the human condition of being...

Adolescent Condom Use and Connectivity in the Social-Planful Brain.

Science.gov (United States)

Caouette, Justin D; Hudson, Karen A; Bryan, Angela D; Feldstein Ewing, Sarah W

2018-05-14

To reduce rates of sexually transmitted infections (STIs) and unwanted pregnancy among adolescents, it is critical to investigate brain connectivity that may underlie adolescents' sexual health decision-making in the context of intercourse. This study explored relationships between adolescent condom use frequency and the brain's resting-state functional connectivity, to identify differential patterns of social-affective processing among sexually active youth. In this study, N = 143 sexually active adolescents (68.5% male, Mage = 16.2 years, SD = 1.06) completed magnetic resonance imaging and reported past 3-month frequency of condom use. Resting-state connectivity, seeded on a social region of the brain, the temporoparietal junction (TPJ), was assessed to determine its correspondence with protected sex (condom use). Condom use was associated with positive connectivity between the left TPJ and bilateral inferior frontal gyrus (IFG). This relationship was observed in adolescent males only; no connectivity differences were observed with adolescent females. This study reflects functional synchrony between nodes of the "social brain," including the TPJ, and a region of planfulness and control, the IFG. The relationship between these regions suggests that adolescents who have more coordinated systems of communication between these critical components of the brain are more likely to be successful in planning and engaging in safer sexual decision-making; for young males, this differentiated more frequent from less frequent condom use. In turn, interventions designed to reduce STIs/human immunodeficiency virus may benefit from targeting social-planfulness dimensions to help youth implement safer sex behaviors.

Connecting food environments and health through the relational nature of aesthetics: gaining insight through the community gardening experience.

Science.gov (United States)

Hale, James; Knapp, Corrine; Bardwell, Lisa; Buchenau, Michael; Marshall, Julie; Sancar, Fahriye; Litt, Jill S

2011-06-01

Current environmental and health challenges require us to identify ways to better align aesthetics, ecology, and health. At the local level, community gardens are increasingly praised for their therapeutic qualities. They also provide a lens through which we can explore relational processes that connect people, ecology and health. Using key-informant interview data, this research explores gardeners' tactile, emotional, and value-driven responses to the gardening experience and how these responses influence health at various ecological levels (n = 67 participants, 28 urban gardens). Our findings demonstrate that gardeners' aesthetic experiences generate meaning that encourages further engagement with activities that may lead to positive health outcomes. Gardeners directly experience nearby nature by 'getting their hands dirty' and growing food. They enjoy the way vegetables taste and form emotional connections with the garden. The physical and social qualities of garden participation awaken the senses and stimulate a range of responses that influence interpersonal processes (learning, affirming, expressive experiences) and social relationships that are supportive of positive health-related behaviors and overall health. This research suggests that the relational nature of aesthetics, defined as the most fundamental connection between people and place, can help guide community designers and health planners when designing environment and policy approaches to improve health behaviors. Copyright © 2011 Elsevier Ltd. All rights reserved.

Designing for scale: optimising the health information system architecture for mobile maternal health messaging in South Africa (MomConnect)

CSIR Research Space (South Africa)

Seebregts, C

2018-04-01

Full Text Available MomConnect is a national initiative coordinated by the South African National Department of Health that sends text-based mobile phone messages free of charge to pregnant women who voluntarily register at any public healthcare facility in South...

Critical complexity in environmental health practice: simplify and complexify

Directory of Open Access Journals (Sweden)

Keune Hans

2012-06-01

Full Text Available Abstract The magic word ‘complexity’ has been buzzing around in science, policy and society for quite some time now. There seems to be a common feel for a ‘new way’ of doing things, for overcoming the limits of tradition. From the combined perspective of critical complexity thinking and environment and health practice we want to contribute to the development of alternative routines that may help overcome the limitations of traditional environment and health science. On the one hand traditional environment and health science is too self-confident with respect to potential scientific insight in environment and health problems: complexity condemns us to limited and ambiguous knowledge and the need for simplification. A more modest attitude would be more realistic from that point of view. On the other hand from a problem solving perspective more boldness is required. Waiting for Godot (perfect undisputed knowledge will not help us with respect to the challenges posed to society by environment and health problems. A sense of urgency is legitimate: the paralysis by traditional analysis should be resolved. Nevertheless this sense of urgency should not withhold us from investing in the problem solving quality of our endeavour; quality takes time, fastness from a quality perspective often leads us to a standstill. We propose the concept of critical complexification of environment and health practice that will enable the integration of relevant actors and factors in a pragmatic manner. We will illustrate this with practical examples and especially draw attention to the practical complexities involved, confronting us not only with fundamental questions, but also with fundamental challenges.

Wildlife disease and environmental health in Alaska

Science.gov (United States)

Van Hemert, Caroline; Pearce, John; Oakley, Karen; Whalen, Mary

2013-01-01

Environmental health is defined by connections between the physical environment, ecological health, and human health. Current research within the U.S. Geological Survey (USGS) recognizes the importance of this integrated research philosophy, which includes study of disease and pollutants as they pertain to wildlife and humans. Due to its key geographic location and significant wildlife resources, Alaska is a critical area for future study of environmental health.

The ConNECT Framework: a model for advancing behavioral medicine science and practice to foster health equity.

Science.gov (United States)

Alcaraz, Kassandra I; Sly, Jamilia; Ashing, Kimlin; Fleisher, Linda; Gil-Rivas, Virginia; Ford, Sabrina; Yi, Jean C; Lu, Qian; Meade, Cathy D; Menon, Usha; Gwede, Clement K

2017-02-01

Health disparities persist despite ongoing efforts. Given the United States' rapidly changing demography and socio-cultural diversity, a paradigm shift in behavioral medicine is needed to advance research and interventions focused on health equity. This paper introduces the ConNECT Framework as a model to link the sciences of behavioral medicine and health equity with the goal of achieving equitable health and outcomes in the twenty-first century. We first evaluate the state of health equity efforts in behavioral medicine science and identify key opportunities to advance the field. We then discuss and present actionable recommendations related to ConNECT's five broad and synergistic principles: (1) Integrating Context; (2) Fostering a Norm of Inclusion; (3) Ensuring Equitable Diffusion of Innovations; (4) Harnessing Communication Technology; and (5) Prioritizing Specialized Training. The framework holds significant promise for furthering health equity and ushering in a new and refreshing era of behavioral medicine science and practice.

Connections between Men and Health: discussing some scratches of masculinity

Directory of Open Access Journals (Sweden)

Andréia Burille

2013-07-01

Full Text Available In this article seeks to discuss the connections between men and health addressing some scratches of masculinity. At first, bring up some data from the thematic seminar "Being a man today: discussing some scratches masculinity," presented at the International Seminar Reviews Routes III, held in Porto Alegre, Brazil, in 2011. Therefore, we discuss the process of male socialization and scores some aspects of everyday life that can endanger / or scratch threaten masculinity, such as seeking care and even the aging process itself. It is noted that the heteronormative masculinity configures itself as the hegemonic model, stand out among other models. So, being a man is to fulfill roles and prescriptions which are rooted in a society that is structured on the basis of gender, even for this have to endanger your health.

HIV/AIDS, beersellers and critical community health psychology in Cambodia: a case study.

Science.gov (United States)

Lubek, Ian; Lee, Helen; Kros, Sarath; Wong, Mee Lian; Van Merode, Tiny; Liu, James; McCreanor, Tim; Idema, Roel; Campbell, Catherine

2014-01-01

This case study illustrates a participatory framework for confronting critical community health issues using 'grass-roots' research-guided community-defined interventions. Ongoing work in Cambodia has culturally adapted research, theory and practice for particular, local health-promotion responses to HIV/AIDS, alcohol abuse and other challenges in the community of Siem Reap. For resource-poor communities in Cambodia, we recycle such 'older' concepts as 'empowerment' and 'action research'. We re-imagine community health psychology, when confronted with 'critical', life-and-death issues, as adjusting its research and practices to local, particular ontological and epistemological urgencies of trauma, morbidity and mortality.

Development of a structural health monitoring system for the life assessment of critical transportation infrastructure.

Energy Technology Data Exchange (ETDEWEB)

Roach, Dennis Patrick; Jauregui, David Villegas (New Mexico State University, Las Cruces, NM); Daumueller, Andrew Nicholas (New Mexico State University, Las Cruces, NM)

2012-02-01

Recent structural failures such as the I-35W Mississippi River Bridge in Minnesota have underscored the urgent need for improved methods and procedures for evaluating our aging transportation infrastructure. This research seeks to develop a basis for a Structural Health Monitoring (SHM) system to provide quantitative information related to the structural integrity of metallic structures to make appropriate management decisions and ensuring public safety. This research employs advanced structural analysis and nondestructive testing (NDT) methods for an accurate fatigue analysis. Metal railroad bridges in New Mexico will be the focus since many of these structures are over 100 years old and classified as fracture-critical. The term fracture-critical indicates that failure of a single component may result in complete collapse of the structure such as the one experienced by the I-35W Bridge. Failure may originate from sources such as loss of section due to corrosion or cracking caused by fatigue loading. Because standard inspection practice is primarily visual, these types of defects can go undetected due to oversight, lack of access to critical areas, or, in riveted members, hidden defects that are beneath fasteners or connection angles. Another issue is that it is difficult to determine the fatigue damage that a structure has experienced and the rate at which damage is accumulating due to uncertain history and load distribution in supporting members. A SHM system has several advantages that can overcome these limitations. SHM allows critical areas of the structure to be monitored more quantitatively under actual loading. The research needed to apply SHM to metallic structures was performed and a case study was carried out to show the potential of SHM-driven fatigue evaluation to assess the condition of critical transportation infrastructure and to guide inspectors to potential problem areas. This project combines the expertise in transportation infrastructure at New

Measuring culture: a critical review of acculturation and health in Asian immigrant populations.

Science.gov (United States)

Salant, Talya; Lauderdale, Diane S

2003-07-01

The number of studies examining how acculturation affects the health of Asian immigrants has increased in recent years. The proliferation of studies reflects the growing size and heterogeneity of Asian immigrant populations in the United States, Canada, Australia, New Zealand, and the United Kingdom. This paper compares various approaches to acculturation within the health literature on Asian immigrants by reviewing the literature in three-health domains (1) mental health (2) physical health and (3) health services use. The review critically examines the conceptualizations and measures of acculturation in these three domains and presents major findings. We observe that measurement difficulties posed by the experiences of heterogeneous Asian groups compound theoretical and disciplinary disparities between acculturation instruments. The extent to which conceptual and methodological critiques of acculturation studies in Hispanic populations apply to studies of Asian populations is also discussed. The critical review thus provides insights into the diverse ways that the relationship between culture and health is measured in this complicated and growing literature.

Understanding Digital Health as Public Pedagogy: A Critical Framework

Directory of Open Access Journals (Sweden)

Emma Rich

2014-06-01

Full Text Available This paper argues on behalf of a public pedagogy approach to developing a critical understanding of digital health technologies. It begins by appraising the hitherto polarised articulations of digital innovation as either techno-utopian or techno-dystopian, examining these expectations of technology and considering the tensions between them. It subsequently outlines how a public pedagogy approach can help mediate between these views, offering a more contextualised, socio-political perspective of mHealth. This approach teases out the nuances of digital health by engaging with the complexities of embodied learning. Furthermore, it urges caution against viewing these pedagogical forces as one of transference, or simple governance. To this end, we therefore contextualise our critique of digital health, within an attempt to reconstitute an understanding of public pedagogies of technology.

Domination criticality in product graphs

Directory of Open Access Journals (Sweden)

M.R. Chithra

2015-07-01

Full Text Available A connected dominating set is an important notion and has many applications in routing and management of networks. Graph products have turned out to be a good model of interconnection networks. This motivated us to study the Cartesian product of graphs G with connected domination number, γc(G=2,3 and characterize such graphs. Also, we characterize the k−γ-vertex (edge critical graphs and k−γc-vertex (edge critical graphs for k=2,3 where γ denotes the domination number of G. We also discuss the vertex criticality in grids.

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

Directory of Open Access Journals (Sweden)

Evmorfia Koukia

2013-01-01

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

Selection and Evaluation of Media for Behavioral Health Interventions Employing Critical Media Analysis.

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Wilson, Patrick A; Cherenack, Emily M; Jadwin-Cakmak, Laura; Harper, Gary W

2018-01-01

Although a growing number of psychosocial health promotion interventions use the critical analysis of media to facilitate behavior change, no specific guidelines exist to assist researchers and practitioners in the selection and evaluation of culturally relevant media stimuli for intervention development. Mobilizing Our Voices for Empowerment is a critical consciousness-based health enhancement intervention for HIV-positive Black young gay/bisexual men that employs the critical analysis of popular media. In the process of developing and testing this intervention, feedback on media stimuli was collected from youth advisory board members (n = 8), focus group participants (n = 19), intervention participants (n = 40), and intervention facilitators (n = 6). A thematic analysis of qualitative data resulted in the identification of four key attributes of media stimuli and participants' responses to media stimuli that are important to consider when selecting and evaluating media stimuli for use in behavioral health interventions employing the critical analysis of media: comprehension, relevance, emotionality, and action. These four attributes are defined and presented as a framework for evaluating media, and adaptable tools are provided based on this framework to guide researchers and practitioners in the selection and evaluation of media for similar interventions.

Evidence and its uses in health care and research: the role of critical thinking.

Science.gov (United States)

Jenicek, Milos; Croskerry, Pat; Hitchcock, David L

2011-01-01

Obtaining and critically appraising evidence is clearly not enough to make better decisions in clinical care. The evidence should be linked to the clinician's expertise, the patient's individual circumstances (including values and preferences), and clinical context and settings. We propose critical thinking and decision-making as the tools for making that link. Critical thinking is also called for in medical research and medical writing, especially where pre-canned methodologies are not enough. It is also involved in our exchanges of ideas at floor rounds, grand rounds and case discussions; our communications with patients and lay stakeholders in health care; and our writing of research papers, grant applications and grant reviews. Critical thinking is a learned process which benefits from teaching and guided practice like any discipline in health sciences. Training in critical thinking should be a part or a pre-requisite of the medical curriculum.

Evidence and its uses in health care and research: The role of critical thinking

Science.gov (United States)

Jenicek, Milos; Croskerry, Pat; Hitchcock, David L.

2011-01-01

Summary Obtaining and critically appraising evidence is clearly not enough to make better decisions in clinical care. The evidence should be linked to the clinician’s expertise, the patient’s individual circumstances (including values and preferences), and clinical context and settings. We propose critical thinking and decision-making as the tools for making that link. Critical thinking is also called for in medical research and medical writing, especially where pre-canned methodologies are not enough. It is also involved in our exchanges of ideas at floor rounds, grand rounds and case discussions; our communications with patients and lay stakeholders in health care; and our writing of research papers, grant applications and grant reviews. Critical thinking is a learned process which benefits from teaching and guided practice like any discipline in health sciences. Training in critical thinking should be a part or a pre-requisite of the medical curriculum. PMID:21169920

Health-promoting conversations-A novel approach to families experiencing critical illness in the ICU environment.

Science.gov (United States)

Hollman Frisman, Gunilla; Wåhlin, Ingrid; Orvelius, Lotti; Ågren, Susanna

2018-02-01

To identify and describe the outcomes of a nurse-led intervention, "Health-promoting conversations with families," regarding family functioning and well-being in families with a member who was critically ill. Families who have a critically ill family member in an intensive care unit face a demanding situation, threatening the normal functioning of the family. Yet, there is a knowledge gap regarding family members' well-being during and after critical illness. The study used a qualitative inductive-descriptive design. Eight families participated in health-promoting conversations aimed to create a context for change related to the families' identified problems and resources. Fifteen qualitative interviews were conducted with 18 adults who participated in health-promoting conversations about a critical illness in the family. Eight participants were patients (six men, two women) and 10 were family members (two male partners, five female partners, one mother, one daughter, one female grandchild). The interviews were analysed by conventional content analysis. Family members experienced strengthened togetherness, a caring attitude and confirmation through health-promoting conversations. The caring and calming conversations were appreciated despite the reappearance of exhausting feelings. Working through the experience and being confirmed promoted family well-being. Health-promoting conversations were considered to be healing, as the family members take part in sharing each other's feelings, thoughts and experiences with the critical illness. Health-promoting conversations could be a simple and effective nursing intervention for former intensive care patients and their families in any cultural context. © 2017 John Wiley & Sons Ltd.

A critical analysis of the literature on the Internet and consumer health information.

Science.gov (United States)

Powell, J A; Lowe, P; Griffiths, F E; Thorogood, M

2005-01-01

A critical review of the published literature investigating the Internet and consumer health information was undertaken in order to inform further research and policy. A qualitative, narrative method was used, consisting of a three-stage process of identification and collation, thematic coding, and critical analysis. This analysis identified five main themes in the research in this area: (1) the quality of online health information for consumers; (2) consumer use of the Internet for health information; (3) the effect of e-health on the practitioner-patient relationship; (4) virtual communities and online social support and (5) the electronic delivery of information-based interventions. Analysis of these themes revealed more about the concerns of health professionals than about the effect of the Internet on users. Much of the existing work has concentrated on quantifying characteristics of the Internet: for example, measuring the quality of online information, or describing the numbers of users in different health-care settings. There is a lack of qualitative research that explores how citizens are actually using the Internet for health care.

Health and productivity of commuter railroad employees involved in critical incidents.

Science.gov (United States)

2011-02-15

ABSTRACTThe effects of accidentstermed Critical Incidentson the health and productivity of rail transit workers have not been fully investigated. Anecdotal evidence suggests lasting effects of these incidents. Surveys were obtained from 363 com...

An Integrative Review of the Concealed Connection: Nurse Educators' Critical Thinking.

Science.gov (United States)

Raymond, Christy; Profetto-McGrath, Joanne; Myrick, Florence; Strean, William B

2017-11-01

The role of nurse educators in the development of students' critical thinking has been overlooked despite the emphasized need for effective teaching methods. An integrative review was performed to examine both quantitative and qualitative research published from 2000 to 2015 related to nurse educators' critical thinking. Many barriers and facilitators existing on individual, interpersonal, and contextual levels affected nurse educators' critical thinking. Various tools have been used to measure nurse educators' critical thinking. This review also highlighted the continued lack of a consensus definition of critical thinking and the limited presence of conceptual models to guide the use of critical thinking in nursing education. Continued examination of nurse educators' critical thinking is needed, given the limited number of studies that have been completed. Much needs to be explored further, including conceptualizations of critical thinking and confirmation of emerging themes identified in this review. [J Nurs Educ. 2017;56(11):648-654.]. © 2017 Raymond, Profetto-McGrath, Myrick, et al.

Using School Gardening as a Vehicle for Critical and Creative Thinking in Health Education

Science.gov (United States)

Ausherman, Judith A.; Ubbes, Valerie A.; Kowalski, Jacqueline

2014-01-01

This strategy is to provide health education teacher candidates with critical and creative thinking tools to explore gardening as a vehicle to integrate health education content with other subjects. According to the Competency-Based Framework for the Health Education Specialist (2010a), entry-level health educators should have skills and…

The Nexus Between Health Literacy and Empowerment

DEFF Research Database (Denmark)

Crondahl, Kristine; Eklund Karlsson, Leena

2016-01-01

The aim of this article was to explore what is known about the assumed connection between health literacy and empowerment and how this connection is portrayed in the scientific literature. If empowerment is an outcome of health literacy, what are the mechanisms behind this process? A literature...... search onducted in 2013 yielded 216 hits, of which five met the inclusion criteria, and thus were read in depth and analyzed through a narrative-review approach. The findings indicate that Health literacy might be regarded as a tool for empowerment but does not automatically lead to empowerment. Health...... literacy might be increased by health education. Crucial for empowerment is to achieve the critical level of health literacy including an ability to question and reflect on the prevailing power relations and societal conditions; increased senses of power, selfesteem, and self-efficacy; and an ability...

Cooperative doping effects of Ti and nano-SiC on transport critical current density and grain connectivity of in situ MgB{sub 2} tapes

Energy Technology Data Exchange (ETDEWEB)

Pan, X.F., E-mail: PAN.Xifeng@nims.go.jp [National Institute for Materials Science, Superconducting Materials Research Center, 1-2-1, Sengen, Tsukuba, Ibaraki 305-0047 (Japan)] [Key Laboratory of Magnetic Levitation and Maglev Trains (Ministry of Education of China), Superconductivity R and D Center (SRDC), Southwest Jiaotong University, Chengdu 610031 (China); Matsumoto, A.; Kumakura, H. [National Institute for Materials Science, Superconducting Materials Research Center, 1-2-1, Sengen, Tsukuba, Ibaraki 305-0047 (Japan); Cheng, C.H.; Zhao, Y. [Key Laboratory of Magnetic Levitation and Maglev Trains (Ministry of Education of China), Superconductivity R and D Center (SRDC), Southwest Jiaotong University, Chengdu 610031 (China)] [School of Materials Science and Engineering, University of New South Wales, Sydney 2052, NSW (Australia)

2011-11-15

We studied the cooperative doping effects of Ti and nano-SiC on transport J{sub c} and grain connectivity of MgB{sub 2} tape. Ti doping significantly weakens the current dependence of T{sub c} of MgB{sub 2} tapes at self-field, and does not change T{sub c} or slightly increases T{sub c}. Further Ti adding can enhance in-field J{sub c} performance of SiC doped MgB{sub 2} tapes by a factor of 50-100% at 4.2 K and 10 T. Ti addition improves the J{sub c} performance of undoped and SiC doped MgB{sub 2} by modifying their grains connection. By now, nano-SiC powder (20-30 nm) is still the most effective additive for improving upper critical field and critical current density of MgB{sub 2}-based superconducting materials. However, some decomposed carbon aggregates at grain boundaries and results in serious weak-links of MgB{sub 2} grains, and these weak-links limit the further improvement of critical current density, J{sub c} of MgB{sub 2}, especially at lower fields. Ti doping is reported to increase the compactness of MgB{sub 2}, and modify its intergranular coupling by forming ultrathin TiB{sub 2} layer at grain boundaries. In this work, we studied the cooperative doping effects of Ti and nano-SiC on transport J{sub c} and grain connectivity of MgB{sub 2} and the possibility to improve transport J{sub c} of SiC doped MgB{sub 2} by introducing Ti additive. The results suggest the Ti addition can obviously improve J{sub c} of MgB{sub 2} at lower fields and also enhance the J{sub c} of SiC doped MgB{sub 2} by improving their grain connectivity which shows serious intergranular weak-links.

Who should be responsible for supporting individuals with mental health problems? A critical literature review.

Science.gov (United States)

Pope, Megan A; Malla, Ashok K; Iyer, Srividya N

2018-05-01

Individuals with mental health problems have many support needs that are often inadequately met; however, perceptions of who should be responsible for meeting these needs have been largely unexplored. Varying perceptions may influence whether, how, and to what extent relevant stakeholders support individuals with mental health problems. To critically evaluate the literature to determine who different stakeholders believe should be responsible for supporting individuals with mental health problems, what factors shape these perceptions, and how they relate to one another. A critical literature review was undertaken. Following an extensive literature search, the conceptual contributions of relevant works were critically evaluated. A concept map was created to build a conceptual framework of the topic. Views of individual versus societal responsibility for need provision and health; the morality of caring; and attributions of responsibility for mental illness offered valuable understandings of the review questions. Creating a concept map revealed that various interrelated factors may influence perceptions of responsibility. Varying perceptions of who should be responsible for supporting individuals with mental health problems may contribute to unmet support needs among this group. Our critical review helps build a much-needed conceptual framework of factors influencing perceptions of responsibility. Such a framework is essential as these views iteratively shape and reflect the complex divisions of mental healthcare roles and responsibilities. Understanding these perceptions can help define relevant stakeholders' roles more clearly, which can improve mental health services and strengthen stakeholder accountability.

MedlinePlus Connect: Linking Patient Portals and Electronic Health Records to Health Information

Science.gov (United States)

... Here: Home → MedlinePlus Connect URL of this page: https://medlineplus.gov/connect/overview.html MedlinePlus Connect Linking ... will change.) Old URLs New URLs Web Application https://apps.nlm.nih.gov/medlineplus/services/mpconnect.cfm? ...

Transgender Stigma and Health: A Critical Review of Stigma Determinants, Mechanisms, and Interventions

Science.gov (United States)

White Hughto, Jaclyn M.; Reisner, Sari L.; Pachankis, John E.

2015-01-01

Rationale Transgender people in the United States experience widespread prejudice, discrimination, violence, and other forms of stigma. Objective This critical review aims to integrate the literature on stigma towards transgender people in the US. Results This review demonstrates that transgender stigma limits opportunities and access to resources in a number of critical domains (e.g., employment, healthcare), persistently affecting the physical and mental health of transgender people. The applied social ecological model employed here elucidates that transgender stigma operates at multiple levels (i.e., individual, interpersonal, structural) to impact health. Stigma prevention and coping interventions hold promise for reducing stigma and its adverse health-related effects in transgender populations. Conclusion Additional research is needed to document the causal relationship between stigma and adverse health as well as the mediators and moderators of stigma in US transgender populations. Multi-level interventions to prevent stigma towards transgender people are warranted. PMID:26599625

Oral-to-inhalation route extrapolation in occupational health risk assessment: A critical assessment

NARCIS (Netherlands)

Rennen, M.A.J.; Bouwman, T.; Wilschut, A.; Bessems, J.G.M.; Heer, C.de

2004-01-01

Due to a lack of route-specific toxicity data, the health risks resulting from occupational exposure are frequently assessed by route-to-route (RtR) extrapolation based on oral toxicity data. Insight into the conditions for and the uncertainties connected with the application of RtR extrapolation

Theory analysis for Pender's health promotion model (HPM) by Barnum's criteria: a critical perspective.

Science.gov (United States)

Khoshnood, Zohreh; Rayyani, Masoud; Tirgari, Batool

2018-01-13

Background Analysis of nursing theoretical works and its role in knowledge development is presented as an essential process of critical reflection. Health promotion model (HPM) focuses on helping people achieve higher levels of well-being and identifies background factors that influence health behaviors. Objectives This paper aims to evaluate, and critique HPM by Barnum's criteria. Methods The present study reviewed books and articles derived from Proquest, PubMed, Blackwell Databases. The method of evaluation for this model is based on Barnum's criteria for analysis, application and evaluation of nursing theories. The criteria selected by Barnum embrace both internal and external criticism. Internal criticism deals with how theory components fit with each other (internal construction of theory) and external criticism deals with the way in which theory relates to the extended world (which considers theory in its relationships to human beings, nursing, and health). Results The electronic database search yielded over 27,717 titles and abstracts. Following removal of duplicates, 18,963 titles and abstracts were screened using the inclusion criteria and 1278 manuscripts were retrieved. Of these, 80 were specific to HPM and 23 to analysis of any theory in nursing relating to the aim of this article. After final selection using the inclusion criteria for this review, 28 manuscripts were identified as examining the factors contributing to theory analysis. Evaluation of health promotion theory showed that the philosophical claims and their content are consistent and clear. HPM has a logical structure and was applied to diverse age groups from differing cultures with varying health concerns. Conclusion In conclusion, among the strategies for theory critique, the Barnum approach is structured and accurate, considers theory in its relationship to human beings, community psychiatric nursing, and health. While according to Pender, nursing assessment, diagnosis and interventions

Transgender stigma and health: A critical review of stigma determinants, mechanisms, and interventions.

Science.gov (United States)

White Hughto, Jaclyn M; Reisner, Sari L; Pachankis, John E

2015-12-01

Transgender people in the United States experience widespread prejudice, discrimination, violence, and other forms of stigma. This critical review aims to integrate the literature on stigma towards transgender people in the U.S. This review demonstrates that transgender stigma limits opportunities and access to resources in a number of critical domains (e.g., employment, healthcare), persistently affecting the physical and mental health of transgender people. The applied social ecological model employed here elucidates that transgender stigma operates at multiple levels (i.e., individual, interpersonal, structural) to impact health. Stigma prevention and coping interventions hold promise for reducing stigma and its adverse health-related effects in transgender populations. Additional research is needed to document the causal relationship between stigma and adverse health as well as the mediators and moderators of stigma in US transgender populations. Multi-level interventions to prevent stigma towards transgender people are warranted. Copyright © 2015 Elsevier Ltd. All rights reserved.

Measuring functional, interactive and critical health literacy of Chinese secondary school students: reliable, valid and feasible?

Science.gov (United States)

Guo, Shuaijun; Davis, Elise; Yu, Xiaoming; Naccarella, Lucio; Armstrong, Rebecca; Abel, Thomas; Browne, Geoffrey; Shi, Yanqin

2018-04-01

Health literacy is an increasingly important topic in the global context. In mainland China, health literacy measures mainly focus on health knowledge and practices or on the functional domain for adolescents. However, little is known about interactive and critical domains. This study aimed to adopt a skills-based and three-domain (functional, interactive and critical) instrument to measure health literacy in Chinese adolescents and to examine the status and determinants of each domain. Using a systematic review, the eight-item Health Literacy Assessment Tool (HLAT-8) was selected and translated from English to Chinese (c-HLAT-8). Following the translation process, a cross-sectional study was conducted in four secondary schools in Beijing, China. A total of 650 students in Years 7-9 were recruited to complete a self-administered questionnaire that assessed socio-demographics, self-efficacy, social support, school environment, community environment and health literacy. Results showed that the c-HLAT-8 had satisfactory reliability (Cronbach's α = 0.79; intra-class correlation coefficient = 0.72) and strong validity (translation validity index (TVI) ≥0.95; χ 2 / df = 3.388, p students had an average score of 26.37 (±5.89) for the c-HLAT-8. When the determinants of each domain of health literacy were examined, social support was the strongest predictor of interactive and critical health literacy. On the contrary, self-efficacy and school environment played more dominant roles in predicting functional health literacy. The c-HLAT-8 was demonstrated to be a reliable, valid and feasible instrument for measuring functional, interactive and critical health literacy among Chinese students. The current findings indicate that increasing self-efficacy, social support and creating supportive environments are important for promoting health literacy in secondary school settings in China.

Bringing Health and Fitness Data Together for Connected Health Care: Mobile Apps as Enablers of Interoperability.

Science.gov (United States)

Gay, Valerie; Leijdekkers, Peter

2015-11-18

A transformation is underway regarding how we deal with our health. Mobile devices make it possible to have continuous access to personal health information. Wearable devices, such as Fitbit and Apple's smartwatch, can collect data continuously and provide insights into our health and fitness. However, lack of interoperability and the presence of data silos prevent users and health professionals from getting an integrated view of health and fitness data. To provide better health outcomes, a complete picture is needed which combines informal health and fitness data collected by the user together with official health records collected by health professionals. Mobile apps are well positioned to play an important role in the aggregation since they can tap into these official and informal health and data silos. The objective of this paper is to demonstrate that a mobile app can be used to aggregate health and fitness data and can enable interoperability. It discusses various technical interoperability challenges encountered while integrating data into one place. For 8 years, we have worked with third-party partners, including wearable device manufacturers, electronic health record providers, and app developers, to connect an Android app to their (wearable) devices, back-end servers, and systems. The result of this research is a health and fitness app called myFitnessCompanion, which enables users to aggregate their data in one place. Over 6000 users use the app worldwide to aggregate their health and fitness data. It demonstrates that mobile apps can be used to enable interoperability. Challenges encountered in the research process included the different wireless protocols and standards used to communicate with wireless devices, the diversity of security and authorization protocols used to be able to exchange data with servers, and lack of standards usage, such as Health Level Seven, for medical information exchange. By limiting the negative effects of health data silos

Critical appraisal skills training for health care professionals: a randomized controlled trial [ISRCTN46272378

Directory of Open Access Journals (Sweden)

Ewings Paul E

2004-12-01

Full Text Available Abstract Introduction Critical appraisal skills are believed to play a central role in an evidence-based approach to health practice. The aim of this study was to evaluate the effectiveness and costs of a critical appraisal skills educational intervention aimed at health care professionals. Methods This prospective controlled trial randomized 145 self-selected general practitioners, hospital physicians, professions allied to medicine, and healthcare managers/administrators from the South West of England to a half-day critical appraisal skills training workshop (based on the model of problem-based small group learning or waiting list control. The following outcomes were assessed at 6-months follow up: knowledge of the principles necessary for appraising evidence; attitudes towards the use of evidence about healthcare; evidence seeking behaviour; perceived confidence in appraising evidence; and ability to critically appraise a systematic review article. Results At follow up overall knowledge score [mean difference: 2.6 (95% CI: 0.6 to 4.6] and ability to appraise the results of a systematic review [mean difference: 1.2 (95% CI: 0.01 to 2.4] were higher in the critical skills training group compared to control. No statistical significant differences in overall attitude towards evidence, evidence seeking behaviour, perceived confidence, and other areas of critical appraisal skills ability (methodology or generalizability were observed between groups. Taking into account the workshop provision costs and costs of participants time and expenses of participants, the average cost of providing the critical appraisal workshops was approximately £250 per person. Conclusions The findings of this study challenge the policy of funding 'one-off' educational interventions aimed at enhancing the evidence-based practice of health care professionals. Future evaluations of evidence-based practice interventions need to take in account this trial's negative findings

A Critical Interpretive Synthesis of the Literature Linking Music and Adolescent Mental Health

Science.gov (United States)

McFerran, Katrina Skewes; Garrido, Sandra; Saarikallio, Suvi

2016-01-01

There is a diverse literature that explores the relationship between youth, music, and mental health, with few attempts at systematic synthesis. This critical interpretive review included 33 studies published between 2000 and 2012 investigating the relationship between music and the mental health of young people, particularly targeting depression.…

Detecting Functional Connectivity During Audiovisual Integration with MEG: A Comparison of Connectivity Metrics.

Science.gov (United States)

Ard, Tyler; Carver, Frederick W; Holroyd, Tom; Horwitz, Barry; Coppola, Richard

2015-08-01

In typical magnetoencephalography and/or electroencephalography functional connectivity analysis, researchers select one of several methods that measure a relationship between regions to determine connectivity, such as coherence, power correlations, and others. However, it is largely unknown if some are more suited than others for various types of investigations. In this study, the authors investigate seven connectivity metrics to evaluate which, if any, are sensitive to audiovisual integration by contrasting connectivity when tracking an audiovisual object versus connectivity when tracking a visual object uncorrelated with the auditory stimulus. The authors are able to assess the metrics' performances at detecting audiovisual integration by investigating connectivity between auditory and visual areas. Critically, the authors perform their investigation on a whole-cortex all-to-all mapping, avoiding confounds introduced in seed selection. The authors find that amplitude-based connectivity measures in the beta band detect strong connections between visual and auditory areas during audiovisual integration, specifically between V4/V5 and auditory cortices in the right hemisphere. Conversely, phase-based connectivity measures in the beta band as well as phase and power measures in alpha, gamma, and theta do not show connectivity between audiovisual areas. The authors postulate that while beta power correlations detect audiovisual integration in the current experimental context, it may not always be the best measure to detect connectivity. Instead, it is likely that the brain utilizes a variety of mechanisms in neuronal communication that may produce differential types of temporal relationships.

Worker’s Health: Considerations Based on a Criticism of Political Economy

OpenAIRE

Ricardo Lara

2011-01-01

The purpose of this article is to analyze worker health, based on a criticism of political economy. It seeks to understand the causes of illnesses and accidents among workers, and to highlight elements to consider the struggles of the working class in the realm of health, principally concerning public policies and union practices. It infers that under contemporary labor relations, workers get ill and have accidents due to the intensified pace of production, whether in activities on the factor...

The critic as transvestite: the parody nature of literary criticism

Directory of Open Access Journals (Sweden)

David Pruneda Sentíes

2016-09-01

Full Text Available This paper explores a path in the analysis of literary criticism as an object of study. In order to convey this, this essay attempts to define literary criticism as a genre that parodies the literary text it aspires to examine. Mikhail Bakhtin’s analysis of the novelistic discourse is useful to establish a connection between parody and criticism. Although Bakhtin discusses the novel, I ascertain that his arguments may be applied to the description of criticism as a parodic-travestying genre. Secondly, this paper discusses Linda Hutcheon’s work, which states that parody is a repetition of the original text. According to Hutcheon, this repetition implies a critical distance with the parodied text, which marks difference rather than similarity.

Connectivity: An emerging concept for physiotherapy practice.

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Nicholls, David A; Atkinson, Karen; Bjorbækmo, Wenche S; Gibson, Barbara E; Latchem, Julie; Olesen, Jens; Ralls, Jenny; Setchell, Jennifer

2016-01-01

Having spent their first century anchored to a biomedical model of practice, physiotherapists have been increasingly interested in exploring new models and concepts that will better equip them for serving the health-care needs of 21st century clients/patients. Connectivity offers one such model. With an extensive philosophical background in phenomenology, symbolic interactionism, structuralism, and postmodern research, connectivity resists the prevailing western biomedical view that health professionals should aim to increase people's independence and autonomy, preferring instead to identify and amplify opportunities for collaboration and co-dependence. Connectivity critiques the normalization that underpins modern health care, arguing that our constant search for deviance is building stigma and discrimination into our everyday practice. It offers provocative opportunities for physiotherapists to rethink some of the fundamental tenets of their profession and better align physiotherapy with 21st century societal expectations. In this paper, we provide a background to the place connectivity may play in future health care, and most especially future physiotherapy practice. The paper examines some of the philosophical antecedents that have made connectivity an increasingly interesting and challenging concept in health care today.

Critical evaluation of international health programs: Reframing global health and evaluation.

Science.gov (United States)

Chi, Chunhuei; Tuepker, Anaïs; Schoon, Rebecca; Núñez Mondaca, Alicia

2018-01-05

Striking changes in the funding and implementation of international health programs in recent decades have stimulated debate about the role of communities in deciding which health programs to implement. An important yet neglected piece of that discussion is the need to change norms in program evaluation so that analysis of community ownership, beyond various degrees of "participation," is seen as central to strong evaluation practices. This article challenges mainstream evaluation practices and proposes a framework of Critical Evaluation with 3 levels: upstream evaluation assessing the "who" and "how" of programming decisions; midstream evaluation focusing on the "who" and "how" of selecting program objectives; and downstream evaluation, the focus of current mainstream evaluation, which assesses whether the program achieved its stated objectives. A vital tenet of our framework is that a community possesses the right to determine the path of its health development. A prerequisite of success, regardless of technical outcomes, is that programs must address communities' high priority concerns. Current participatory methods still seldom practice community ownership of program selection because they are vulnerable to funding agencies' predetermined priorities. In addition to critiquing evaluation practices and proposing an alternative framework, we acknowledge likely challenges and propose directions for future research. Copyright © 2018 John Wiley & Sons, Ltd.

Sectio Aurea Conditions for Mityuk's Radius of Two-Connected Domains

Directory of Open Access Journals (Sweden)

A.V. Kazantsev

2017-03-01

Full Text Available Connection of an exterior inverse boundary value problem with the critical points of some surface is one of the central themes in the theory of exterior inverse boundary value problems for analytic functions. In the simply connected case, such a surface is defined by the inner mapping radius; in the multiply connected one, by the function Ω(w such that M(w = (2π–1ln Ω(w is Mityuk's version of a generalized reduced module. In the present paper, the relation between the curvature of the surface Ω = Ω(w with the Schwarzian derivatives of the mapping functions and with the Bergman kernel functions k0(w,ω and l0(w,ω is established for an arbitrary multiply connected domain. When passing to two-connected domains, due to the choice of the ring as a canonical domain, we construct the conditions for the critical points of Mityuk's radius to concentrate on the golden section circle of the ring. Finally, we show that the minimal collection of the critical points of the Mityuk radius in the two-connected case, consisting of one maximum and one saddle, is attained for the linear-fractional solution of the exterior inverse boundary value problem.

Validation of the Dutch functional, communicative and critical health literacy scales

NARCIS (Netherlands)

van der Vaart, R.; Drossaert, Constance H.C.; Taal, Erik; ten Klooster, Peter M.; Hilderink-Koertshuis, Rianne T.E.; Klaase, Joost M.; van de Laar, Mart A F J

2012-01-01

Objective: While most existing health literacy (HL) measures focus primarily on reading comprehension, the functional, communicative and critical HL scales from Ishikawa et al. [19] aim to measure a broader HL spectrum. The objective of this study was to evaluate the validity of the Dutch

The Health and Safety Executive's regulatory framework for control of nuclear criticality safety

International Nuclear Information System (INIS)

Smith, K.; Simister, D.N.

1991-01-01

In the United Kingdom the Health and Safety at Work Act, 1974 is the main legal instrument under which risks to people from work activities are controlled. Certain sections of the Nuclear Installations Act, 1965 which deal with the licensing of nuclear sites and the regulatory control of risks arising from them, including the risk from accidental criticality, are relevant statutory provisions of the Health and Safety at Work Act. The responsibility for safety rests with the operator who has to make and implement arrangements to prevent accidental criticality. The adequacy of these arrangements must be demonstrated in a safety case to the regulatory authorities. Operators are encouraged to treat each plant on its own merits and develop the safety case accordingly. The Nuclear Installations Inspectorate (NII), for its part, assesses the adequacy of the operator's safety case against the industry's own standards and criteria, but more particularly against the NII's safety assessment principles and guides, and international standards. Risks should be made as low as reasonably practicable. Generally, the NII seeks improvements in safety using an enforcement policy which operates at a number of levels, ranging from persuasion through discussion to the ultimate deterrent of withdrawal of a site licence. This paper describes the role of the NII, which includes a specialist criticality expertise, within the Health and Safety Executive, in regulating the nuclear sites from the criticality safety viewpoint. (Author)

Common and Critical Components Among Community Health Assessment and Community Health Improvement Planning Models.

Science.gov (United States)

Pennel, Cara L; Burdine, James N; Prochaska, John D; McLeroy, Kenneth R

Community health assessment and community health improvement planning are continuous, systematic processes for assessing and addressing health needs in a community. Since there are different models to guide assessment and planning, as well as a variety of organizations and agencies that carry out these activities, there may be confusion in choosing among approaches. By examining the various components of the different assessment and planning models, we are able to identify areas for coordination, ways to maximize collaboration, and strategies to further improve community health. We identified 11 common assessment and planning components across 18 models and requirements, with a particular focus on health department, health system, and hospital models and requirements. These common components included preplanning; developing partnerships; developing vision and scope; collecting, analyzing, and interpreting data; identifying community assets; identifying priorities; developing and implementing an intervention plan; developing and implementing an evaluation plan; communicating and receiving feedback on the assessment findings and/or the plan; planning for sustainability; and celebrating success. Within several of these components, we discuss characteristics that are critical to improving community health. Practice implications include better understanding of different models and requirements by health departments, hospitals, and others involved in assessment and planning to improve cross-sector collaboration, collective impact, and community health. In addition, federal and state policy and accreditation requirements may be revised or implemented to better facilitate assessment and planning collaboration between health departments, hospitals, and others for the purpose of improving community health.

Connecting Creativity and Critical Thinking to the Campaign Planning Process

Science.gov (United States)

Matthews, Marsha Little

2011-01-01

Creativity is the central source of meaning for humans and is inseparable from critical thinking. Creativity and critical thinking are required in the fields of communication, public relations, and advertising. Most college students know the "rules" of the "game" of schooling, but for the majority, creativity has been all but extinguished by the…

The WHO/WTO study on trade and public health: a critical assessment.

Science.gov (United States)

Howse, Robert

2004-04-01

This article provides a brief critical examination of a 2002 report jointly issued by the World Health Organization and the World Trade Organization on WTO law and public health. The author argues that the report is in many respects misleading as to the content of WTO law, as interpreted by the Appellate Body of the WTO, its final court. In particular, the WHO/WTO report systematically understates or underestimates the margins of regulatory autonomy that WTO member states have to make regulations that protect public health.

The mental health of Indigenous peoples in Canada: A critical review of research.

Science.gov (United States)

Nelson, Sarah E; Wilson, Kathi

2017-03-01

Many scholars assert that Indigenous peoples across the globe suffer a disproportionate burden of mental illness. Research indicates that colonialism and its associated processes are important determinants of Indigenous peoples' health internationally. In Canada, despite an abundance of health research documenting inequalities in morbidity and mortality rates for Indigenous peoples, relatively little research has focused on mental health. This paper provides a critical scoping review of the literature related to Indigenous mental health in Canada. We searched eleven databases and two Indigenous health-focused journals for research related to mental health, Indigenous peoples, and Canada, for the years 2006-2016. Over two hundred papers are included in the review and coded according to research theme, population group, and geography. Results demonstrate that the literature is overwhelmingly concerned with issues related to colonialism in mental health services and the prevalence and causes of mental illness among Indigenous peoples in Canada, but with several significant gaps. Mental health research related to Indigenous peoples in Canada overemphasizes suicide and problematic substance use; a more critical use of the concepts of colonialism and historical trauma is advised; and several population groups are underrepresented in research, including Métis peoples and urban or off-reserve Indigenous peoples. The findings are useful in an international context by providing a starting point for discussions, dialogue, and further study regarding mental health research for Indigenous peoples around the world. Copyright © 2017 Elsevier Ltd. All rights reserved.

A Habermasian Approach to Critical Reading

Science.gov (United States)

Lee, Cheu-jey

2016-01-01

This article explores the connection between critical reading and Jurgen Habermas's theory of communicative action. It proposes that Habermas's criteria used for evaluating validity claims in communicative action can be applied in reading texts critically. Analyses of different types of texts are presented to show how critical reading is done in a…

Critical thinking and contemporary mental health care: Michel Foucault's "history of the present".

Science.gov (United States)

Roberts, Marc

2017-04-01

In order to be able to provide informed, effective and responsive mental health care and to do so in an evidence-based, collaborative and recovery-focused way with those who use mental health services, there is a recognition of the need for mental health professionals to possess sophisticated critical thinking capabilities. This article will therefore propose that such capabilities can be productively situated within the context of the work of the French philosopher Michel Foucault, one of the most challenging, innovative and influential thinkers of the 20th century. However, rather than focusing exclusively upon the content of Foucault's work, it will be suggested that it is possible to discern a general methodological approach across that work, a methodological approach that he refers to as "the history of the present." In doing so, Foucault's history of the present can be understood as a productive, albeit provisional, framework in which to orientate the purpose and process of critical thinking for mental health professionals by emphasizing the need to both historicize and politicize the theoretical perspectives and therapeutic practices that characterize contemporary mental health care. © 2016 John Wiley & Sons Ltd.

Functional, interactive and critical health literacy: Varying relationships with control over care and number of GP visits.

Science.gov (United States)

van der Heide, Iris; Heijmans, Monique; Schuit, A Jantine; Uiters, Ellen; Rademakers, Jany

2015-08-01

The aim of this study is to examine the extent to which functional, interactive and critical health literacy are associated with patients' perceived control over care and frequency of GP visits. Data from the Dutch 'National Panel of People with Chronic Illness or Disability' was used (N=2508). Health literacy was assessed by the Functional, Communicative and Critical Health Literacy measure. Perceived control over care was indicated by perceived ability to organize care, interact with providers and to perform self-care. By multivariate linear and logistic regression analyses, associations between health literacy and perceived control over care and subsequently frequency of GP visits were studied. Mainly interactive health literacy was associated with patients' perceived ability to organize care, interact with healthcare providers and perform self-care, whereas only functional health literacy was associated with number of GP visits. The results imply that some patients' may be less able to exert control over their care because of lower health literacy. Functional, interactive and critical health literacy vary in their relevance for patients' ability to exert control. Initiatives for strengthening patients' role in healthcare may be improved by paying attention to patients' health literacy, specifically functional and interactive health literacy. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Baccalaureate Nursing Students' Abilities in Critically Identifying and Evaluating the Quality of Online Health Information.

Science.gov (United States)

Theron, Maggie; Redmond, Anne; Borycki, Elizabeth M

2017-01-01

Both the Internet and social media have become important tools that patients and health professionals, including health professional students, use to obtain information and support their decision-making surrounding health care. Students in the health sciences require increased competence to select, appraise, and use online sources to adequately educate and support patients and advocate for patient needs and best practices. The purpose of this study was to ascertain if second year nursing students have the ability to critically identify and evaluate the quality of online health information through comparisons between student and expert assessments of selected online health information postings using an adapted Trust in Online Health Information scale. Interviews with experts provided understanding of how experts applied the selected criteria and what experts recommend for implementing nursing informatics literacy in curriculums. The difference between student and expert assessments of the quality of the online information is on average close to 40%. Themes from the interviews highlighted several possible factors that may influence informatics competency levels in students, specifically regarding the critical appraisal of the quality of online health information.

Transient stability with grid connection and wind turbine drive-train effects

DEFF Research Database (Denmark)

Fajardo-R, Luis A.; Medina, Aurelio; Iov, Florin

2009-01-01

This paper assesses transient stability of grid-connected wind turbines, combining grid-connection, wind turbine flexibility, and induction generator stability features. Through a grid-connected 2 MW wind turbine cage-generator, the investigation is conducted to identify the critical clearing time...

Heritable Disorders of Connective Tissue

Science.gov (United States)

... Home Health Topics English Español Heritable Disorders of Connective Tissue Basics In-Depth Download Download EPUB Download PDF ... they? Points To Remember About Heritable Disorders of Connective Tissue There are more than 200 heritable disorders that ...

How mental health nurses improve their critical thinking through problem-based learning.

Science.gov (United States)

Hung, Tsui-Mei; Tang, Lee-Chun; Ko, Chen-Ju

2015-01-01

Critical thinking has been regarded as one of the most important elements for nurses to improve quality of patient care. The aim of this study was to use problem-based learning (PBL) as a method in a continuing education program to evaluate nurses' critical thinking skills. A quasiexperimental study design was carried out. The "Critical Thinking Disposition Inventory" in Chinese was used for data collection. The results indicated significant improvement after PBL continuous education, notably in the dimensions of systematic analysis and curiosity. Content analysis extracted four themes: (a) changes in linear thinking required, (b) logical and systematic thinking required performance improved, (3) integration of prior knowledge and clinical application, and (4) brainstorming learning strategy. The study supports PBL as a continuing education strategy for mental health nurses, and that systematic analysis and curiosity effectively facilitate the development of critical thinking.

Knowledge mobilisation in healthcare: a critical review of health sector and generic management literature.

Science.gov (United States)

Ferlie, Ewan; Crilly, Tessa; Jashapara, Ashok; Peckham, Anna

2012-04-01

The health policy domain has displayed increasing interest in questions of knowledge management and knowledge mobilisation within healthcare organisations. We analyse here the findings of a critical review of generic management and health-related literatures, covering the period 2000-2008. Using 29 pre-selected journals, supplemented by a search of selected electronic databases, we map twelve substantive domains classified into four broad groups: taxonomic and philosophical (e.g. different types of knowledge); theoretical discourse (e.g. critical organisational studies); disciplinary fields (e.g. organisational learning and Information Systems/Information Technology); and organisational processes and structures (e.g. organisational form). We explore cross-overs and gaps between these traditionally separate literature streams. We found that health sector literature has absorbed some generic concepts, notably Communities of Practice, but has not yet deployed the performance-oriented perspective of the Resource Based View (RBV) of the Firm. The generic literature uses healthcare sites to develop critical analyses of power and control in knowledge management, rooted in neo-Marxist/labour process and Foucauldian approaches. The review generates three theoretically grounded statements to inform future enquiry, by: (a) importing the RBV stream; (b) developing the critical organisational studies perspective further; and (c) exploring the theoretical argument that networks and other alternative organisational forms facilitate knowledge sharing. Copyright © 2012 Elsevier Ltd. All rights reserved.

Functional outcome in contemporary children with total cavopulmonary connection - Health-related physical fitness, exercise capacity and health-related quality of life.

Science.gov (United States)

Hock, Julia; Reiner, Barbara; Neidenbach, Rhoia C; Oberhoffer, Renate; Hager, Alfred; Ewert, Peter; Müller, Jan

2018-03-15

Children and adolescents with an univentricular heart after total cavopulmonary connection (TCPC) have functional impairments. This study assesses health-related physical fitness (HRPF) and exercise capacity, as well as their relation to health-related quality of life (HRQoL) in patients with an univentricular heart after total-pulmonary connection (TCPC). Between July 2014 and October 2016 a total of 78 children and adolescents with TCPC (12.0±3.2years, 21 female) performed a motor test including five tasks for strength and flexibility during their routine follow-up appointment. They also underwent a symptom limited cardio-pulmonary exercise test and filled in a HRQoL questionnaire (KINDL-R). Patients' data were compared to a recent sample of healthy children (n=1650, 12.6±2.4years, 49% female). Multivariable regressions corrected for sex, age and BMI showed that TCPC patients achieved 12.4 repetitions of curl-ups (pflexibility (-4.7cm; pmotor competence and exercise capacity, early screening for HRPF and early treatment, if indicated, is recommended. Copyright © 2017 Elsevier Ireland Ltd. All rights reserved.

A robust uniqueness-and-anonymity-preserving remote user authentication scheme for connected health care.

Science.gov (United States)

Wen, Fengtong

2013-12-01

User authentication plays an important role to protect resources or services from being accessed by unauthorized users. In a recent paper, Das et al. proposed a secure and efficient uniqueness-and-anonymity-preserving remote user authentication scheme for connected health care. This scheme uses three factors, e.g. biometrics, password, and smart card, to protect the security. It protects user privacy and is believed to have many abilities to resist a range of network attacks, even if the secret information stored in the smart card is compromised. In this paper, we analyze the security of Das et al.'s scheme, and show that the scheme is in fact insecure against the replay attack, user impersonation attacks and off-line guessing attacks. Then, we also propose a robust uniqueness-and-anonymity-preserving remote user authentication scheme for connected health care. Compared with the existing schemes, our protocol uses a different user authentication mechanism to resist replay attack. We show that our proposed scheme can provide stronger security than previous protocols. Furthermore, we demonstrate the validity of the proposed scheme through the BAN (Burrows, Abadi, and Needham) logic.

Integrated specialty service readiness in health reform: connections in haemophilia comprehensive care.

Science.gov (United States)

Pritchard, A M; Page, D

2008-05-01

The World Health Organization (WHO) has identified primary healthcare reform as a global priority whereby innovative practice changes are directed at improving health. This transformation to health reform in haemophilia service requires clarification of comprehensive care to reflect the WHO definition of health and key elements of primary healthcare reform. While comprehensive care supports effective healthcare delivery, comprehensive care must also be regarded beyond immediate patient management to reflect the broader system purpose in the care continuum with institutions, community agencies and government. Furthermore, health reform may be facilitated through integrated service delivery (ISD). ISD in specialty haemophilia care has the potential to reduce repetition of assessments, enhance care plan communication between providers and families, provide 24-h access to care, improve information availability regarding care quality and outcomes, consolidate access for multiple healthcare encounters and facilitate family self-efficacy and autonomy [1]. Three core aspects of ISD have been distinguished: clinical integration, information management and technology and vertical integration in local communities [2]. Selected examples taken from Canadian haemophilia comprehensive care illustrate how practice innovations are bridged with a broader system level approach and may support initiatives in other contexts. These innovations are thought to indicate readiness regarding ISD. Reflecting on the existing capacity of haemophilia comprehensive care teams will assist providers to connect and direct their existing strengths towards ISD and health reform.

Synchronization from Second Order Network Connectivity Statistics

Science.gov (United States)

Zhao, Liqiong; Beverlin, Bryce; Netoff, Theoden; Nykamp, Duane Q.

2011-01-01

We investigate how network structure can influence the tendency for a neuronal network to synchronize, or its synchronizability, independent of the dynamical model for each neuron. The synchrony analysis takes advantage of the framework of second order networks, which defines four second order connectivity statistics based on the relative frequency of two-connection network motifs. The analysis identifies two of these statistics, convergent connections, and chain connections, as highly influencing the synchrony. Simulations verify that synchrony decreases with the frequency of convergent connections and increases with the frequency of chain connections. These trends persist with simulations of multiple models for the neuron dynamics and for different types of networks. Surprisingly, divergent connections, which determine the fraction of shared inputs, do not strongly influence the synchrony. The critical role of chains, rather than divergent connections, in influencing synchrony can be explained by their increasing the effective coupling strength. The decrease of synchrony with convergent connections is primarily due to the resulting heterogeneity in firing rates. PMID:21779239

In Search of the Socially Critical in Health Education: Exploring the Views of Health and Physical Education Preservice Teachers in Australia

Science.gov (United States)

Wright, Jan; O'Flynn, Gabrielle; Welch, Rosie

2018-01-01

Purpose: Health education still tends to be dominated by an approach designed to achieve individual behaviour change through the provision of knowledge to avoid risk. In contrast, a critical inquiry approach educates children and young people to develop their capacity to engage critically with knowledge, through reasoning, problem solving and…

Health Monitor for Multitasking, Safety-Critical, Real-Time Software

Science.gov (United States)

Zoerner, Roger

2011-01-01

Health Manager can detect Bad Health prior to a failure occurring by periodically monitoring the application software by looking for code corruption errors, and sanity-checking each critical data value prior to use. A processor s memory can fail and corrupt the software, or the software can accidentally write to the wrong address and overwrite the executing software. This innovation will continuously calculate a checksum of the software load to detect corrupted code. This will allow a system to detect a failure before it happens. This innovation monitors each software task (thread) so that if any task reports "bad health," or does not report to the Health Manager, the system is declared bad. The Health Manager reports overall system health to the outside world by outputting a square wave signal. If the square wave stops, this indicates that system health is bad or hung and cannot report. Either way, "bad health" can be detected, whether caused by an error, corrupted data, or a hung processor. A separate Health Monitor Task is started and run periodically in a loop that starts and stops pending on a semaphore. Each monitored task registers with the Health Manager, which maintains a count for the task. The registering task must indicate if it will run more or less often than the Health Manager. If the task runs more often than the Health Manager, the monitored task calls a health function that increments the count and verifies it did not go over max-count. When the periodic Health Manager runs, it verifies that the count did not go over the max-count and zeroes it. If the task runs less often than the Health Manager, the periodic Health Manager will increment the count. The monitored task zeroes the count, and both the Health Manager and monitored task verify that the count did not go over the max-count.

Transferring disease management and health promotion programs to other countries: critical success factors.

Science.gov (United States)

Azarmina, Pejman; Prestwich, Graham; Rosenquist, Joel; Singh, Debbie

2008-12-01

Governments and health service providers around the world are under pressure to improve health outcomes while containing rising healthcare costs. In response to such challenges, many regions have implemented services that have been successful in other countries-but 'importing' initiatives has many challenges. This article summarizes factors found to be critical to the success of adapting a US disease management and health promotion programme for use in Italy and the UK. Using three illustrative case studies, it describes how in each region the programme needed to adapt (i) the form and content of the disease management service, (ii) the involvement and integration with local clinicians and services and (iii) the evaluation of programme outcomes. We argue that it is important to implement evidence-based practice by learning lessons from other countries and service initiatives, but that it is equally important to take into consideration the '3Ps' that are critical for successful service implementation: payers, practitioners and patients.

Worker’s Health: Considerations Based on a Criticism of Political Economy

Directory of Open Access Journals (Sweden)

Ricardo Lara

2011-05-01

Full Text Available The purpose of this article is to analyze worker health, based on a criticism of political economy. It seeks to understand the causes of illnesses and accidents among workers, and to highlight elements to consider the struggles of the working class in the realm of health, principally concerning public policies and union practices. It infers that under contemporary labor relations, workers get ill and have accidents due to the intensified pace of production, whether in activities on the factory floor or in scientific management of labor.

Connecting Leadership and Learning: Do Versatile Learners make Connective Leaders?

OpenAIRE

Jill L. Robinson

2016-01-01

Recent failures in leadership, suggest that creating better-quality leadership development programs is critical. In moving from theory to practice, this paper examined the relationship between learning style and leadership style which may enable us to move away from one-size-fits-all leadership development programs. Utilizing Kolb’s Experiential Learning Model and Connective Leadership theory, approximately 3600 college students were analyzed to discover whether versatility in learning styles...

Connecting leadership and learning: Do versatile learners make connective leaders?

OpenAIRE

Robinson, Jill L.

2016-01-01

Recent failures in leadership, suggest that creating better-quality leadership development programs is critical. In moving from theory to practice, this paper examined the relationship between learning style and leadership style which may enable us to move away from one-size-fits-all leadership development programs. Utilizing Kolb’s Experiential Learning Model and Connective Leadership theory, approximately 3600 college students were analyzed to discover whether versatility in learning styles...

Connecting Leadership and Learning: Do Versatile Learners make Connective Leaders?

OpenAIRE

Jill L. Robinson

2016-01-01

Abstract Recent failures in leadership, suggest that creating better-quality leadership development programs is critical. In moving from theory to practice, this paper examined the relationship between learning style and leadership style which may enable us to move away from one-size-fits-all leadership development programs. Utilizing Kolb’s Experiential Learning Model and Connective Leadership theory, approximately 3600 college students were analyzed to discover whether versatility in le...

The Impact of Transformer Winding Connections of A Grid-Connected PV on Voltage Quality Improvement

Energy Technology Data Exchange (ETDEWEB)

Muljadi, Eduard [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Tumbelaka, Hanny H. [Petra Christian University; Gao, Wenzhong [University of Denver

2018-03-01

In this paper, the high-power PV plant is connected to the weak grid by means of a three-phase power transformer. The selection of transformer winding connection is critical especially when the PV inverter has a reactive power controller. In general, transformer winding connection can be arranged in star-star (with neutral earthed) or star-delta. The reactive power controller supports voltage regulation of the power system particularly under transient faults. Its control strategy is based on utilizing the grid currents to make a three-phase reactive unbalanced current with a small gain. The gain is determined by the system impedance. Simulation results exhibit that the control strategy works very well particularly under disturbance conditions when the transformer winding connection is star-star with both neutrals grounded. The power quality in terms of the voltage quality is improved.

Influence of the current-phase relation on the critical-current-applied-magnetic-flux dependence in parallel-connected Josephson junctions

International Nuclear Information System (INIS)

Tsang, W.; Van Duzer, T.

1976-01-01

The form of the current-phase relations for the Josephson junctions is shown to have a significant influence on the relation I/sub c/(theta/sub a/) between critical current and applied flux for two junctions connected in parallel in a superconducting circuit. The observed one-flux-quantum periodicity and inversion symmetry of the I/sub c/(theta/sub a/) relation are shown to result from the fact that the current-phase, i-phi, relations of the junctions satisfy i (phi+2mπ) =i (phi) and i (-phi) =-i (phi), respectively. It is also shown that if the current-phase relations for the two junctions are different, an asymmetry appears in the I/sub c/(theta/sub a/)

Critical health infrastructure for refugee resettlement in rural Australia: case study of four rural towns.

Science.gov (United States)

Sypek, Scott; Clugston, Gregory; Phillips, Christine

2008-12-01

To explore the reported impact of regional resettlement of refugees on rural health services, and identify critical health infrastructure for refugee resettlement. Comparative case study, using interviews and situational analysis. Four rural communities in New South Wales, which had been the focus of regional resettlement of refugees since 1999. Refugees, general practitioners, practice managers and volunteer support workers in each town (n = 24). The capacity of health care workers to provide comprehensive care is threatened by low numbers of practitioners, and high levels of turnover of health care staff, which results in attrition of specialised knowledge among health care workers treating refugees. Critical health infrastructure includes general practices with interest and surge capacity, subsidised dental services, mental health support services; clinical support services for rural practitioners; care coordination in the early settlement period; and a supported volunteer network. The need for intensive medical support is greatest in the early resettlement period for 'catch-up' primary health care. The difficulties experienced by rural Australia in securing equitable access to health services are amplified for refugees. While there are economic arguments about resettlement of refugees in regional Australia, the fragility of health services in regional Australia should also be factored into considerations about which towns are best suited to regional resettlement.

Dignity in health-care: a critical exploration using feminism and theories of recognition.

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Aranda, Kay; Jones, Andrea

2010-09-01

Growing concerns over undignified health-care has meant the concept of dignity is currently much discussed in the British National Health Service. This has led to a number of policies attempting to reinstate dignity as a core ethical value governing nursing practice and health-care provision. Yet these initiatives continue to draw upon a concept of dignity which remains reliant upon a depoliticised, ahistorical and decontexualised subject. In this paper, we argue the need to revise the dignity debate through the lens of feminism and theories of recognition. Postmodern feminist theories provide major challenges to what remain dominant liberal approaches as they pay attention to the contingent, reflexive, and affective aspects of care work. Theories of recognition provide a further critical resource for understanding how moral obligations and responsibilities towards others and our public and private responses to difference arise. This re-situates dignity as a highly contested and politicised concept involving complex moral deliberations and diverse political claims of recognition. The dignity debate is thus moved beyond simplistic rational injunctions to care, or to care more, and towards critical discussions of complex politicised, moral practices infused with power that involve the recognition of difference in health-care.

Strings, fields and critical phenomena

International Nuclear Information System (INIS)

Ambjoern, J.

1987-07-01

The connection between field theory and critical phenomena is reviewed. Emphasis is put on the use of Monte Carlo methods in the study of non-perturbative aspects of field theory. String theory is then described as a statistical theory of random surfaces and the critical behaviour is analyzed both by analytical and numerical methods. (orig.)

The past, present, and future of health development campaigns: reflexivity and the critical-cultural approach.

Science.gov (United States)

Dutta, Mohan Jyoti; de Souza, Rebecca

2008-07-01

In contemporary society, health issues have gained increasing urgency in both political and academic spheres. Looking back at the failure of the modernist development initiatives, there is the need to realize that we live in a time of increasing sociopolitical complexity. The present moment is perhaps best understood in terms of a complex tension and linkage between the past and present, global and local, modern and postmodern. The critical-cultural approach to health campaigns is an approach that, through the reflexive interrogation of modernist assumptions underlying health communication campaigns, attempts to foreground the tensions inherent in the practice of health campaigns. This essay discusses the manner in which the critical-cultural approach interrogates modernist assumptions and provides an alternative paradigm for approaching the theory and practice of health campaigns by suggesting the necessity for reflexivity. Specifically, we discuss how the perspective interrogates the role of the media in development, the significance of culture, the locus of health responsibility, the impact of structural conditions, and the politics of knowledge, providing examples of campaigns that illustrate this reflexivity.

Our land, our language: connecting dispossession and health equity in an indigenous context.

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Brown, Helen J; McPherson, Gladys; Peterson, Ruby; Newman, Vera; Cranmer, Barbara

2012-06-01

For contemporary Indigenous people, colonial relations (past and present) intersect with neoliberal policies and practices to create subtle forms of dispossession.These undermine the health of Indigenous peoples and create barriers restricting access to appropriate health services. Integrating insights from the critical geographer David Harvey, the authors demonstrate how the dispossession of land and language threaten health and well-being and worsen existing illness conditions. Drawing on the qualitative findings from a program of community-based research with the 'Namgis First Nation in the Canadian province of British Columbia, the authors argue for an account of how neoliberal mechanisms operate to further the "accumulation by dispossession" associated with historical and ongoing colonialism. Specifically, they show how neoliberal ideologies operate to sustain medical colonialism and health inequities for Indigenous peoples. The authors discuss the implications for nursing actions to achieve health equity in rural First Nations communities.

Building Economic Security Today: making the health-wealth connection in Contra Costa county's maternal and child health programs.

Science.gov (United States)

Parthasarathy, Padmini; Dailey, Dawn E; Young, Maria-Elena D; Lam, Carrie; Pies, Cheri

2014-02-01

In recent years, maternal and child health professionals have been seeking approaches to integrating the Life Course Perspective and social determinants of health into their work. In this article, we describe how community input, staff feedback, and evidence from the field that the connection between wealth and health should be addressed compelled the Contra Costa Family, Maternal and Child Health (FMCH) Programs Life Course Initiative to launch Building Economic Security Today (BEST). BEST utilizes innovative strategies to reduce inequities in health outcomes for low-income Contra Costa families by improving their financial security and stability. FMCH Programs' Women, Infants, and Children Program (WIC) conducted BEST financial education classes, and its Medically Vulnerable Infant Program (MVIP) instituted BEST financial assessments during public health nurse home visits. Educational and referral resources were also developed and distributed to all clients. The classes at WIC increased clients' awareness of financial issues and confidence that they could improve their financial situations. WIC clients and staff also gained knowledge about financial resources in the community. MVIP's financial assessments offered clients a new and needed perspective on their financial situations, as well as support around the financial and psychological stresses of caring for a child with special health care needs. BEST offered FMCH Programs staff opportunities to engage in non-traditional, cross-sector partnerships, and gain new knowledge and skills to address a pressing social determinant of health. We learned the value of flexible timelines, maintaining a long view for creating change, and challenging the traditional paradigm of maternal and child health.

The Practices of Critical Thinking Component and Its Impact in Malaysian Nurses Health Education

Science.gov (United States)

Abdullah, Abdul Ghani Kanesan; Alzaidiyeen, Naser Jamil; Yee, Ng Mooi

2010-01-01

The purpose of this research is to study the impact of the critical thinking component in the health education curriculum of nurses for patients with different health needs. Data for this research was gathered from mixed approaches, quantitative and qualitative approaches. For the quantitative approach 84 student nurses were selected randomly to…

Internalizing Mental Health Disorders: Examining the Connection between Children's Symptoms and Parent Involvement and Autonomy Support

Science.gov (United States)

Walsh, Anne

2010-01-01

The primary purpose of this study is to examine the connection between parent involvement and autonomy support, as well as the combined construct of autonomy supportive parent involvement, with internalized mental health symptoms. A secondary purpose of this study is to determine how certain parent demographics relate to attitudes and behaviors…

Critical incidents connected to nurses’ leadership in Intensive Care Units

Directory of Open Access Journals (Sweden)

Elaine Cantarella Lima

Full Text Available ABSTRACT Objective: The goal of this study is to analyze nurses’ leadership in intensive care units at hospitals in the state of São Paulo, Brazil, in the face of positive and negative critical incidents. Method: Exploratory, descriptive study, conducted with 24 nurses by using the Critical Incident Technique as a methodological benchmark. Results: Results were grouped into 61 critical incidents distributed into categories. Researchers came to the conclusion that leadership-related situations interfere with IC nurses’ behaviors. Among these situations they found: difficulty in the communication process; conflicts in the daily exercise of nurses’ activities; people management; and the setting of high quality care targets. Final considerations: Researchers identified a mixed leadership model, leading them to the conclusion that nurses’ knowledge and practice of contemporary leadership theories/styles are crucial because they facilitate the communication process, focusing on behavioral aspects and beliefs, in addition to valuing flexibility. This positively impacts the organization’s results.

Self-organized criticality in developing neuronal networks.

Directory of Open Access Journals (Sweden)

Christian Tetzlaff

Full Text Available Recently evidence has accumulated that many neural networks exhibit self-organized criticality. In this state, activity is similar across temporal scales and this is beneficial with respect to information flow. If subcritical, activity can die out, if supercritical epileptiform patterns may occur. Little is known about how developing networks will reach and stabilize criticality. Here we monitor the development between 13 and 95 days in vitro (DIV of cortical cell cultures (n = 20 and find four different phases, related to their morphological maturation: An initial low-activity state (≈19 DIV is followed by a supercritical (≈20 DIV and then a subcritical one (≈36 DIV until the network finally reaches stable criticality (≈58 DIV. Using network modeling and mathematical analysis we describe the dynamics of the emergent connectivity in such developing systems. Based on physiological observations, the synaptic development in the model is determined by the drive of the neurons to adjust their connectivity for reaching on average firing rate homeostasis. We predict a specific time course for the maturation of inhibition, with strong onset and delayed pruning, and that total synaptic connectivity should be strongly linked to the relative levels of excitation and inhibition. These results demonstrate that the interplay between activity and connectivity guides developing networks into criticality suggesting that this may be a generic and stable state of many networks in vivo and in vitro.

Health visiting assessment--unpacking critical attributes in health visitor needs assessment practice: a case study.

Science.gov (United States)

Appleton, Jane V; Cowley, Sarah

2008-02-01

Assessment of family health need is a central feature of health visiting practice in which a range of skills, knowledge and judgements are used. These assessments are pivotal in uncovering need, safeguarding children and in determining levels of health intervention to be offered to children and their families by the health visiting service in the UK. The central focus of this paper is to outline the critical attributes of the basic principles that underpin health visiting assessment practice that emerged as part of a case study enquiry. A case study design informed by a constructivist methodology was used to examine health visitors' professional judgements and use of formal guidelines in identifying health needs and prioritising families requiring extra health visiting support. The main study was conducted in three community Trust case sites in England, UK, with pilot work being undertaken in a fourth site. Fifteen health visitors participated in the main study and data were collected during 56 observed home visits to families receiving extra health visiting support. Separate in-depth interviews were conducted with the health visitors, pre- and post-home contacts, while 53 client interviews also took place. The analysis suggests that there are certain fundamental elements associated with the majority of health visitor assessments and these have been termed assessment principles. These characteristics are integral to, and provide the basis upon which health visitors' assessments are conducted and professional judgement is formed. They reflect the basic principles of health visiting assessment practice, which exist despite the constraints and realities of the practice context and can be differentiated from the activity centred methods of assessment processes.

Health and illness in a connected world: how might sharing experiences on the internet affect people's health?

Science.gov (United States)

Ziebland, Sue; Wyke, Sally

2012-06-01

The use of the Internet for peer-to-peer connection has been one of its most dramatic and transformational features. Yet this is a new field with no agreement on a theoretical and methodological basis. The scientific base underpinning this activity needs strengthening, especially given the explosion of web resources that feature experiences posted by patients themselves. This review informs a National Institute for Health Research (NIHR) (UK) research program on the impact of online patients' accounts of their experiences with health and health care, which includes the development and validation of a new e-health impact questionnaire. We drew on realist review methods to conduct a conceptual review of literature in the social and health sciences. We developed a matrix to summarize the results, which we then distilled from a wide and diverse reading of the literature. We continued reading until we reached data saturation and then further refined the results after testing them with expert colleagues and a public user panel. We identified seven domains through which online patients' experiences could affect health. Each has the potential for positive and negative impacts. Five of the identified domains (finding information, feeling supported, maintaining relationships with others, affecting behavior, and experiencing health services) are relatively well rehearsed, while two (learning to tell the story and visualizing disease) are less acknowledged but important features of online resources. The value of first-person accounts, the appeal and memorability of stories, and the need to make contact with peers all strongly suggest that reading and hearing others' accounts of their own experiences of health and illnesss will remain a key feature of e-health. The act of participating in the creation of health information (e.g., through blogging and contributing to social networking on health topics) also influences patients' experiences and has implications for our

Beneficial Effects of Two Types of Personal Health Record Services Connected With Electronic Medical Records Within the Hospital Setting.

Science.gov (United States)

Lee, Jisan; Kim, James G Boram; Jin, Meiling; Ahn, Kiwhan; Kim, Byungjun; Kim, Sukwha; Kim, Jeongeun

2017-11-01

Healthcare consumers must be able to make decisions based on accurate health information. To assist with this, we designed and developed an integrated system connected with electronic medical records in hospitals to ensure delivery of accurate health information. The system-called the Consumer-centered Open Personal Health Record platform-is composed of two services: a portal for users with any disease and a mobile application for users with cleft lip/palate. To assess the benefits of these services, we used a quasi-experimental, pretest-posttest design, assigning participants to the portal (n = 50) and application (n = 52) groups. Both groups showed significantly increased knowledge, both objective (actual knowledge of health information) and subjective (perceived knowledge of health information), after the intervention. Furthermore, while both groups showed higher information needs satisfaction after the intervention, the application group was significantly more satisfied. Knowledge changes were more affected by participant characteristics in the application group. Our results may be due to the application's provision of specific disease information and a personalized treatment plan based on the participant and other users' data. We recommend that services connected with electronic medical records target specific diseases to provide personalized health management to patients in a hospital setting.

Passivity-Based Stability Assessment of Grid-Connected VSCs - An Overview

DEFF Research Database (Denmark)

Harnefors, Lennart; Wang, Xiongfei; Yepes, Alejandro G.

2016-01-01

The interconnection stability of a grid-connected voltage-source converter (VSC) can be assessed by the passivity properties of the VSC input admittance. If critical grid resonances fall within regions where the input admittance acts passively, i.e., has nonnegative real part, then their destabil......The interconnection stability of a grid-connected voltage-source converter (VSC) can be assessed by the passivity properties of the VSC input admittance. If critical grid resonances fall within regions where the input admittance acts passively, i.e., has nonnegative real part...

Social Network Assessments and Interventions for Health Behavior Change: A Critical Review.

Science.gov (United States)

Latkin, Carl A; Knowlton, Amy R

2015-01-01

Social networks provide a powerful approach for health behavior change. This article documents how social network interventions have been successfully used for a range of health behaviors, including HIV risk practices, smoking, exercise, dieting, family planning, bullying, and mental health. We review the literature that suggests the relationship between health behaviors and social network attributes demonstrates a high degree of specificity. The article then examines hypothesized social influence mechanisms including social norms, modeling, and social rewards and the factors of social identity and social rewards that can be employed to sustain social network interventions. Areas of future research avenues are highlighted, including the need to examine and to adjust analytically for contamination and social diffusion, social influence versus differential affiliation, and network change. Use and integration of mhealth and face-to-face networks for promoting health behavior change are also critical research areas.

Health activism and the logic of connective action. A case study of rare disease patient organisations.

Science.gov (United States)

Vicari, Stefania; Cappai, Franco

2016-11-01

This exploratory work investigates the role of digital media in expanding health discourse practices in a way to transform traditional structures of agency in public health. By focusing on a sample of rare disease patient organisations as representative of contemporary health activism, this study investigates the role of digital communication in the development of (1) bottom-up sharing and co-production of health knowledge, (2) health public engagement dynamics and (3) health information pathways. Findings show that digital media affordances for patient organisations go beyond the provision of social support for patient communities; they ease one-way, two-way and crowdsourced processes of health knowledge sharing, exchange and co-production, provide personalised routes to health public engagement and bolster the emergence of varied pathways to health information where experiential knowledge and medical authority are equally valued. These forms of organisationally enabled connective action can help the surfacing of personal narratives that strengthen patient communities, the bottom-up production of health knowledge relevant to a wider public and the development of an informational and eventually cultural context that eases patients' political action.

WORKSHOP TO IDENTIFY CRITICAL WINDOWS OF EXPOSURE FOR CHILDREN'S HEALTH: REPRODUCTIVE HEALTH IN CHILDREN AND ADOLESCENTS WORK GROUP SUMMARY

Science.gov (United States)

This workgroup report addresses the central question: what are the critical windows during development (pre-conception through puberty) when exposure to xenobiotics may have the greatest adverse impact on subsequent reproductive health. The reproductive system develops in stages...

Processes linking cultural ingroup bonds and mental health: the roles of social connection and emotion regulation.

Science.gov (United States)

Roberts, Nicole A; Burleson, Mary H

2013-01-01

Cultural and ethnic identities influence the relationships individuals seek out and how they feel and behave in these relationships, which can strongly affect mental and physical health through their impacts on emotions, physiology, and behavior. We proposed and tested a model in which ethnocultural identifications and ingroup affiliations were hypothesized explicitly to enhance social connectedness, which would in turn promote expectancy for effective regulation of negative emotions and reduce self-reported symptoms of depression and anxiety. Our sample comprised women aged 18-30 currently attending college in the Southwestern US, who self-identified as Hispanic of Mexican descent (MAs; n = 82) or as non-Hispanic White/European American (EAs; n = 234) and who completed an online survey. In the full sample and in each subgroup, stronger ethnocultural group identity and greater comfort with mainstream American culture were associated with higher social connectedness, which in turn was associated with expectancy for more effective regulation of negative emotions, fewer depressive symptoms, and less anxiety. Unexpectedly, preference for ingroup affiliation predicted lower social connectedness in both groups. In addition to indirect effects through social connection, direct paths from mainstream comfort and preference for ingroup affiliation to emotion regulation expectancy were found for EAs. Models of our data underscore that social connection is a central mechanism through which ethnocultural identities-including with one's own group and the mainstream cultural group-relate to mental health, and that emotion regulation may be a key aspect of this linkage. We use the term ethnocultural social connection to make explicit a process that, we believe, has been implied in the ethnic identity literature for many years, and that may have consequential implications for mental health and conceptualizations of processes underlying mental disorders.

Processes linking cultural ingroup bonds and mental health: the roles of social connection and emotion regulation

Science.gov (United States)

Roberts, Nicole A.; Burleson, Mary H.

2013-01-01

Cultural and ethnic identities influence the relationships individuals seek out and how they feel and behave in these relationships, which can strongly affect mental and physical health through their impacts on emotions, physiology, and behavior. We proposed and tested a model in which ethnocultural identifications and ingroup affiliations were hypothesized explicitly to enhance social connectedness, which would in turn promote expectancy for effective regulation of negative emotions and reduce self-reported symptoms of depression and anxiety. Our sample comprised women aged 18–30 currently attending college in the Southwestern US, who self-identified as Hispanic of Mexican descent (MAs; n = 82) or as non-Hispanic White/European American (EAs; n = 234) and who completed an online survey. In the full sample and in each subgroup, stronger ethnocultural group identity and greater comfort with mainstream American culture were associated with higher social connectedness, which in turn was associated with expectancy for more effective regulation of negative emotions, fewer depressive symptoms, and less anxiety. Unexpectedly, preference for ingroup affiliation predicted lower social connectedness in both groups. In addition to indirect effects through social connection, direct paths from mainstream comfort and preference for ingroup affiliation to emotion regulation expectancy were found for EAs. Models of our data underscore that social connection is a central mechanism through which ethnocultural identities—including with one's own group and the mainstream cultural group—relate to mental health, and that emotion regulation may be a key aspect of this linkage. We use the term ethnocultural social connection to make explicit a process that, we believe, has been implied in the ethnic identity literature for many years, and that may have consequential implications for mental health and conceptualizations of processes underlying mental disorders. PMID:23450647

Processes linking cultural ingroup bonds and mental health: The roles of social connection and emotion regulation

Directory of Open Access Journals (Sweden)

Nicole A Roberts

2013-02-01

Full Text Available Cultural and ethnic identities influence the relationships individuals seek out and how they feel and behave in these relationships, which can strongly affect mental and physical health through their impacts on emotions, physiology, and behavior. We proposed and tested a model in which ethnocultural identifications and ingroup affiliations were hypothesized explicitly to enhance social connectedness, which would in turn promote expectancy for effective regulation of negative emotions and reduce self-reported symptoms of depression and anxiety. Our sample comprised women aged 18 to 30 currently attending college in the Southwestern US, who self-identified as Hispanic of Mexican descent (n=82; MAs or as non-Hispanic White/European American (EAs; n=234 and who completed an online survey. In the full sample and in each subgroup, stronger ethnocultural group identity and greater comfort with mainstream American culture were associated with higher social connectedness, which in turn was associated with expectancy for more effective regulation of negative emotions, fewer depressive symptoms, and less anxiety. Unexpectedly, preference for ingroup affiliation predicted lower social connectedness in both groups. In addition to indirect effects through social connection, direct paths from mainstream comfort and preference for ingroup affiliation to emotion regulation expectancy were found for EAs. Models of our data underscore that social connection is a central mechanism through which ethnocultural identities—including with one’s own group and the mainstream cultural group—relate to mental health, and that emotion regulation may be a key aspect of this linkage. We use the term ethnocultural social connection to make explicit a process that, we believe, has been implied in the ethnic identity literature for many years, and that may have consequential implications for mental health and conceptualizations of processes underlying mental disorders.

Utopia and Education in Critical Theory

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Lewis, Tyson

2006-01-01

In this article the author examines the intimate connections between utopia and education in Frankfurt School critical theory. Although substantial links have been made in the critical pedagogy tradition between education, critique, and utopian dreaming, an in-depth analysis of the utopia-education matrix in the works of Herbert Marcuse, Theodor…

The Criticality of Connecting People to Financial Results ‒ an ROI Calculation Model for Romanian FSOs

Directory of Open Access Journals (Sweden)

Daniela Niculescu

2016-02-01

Full Text Available Organisational culture and employee engagement have been the focus of recent broad-based research efforts. Adding this concern to the revealed importance of performance indicators on human capital, and that their use is getting momentum, in order to attach financial values to knowledge management assets, it becomes more and more critical to measure human capital value. Key for Romanian FSO’s managers becomes to consider that both human and financial values have a focus on adding value in every process and function in the organisation, and to perpetuate organisational profitability by the corporate culture, on the one hand, where culture is a powerful factor that helps a company to engage, on the other hand, talented people. There is a substantial concern on using ROI on Learning and Development programmes, but whilst this is still declared, Romanian FSOs do not yet have a consistent method to measure it. This study is showing the criticality of connecting people to financial results and data analysis suggests that ROI calculation has a positive impact on creating and fostering a powerful organisational culture and that employees’ awareness of ROI values within their organisation has a powerful effect on their sense of engagement. Our findings have a more practical implication for the analysed industry by shaping a formal ROI measurement mechanisms blueprint, an ROI calculation model for the Romanian FSOs, in the form of a mechanism that could be employed when considering the design of an ROI Methodology for Romanian FSOs.

Questioning: a critical skill in postmodern health-care service delivery.

Science.gov (United States)

Brown, Cary A; Bannigan, Katrina; Gill, Joanna R

2009-06-01

Occupational therapists can no longer rely exclusively on biomedical frameworks to guide their practice and facilitate clinical problem-solving. A postmodernist perspective of health and well-being underlines that the illness experience is not a linear, cause-and-effect equation. Rather, life experiences are constructed through a myriad of social, cultural, physical and economic contexts that are highly unique to each individual. In other words, the assumption that 'one-size-fits-all' is as flawed in health care as it is in clothing design. This paper contributes to the growing discussion of health care within the postmodern context of the twenty-first century through first presenting a brief discussion of emerging postmodern thinking and application within the profession, followed by a rationale for the need to scrutinise prevalent modernist assumptions that guide decision-making. Finally, the paper introduces the method of Socratic questioning as a critical tool in successfully carrying out this scrutiny in an empowering and respectful manner for all stakeholders.

Critical Race Theory-Social Constructivist Bricolage: A Health-Promoting Schools Research Methodology

Science.gov (United States)

Nyika, Lawrence; Murray-Orr, Anne

2017-01-01

While the current literature recognises the capacity of diverse methodologies to provide informative understandings of health-promoting schools (HPS), there is a paucity of examples to show how different research strategies can be used. We address this knowledge gap by examining the significance of a critical race theory-social constructivist…

Teaching For Art Criticism: Incorporating Feldman’s Critical Analysis Learning Model In Students’ Studio Practice

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Maithreyi Subramaniam

2016-01-01

Full Text Available This study adopted 30 first year graphic design students’ artwork, with critical analysis using Feldman’s model of art criticism. Data were analyzed quantitatively; descriptive statistical techniques were employed. The scores were viewed in the form of mean score and frequencies to determine students’ performances in their critical ability. Pearson Correlation Coefficient was used to find out the correlation between students’ studio practice and art critical ability scores. The findings showed most students performed slightly better than average in the critical analyses and performed best in selecting analysis among the four dimensions assessed. In the context of the students’ studio practice and critical ability, findings showed there are some connections between the students’ art critical ability and studio practice.

Critical Care Organizations: Business of Critical Care and Value/Performance Building.

Science.gov (United States)

Leung, Sharon; Gregg, Sara R; Coopersmith, Craig M; Layon, A Joseph; Oropello, John; Brown, Daniel R; Pastores, Stephen M; Kvetan, Vladimir

2018-01-01

New, value-based regulations and reimbursement structures are creating historic care management challenges, thinning the margins and threatening the viability of hospitals and health systems. The Society of Critical Care Medicine convened a taskforce of Academic Leaders in Critical Care Medicine on February 22, 2016, during the 45th Critical Care Congress to develop a toolkit drawing on the experience of successful leaders of critical care organizations in North America for advancing critical care organizations (Appendix 1). The goal of this article was to provide a roadmap and call attention to key factors that adult critical care medicine leadership in both academic and nonacademic setting should consider when planning for value-based care. Relevant medical literature was accessed through a literature search. Material published by federal health agencies and other specialty organizations was also reviewed. Collaboratively and iteratively, taskforce members corresponded by electronic mail and held monthly conference calls to finalize this report. The business and value/performance critical care organization building section comprised of leaders of critical care organizations with expertise in critical care administration, healthcare management, and clinical practice. Two phases of critical care organizations care integration are described: "horizontal," within the system and regionalization of care as an initial phase, and "vertical," with a post-ICU and postacute care continuum as a succeeding phase. The tools required for the clinical and financial transformation are provided, including the essential prerequisites of forming a critical care organization; the manner in which a critical care organization can help manage transformational domains is considered. Lastly, how to achieve organizational health system support for critical care organization implementation is discussed. A critical care organization that incorporates functional clinical horizontal and

Perceptions of the Religion--Health Connection among African Americans in the Southeastern United States: Sex, Age, and Urban/Rural Differences

Science.gov (United States)

Holt, Cheryl L.; Schulz, Emily; Wynn, Theresa A.

2009-01-01

Extensive literature reviews suggest that religiousness is positively associated with health. Much less understood is the particular nature of the religion-health connection. Religion and the church play a central role in the lives of many African Americans. This study used a mixed-methods approach to examine perceptions of the religion-health…

The missing lynx of Eurasia at its Southern edge: a connection to the critically endangered Balkan lynx.

Science.gov (United States)

Cömert, Numan; Carlı, Oya; Dinçtürk, H Benan

2018-03-08

The populations of Eurasian lynx in Anatolia are as fragmented as the European populations. Although the origins of and the connections between the European lynx populations have been elucidated, there have been no genetic studies on the lynx populations in Turkey. The lack of genetic and evolutionary information about lynx in Anatolia, which is considered to be a biodiversity hotspot, makes it difficult to track the migration routes during the Quaternary. In this study, we present the genetic characteristics of two isolated lynx populations in Southwest Taurus Mountains and the Turkish Caucasus as well as two individuals from Erzincan area. DNA purified from the ecological scat samples collected from Çığlıkara Nature Reserve in Elmalı-Antalya and Allahuekber Mountains in Sarıkamış-Kars, as well as two roadkill samples from Erzincan, has been analysed for phylogenetic markers such as the mitochondrial DNA control region and cytochrome b. The DNA sequences were compared with haplotypes previously detected in populations from Europe and the Caucasus in order to determine the evolutionary relationships of the populations. This study compares the current genetic structure of some of the Turkish lynx populations to the other lynx genetic data, mostly carried out with museum samples around the world. Three haplotypes were found in three different regions of Anatolia. The Northeast and Southwest populations harbour genetically distinct haplotypes, the latter one, a new haplotype: H13-TR is the only phylogenetic connection to the critically endangered Balkan lynx yet to be described.

Improvement of a uniqueness-and-anonymity-preserving user authentication scheme for connected health care.

Science.gov (United States)

Xie, Qi; Liu, Wenhao; Wang, Shengbao; Han, Lidong; Hu, Bin; Wu, Ting

2014-09-01

Patient's privacy-preserving, security and mutual authentication between patient and the medical server are the important mechanism in connected health care applications, such as telecare medical information systems and personally controlled health records systems. In 2013, Wen showed that Das et al.'s scheme is vulnerable to the replay attack, user impersonation attacks and off-line guessing attacks, and then proposed an improved scheme using biometrics, password and smart card to overcome these weaknesses. However, we show that Wen's scheme is still vulnerable to off-line password guessing attacks, does not provide user's anonymity and perfect forward secrecy. Further, we propose an improved scheme to fix these weaknesses, and use the applied pi calculus based formal verification tool ProVerif to prove the security and authentication.

Battery impedance spectroscopy using bidirectional grid connected

Indian Academy of Sciences (India)

Keywords. Impedance spectroscopy; grid connection; battery converter; state of charge; health monitoring ... The converter is grid connected and controlled to operate at unity power factor. Additional ... Sadhana. Current Issue : Vol. 43, Issue 6.

Effects of School-Based Educational Interventions for Enhancing Adolescents Abilities in Critical Appraisal of Health Claims: A Systematic Review.

Directory of Open Access Journals (Sweden)

Lena V Nordheim

Full Text Available Adolescents are frequent media users who access health claims from various sources. The plethora of conflicting, pseudo-scientific, and often misleading health claims in popular media makes critical appraisal of health claims an essential ability. Schools play an important role in educating youth to critically appraise health claims. The objective of this systematic review was to evaluate the effects of school-based educational interventions for enhancing adolescents' abilities in critically appraising health claims.We searched MEDLINE, Embase, PsycINFO, AMED, Cinahl, Teachers Reference Centre, LISTA, ERIC, Sociological Abstracts, Social Services Abstracts, The Cochrane Library, Science Citation Index Expanded, Social Sciences Citation Index, and sources of grey literature. Studies that evaluated school-based educational interventions to improve adolescents' critical appraisal ability for health claims through advancing the students' knowledge about science were included. Eligible study designs were randomised and non-randomised controlled trials, and interrupted time series. Two authors independently selected studies, extracted data, and assessed risk of bias in included studies. Due to heterogeneity in interventions and inadequate reporting of results, we performed a descriptive synthesis of studies. We used GRADE (Grading of Recommendations, Assessment, Development, and Evaluation to assess the certainty of the evidence.Eight studies were included: two compared different teaching modalities, while the others compared educational interventions to instruction as usual. Studies mostly reported positive short-term effects on critical appraisal-related knowledge and skills in favour of the educational interventions. However, the certainty of the evidence for all comparisons and outcomes was very low.Educational interventions in schools may have beneficial short-term effects on knowledge and skills relevant to the critical appraisal of health

Effects of School-Based Educational Interventions for Enhancing Adolescents Abilities in Critical Appraisal of Health Claims: A Systematic Review.

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Nordheim, Lena V; Gundersen, Malene W; Espehaug, Birgitte; Guttersrud, Øystein; Flottorp, Signe

2016-01-01

Adolescents are frequent media users who access health claims from various sources. The plethora of conflicting, pseudo-scientific, and often misleading health claims in popular media makes critical appraisal of health claims an essential ability. Schools play an important role in educating youth to critically appraise health claims. The objective of this systematic review was to evaluate the effects of school-based educational interventions for enhancing adolescents' abilities in critically appraising health claims. We searched MEDLINE, Embase, PsycINFO, AMED, Cinahl, Teachers Reference Centre, LISTA, ERIC, Sociological Abstracts, Social Services Abstracts, The Cochrane Library, Science Citation Index Expanded, Social Sciences Citation Index, and sources of grey literature. Studies that evaluated school-based educational interventions to improve adolescents' critical appraisal ability for health claims through advancing the students' knowledge about science were included. Eligible study designs were randomised and non-randomised controlled trials, and interrupted time series. Two authors independently selected studies, extracted data, and assessed risk of bias in included studies. Due to heterogeneity in interventions and inadequate reporting of results, we performed a descriptive synthesis of studies. We used GRADE (Grading of Recommendations, Assessment, Development, and Evaluation) to assess the certainty of the evidence. Eight studies were included: two compared different teaching modalities, while the others compared educational interventions to instruction as usual. Studies mostly reported positive short-term effects on critical appraisal-related knowledge and skills in favour of the educational interventions. However, the certainty of the evidence for all comparisons and outcomes was very low. Educational interventions in schools may have beneficial short-term effects on knowledge and skills relevant to the critical appraisal of health claims. The small

Critical elements for human health risk assessment of less than lifetime exposures.

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Geraets, Liesbeth; Nijkamp, Monique M; Ter Burg, Wouter

2016-11-01

Less than lifetime exposure has confronted risk assessors as to how to interpret the risks for human health in case a chronic health-based limit is exceeded. Intermittent, fluctuating and peak exposures do not match with the basis of the chronic limit values possibly leading to conservative outcomes. This paper presents guidance on how to deal with human risk assessment of less than lifetime exposure. Important steps to be considered are characterization of the human exposure situation, evaluation whether the human less than lifetime exposure scenario corresponds to a non-chronic internal exposure: toxicokinetic and toxicodynamic considerations, and, finally, re-evaluation of the risk assessment. Critical elements for these steps are the mode of action, Haber's rule, and toxicokinetics (ADME) amongst others. Previous work for the endpoints non-genotoxic carcinogenicity and developmental toxicity is included in the guidance. The guidance provides a way to consider the critical elements, without setting default factors to correct for the less than lifetime exposure in risk assessment. Copyright © 2016 Elsevier Inc. All rights reserved.

Connecting health and natural history: a failed initiative at the American Museum of Natural History, 1909-1922.

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Brown, Julie K

2014-10-01

In 1909, curator Charles-Edward Winslow established a department of public health in New York City's American Museum of Natural History (AMNH). Winslow introduced public health as a biological science that connected human health-the modern sciences of physiology, hygiene, and urban sanitation-to the natural history of plants and animals. This was the only time an American museum created a curatorial department devoted to public health. The AMNH's Department of Public Health comprised a unique collection of live bacterial cultures-a "Living Museum"-and an innovative plan for 15 exhibits on various aspects of health. I show how Winslow, facing opposition from AMNH colleagues, gathered scientific experts and financial support, and explain the factors that made these developments seem desirable and possible. I finish with a discussion of how the Department of Public Health met an abrupt and "inglorious end" in 1922 despite the success of its collections and exhibitions.

Critical discourse analysis of social justice in nursing's foundational documents.

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Valderama-Wallace, Claire P

2017-07-01

Social inequities threaten the health of the global population. A superficial acknowledgement of social justice by nursing's foundational documents may limit the degree to which nurses view injustice as relevant to nursing practice and education. The purpose was to examine conceptualizations of social justice and connections to broader contexts in the most recent editions. Critical discourse analysis examines and uncovers dynamics related to power, language, and inequality within the American Nurses Association's Code of Ethics, Scope and Standards of Practice, and Social Policy Statement. This analysis found ongoing inconsistencies in conceptualizations of social justice. Although the Code of Ethics integrates concepts related to social justice far more than the other two, tension between professionalism and social change emerges. The discourse of professionalism renders interrelated cultural, social, economic, historical, and political contexts nearly invisible. Greater consistency would provide a clearer path for nurses to mobilize and engage in the courageous work necessary to address social injustice. These findings also call for an examination of how nurses can critique and use the power and privilege of professionalism to amplify the connection between social institutions and health equity in nursing education, practice, and policy development. © 2017 Wiley Periodicals, Inc.

A knowledge-based taxonomy of critical factors for adopting electronic health record systems by physicians: a systematic literature review

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Martínez-García Ana I

2010-10-01

Full Text Available Abstract Background The health care sector is an area of social and economic interest in several countries; therefore, there have been lots of efforts in the use of electronic health records. Nevertheless, there is evidence suggesting that these systems have not been adopted as it was expected, and although there are some proposals to support their adoption, the proposed support is not by means of information and communication technology which can provide automatic tools of support. The aim of this study is to identify the critical adoption factors for electronic health records by physicians and to use them as a guide to support their adoption process automatically. Methods This paper presents, based on the PRISMA statement, a systematic literature review in electronic databases with adoption studies of electronic health records published in English. Software applications that manage and process the data in the electronic health record have been considered, i.e.: computerized physician prescription, electronic medical records, and electronic capture of clinical data. Our review was conducted with the purpose of obtaining a taxonomy of the physicians main barriers for adopting electronic health records, that can be addressed by means of information and communication technology; in particular with the information technology roles of the knowledge management processes. Which take us to the question that we want to address in this work: "What are the critical adoption factors of electronic health records that can be supported by information and communication technology?". Reports from eight databases covering electronic health records adoption studies in the medical domain, in particular those focused on physicians, were analyzed. Results The review identifies two main issues: 1 a knowledge-based classification of critical factors for adopting electronic health records by physicians; and 2 the definition of a base for the design of a conceptual

A knowledge-based taxonomy of critical factors for adopting electronic health record systems by physicians: a systematic literature review.

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Castillo, Víctor H; Martínez-García, Ana I; Pulido, J R G

2010-10-15

The health care sector is an area of social and economic interest in several countries; therefore, there have been lots of efforts in the use of electronic health records. Nevertheless, there is evidence suggesting that these systems have not been adopted as it was expected, and although there are some proposals to support their adoption, the proposed support is not by means of information and communication technology which can provide automatic tools of support. The aim of this study is to identify the critical adoption factors for electronic health records by physicians and to use them as a guide to support their adoption process automatically. This paper presents, based on the PRISMA statement, a systematic literature review in electronic databases with adoption studies of electronic health records published in English. Software applications that manage and process the data in the electronic health record have been considered, i.e.: computerized physician prescription, electronic medical records, and electronic capture of clinical data. Our review was conducted with the purpose of obtaining a taxonomy of the physicians main barriers for adopting electronic health records, that can be addressed by means of information and communication technology; in particular with the information technology roles of the knowledge management processes. Which take us to the question that we want to address in this work: "What are the critical adoption factors of electronic health records that can be supported by information and communication technology?". Reports from eight databases covering electronic health records adoption studies in the medical domain, in particular those focused on physicians, were analyzed. The review identifies two main issues: 1) a knowledge-based classification of critical factors for adopting electronic health records by physicians; and 2) the definition of a base for the design of a conceptual framework for supporting the design of knowledge

Health information exchange implementation: lessons learned and critical success factors from a case study.

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Feldman, Sue S; Schooley, Benjamin L; Bhavsar, Grishma P

2014-08-15

Much attention has been given to the proposition that the exchange of health information as an act, and health information exchange (HIE), as an entity, are critical components of a framework for health care change, yet little has been studied to understand the value proposition of implementing HIE with a statewide HIE. Such an organization facilitates the exchange of health information across disparate systems, thus following patients as they move across different care settings and encounters, whether or not they share an organizational affiliation. A sociotechnical systems approach and an interorganizational systems framework were used to examine implementation of a health system electronic medical record (EMR) system onto a statewide HIE, under a cooperative agreement with the Office of the National Coordinator for Health Information Technology, and its collaborating organizations. The objective of the study was to focus on the implementation of a health system onto a statewide HIE; provide insight into the technical, organizational, and governance aspects of a large private health system and the Virginia statewide HIE (organizations with the shared goal of exchanging health information); and to understand the organizational motivations and value propositions apparent during HIE implementation. We used a formative evaluation methodology to investigate the first implementation of a health system onto the statewide HIE. Qualitative methods (direct observation, 36 hours), informal information gathering, semistructured interviews (N=12), and document analysis were used to gather data between August 12, 2012 and June 24, 2013. Derived from sociotechnical concepts, a Blended Value Collaboration Enactment Framework guided the data gathering and analysis to understand organizational stakeholders' perspectives across technical, organizational, and governance dimensions. Several challenges, successes, and lessons learned during the implementation of a health system to the

A dialogue between naturopathy and critical medical anthropology: what constitutes holistic health?

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Baer, Hans A; Beale, Cheryl; Canaway, Rachel; Connolly, Greg

2012-06-01

Building on a dialogue between three trained naturopaths and a proponent of critical medical anthropology (CMA), this article highlights the relationship between health and society from the viewpoint of two fields that share this focal concern. Both naturopathy and CMA are committed to the notion of holistic health, although their approaches have historically been somewhat different. The responses of the three naturopaths to CMA exhibit both similarities and differences, particularly in terms of insights that CMA may make to naturopathy. This essay also articulates the CMA perspective of naturopathy and posits lessons that naturopathy can teach CMA.

Critical Anthropology of Global Health "takes a stand" statement: a critical medical anthropological approach to the U.S.'s Affordable Care Act.

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Horton, Sarah; Abadía, Cesar; Mulligan, Jessica; Thompson, Jennifer Jo

2014-03-01

The Affordable Care Act (ACA) of 2010--the U.S.'s first major health care reform in over half a century-has sparked new debates in the United States about individual responsibility, the collective good, and the social contract. Although the ACA aims to reduce the number of the uninsured through the simultaneous expansion of the private insurance industry and government-funded Medicaid, critics charge it merely expands rather than reforms the existing fragmented and costly employer-based health care system. Focusing in particular on the ACA's individual mandate and its planned Medicaid expansion, this statement charts a course for ethnographic contributions to the on-the-ground impact of the ACA while showcasing ways critical medical anthropologists can join the debate. We conclude with ways that anthropologists may use critiques of the ACA as a platform from which to denaturalize assumptions of "cost" and "profit" that underpin the global spread of market-based medicine more broadly. © 2014 by the American Anthropological Association.

Nursing, sexual health and youth with disabilities: a critical ethnography.

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McCabe, Janet; Holmes, Dave

2014-01-01

To explore the experiences of nurses providing sexual health care to adolescents with physical and/or developmental disabilities, with attention to the institutional and social discourses that shape these interactions. Previous research has shown that nurses demonstrate a lack of attention to the impact of illness or disability on sexual health. However, in their therapeutic relationship with patients and families, nurses are in an ideal position to promote sexual health. A critical ethnography study was conducted in an urban paediatric rehabilitative facility. Field work occurred over 4 months (2008-2009) and data collection included interviews (n = 9), key informant discussions, collection of documentary evidence and observation of the institutional setting. Four themes were identified (institutional space, professional interactions, engaging with sexuality, nursing experience), which revealed that nurse-patient interactions about sexual health were affected by a complex network of discourses. These encounters were shaped by practical discourses, such as time and space and by more complex discourses, such as professional relationships, normalization and asexuality. Nurses occupy and strive to maintain, the role of a caring agent. However, aspects of the clinical, institutional and broader social environments may undermine their ability to promote sexual health. In nurses' efforts to maintain therapeutic relationships with clients, sexual health is often medicalised to legitimize it as an appropriate topic of discussion with patients and families. Facilities serving youth with disabilities should take steps to address barriers to the delivery of sexual health promotion and several solutions are proposed. © 2013 Blackwell Publishing Ltd.

Hidden Connectivity in Networks with Vulnerable Classes of Nodes

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Sebastian M. Krause

2016-10-01

Full Text Available In many complex systems representable as networks, nodes can be separated into different classes. Often these classes can be linked to a mutually shared vulnerability. Shared vulnerabilities may be due to a shared eavesdropper or correlated failures. In this paper, we show the impact of shared vulnerabilities on robust connectivity and how the heterogeneity of node classes can be exploited to maintain functionality by utilizing multiple paths. Percolation is the field of statistical physics that is generally used to analyze connectivity in complex networks, but in its existing forms, it cannot treat the heterogeneity of multiple vulnerable classes. To analyze the connectivity under these constraints, we describe each class as a color and develop a “color-avoiding” percolation. We present an analytic theory for random networks and a numerical algorithm for all networks, with which we can determine which nodes are color-avoiding connected and whether the maximal set percolates in the system. We find that the interaction of topology and color distribution implies a rich critical behavior, with critical values and critical exponents depending both on the topology and on the color distribution. Applying our physics-based theory to the Internet, we show how color-avoiding percolation can be used as the basis for new topologically aware secure communication protocols. Beyond applications to cybersecurity, our framework reveals a new layer of hidden structure in a wide range of natural and technological systems.

Critical Care

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Critical care helps people with life-threatening injuries and illnesses. It might treat problems such as complications from surgery, ... attention by a team of specially-trained health care providers. Critical care usually takes place in an ...

Potential and Actual Health Hazards in the Dense Urban Operational Environment: Critical Gaps and Solutions for Military Occupational Health.

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Patterson, Steven L; Dancy, Blair C R; Ippolito, Danielle L; Stallings, Jonathan D

2017-11-01

: This paper presents environmental health risks which are prevalent in dense urban environments.We review the current literature and recommendations proposed by environmental medicine experts in a 2-day symposium sponsored by the Department of Defense and supported by the Johns Hopkins University Applied Physics Laboratory.Key hazards in the dense urban operational environment include toxic industrial chemicals and materials, water pollution and sewage, and air pollution. Four critical gaps in environmental medicine were identified: prioritizing chemical and environmental concerns, developing mobile decision aids, personalized health assessments, and better real-time health biomonitoring.As populations continue to concentrate in cities, civilian and military leaders will need to meet emerging environmental health concerns by developing and delivering adequate technology and policy solutions.

Synchronization from second order network connectivity statistics

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Liqiong eZhao

2011-07-01

Full Text Available We investigate how network structure can influence the tendency for a neuronal network to synchronize, or its synchronizability, independent of the dynamical model for each neuron. The synchrony analysis takes advantage of the framework of second order networks (SONETs, which defines four second order connectivity statistics based on the relative frequency of two-connection network motifs. The analysis identifies two of these statistics, convergent connections and chain connections, as highly influencing the synchrony. Simulations verify that synchrony decreases with the frequency of convergent connections and increases with the frequency of chain connections. These trends persist with simulations of multiple models for the neuron dynamics and for different types of networks. Surprisingly, divergent connections, which determine the fraction of shared inputs, do not strongly influence the synchrony. The critical role of chains, rather than divergent connections, in influencing synchrony can be explained by a pool and redistribute mechanism. The pooling of many inputs averages out independent fluctuations, amplifying weak correlations in the inputs. With increased chain connections, neurons with many inputs tend to have many outputs. Hence, chains ensure that the amplified correlations in the neurons with many inputs are redistributed throughout the network, enhancing the development of synchrony across the network.

Beyond the Arcuate Fasciculus: Consensus and Controversy in the Connectional Anatomy of Language

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Dick, Anthony Steven; Tremblay, Pascale

2012-01-01

The growing consensus that language is distributed into large-scale cortical and subcortical networks has brought with it an increasing focus on the connectional anatomy of language, or how particular fibre pathways connect regions within the language network. Understanding connectivity of the language network could provide critical insights into…

The Effect of Criticism on Functional Brain Connectivity and Associations with Neuroticism

NARCIS (Netherlands)

Servaas, Michelle Nadine; Riese, Harriette; Renken, Remco Jan; Marsman, Jan-Bernard Cornelis; Lambregs, Johan; Ormel, Johan; Aleman, Andre

2013-01-01

Neuroticism is a robust personality trait that constitutes a risk factor for psychopathology, especially anxiety disorders and depression. High neurotic individuals tend to be more self-critical and are overly sensitive to criticism by others. Hence, we used a novel resting-state paradigm to

Two Approaches for Using Web Sharing and Photography Assignments to Increase Critical Thinking in the Health Sciences

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Walter, Katherine Ott; Baller, Stephanie L.; Kuntz, Aaron M.

2012-01-01

Increasing student critical thinking and active engagement with course content is an ongoing challenge in tertiary education. The present article explores the use of photography in two health sciences courses as a catalyst for the encouragement of critical thinking, creativity, engagement, and problem solving. The authors adapted photography…

One Health in China

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Jianyong Wu

2016-11-01

Full Text Available As a result of rapid economic growth over the previous three decades, China has become the second largest economy worldwide since 2010. However, as a developing country with the largest population, this rapid economic growth primarily based on excessive consumption and waste of resources. Thus, China has been facing particularly severe ecological and environmental problems in speeding up industrialization and urbanization. The impact of the health risk factors is complex and difficult to accurately predict. Therefore, it is critical to investigate potential threats in the context of the human-animal-environment interface to protect human and animal health. The “One Health” concept recognizes that human health is connected to animal and environmental health. This review primarily discusses specific health problems in China, particularly zoonoses, and explains the origin and development of the One Health approach, as well as the importance of a holistic approach in China.

Symmetries of the Space of Linear Symplectic Connections

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Fox, Daniel J. F.

2017-01-01

There is constructed a family of Lie algebras that act in a Hamiltonian way on the symplectic affine space of linear symplectic connections on a symplectic manifold. The associated equivariant moment map is a formal sum of the Cahen-Gutt moment map, the Ricci tensor, and a translational term. The critical points of a functional constructed from it interpolate between the equations for preferred symplectic connections and the equations for critical symplectic connections. The commutative algebra of formal sums of symmetric tensors on a symplectic manifold carries a pair of compatible Poisson structures, one induced from the canonical Poisson bracket on the space of functions on the cotangent bundle polynomial in the fibers, and the other induced from the algebraic fiberwise Schouten bracket on the symmetric algebra of each fiber of the cotangent bundle. These structures are shown to be compatible, and the required Lie algebras are constructed as central extensions of their! linear combinations restricted to formal sums of symmetric tensors whose first order term is a multiple of the differential of its zeroth order term.

ASIC-based design of NMR system health monitor for mission/safety-critical applications.

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Balasubramanian, P

2016-01-01

N-modular redundancy (NMR) is a generic fault tolerance scheme that is widely used in safety-critical circuit/system designs to guarantee the correct operation with enhanced reliability. In passive NMR, at least a majority (N + 1)/2 out of N function modules is expected to operate correctly at any time, where N is odd. Apart from a conventional realization of the NMR system, it would be useful to provide a concurrent indication of the system's health so that an appropriate remedial action may be initiated depending upon an application's safety criticality. In this context, this article presents the novel design of a generic NMR system health monitor which features: (i) early fault warning logic, that is activated upon the production of a conflicting result by even one output of any arbitrary function module, and (ii) error signalling logic, which signals an error when the number of faulty function modules unfortunately attains a majority and the system outputs may no more be reliable. Two sample implementations of NMR systems viz. triple modular redundancy and quintuple modular redundancy with the proposed system health monitoring are presented in this work, with a 4-bit ALU used for the function modules. The simulations are performed using a 32/28 nm CMOS process technology.

Research on comprehensive decision-making of PV power station connecting system

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Zhou, Erxiong; Xin, Chaoshan; Ma, Botao; Cheng, Kai

2018-04-01

In allusion to the incomplete indexes system and not making decision on the subjectivity and objectivity of PV power station connecting system, based on the combination of improved Analytic Hierarchy Process (AHP), Criteria Importance Through Intercriteria Correlation (CRITIC) as well as grey correlation degree analysis (GCDA) is comprehensively proposed to select the appropriate system connecting scheme of PV power station. Firstly, indexes of PV power station connecting system are divided the recursion order hierarchy and calculated subjective weight by the improved AHP. Then, CRITIC is adopted to determine the objective weight of each index through the comparison intensity and conflict between indexes. The last the improved GCDA is applied to screen the optimal scheme, so as to, from the subjective and objective angle, select the connecting system. Comprehensive decision of Xinjiang PV power station is conducted and reasonable analysis results are attained. The research results might provide scientific basis for investment decision.

Health problems in connection with radiation from radioactive matter in fertilizers, soils and rocks

International Nuclear Information System (INIS)

Laag, J.

1988-01-01

Under the last world congress of the International Society of Soil Science in Hamburg in August 1986, the working group ''Soil and Geomedicine'' was set up. The symposium on health problems in connection with radiation from radioactive matter in fertilizers, soils and rocks was a joint arrangement of this working group and a permanent committe of The Norwegian Academy of Science and Letters. The book presents the full text of 13 of the papers presented at the symposium. Separate abstacts have been submitted for 12 of these papers

Understanding the health of lorry drivers in context: A critical discourse analysis.

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Caddick, Nick; Varela-Mato, Veronica; Nimmo, Myra A; Clemes, Stacey; Yates, Tom; King, James A

2017-01-01

This article moves beyond previous attempts to understand health problems in the lives of professional lorry drivers by placing the study of drivers' health in a wider social and cultural context. A combination of methods including focus groups, interviews and observations were used to collect data from a group of 24 lorry drivers working at a large transport company in the United Kingdom. Employing a critical discourse analysis, we identified the dominant discourses and subject positions shaping the formation of drivers' health and lifestyle choices. This analysis was systematically combined with an exploration of the gendered ways in which an almost exclusively male workforce talked about health. Findings revealed that drivers were constituted within a neoliberal economic discourse, which is reflective of the broader social structure, and which partly restricted drivers' opportunities for healthy living. Concurrently, drivers adopted the subject position of 'average man' as a way of defending their personal and masculine status in regards to health and to justify jettisoning approaches to healthy living that were deemed too extreme or irrational in the face of the constraints of their working lives. Suggestions for driver health promotion include refocusing on the social and cultural - rather than individual - underpinnings of driver health issues and a move away from moralistic approaches to health promotion.

A critical public-health ethics analysis of Canada's international response to HIV.

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Nixon, Stephanie A; Benatar, Solomon R

2011-01-01

As interconnections between health, ideology and politics become increasingly acknowledged, gaps in the literature also become visible in terms of analytic frameworks to engage these issues and empirical studies to understand the complexities. 'Critical public-health ethics' provides such an analytic lens. This article presents the results of a critical public-health ethics analysis of the government of Canada's international response to HIV. This qualitative study involved in-depth, semi-structured interviews with 23 experts on Canada's international response over time. Descriptive, thematic and theoretical analyses revealed an underlying dilemma between Canada's philanthropic desire to 'do the right thing' for the broader public good and Canada's commitment to its own economic growth and other forms of self-interest. Related to this tension were four conspicuous areas of silence in the data: (1) The relative absence of moral vocabulary for discussing Canada's duty to respond to the global HIV pandemic. (2) Scant reference to solutions based on poverty reduction. (3) Little awareness about the dominance of neoliberal economic rationality and its impact on HIV. (4) Limited understanding of Canada's function within the international economic order in terms of its role in poverty creation. Our study has implications for Canada and other rich nations through its empirical contribution to the chorus of calls challenging the legitimised, institutionalised and normative practice of considering the economic growth of wealthy countries as the primary objective of global economic policy.

Connective tissue fibroblasts and Tcf4 regulate myogenesis

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Mathew, Sam J.; Hansen, Jody M.; Merrell, Allyson J.; Murphy, Malea M.; Lawson, Jennifer A.; Hutcheson, David A.; Hansen, Mark S.; Angus-Hill, Melinda; Kardon, Gabrielle

2011-01-01

Muscle and its connective tissue are intimately linked in the embryo and in the adult, suggesting that interactions between these tissues are crucial for their development. However, the study of muscle connective tissue has been hindered by the lack of molecular markers and genetic reagents to label connective tissue fibroblasts. Here, we show that the transcription factor Tcf4 (transcription factor 7-like 2; Tcf7l2) is strongly expressed in connective tissue fibroblasts and that Tcf4GFPCre mice allow genetic manipulation of these fibroblasts. Using this new reagent, we find that connective tissue fibroblasts critically regulate two aspects of myogenesis: muscle fiber type development and maturation. Fibroblasts promote (via Tcf4-dependent signals) slow myogenesis by stimulating the expression of slow myosin heavy chain. Also, fibroblasts promote the switch from fetal to adult muscle by repressing (via Tcf4-dependent signals) the expression of developmental embryonic myosin and promoting (via a Tcf4-independent mechanism) the formation of large multinucleate myofibers. In addition, our analysis of Tcf4 function unexpectedly reveals a novel mechanism of intrinsic regulation of muscle fiber type development. Unlike other intrinsic regulators of fiber type, low levels of Tcf4 in myogenic cells promote both slow and fast myogenesis, thereby promoting overall maturation of muscle fiber type. Thus, we have identified novel extrinsic and intrinsic mechanisms regulating myogenesis. Most significantly, our data demonstrate for the first time that connective tissue is important not only for adult muscle structure and function, but is a vital component of the niche within which muscle progenitors reside and is a critical regulator of myogenesis. PMID:21177349

Why “Animal (De)liberation” survives early criticism and is pivotal to public health

OpenAIRE

Deckers, Jan

2017-01-01

Summary In 2016, the book Animal (De)liberation: Should the Consumption of Animal Products Be Banned? was published. This article aims to engage with the critique that this book has received and to clarify and reinforce its importance for human health. It is argued that the ideas developed in the book withstand critical scrutiny. As qualified moral veganism avoids the pitfalls of other moral positions on human diets, public health policies must be altered accordingly, subject to adequate poli...

Do social marketing campaigns in health work? A critical analysis of four UK campaigns

OpenAIRE

Coope, David

2007-01-01

This management project looks at four recent social marketing campaigns in the field of health in the UK to determine whether such campaigns work. The project critically analyses the marketing campaigns used, and aims to determine the range of factors that create a successful social marketing campaign in health. There is analysis of four case studies undertaken after secondary research into social marketing campaigns run by a range of different organisations. The case studies are the ...

On Non-Universality of Solar-Terrestrial Connections

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Pustilnik, Lev; Yom Din, Gregory

The discussion on the principal possibility of a causal chain from solar activity and space weather to the earth weather and agriculture price dynamics continues over 200 years from the first publication of Herschel (1801) up to the current time. We analyze main arguments of the two sides and show that the root of the critics of this possibility lies in the wide accepted conception of the universality of the solar-terrestrial connection (that can appear, for example, in daily and seasonal variations) what suggest that the effect can be observed in any historical period and in any region. We show that this expectation is not correct because of the solar-terrestrial connections generated by different sides of solar activity with different agents of solar magnetic dynamo process that have different and non-stable phase patterns. We remind that the realization of the causal chain “solar activity/space weather” - “earth weather” - “crops” -“market reaction” may have a place only in specific historical periods and in specific zones where and when the three necessary conditions hold true. This limitation leads to one of four possible scenarios of the market reaction. We show that the critical arguments used for rejecting a principal possibility of the causal connection “solar activity” - Earth agriculture markets” are based on neglecting the three necessary conditions for realization of this connection, and on analyzing periods and regions when and where the necessary conditions are not hold.

DMPD: Critical role of toll-like receptors and nucleotide oligomerisation domain inthe regulation of health and disease. [Dynamic Macrophage Pathway CSML Database

Lifescience Database Archive (English)

Full Text Available and nucleotide oligomerisation domain inthe regulation of health and disease. Pu...bmedID 17535871 Title Critical role of toll-like receptors and nucleotide oligomerisation domain inthe regulation of health...17535871 Critical role of toll-like receptors and nucleotide oligomerisation domain inthe regulation of heal...th and disease. Mitchell JA, Paul-Clark MJ, Clarke GW, McMaster SK, Cartwright N. J

High Out-of-Pocket Health Spending in Countries With a Mediterranean Connection

Directory of Open Access Journals (Sweden)

Simon Grima

2018-05-01

Full Text Available In this study, we analyzed healthcare provision and health expenditure across six Mediterranean countries that adopt the National Health System (Beveridge model and that form part of the European Union (EU with the main aim being that of analyzing and comparing out-of-pocket health spending in countries with a European Mediterranean connection. To this end, we considered various economic indicators and statistics to derive commonalities and differences across these countries and also compared trends in these indicators to those observed across the rest of the EU. We then analyzed these findings in light of other data related to the quality of healthcare delivery and the infrastructure of the health system and discussed recent developments in healthcare within each country and the main challenges faced by the respective health systems. The results show that on average, Mediterranean countries spend less on total healthcare expenditure (THE than the EU average, both as a proportion of GDP, as well as in per capita terms. This is primarily driven by lower-than-EU-average public funding of healthcare. The 2008/2009 macro-economic and financial crisis had a significant impact on the countries under review, and explains the persistent reductions in public health spending as part of the austerity measures put in force across sectors. On the flipside, Mediterranean countries have a higher presence of private health providers in total funding, thereby explaining the higher Out-of-Pocket (OOPs health expenditures in these countries relative to the EU-average. With regard to the overall health infrastructure in these countries, we observed that although the supply of physicians is largely in line with the rest of the EU, there is under-supply when it comes to hospital beds. This may be symptomatic of lower government funding. Nonetheless, all countries score highly in the evaluation of the quality of health services, as recorded by international rankings

Does use of an electronic health record with dental diagnostic system terminology promote dental students' critical thinking?

Science.gov (United States)

Reed, Susan G; Adibi, Shawn S; Coover, Mullen; Gellin, Robert G; Wahlquist, Amy E; AbdulRahiman, Anitha; Hamil, Lindsey H; Walji, Muhammad F; O'Neill, Paula; Kalenderian, Elsbeth

2015-06-01

The Consortium for Oral Health Research and Informatics (COHRI) is leading the way in use of the Dental Diagnostic System (DDS) terminology in the axiUm electronic health record (EHR). This collaborative pilot study had two aims: 1) to investigate whether use of the DDS terms positively impacted predoctoral dental students' critical thinking skills measured by the Health Sciences Reasoning Test (HSRT), and 2) to refine study protocols. The study design was a natural experiment with cross-sectional data collection using the HSRT for 15 classes (2013-17) of students at three dental schools. Characteristics of students who had been exposed to the DDS terms were compared with students who had not, and the differences were tested by t-tests or chi-square tests. Generalized linear models were used to evaluate the relationship between exposure and outcome on the overall critical thinking score. The results showed that exposure was significantly related to overall score (p=0.01), with not-exposed students having lower mean overall scores. This study thus demonstrated a positive impact of using the DDS terminology in an EHR on the critical thinking skills of predoctoral dental students in three COHRI schools as measured by their overall score on the HSRT. These preliminary findings support future research to further evaluate a proposed model of critical thinking in clinical dentistry.

Does Use of an Electronic Health Record with Dental Diagnostic System Terminology Promote Dental Students’ Critical Thinking?

Science.gov (United States)

Reed, Susan G.; Adibi, Shawn S.; Coover, Mullen; Gellin, Robert G.; Wahlquist, Amy E.; AbdulRahiman, Anitha; Hamil, Lindsey H.; Walji, Muhammad F.; O’Neill, Paula; Kalenderian, Elsbeth

2015-01-01

The Consortium for Oral Health Research and Informatics (COHRI) is leading the way in use of the Dental Diagnostic System (DDS) terminology in the axiUm electronic health record (EHR). This collaborative pilot study had two aims: 1) to investigate whether use of the DDS terms positively impacted predoctoral dental students’ critical thinking skills measured by the Health Sciences Reasoning Test (HSRT), and 2) to refine study protocols. The study design was a natural experiment with cross-sectional data collection using the HSRT for 15 classes (2013–17) of students at three dental schools. Characteristics of students who had been exposed to the DDS terms were compared with students who had not, and the differences were tested by t-tests or chi-square tests. Generalized linear models were used to evaluate the relationship between exposure and outcome on the overall critical thinking score. The results showed that exposure was significantly related to overall score (p=0.01), with not-exposed students having lower mean overall scores. This study thus demonstrated a positive impact of using the DDS terminology in an EHR on the critical thinking skills of predoctoral dental students in three COHRI schools as measured by their overall score on the HSRT. These preliminary findings support future research to further evaluate a proposed model of critical thinking in clinical dentistry. PMID:26034034

Who Done It? Connecting Murder Mysteries to the Communication Classroom

Science.gov (United States)

Macchi, Stacey; Ridle, Cynthia

2012-01-01

It is important for students to understand various communication principles and be able to apply them in a variety of settings using critical thinking skills. Students must learn how to think critically, which includes the ability to apply, connect, analyze, and evaluate information. Teachers, instructors, and professors who are able to integrate…

Looking for hotspots of marine metacommunity connectivity: a methodological framework

Science.gov (United States)

Melià, Paco; Schiavina, Marcello; Rossetto, Marisa; Gatto, Marino; Fraschetti, Simonetta; Casagrandi, Renato

2016-03-01

Seascape connectivity critically affects the spatiotemporal dynamics of marine metacommunities. Understanding how connectivity patterns emerge from physically and biologically-mediated interactions is therefore crucial to conserve marine ecosystem functions and biodiversity. Here, we develop a set of biophysical models to explore connectivity in assemblages of species belonging to a typical Mediterranean community (Posidonia oceanica meadows) and characterized by different dispersing traits. We propose a novel methodological framework to synthesize species-specific results into a set of community connectivity metrics and show that spatiotemporal variation in magnitude and direction of the connections, as well as interspecific differences in dispersing traits, are key factors structuring community connectivity. We eventually demonstrate how these metrics can be used to characterize the functional role of each marine area in determining patterns of community connectivity at the basin level and to support marine conservation planning.

Is There a Connection Between Vaccines and Autism?

Science.gov (United States)

... Search English Español Is There a Connection Between Vaccines and Autism? KidsHealth / For Parents / Is There a Connection Between Vaccines and Autism? Print en español ¿Existe una conexión ...

Cybersecurity for Connected Diabetes Devices.

Science.gov (United States)

Klonoff, David C

2015-04-16

Diabetes devices are increasingly connected wirelessly to each other and to data-displaying reader devices. Threats to the accurate flow of information and commands may compromise the function of these devices and put their users at risk of health complications. Sound cybersecurity of connected diabetes devices is necessary to maintain confidentiality, integrity, and availability of the data and commands. Diabetes devices can be hacked by unauthorized agents and also by patients themselves to extract data that are not automatically provided by product software. Unauthorized access to connected diabetes devices has been simulated and could happen in reality. A cybersecurity standard designed specifically for connected diabetes devices will improve the safety of these products and increase confidence of users that the products will be secure. © 2015 Diabetes Technology Society.

Mindfulness as an Alternative for Supporting University Student Mental Health: Cognitive-Emotional and Depressive Self-Criticism Measures

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Azam, Muhammad Abid; Mongrain, Myriam; Vora, Khushboo; Pirbaglou, Meysam; Azargive, Saam; Changoor, Tina; Wayne, Noah; Guglietti, Crissa; Macpherson, Alison; Irvine, Jane; Rotondi, Michael; Smith, Dawn; Perez, Daniel; Ritvo, Paul

2016-01-01

Increases in university-based mental health problems require alternative mental health programs, applicable to students with elevated psychological risks due to personality traits. This study examined the cognitive-emotional outcomes of a university mindfulness meditation (MM) program and their relationship with Self-Criticism (SC), a personality…

Connecting Vietnam's isolated communities to improve healthcare ...

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

2018-01-29

Jan 29, 2018 ... Connecting Vietnam's isolated communities to improve healthcare ... of pregnancy and new motherhood improved their interactions with health workers. ... Return to main page: Overcoming eHealth challenges with social and ...

Positioning positivism, critical realism and social constructionism in the health sciences: a philosophical orientation.

Science.gov (United States)

Cruickshank, Justin

2012-03-01

Positioning positivism, critical realism and social constructionism in the health sciences: a philosophical orientation This article starts by considering the differences within the positivist tradition and then it moves on to compare two of the most prominent schools of postpositivism, namely critical realism and social constructionism. Critical realists hold, with positivism, that knowledge should be positively applied, but reject the positivist method for doing this, arguing that causal explanations have to be based not on empirical regularities but on references to unobservable structures. Social constructionists take a different approach to postpositivism and endorse a relativist rejection of truth and hold that the task of research is to foster a scepticism that undermines any positive truth claim made. It is argued that social constructionism is a contradictory position. © 2011 Blackwell Publishing Ltd.

Rocket Engine Health Management: Early Definition of Critical Flight Measurements

Science.gov (United States)

Christenson, Rick L.; Nelson, Michael A.; Butas, John P.

2003-01-01

The NASA led Space Launch Initiative (SLI) program has established key requirements related to safety, reliability, launch availability and operations cost to be met by the next generation of reusable launch vehicles. Key to meeting these requirements will be an integrated vehicle health management ( M) system that includes sensors, harnesses, software, memory, and processors. Such a system must be integrated across all the vehicle subsystems and meet component, subsystem, and system requirements relative to fault detection, fault isolation, and false alarm rate. The purpose of this activity is to evolve techniques for defining critical flight engine system measurements-early within the definition of an engine health management system (EHMS). Two approaches, performance-based and failure mode-based, are integrated to provide a proposed set of measurements to be collected. This integrated approach is applied to MSFC s MC-1 engine. Early identification of measurements supports early identification of candidate sensor systems whose design and impacts to the engine components must be considered in engine design.

The mixed health messages of Millsberry: a critical study of online child-targeted food advergaming.

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Thomson, Deborah M

2011-06-01

This paper offers a critical study of the contradictions of Millsberry.com, a General Mills (GM) advergaming website used to market GM's breakfast cereal brands to children. The paper takes a critical semiotic approach to argue that Millsberry.com sends players contradictory messages about health by simultaneously promoting nutritional wellness and consumption of high-sugar cereals, essentially conflating the two. Players on Millsberry.com create a virtual self (a Buddy) who lives in the fictional town of Millsberry, and a Buddy's health is tracked over time as players make nutritional choices for the Buddy. Health on Millsberry equates to eating from multiple food groups (nutritional balance) and eating only until full (caloric moderation). Yet both of these health messages are essentially undermined by play on the site. Nutritional balance is undermined by both the excessive promotion of high-sugar cereals and the differences between depictions of branded and unbranded foods. Caloric moderation is contradicted by digital advergames that operate on a logic of maximal consumption, by narratives of branded spokescharacters' endless appetites for cereal, and by giveaways of "free" boxes of virtual cereal that can be eaten by the Buddy in a single bite. The study concludes that such mixed messages about nutritional health are highly problematic, particularly given the alarming increase in diet and weight-related diseases among children.

Health promotion in connection to the health care students

Directory of Open Access Journals (Sweden)

S. Kyuchukova

2017-09-01

Full Text Available The activities of health promotion for the students in health care specialties is organized and managed by the teacher process. During the training communication skills are acquired. It is the time for preparing students for work in counseling and patient education, collecting and providing health information - promotive function in the process of care (1. We assumed that these opportunities could be used in our work with children deprived of parental care. We set a goal to explore experiences, attitudes and ideas about students’ participation in health care in health promotion in the community of children and individuals. The study found that students are aware of the social importance of the knowledge acquired during the training and are convinced of the need to support adolescents to develop a responsible attitude towards their own health.

The social production of health: critical contributions from evolutionary, biological, and cultural anthropology.

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Levin, Betty Wolder; Browner, C H

2005-08-01

In 1946, the newly formed World Health Organization boldly sought to conceptualize "health" as wellbeing in the positive sense, "not merely the absence of disease or infirmity." Yet nearly six decades later, researchers are still principally concerned with pathology and its characteristics and consequences. This special issue is the result of an effort to broaden the focus. Anthropologists working from evolutionary, biological and sociocultural perspectives and in diverse geographic regions were asked to examine meanings associated with health and/or to identify social conditions and practices that have contributed to positive physiological and psychological states in particular cultures, times, or across time. Most notable, perhaps, was discovering how difficult it is for Western social scientists to move beyond pathology-based thinking; most authors represented here regard health primarily as the absence of disease. Still, these papers articulate and address questions key to understanding health in and of itself, including: How is health conceptualized? What kinds of social conditions lead to health? And, how do social inequalities affect health? This introduction critically discusses previous work on the subject to contextualize the original research papers offered here.

Nuclear critical opalescence and electromagnetic probes

International Nuclear Information System (INIS)

Delorme, J.

1980-01-01

A description of nuclear critical opalescence is presented with emphasis on the information which can be gained from electromagnetic probes. The connection with standard nuclear physics treatments is given. Experimental possibilities are reviewed. Present information from electron scattering is shown to be unconclusive. The maximum sensitivity to critical phenomena would be attained by measurements of longitudinal spin form factors. Photopion reactions are analyzed in this spirit and found to be promising

Toward a critical anthropology on the impact of global warming on health and human societies.

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Baer, Hans A

2008-01-01

This op-ed essay urges medical anthropologists to join a growing number of public health scholars to examine the impact of global warming on health. Adopting a critical medical anthropology perspective, I argue that global warming is yet another manifestation of the contradictions of the capitalist world system. Ultimately, an serious effort to mitigate the impact of global warming not only on health but also settlement patterns and subsistence will require the creation of a new global political economy based upon social parity, democratic processes, and environmental sustainability.

Potential for Bias When Estimating Critical Windows for Air Pollution in Children's Health.

Science.gov (United States)

Wilson, Ander; Chiu, Yueh-Hsiu Mathilda; Hsu, Hsiao-Hsien Leon; Wright, Robert O; Wright, Rosalind J; Coull, Brent A

2017-12-01

Evidence supports an association between maternal exposure to air pollution during pregnancy and children's health outcomes. Recent interest has focused on identifying critical windows of vulnerability. An analysis based on a distributed lag model (DLM) can yield estimates of a critical window that are different from those from an analysis that regresses the outcome on each of the 3 trimester-average exposures (TAEs). Using a simulation study, we assessed bias in estimates of critical windows obtained using 3 regression approaches: 1) 3 separate models to estimate the association with each of the 3 TAEs; 2) a single model to jointly estimate the association between the outcome and all 3 TAEs; and 3) a DLM. We used weekly fine-particulate-matter exposure data for 238 births in a birth cohort in and around Boston, Massachusetts, and a simulated outcome and time-varying exposure effect. Estimates using separate models for each TAE were biased and identified incorrect windows. This bias arose from seasonal trends in particulate matter that induced correlation between TAEs. Including all TAEs in a single model reduced bias. DLM produced unbiased estimates and added flexibility to identify windows. Analysis of body mass index z score and fat mass in the same cohort highlighted inconsistent estimates from the 3 methods. © The Author(s) 2017. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

The position of Ghana on the progressive map of positive mental health: A critical perspective.

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Wilson, Angelina; Somhlaba, Nceba Z

2017-05-01

According to the World Health Organisation (WHO), mental health is a state of well-being and not just the absence of diseases. With this definition, there has been a surge of mental health research, albeit still predominantly in Western countries, which is reflected in contemporary theories on positive mental health that include 'flourishing mental health', 'salutogenesis', and 'fortigenesis'. However, in low- and middle-income countries (LMICs), mental health research is slowly receiving scholarly attention. The aim of this paper was twofold: Firstly, to highlight progress that had been made in some LMICs, giving consideration to research across different settings and populations as a basis to argue for more research on positive mental health in the Ghanaian context. Secondly, to present a critical perspective on the current mental health research trends in Ghana, thus discussing important recommendations for future research.

Connecting a sociology of childhood perspective with the study of child health, illness and wellbeing: introduction.

Science.gov (United States)

Brady, Geraldine; Lowe, Pam; Olin Lauritzen, Sonja

2015-02-01

In the last decades we have seen a growing interest in research into children's own experiences and understandings of health and illness. This development, we would argue, is much stimulated by the sociology of childhood which has drawn our attention to how children as a social group are placed and perceived within the structure of society, and within inter-generational relations, as well as how children are social agents and co-constructors of their social world. Drawing on this tradition, we here address some cross-cutting themes that we think are important to further the study of child health: situating children within health policy, drawing attention to practices around children's health and well-being and a focus on children as health actors. The paper contributes to a critical analysis of child health policy and notions of child health and normality, pointing to theoretical and empirical research potential for the sociology of children's health and illness. © 2015 The Authors. Sociology of Health & Illness © 2015 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

Holding Firm: Power, Push-Back, and Opportunities in Navigating the Liminal Space of Critical Qualitative Health Research.

Science.gov (United States)

Hart, Corinne; Poole, Jennifer M; Facey, Marcia E; Parsons, Janet A

2017-10-01

Critical qualitative health researchers typically occupy and navigate liminal academic spaces and statuses, with one foot planted in the arts and social sciences and the other in biomedical science. We are at once marginalized and empowered, and this liminality presents both challenges and opportunities. In this article, we draw on our experiences of being (often the lone) critical qualitative health scholars on thesis advisory committees and dissertation examinations, as well as our experiences of publishing and securing funding, to illuminate how power and knowledge relations create conditions that shape the nature of our roles. We share strategies we have developed for standing our theoretical and methodological ground. We discuss how we use the power of our liminality to hold firm, push back, and push forward, to ensure that critical qualitative research is not further relegated to the margins and its quality and integrity sustained.

Examining the social construction of surveillance: A critical issue for health visitors and public health nurses working with mothers and children.

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Peckover, Sue; Aston, Megan

2018-01-01

To critically examine surveillance practices of health visitors (HV) in the UK and public health nurses (PHNs) in Canada. The practice and meaning of surveillance shifts and changes depending on the context and intent of relationships between mothers and HVs or PHNs. We present the context and practice of HVs in the UK and PHNs in Canada and provide a comprehensive literature review regarding surveillance of mothers within public health systems. We then present our critique of the meaning and practice of surveillance across different settings. Concepts from Foucault and discourse analysis are used to critically examine and discuss the meaning of surveillance. Surveillance is a complex concept that shifts meaning and is socially and institutionally constructed through relations of power. Healthcare providers need to understand the different meanings and practices associated with surveillance to effectively inform practice. Healthcare providers should be aware of how their positions of expert and privilege within healthcare systems affect relationships with mothers. A more comprehensive understanding of personal, social and institutional aspects of surveillance will provide opportunities to reflect upon and change practices that are supportive of mothers and their families. © 2017 John Wiley & Sons Ltd.

A critical period for experience-dependent remodeling of adult-born neuron connectivity.

Science.gov (United States)

Bergami, Matteo; Masserdotti, Giacomo; Temprana, Silvio G; Motori, Elisa; Eriksson, Therese M; Göbel, Jana; Yang, Sung Min; Conzelmann, Karl-Klaus; Schinder, Alejandro F; Götz, Magdalena; Berninger, Benedikt

2015-02-18

Neurogenesis in the dentate gyrus (DG) of the adult hippocampus is a process regulated by experience. To understand whether experience also modifies the connectivity of new neurons, we systematically investigated changes in their innervation following environmental enrichment (EE). We found that EE exposure between 2-6 weeks following neuron birth, rather than merely increasing the number of new neurons, profoundly affected their pattern of monosynaptic inputs. Both local innervation by interneurons and to even greater degree long-distance innervation by cortical neurons were markedly enhanced. Furthermore, following EE, new neurons received inputs from CA3 and CA1 inhibitory neurons that were rarely observed under control conditions. While EE-induced changes in inhibitory innervation were largely transient, cortical innervation remained increased after returning animals to control conditions. Our findings demonstrate an unprecedented experience-dependent reorganization of connections impinging onto adult-born neurons, which is likely to have important impact on their contribution to hippocampal information processing. Copyright © 2015 Elsevier Inc. All rights reserved.

Why “Animal (De)liberation” survives early criticism and is pivotal to public health

Science.gov (United States)

2017-01-01

Summary In 2016, the book Animal (De)liberation: Should the Consumption of Animal Products Be Banned? was published. This article aims to engage with the critique that this book has received and to clarify and reinforce its importance for human health. It is argued that the ideas developed in the book withstand critical scrutiny. As qualified moral veganism avoids the pitfalls of other moral positions on human diets, public health policies must be altered accordingly, subject to adequate political support for its associated vegan project. PMID:28776902

Susceptibility of forests in the northeastern USA to nitrogen and sulfur deposition: critical load exceedance and forest health

Science.gov (United States)

N. Duarte; L.H. Pardo; M.J. Robin-Abbott

2013-01-01

The objectives of this study were to assess susceptibility to acidification and nitrogen (N) saturation caused by atmospheric deposition to northeastern US forests, evaluate the benefits and shortcomings of making critical load assessments using regional data, and assess the relationship between expected risk (exceedance) and forest health. We calculated the critical...

Stimulus-Elicited Connectivity Influences Resting-State Connectivity Years Later in Human Development: A Prospective Study.

Science.gov (United States)

Gabard-Durnam, Laurel Joy; Gee, Dylan Grace; Goff, Bonnie; Flannery, Jessica; Telzer, Eva; Humphreys, Kathryn Leigh; Lumian, Daniel Stephen; Fareri, Dominic Stephen; Caldera, Christina; Tottenham, Nim

2016-04-27

-term phasic molding hypothesis that resting-state network development is influenced by recurring stimulus-elicited connectivity through prospective examination of the developing human amygdala-cortical functional connections. Our results provide critical insight into how early environmental events sculpt functional network architecture across development and highlight childhood as a potential developmental period of heightened malleability for the amygdala-medial prefrontal cortex circuit. These findings have implications for how both positive and adverse experiences influence the developing brain and motivate future investigations of whether this molding mechanism reflects a general phenomenon of brain development. Copyright © 2016 the authors 0270-6474/16/364772-14$15.00/0.

Connecting Health and Natural History: A Failed Initiative at the American Museum of Natural History, 1909–1922

Science.gov (United States)

2014-01-01

In 1909, curator Charles-Edward Winslow established a department of public health in New York City’s American Museum of Natural History (AMNH). Winslow introduced public health as a biological science that connected human health—the modern sciences of physiology, hygiene, and urban sanitation—to the natural history of plants and animals. This was the only time an American museum created a curatorial department devoted to public health. The AMNH’s Department of Public Health comprised a unique collection of live bacterial cultures—a “Living Museum”—and an innovative plan for 15 exhibits on various aspects of health. I show how Winslow, facing opposition from AMNH colleagues, gathered scientific experts and financial support, and explain the factors that made these developments seem desirable and possible. I finish with a discussion of how the Department of Public Health met an abrupt and “inglorious end” in 1922 despite the success of its collections and exhibitions. PMID:24205997

Critical interactions between the Global Fund-supported HIV programs and the health system in Ghana

DEFF Research Database (Denmark)

Atun, Rifat; Pothapregada, Sai Kumar; Kwansah, Janet

2011-01-01

of the strengths and weaknesses of the relationship between Global Fund-supported activities and the health system and to identify positive synergies and unintended consequences of integration. Ghana has a well-functioning sector-wide approach to financing its health system, with a strong emphasis on integrated......The support of global health initiatives in recipient countries has been vigorously debated. Critics are concerned that disease-specific programs may be creating vertical and parallel service delivery structures that to some extent undermine health systems. This case study of Ghana aimed to explore...... how the Global Fund-supported HIV program interacts with the health system there and to map the extent and nature of integration of the national disease program across 6 key health systems functions. Qualitative interviews of national stakeholders were conducted to understand the perceptions...

Integrating Resources into Curriculum with the Systems Connect Planning Guide

Science.gov (United States)

Oshry, A.; Bean, J. R.

2017-12-01

A broadly applicable and guided approach for planning curriculum and instruction around new academic standards or initiatives is critical for implementation success. Curriculum and assessment differs across schools and districts, so built-in adaptability is important for maximal adoption and ease of use by educators. The Systems Connect Planning Guide directs the flow of instruction for building conceptual links between topics in a unit/curriculum through critical vetting and integration of relevant resources. This curricular template is flexible for use in any setting or subject area, and ensures applicability, high impact and responsiveness to academic standards while providing inquiry-based, real-world investigations and action that incorporate authentic research and data. These needs are what informed the creation of the three components of the planning guide:• Curriculum Anchor: alignment with academic standards & learning outcomes and setting the context of the topic• Issues Investigations: informing how students explore topics, and incorporate authentic research and data into learning progressions• Civic Action: development of how students could apply their knowledgeThe Planning Guide also incorporates criteria from transdisciplinary practices, cross-cutting concepts, and organizational charts for outlining guiding questions and conceptual links embedded in the guide. Integration of experiential learning and real-world connections into curricula is important for proficiency and deeper understanding of content, replacing discrete, stand-alone experiences which are not explicitly connected. Rather than information being dispelled through individual activities, relying on students to make the connections, intentionally documenting explicit connections provides opportunities to foster deeper understanding by building conceptual links between topics, which is how fundamental knowledge about earth and living systems is gained. Through the critical vetting

Building a scholar in writing (BSW): A model for developing students' critical writing skills.

Science.gov (United States)

Bailey, Annette; Zanchetta, Margareth; Velasco, Divine; Pon, Gordon; Hassan, Aafreen

2015-11-01

Several authors have highlighted the importance of writing in developing reflective thinking skills, transforming knowledge, communicating expressions, and filling knowledge gaps. However, difficulties with higher order processing and critical analysis affect students' ability to write critical and thoughtful essays. The Building a Scholar in Writing (BSW) model is a 6-step process of increasing intricacies in critical writing development. Development of critical writing is proposed to occur in a processed manner that transitions from presenting simple ideas (just bones) in writing, to connecting ideas (connecting bones), to formulating a thesis and connecting key components (constructing a skeleton), to supporting ideas with evidence (adding muscle), to building creativity and originality (adding essential organs), and finally, developing strong, integrated, critical arguments (adding brain). This process symbolically represents the building of a scholar. The idea of building a scholar equates to progressively giving life and meaning to a piece of writing with unique scholarly characteristics. This progression involves a transformation in awareness, thinking, and understanding, as well as advancement in students' level of critical appraisal skills. Copyright © 2015 Elsevier Ltd. All rights reserved.

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.

Nuclear critical opalescence and electromagnetic probes

International Nuclear Information System (INIS)

Delorme, J.

1981-01-01

A description of nuclear critical opalescence is presented with emphasis on the information which can be gained from electromagnetic probes. The connection with standard nuclear physics treatments is given. Experimental possibilities are reviewed. Present information from electron scattering is shown to be unconclusive. The maximum sensitivity to critical phenomena would be attained by measurements of longitudinal spin form factors. Photopion reactions are analyzed in this spirit and found to be promising. (orig.)

Understanding health decisions using critical realism: home-dialysis decision-making during chronic kidney disease.

Science.gov (United States)

Harwood, Lori; Clark, Alexander M

2012-03-01

Understanding health decisions using critical realism: home-dialysis decision-making during chronic kidney disease This paper examines home-dialysis decision making in people with Chronic Kidney Disease (CKD) from the perspective of critical realism. CKD programmes focus on patient education for self-management to delay the progression of kidney disease and the preparation and support for renal replacement therapy e.g.) dialysis and transplantation. Home-dialysis has clear health, societal and economic benefits yet service usage is low despite efforts to realign resources and educate individuals. Current research on the determinants of modality selection is superficial and insufficient to capture the complexities embedded in the process of dialysis modality selection. Predictors of home-dialysis selection and the effect of chronic kidney disease educational programmes provide a limited explanation of this experience. A re-conceptualization of the problem is required in order to fully understand this process. The epistemology and ontology of critical realism guides our knowledge and methodology particularly suited for examination of these complexities. This approach examines the deeper mechanisms and wider determinants associated with modality decision making, specifically who chooses home dialysis and under what circumstances. Until more is known regarding dialysis modality decision making service usage of home dialysis will remain low as interventions will be based on inadequate epistemology. © 2011 Blackwell Publishing Ltd.

A Critical Interdisciplinary Analysis of Culturally Appropriate Research Approach and Practices in Health Care and Social Work

Science.gov (United States)

Shams, Manfusa; Robinson, Lena

2005-01-01

This paper presents a critique of research approaches used in health and social care research with vulnerable and socially disadvantaged groups, and children and young people from minority ethnic backgrounds in Britain. The paper aims to critically examine research processes in health and social care from a psychological perspective and a social…

C3-PRO: Connecting ResearchKit to the Health System Using i2b2 and FHIR.

Directory of Open Access Journals (Sweden)

Pascal B Pfiffner

Full Text Available A renewed interest by consumer information technology giants in the healthcare domain is focused on transforming smartphones into personal health data storage devices. With the introduction of the open source ResearchKit, Apple provides a framework for researchers to inform and consent research subjects, and to readily collect personal health data and patient reported outcomes (PRO from distributed populations. However, being research backend agnostic, ResearchKit does not provide data transmission facilities, leaving research apps disconnected from the health system. Personal health data and PROs are of the most value when presented in context along with health system data. Our aim was to build a toolchain that allows easy and secure integration of personal health and PRO data into an open source platform widely adopted across 140 academic medical centers. We present C3-PRO: the Consent, Contact, and Community framework for Patient Reported Outcomes. This open source toolchain connects, in a standards-compliant fashion, any ResearchKit app to the widely-used clinical research infrastructure Informatics for Integrating Biology and the Bedside (i2b2. C3-PRO leverages the emerging health data standard Fast Healthcare Interoperability Resources (FHIR.

C3-PRO: Connecting ResearchKit to the Health System Using i2b2 and FHIR.

Science.gov (United States)

Pfiffner, Pascal B; Pinyol, Isaac; Natter, Marc D; Mandl, Kenneth D

2016-01-01

A renewed interest by consumer information technology giants in the healthcare domain is focused on transforming smartphones into personal health data storage devices. With the introduction of the open source ResearchKit, Apple provides a framework for researchers to inform and consent research subjects, and to readily collect personal health data and patient reported outcomes (PRO) from distributed populations. However, being research backend agnostic, ResearchKit does not provide data transmission facilities, leaving research apps disconnected from the health system. Personal health data and PROs are of the most value when presented in context along with health system data. Our aim was to build a toolchain that allows easy and secure integration of personal health and PRO data into an open source platform widely adopted across 140 academic medical centers. We present C3-PRO: the Consent, Contact, and Community framework for Patient Reported Outcomes. This open source toolchain connects, in a standards-compliant fashion, any ResearchKit app to the widely-used clinical research infrastructure Informatics for Integrating Biology and the Bedside (i2b2). C3-PRO leverages the emerging health data standard Fast Healthcare Interoperability Resources (FHIR).

An Autonomous Connectivity Restoration Algorithm Based on Finite State Machine for Wireless Sensor-Actor Networks

Directory of Open Access Journals (Sweden)

Ying Zhang

2018-01-01

Full Text Available With the development of autonomous unmanned intelligent systems, such as the unmanned boats, unmanned planes and autonomous underwater vehicles, studies on Wireless Sensor-Actor Networks (WSANs have attracted more attention. Network connectivity algorithms play an important role in data exchange, collaborative detection and information fusion. Due to the harsh application environment, abnormal nodes often appear, and the network connectivity will be prone to be lost. Network self-healing mechanisms have become critical for these systems. In order to decrease the movement overhead of the sensor-actor nodes, an autonomous connectivity restoration algorithm based on finite state machine is proposed. The idea is to identify whether a node is a critical node by using a finite state machine, and update the connected dominating set in a timely way. If an abnormal node is a critical node, the nearest non-critical node will be relocated to replace the abnormal node. In the case of multiple node abnormality, a regional network restoration algorithm is introduced. It is designed to reduce the overhead of node movements while restoration happens. Simulation results indicate the proposed algorithm has better performance on the total moving distance and the number of total relocated nodes compared with some other representative restoration algorithms.

An Autonomous Connectivity Restoration Algorithm Based on Finite State Machine for Wireless Sensor-Actor Networks.

Science.gov (United States)

Zhang, Ying; Wang, Jun; Hao, Guan

2018-01-08

With the development of autonomous unmanned intelligent systems, such as the unmanned boats, unmanned planes and autonomous underwater vehicles, studies on Wireless Sensor-Actor Networks (WSANs) have attracted more attention. Network connectivity algorithms play an important role in data exchange, collaborative detection and information fusion. Due to the harsh application environment, abnormal nodes often appear, and the network connectivity will be prone to be lost. Network self-healing mechanisms have become critical for these systems. In order to decrease the movement overhead of the sensor-actor nodes, an autonomous connectivity restoration algorithm based on finite state machine is proposed. The idea is to identify whether a node is a critical node by using a finite state machine, and update the connected dominating set in a timely way. If an abnormal node is a critical node, the nearest non-critical node will be relocated to replace the abnormal node. In the case of multiple node abnormality, a regional network restoration algorithm is introduced. It is designed to reduce the overhead of node movements while restoration happens. Simulation results indicate the proposed algorithm has better performance on the total moving distance and the number of total relocated nodes compared with some other representative restoration algorithms.

An Autonomous Connectivity Restoration Algorithm Based on Finite State Machine for Wireless Sensor-Actor Networks

Science.gov (United States)

Zhang, Ying; Wang, Jun; Hao, Guan

2018-01-01

With the development of autonomous unmanned intelligent systems, such as the unmanned boats, unmanned planes and autonomous underwater vehicles, studies on Wireless Sensor-Actor Networks (WSANs) have attracted more attention. Network connectivity algorithms play an important role in data exchange, collaborative detection and information fusion. Due to the harsh application environment, abnormal nodes often appear, and the network connectivity will be prone to be lost. Network self-healing mechanisms have become critical for these systems. In order to decrease the movement overhead of the sensor-actor nodes, an autonomous connectivity restoration algorithm based on finite state machine is proposed. The idea is to identify whether a node is a critical node by using a finite state machine, and update the connected dominating set in a timely way. If an abnormal node is a critical node, the nearest non-critical node will be relocated to replace the abnormal node. In the case of multiple node abnormality, a regional network restoration algorithm is introduced. It is designed to reduce the overhead of node movements while restoration happens. Simulation results indicate the proposed algorithm has better performance on the total moving distance and the number of total relocated nodes compared with some other representative restoration algorithms. PMID:29316702

The Critical Bricolage

Directory of Open Access Journals (Sweden)

Kim McMillan

2015-10-01

Full Text Available Change in health care has become rapid and continuous. Much decision-making processes guiding change management are derived from organizational literature which is heavily reflective of managerial perspectives. These perspectives represent and aim to serve only a small subgroup of organizational members. However, change is complex, fragile, and has higher rates of success and sustainability when change management strategies reflect a multitude of organizational voices. There is a dearth of literature exploring the intersect between organizational and nursing discourses on the subject of rapid and continuous change in health care. Multitheoretical, multimethodological, and multidisciplinary informed approaches to methodological decision making are needed to link organizational and nursing discourses in ways that will offer alternative perspectives on the subject of change. Furthermore, critically guided multitheoretical, multimethodological, and multidisciplinary methodologies are timely and important in organizational research. Critically guided research seeks to analyze taken-for-granted assumptions and institutionalized practices seeking alternative perspectives and alternative sources of organizational knowledge. Exploring alternative perspectives from a critical lens recognizes the impact predominant discursive influences have on change management and the subsequent impact on organizational members’ working lives. This article will explore how Kincheloe’s discussions of the critical bricolage serve to support combining critical organizational methodologies (guided by Alvesson and Deetz with a voice-centered relational method of data analysis (guided by Brown and Gilligan to create a critical interpretive methodology that explores the voices of nurses as they experience rapid and continuous change in health care.

Investigating the connections between health lean management and clinical risk management.

Science.gov (United States)

Crema, Maria; Verbano, Chiara

2015-01-01

The purpose of this paper is to investigate connections and overlaps between health lean management (HLM) and clinical risk management (CRM) understanding whether and how these two approaches can be combined together to pursue efficiency and patient safety improvements simultaneously. A systematic literature review has been carried out. Searching in academic databases, papers that focus not only on HLM, but also on clinical errors and risk reduction, were included. The general characteristics of the selected papers were analysed and a content analysis was conducted. In most of the papers, pursing objectives of HLM and CRM and adopting tools and practices of both approaches, results of quality and, particularly, of safety improvements were obtained. A two-way arrow between HLM and CRM emerged but so far, none of the studies has been focused on the relationship between HLM and CRM. Results highlight an emerging research stream, with many useful theoretical and practical implications and opportunities for further research.

A critical discussion of the benefits of e-health in population-level dental research.

Science.gov (United States)

Lam, Raymond; Kruger, Estie; Tennant, Marc

2013-01-01

Population-level research is an essential area of health with the potential to affect quality of life and the broader economy. There are excellent epidemiological studies that have improved health services, but traditional research requires a considerable investment. Although electronic technology has changed the practice of many industries with improved efficiency, its application to health is relatively new. Termed 'e-health', this emerging area has been defined by the World Health Organization as the use of information technology to support many aspects of health such as in administration and scientific information. However, not all professionals are convinced of its use. This paper presents a novel application of this emerging area to describe the benefit in data collation and research to support one of the most pressing issues in public health: oral health and policy. Using the Chronic Disease Dental Scheme as an example, a critical discussion of its benefit to population-level research is presented. The Chronic Disease Dental Scheme method of electronic administration has been shown to enhance research and to complement existing progress in health data linkage. e-Health is an invaluable tool for population-level dental research.

The synergy of creativity and critical thinking in engineering design

DEFF Research Database (Denmark)

Spuzic, Sead; Narayanan, Ramadas; Adriansen, Hanne Kirstine

2016-01-01

framework. It has been widely recognised that engineering design encompasses two ways of thinkingdcreative and critical. A central argument that the synergy of creativity and criticality is significantly enhanced by connecting true interdisciplinary augmentation with the fine arts is discussed along...

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...

Criticality safety analysis for plutonium dissolver using silver mediated electrolytic oxidation method

International Nuclear Information System (INIS)

Umeda, Miki; Sugikawa, Susumu; Nakamura, Kazuhito; Egashira, Tetsurou

1998-08-01

Design and construction of a plutonium dissolver using silver mediated electrolytic oxidation method are promoted in NUCEF. Criticality safety analysis for the plutonium dissolver is described in this report. The electrolytic plutonium dissolver consists of connection pipes and three pots for MOX powder supply, circulation and electrolysis. The criticality control for the dissolver is made by geometrically safe shape with mass limitation. Monte Carlo code KENO-IV using MGCL-137 library based on ENDF/B-IV was used for the criticality safety analysis for the plutonium dissolver. Considering the required size for construction and criticality safety, diameter of pot and distance between two pots were determined. On this condition, the criticality safety analysis for the plutonium dissolver with connection pipes was carried out. As the result of the criticality safety analysis, an effective neutron multiplication factor keff of 0.91 was obtained and the criticality safety of the plutonium dissolver was confirmed on the basis of criteria of ≤0.95. (author)

Using OpenEHR in SICTI an electronic health record system for critical medicine

International Nuclear Information System (INIS)

Filgueira, R; Odriazola, A; Simini, F

2007-01-01

SICTI is a software tool for registering health records in critical medicine environments. Version 1.0 has been in use since 2003. The Biomedical Engineering Group (Nucleo de Ingenieria Biomedica), with support from the Technological Development Programme (Programa de Desarrollo Tecnologico), decided to develop a new version, to provide an aid for more critical medicine processes, based on a framework which would make the application domain change oriented. The team analyzed three alternatives: to develop an original product based on new research, to base the development on OpenEHR framework, or to use HL7 RIM as the reference model for SICTI. The team opted for OpenEHR. This work describes the use of OpenEHR, its strong and weak points, and states future work perspectives

A shared electronic health record: lessons from the coalface.

Science.gov (United States)

Silvester, Brett V; Carr, Simon J

2009-06-01

A shared electronic health record system has been successfully implemented in Australia by a Division of General Practice in northern Brisbane. The system grew out of coordinated care trials that showed the critical need to share summary patient information, particularly for patients with complex conditions who require the services of a wide range of multisector, multidisciplinary health care professionals. As at 30 April 2008, connected users of the system included 239 GPs from 66 general practices, two major public hospitals, three large private hospitals, 11 allied health and community-based provider organisations and 1108 registered patients. Access data showed a patient's shared record was accessed an average of 15 times over a 12-month period. The success of the Brisbane implementation relied on seven key factors: connectivity, interoperability, change management, clinical leadership, targeted patient involvement, information at the point of care, and governance. The Australian Commission on Safety and Quality in Health Care is currently evaluating the system for its potential to reduce errors relating to inadequate information transfer during clinical handover.

Non-myogenic Contribution to Muscle Development and Homeostasis: The Role of Connective Tissues.

Science.gov (United States)

Nassari, Sonya; Duprez, Delphine; Fournier-Thibault, Claire

2017-01-01

Skeletal muscles belong to the musculoskeletal system, which is composed of bone, tendon, ligament and irregular connective tissue, and closely associated with motor nerves and blood vessels. The intrinsic molecular signals regulating myogenesis have been extensively investigated. However, muscle development, homeostasis and regeneration require interactions with surrounding tissues and the cellular and molecular aspects of this dialogue have not been completely elucidated. During development and adult life, myogenic cells are closely associated with the different types of connective tissue. Connective tissues are defined as specialized (bone and cartilage), dense regular (tendon and ligament) and dense irregular connective tissue. The role of connective tissue in muscle morphogenesis has been investigated, thanks to the identification of transcription factors that characterize the different types of connective tissues. Here, we review the development of the various connective tissues in the context of the musculoskeletal system and highlight their important role in delivering information necessary for correct muscle morphogenesis, from the early step of myoblast differentiation to the late stage of muscle maturation. Interactions between muscle and connective tissue are also critical in the adult during muscle regeneration, as impairment of the regenerative potential after injury or in neuromuscular diseases results in the progressive replacement of the muscle mass by fibrotic tissue. We conclude that bi-directional communication between muscle and connective tissue is critical for a correct assembly of the musculoskeletal system during development as well as to maintain its homeostasis in the adult.

School health and education: An interdisciplinary connection

Directory of Open Access Journals (Sweden)

Olga N. Makhubela-Nkondo

2013-04-01

Full Text Available For South Africa, the continent and the world as a whole, formal health literacy begins at school. Higher Education in South Africa is challenged to take heed of the World Health Organization’s (WHO (1996 definition of school health. For the WHO, school health is not merely hygiene, health promotion, health literacy or health education but a ‘combination of services ensuring the physical, mental and social well-being of learners so as to maximize their learning capabilities’. The WHO Expert Committee on School Health asserts that school health can advance public health, education, social and economic development, and that the global expansion of school health attests to the value placed internationally on such programmes (WHO 1996.

Men’s mental health: Connection to urologic health

OpenAIRE

Matthew, Andrew; Elterman, Dean

2014-01-01

Historically, the specialty of urology has focused on single-system diseases. In recent years, however, there has been increasing recognition of the interconnectivity between the various systems, such as cardiovascular disease, metabolic syndrome, erectile dysfunction and prostate cancer. This constellation of disease/syndrome and dysfunction may place urologists at the centre of men’s overall health concerns. As urologists considering taking on a leadership role in men’s health, they should ...

The Framing of Women and Health Disparities: A Critical Look at Race, Gender, and Class from the Perspectives of Grassroots Health Communicators.

Science.gov (United States)

Vardeman-Winter, Jennifer

2017-05-01

As women's health has received significant political and media attention recently, I proposed an expanded structural theory of women's communication about health. Women's health communication and critical race and systemic racism research framed this study. I interviewed 15 communicators and community health workers from grass-roots organizations focused on women's health to learn of their challenges of communicating with women from communities experiencing health disparities. Findings suggest that communicators face difficulties in developing meaningful messaging for publics because of disjunctures between medical and community frames, issues in searching for health among women's many priorities, Whiteness discourses imposed on publics' experiences, and practices of correcting for power differentials. A structural theory of women's health communication, then, consists of tenets around geographic, research/funding, academic/industry, and social hierarchies. Six frames suggesting racial biases about women and health disparities are also defined. This study also includes practical solutions in education, publishing, and policy change for addressing structural challenges.

COST action TD1407: network on technology-critical elements (NOTICE)--from environmental processes to human health threats.

Science.gov (United States)

Cobelo-García, A; Filella, M; Croot, P; Frazzoli, C; Du Laing, G; Ospina-Alvarez, N; Rauch, S; Salaun, P; Schäfer, J; Zimmermann, S

2015-10-01

The current socio-economic, environmental and public health challenges that countries are facing clearly need common-defined strategies to inform and support our transition to a sustainable economy. Here, the technology-critical elements (which includes Ga, Ge, In, Te, Nb, Ta, Tl, the Platinum Group Elements and most of the rare-earth elements) are of great relevance in the development of emerging key technologies-including renewable energy, energy efficiency, electronics or the aerospace industry. In this context, the increasing use of technology-critical elements (TCEs) and associated environmental impacts (from mining to end-of-life waste products) is not restricted to a national level but covers most likely a global scale. Accordingly, the European COST Action TD1407: Network on Technology-Critical Elements (NOTICE)-from environmental processes to human health threats, has an overall objective for creating a network of scientists and practitioners interested in TCEs, from the evaluation of their environmental processes to understanding potential human health threats, with the aim of defining the current state of knowledge and gaps, proposing priority research lines/activities and acting as a platform for new collaborations and joint research projects. The Action is focused on three major scientific areas: (i) analytical chemistry, (ii) environmental biogeochemistry and (iii) human exposure and (eco)-toxicology.

A critical systems perspective on the design of organizational space

NARCIS (Netherlands)

Mobach, Mark P.

2007-01-01

This paper is the first to introduce critical systems thinking into a new emerging research strand: the design of organizational space. The study revealed two things. First, critical systems thinking provides a thorough framework to understand the possibilities to connect organization and building;

Attention-deficit/hyperactivity disorder, joint hypermobility-related disorders and pain: expanding body-mind connections to the developmental age.

Science.gov (United States)

Baeza-Velasco, Carolina; Sinibaldi, Lorenzo; Castori, Marco

2018-02-14

Attention-deficit/hyperactivity disorder (ADHD) and generalized joint hypermobility (JH) are two separated conditions, assessed, and managed by different specialists without overlapping interests. Recently, some researchers highlighted an unexpected association between these two clinical entities. This happens in a scenario of increasing awareness on the protean detrimental effects that congenital anomalies of the connective tissue may have on human health and development. To review pertinent literature to identify possible connections between ADHD and GJH, special emphasis was put on musculoskeletal pain and syndromic presentations of GJH, particularly the hypermobile Ehlers-Danlos syndrome. A comprehensive search of scientific databases and references lists was conducted, encompassing publications based on qualitative and quantitative research. Impaired coordination and proprioception, fatigue, chronic pain, and dysautonomia are identified as potential bridges between ADHD and JH. Based on these findings, a map of the pathophysiological and psychopathological pathways connecting both conditions is proposed. Although ADHD and JH are traditionally separated human attributes, their association may testify for the dyadic nature of mind-body connections during critical periods of post-natal development. Such a mixed picture has potentially important consequences in terms of disability and deserves more clinical and research attention.

Directional connectivity in hydrology and ecology

Science.gov (United States)

Larsen, Laurel G.; Choi, Jungyill; Nungesser, Martha K.; Harvey, Judson W.

2012-01-01

Quantifying hydrologic and ecological connectivity has contributed to understanding transport and dispersal processes and assessing ecosystem degradation or restoration potential. However, there has been little synthesis across disciplines. The growing field of ecohydrology and recent recognition that loss of hydrologic connectivity is leading to a global decline in biodiversity underscore the need for a unified connectivity concept. One outstanding need is a way to quantify directional connectivity that is consistent, robust to variations in sampling, and transferable across scales or environmental settings. Understanding connectivity in a particular direction (e.g., streamwise, along or across gradient, between sources and sinks, along cardinal directions) provides critical information for predicting contaminant transport, planning conservation corridor design, and understanding how landscapes or hydroscapes respond to directional forces like wind or water flow. Here we synthesize progress on quantifying connectivity and develop a new strategy for evaluating directional connectivity that benefits from use of graph theory in ecology and percolation theory in hydrology. The directional connectivity index (DCI) is a graph-theory based, multiscale metric that is generalizable to a range of different structural and functional connectivity applications. It exhibits minimal sensitivity to image rotation or resolution within a given range and responds intuitively to progressive, unidirectional change. Further, it is linearly related to the integral connectivity scale length—a metric common in hydrology that correlates well with actual fluxes—but is less computationally challenging and more readily comparable across different landscapes. Connectivity-orientation curves (i.e., directional connectivity computed over a range of headings) provide a quantitative, information-dense representation of environmental structure that can be used for comparison or detection of

Directional connectivity in hydrology and ecology.

Science.gov (United States)

Larsen, Laurel G; Choi, Jungyill; Nungesser, Martha K; Harvey, Judson W

2012-12-01

Quantifying hydrologic and ecological connectivity has contributed to understanding transport and dispersal processes and assessing ecosystem degradation or restoration potential. However, there has been little synthesis across disciplines. The growing field of ecohydrology and recent recognition that loss of hydrologic connectivity is leading to a global decline in biodiversity underscore the need for a unified connectivity concept. One outstanding need is a way to quantify directional connectivity that is consistent, robust to variations in sampling, and transferable across scales or environmental settings. Understanding connectivity in a particular direction (e.g., streamwise, along or across gradient, between sources and sinks, along cardinal directions) provides critical information for predicting contaminant transport, planning conservation corridor design, and understanding how landscapes or hydroscapes respond to directional forces like wind or water flow. Here we synthesize progress on quantifying connectivity and develop a new strategy for evaluating directional connectivity that benefits from use of graph theory in ecology and percolation theory in hydrology. The directional connectivity index (DCI) is a graph-theory based, multiscale metric that is generalizable to a range of different structural and functional connectivity applications. It exhibits minimal sensitivity to image rotation or resolution within a given range and responds intuitively to progressive, unidirectional change. Further, it is linearly related to the integral connectivity scale length--a metric common in hydrology that correlates well with actual fluxes--but is less computationally challenging and more readily comparable across different landscapes. Connectivity-orientation curves (i.e., directional connectivity computed over a range of headings) provide a quantitative, information-dense representation of environmental structure that can be used for comparison or detection of

The existence of trajectories joining critical points

International Nuclear Information System (INIS)

Yu Shuxiang.

1985-01-01

In this paper, using the notion of an isolating block and the concept of canonical regions, three existence criteria of trajectories connecting a pair of critical points of planar differential equations are given. (author)

Skin Health Connected to the Use of Absorbent Hygiene Products: A Review.

Science.gov (United States)

Bender, Johanna Karlsson; Faergemann, Jan; Sköld, Maria

2017-09-01

Over the past 50 years, absorbent hygiene products such as baby diapers and incontinence products have become essential features of modern day life. Through innovation and enhanced technology, their design, composition and performance have been dramatically upgraded from their early forms, and they have transformed the lives of millions of people, improving their quality of life. Skin health related to the use of absorbent hygiene products has accordingly also greatly improved. Still, the wearing of absorbent hygiene products will affect the skin, and for some users the changes in microclimate, mechanical interactions and the exposure to urine and faeces may result in irritant contact dermatitis, i.e. diaper dermatitis (DD) or incontinence-associated dermatitis (IAD). Babies with developing skin and the elderly with deteriorating skin functions who are the most frequent users of absorbent hygiene products are more vulnerable to the causal factors. Although irritant reactions are the most common, allergic contact dermatitis should be considered if a DD/IAD fails to improve by recommended actions. There is also a connection between IAD and pressure ulcer development of which it is important to be aware. A holistic approach of using high-quality absorbent hygiene products in combination with appropriate skin care will help maintaining good skin health.

Theories and models about learning in connected and ubiquitous environments. Bases for a new theoretical model from a critical vision of “connectivism”

Directory of Open Access Journals (Sweden)

Miguel ZAPATA-ROS

2015-04-01

Full Text Available This paper aims at setting the bases for the construction of a theoretical model of learning and of elaboration of knowledge, within connected learning environments. The starting point is a critical view of connectivism, and a premise: the study and recognition of existing theories, since their scope is still under development as regards their potentialities and affordances when applied in social, ubiquitous environments. The paper also includes reflections and a hypothesis on the causes that underlie in the origin of connectivism in its actual stage of development in the Information and Knowledge Society, in order to use the obtained conclusions as the bases of a new model, at a later phase.

Two decades of Neo-Marxist class analysis and health inequalities: A critical reconstruction

Science.gov (United States)

Muntaner, Carles; Ng, Edwin; Chung, Haejoo; Prins, Seth J

2015-01-01

Most population health researchers conceptualize social class as a set of attributes and material conditions of life of individuals. The empiricist tradition of ‘class as an individual attribute' equates class to an ‘observation', precluding the investigation of unobservable social mechanisms. Another consequence of this view of social class is that it cannot be conceptualized, measured, or intervened upon at the meso- or macro levels, being reduced to a personal attribute. Thus, population health disciplines marginalize rich traditions in Marxist theory whereby ‘class' is understood as a ‘hidden' social mechanism such as exploitation. Yet Neo-Marxist social class has been used over the last two decades in population health research as a way of understanding how health inequalities are produced. The Neo-Marxist approach views social class in terms of class relations that give persons control over productive assets and the labour power of others (property and managerial relations). We critically appraise the contribution of the Neo-Marxist approach during the last two decades and suggest realist amendments to understand class effects on the social determinants of health and health outcomes. We argue that when social class is viewed as a social causal mechanism it can inform social change to reduce health inequalities. PMID:26345311

Critical dynamics in associative memory networks

Directory of Open Access Journals (Sweden)

Maximilian eUhlig

2013-07-01

Full Text Available Critical behavior in neural networks is characterized by scale-free avalanche size distributions and can be explained by self-regulatory mechanisms. Theoretical and experimental evidence indicates that information storage capacity reaches its maximum in the critical regime. We study the effect of structural connectivity formed by Hebbian learning on the criticality of network dynamics. The network endowed with Hebbian learning only does not allow for simultaneous information storage and criticality. However, the critical regime is can be stabilized by short-term synaptic dynamics in the form of synaptic depression and facilitation or, alternatively, by homeostatic adaptation of the synaptic weights. We show that a heterogeneous distribution of maximal synaptic strengths does not preclude criticality if the Hebbian learning is alternated with periods of critical dynamics recovery. We discuss the relevance of these findings for the flexibility of memory in aging and with respect to the recent theory of synaptic plasticity.

Critical incident exposure in South African emergency services personnel: prevalence and associated mental health issues

Science.gov (United States)

Ward, C L; Lombard, C J; Gwebushe, N

2006-01-01

Objectives To assess critical incident exposure among prehospital emergency services personnel in the developing world context of South Africa; and to assess associated mental health consequences. Methods We recruited a representative sample from emergency services in the Western Cape Province, South Africa, to participate in this cross sectional epidemiological study. Questionnaires covered critical incident exposure, general psychopathology, risky alcohol use, symptoms of post‐traumatic stress disorder (PTSD), and psychological and physical aggression between co‐workers. Open ended questions addressed additional stressors. Results Critical incident exposure and rates of general psychopathology were higher than in studies in the developed world. Exposure to critical incidents was associated with general psychopathology, symptoms of PTSD, and with aggression between co‐workers, but not with alcohol use. Ambulance, fire, and sea rescue services had lower general psychopathology scores than traffic police. The sea rescue service also scored lower than traffic police on PTSD and psychological aggression. The defence force had higher rates of exposure to physical assault, and in ambulance services, younger staff were more vulnerable to assault. Women had higher rates of general psychopathology and of exposure to psychological aggression. Other stressors identified included death notification, working conditions, and organisational problems. Conclusions Service organisations should be alert to the possibility that their personnel are experiencing work ‐related mental health and behavioural problems, and should provide appropriate support. Attention should also be given to organisational issues that may add to the stress of incidents. Workplace programmes should support vulnerable groups, and address death notification and appropriate expression of anger. PMID:16498167

Critical current of high Tc superconducting Bi223/Ag tapes

NARCIS (Netherlands)

Huang, Y.; ten Haken, Bernard; ten Kate, Herman H.J.

1998-01-01

The magnetic field dependence of the critical current of various high Tc superconducting Bi2223/Ag tapes indicates that the transport current is carried through two paths: one is through weakly-linked grain boundaries (Josephson junctions); another is through well-connected grains. The critical

Critical incidents connected to nurses' leadership in Intensive Care Units.

Science.gov (United States)

Lima, Elaine Cantarella; Bernardes, Andrea; Baldo, Priscila Lapaz; Maziero, Vanessa Gomes; Camelo, Silvia Helena Henriques; Balsanelli, Alexandre Pazetto

2017-01-01

The goal of this study is to analyze nurses' leadership in intensive care units at hospitals in the state of São Paulo, Brazil, in the face of positive and negative critical incidents. Exploratory, descriptive study, conducted with 24 nurses by using the Critical Incident Technique as a methodological benchmark. Results were grouped into 61 critical incidents distributed into categories. Researchers came to the conclusion that leadership-related situations interfere with IC nurses' behaviors. Among these situations they found: difficulty in the communication process; conflicts in the daily exercise of nurses' activities; people management; and the setting of high quality care targets. Researchers identified a mixed leadership model, leading them to the conclusion that nurses' knowledge and practice of contemporary leadership theories/styles are crucial because they facilitate the communication process, focusing on behavioral aspects and beliefs, in addition to valuing flexibility. This positively impacts the organization's results. Analisar a liderança do enfermeiro em Centros de Terapia Intensiva de hospitais localizados no interior do estado de São Paulo, diante de incidentes críticos positivos e negativos. Estudo exploratório, descritivo, realizado com 24 enfermeiros, que utilizou a Técnica do Incidente Crítico como referencial metodológico. Os resultados foram agrupados em 61 incidentes críticos distribuídos em categorias. Identificou-se que situações relacionadas à liderança interferem no comportamento do enfermeiro de Terapia Intensiva, dentre elas: dificuldade no processo de comunicação, conflitos existentes no dia a dia do exercício profissional, gerenciamento de pessoas e estabelecimento de metas para o alcance da assistência qualificada. Encontrou-se um modelo misto de liderança, o que permite concluir que o conhecimento e a prática dos enfermeiros acerca de teorias/estilos contemporâneos de liderança tornam-se fundamentais, pois

Using OpenEHR in SICTI an electronic health record system for critical medicine

Science.gov (United States)

Filgueira, R.; Odriazola, A.; Simini, F.

2007-11-01

SICTI is a software tool for registering health records in critical medicine environments. Version 1.0 has been in use since 2003. The Biomedical Engineering Group (Núcleo de Ingeniería Biomédica), with support from the Technological Development Programme (Programa de Desarrollo Tecnológico), decided to develop a new version, to provide an aid for more critical medicine processes, based on a framework which would make the application domain change oriented. The team analyzed three alternatives: to develop an original product based on new research, to base the development on OpenEHR framework, or to use HL7 RIM as the reference model for SICTI. The team opted for OpenEHR. This work describes the use of OpenEHR, its strong and weak points, and states future work perspectives.

Health systems guidance appraisal--a critical interpretive synthesis.

Science.gov (United States)

Ako-Arrey, Denis E; Brouwers, Melissa C; Lavis, John N; Giacomini, Mita K

2016-01-22

Health systems guidance (HSG) are systematically developed statements that assist with decisions about options for addressing health systems challenges, including related changes in health systems arrangements. However, the development, appraisal, and reporting of HSG poses unique conceptual and methodological challenges related to the varied types of evidence that are relevant, the complexity of health systems, and the pre-eminence of contextual factors. To address this gap, we are conducting a program of research that aims to create a tool to support the appraisal of HSG and further enhance HSG development and reporting. The focus of this paper was to conduct a knowledge synthesis of the published and grey literatures to determine quality criteria (concepts) relevant for this process. We applied a critical interpretive synthesis (CIS) approach to knowledge synthesis that enabled an iterative, flexible, and dynamic analysis of diverse bodies of literature in order to generate a candidate list of concepts that will constitute the foundational components of the HSG tool. Using our review questions as compasses, we were able to guide the search strategy to look for papers based on their potential relevance to HSG appraisal, development, and reporting. The search strategy included various electronic databases and sources, subject-specific journals, conference abstracts, research reports, book chapters, unpublished data, dissertations, and policy documents. Screening the papers and data extraction was completed independently and in duplicate, and a narrative approach to data synthesis was executed. We identified 43 papers that met eligibility criteria. No existing review was found on this topic, and no HSG appraisal tool was identified. Over one third of the authors implicitly or explicitly identified the need for a high-quality tool aimed to systematically evaluate HSG and contribute to its development/reporting. We identified 30 concepts that may be relevant to the

Evaluating Landscape Connectivity for Puma concolor and Panthera onca Among Atlantic Forest Protected Areas

Science.gov (United States)

Castilho, Camila S.; Hackbart, Vivian C. S.; Pivello, Vânia R.; dos Santos, Rozely F.

2015-06-01

Strictly Protected Areas and riparian forests in Brazil are rarely large enough or connected enough to maintain viable populations of carnivores and animal movement over time, but these characteristics are fundamental for species conservation as they prevent the extinction of isolated animal populations. Therefore, the need to maintain connectivity for these species in human-dominated Atlantic landscapes is critical. In this study, we evaluated the landscape connectivity for large carnivores (cougar and jaguar) among the Strictly Protected Areas in the Atlantic Forest, evaluated the efficiency of the Mosaics of Protected Areas linked to land uses in promoting landscape connectivity, identified the critical habitat connections, and predicted the landscape connectivity status under the implementation of legislation for protecting riparian forests. The method was based on expert opinion translated into land use and land cover maps. The results show that the Protected Areas are still connected by a narrow band of landscape that is permeable to both species and that the Mosaics of Protected Areas increase the amount of protected area but fail to increase the connectivity between the forested mountain ranges (Serra do Mar and Serra da Mantiqueira). Riparian forests greatly increase connectivity, more than tripling the cougars' priority areas. We note that the selection of Brazilian protected areas still fails to create connectivity among the legally protected forest remnants. We recommend the immediate protection of the priority areas identified that would increase the structural landscape connectivity for these large carnivores, especially paths in the SE/NW direction between the two mountain ranges.

Evaluating Landscape Connectivity for Puma concolor and Panthera onca Among Atlantic Forest Protected Areas.

Science.gov (United States)

Castilho, Camila S; Hackbart, Vivian C S; Pivello, Vânia R; dos Santos, Rozely F

2015-06-01

Strictly Protected Areas and riparian forests in Brazil are rarely large enough or connected enough to maintain viable populations of carnivores and animal movement over time, but these characteristics are fundamental for species conservation as they prevent the extinction of isolated animal populations. Therefore, the need to maintain connectivity for these species in human-dominated Atlantic landscapes is critical. In this study, we evaluated the landscape connectivity for large carnivores (cougar and jaguar) among the Strictly Protected Areas in the Atlantic Forest, evaluated the efficiency of the Mosaics of Protected Areas linked to land uses in promoting landscape connectivity, identified the critical habitat connections, and predicted the landscape connectivity status under the implementation of legislation for protecting riparian forests. The method was based on expert opinion translated into land use and land cover maps. The results show that the Protected Areas are still connected by a narrow band of landscape that is permeable to both species and that the Mosaics of Protected Areas increase the amount of protected area but fail to increase the connectivity between the forested mountain ranges (Serra do Mar and Serra da Mantiqueira). Riparian forests greatly increase connectivity, more than tripling the cougars' priority areas. We note that the selection of Brazilian protected areas still fails to create connectivity among the legally protected forest remnants. We recommend the immediate protection of the priority areas identified that would increase the structural landscape connectivity for these large carnivores, especially paths in the SE/NW direction between the two mountain ranges.

Activities of JAERI's health physics department for the criticality accident of JCO

International Nuclear Information System (INIS)

Yamamoto, Katsumune; Kitano, Kyoshiro; Murakami, Hiroyuki; Yamaguchi, Takenori; Tsunoda, Masahiko

2000-01-01

This report describes early health physics activities from September 30 to October 1 taken by the authors' department after the JCO accident. They firstly knew the accident at around 12:20 (about 2 hr after the criticality). The activities involved the planning of schedule for ending the criticality; calculation of scheduled dose for the work to end it; dose measurement around JCO site; loaning out of devices for measuring neutron and of personal dose-meter; collection and radioactivity measurement of dust and soil, and of drinking water; and examination for contamination of people around the site, of their houses inside and of school gardens and equipments. The dose was scheduled to be firstly 20 mSv and then changed to 50 mSv due to the actual measurement at the accident site. The working time was to be 3 min at the site. The work was on either the dose or time. Radiation monitoring outside the JCO site revealed the presence of Na-24 and Cs-138: neutron dose was 10 times as high as γ-ray dose. The time course of dose rate change was found to be in parallel with the progress of works to end the criticality. (K.H.)

Critical thinking in patient centered care.

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Mitchell, Shannon H; Overman, Pamela; Forrest, Jane L

2014-06-01

Health care providers can enhance their critical thinking skills, essential to providing patient centered care, by use of motivational interviewing and evidence-based decision making techniques. The need for critical thinking skills to foster optimal patient centered care is being emphasized in educational curricula for health care professions. The theme of this paper is that evidence-based decision making (EBDM) and motivational interviewing (MI) are tools that when taught in health professions educational programs can aid in the development of critical thinking skills. This paper reviews the MI and EBDM literature for evidence regarding these patient-centered care techniques as they relate to improved oral health outcomes. Comparisons between critical thinking and EBDM skills are presented and the EBDM model and the MI technique are briefly described followed by a discussion of the research to date. The evidence suggests that EBDM and MI are valuable tools; however, further studies are needed regarding the effectiveness of EBDM and MI and the ways that health care providers can best develop critical thinking skills to facilitate improved patient care outcomes. Copyright © 2014 Elsevier Inc. All rights reserved.

Examining Neuronal Connectivity and Its Role in Learning and Memory

Science.gov (United States)

Gala, Rohan

Learning and long-term memory formation are accompanied with changes in the patterns and weights of synaptic connections in the underlying neuronal network. However, the fundamental rules that drive connectivity changes, and the precise structure-function relationships within neuronal networks remain elusive. Technological improvements over the last few decades have enabled the observation of large but specific subsets of neurons and their connections in unprecedented detail. Devising robust and automated computational methods is critical to distill information from ever-increasing volumes of raw experimental data. Moreover, statistical models and theoretical frameworks are required to interpret the data and assemble evidence into understanding of brain function. In this thesis, I first describe computational methods to reconstruct connectivity based on light microscopy imaging experiments. Next, I use these methods to quantify structural changes in connectivity based on in vivo time-lapse imaging experiments. Finally, I present a theoretical model of associative learning that can explain many stereotypical features of experimentally observed connectivity.

Connecting Gender, Race, Class, and Immigration Status to Disease Management at the Workplace

Science.gov (United States)

Rosemberg, Marie-Anne S.; Tsai, Jenny Hsin-Chun

2016-01-01

Objective Chronic diseases are the leading causes of death in the United States. Chronic disease management occurs within all aspects of an individual's life, including the workplace. Though the social constructs of gender, race, class, and immigration status within the workplace have been considered, their connection to disease management among workers has been less explicitly explored. Using a sample of immigrant hotel housekeepers, we explored the connections between these four social constructs and hypertension management. Methods This qualitative research study was guided by critical ethnography methodology. Twenty-seven hotel room cleaners and four housemen were recruited (N = 31) and invited to discuss their experiences with hypertension and hypertension management within the context of their work environments. Results Being a woman worker within the hotel industry was perceived to negatively influence participants’ experience with hypertension and hypertension management. In contrast, being a woman played a protective role outside the workplace. Being an immigrant played both a positive and a negative role in hypertension and its management. Being black and from a low socioeconomic class had only adverse influences on participants’ experience with hypertension and its management. Conclusion Being a woman, black, lower class, and an immigrant simultaneously contribute to immigrant hotel housekeepers’ health and their ability to effectively manage their hypertension. The connection between these four constructs (gender, race, class, and immigration status) and disease management must be considered during care provision. Hotel employers and policy stakeholders need to consider those constructs and how they impact workers’ well-being. More studies are needed to identify what mitigates the associations between the intersectionality of these constructs and immigrant workers’ health and disease management within their work environment. PMID:27695659

Connecting Gender, Race, Class, and Immigration Status to Disease Management at the Workplace.

Science.gov (United States)

Rosemberg, Marie-Anne S; Tsai, Jenny Hsin-Chun

2014-01-01

Chronic diseases are the leading causes of death in the United States. Chronic disease management occurs within all aspects of an individual's life, including the workplace. Though the social constructs of gender, race, class, and immigration status within the workplace have been considered, their connection to disease management among workers has been less explicitly explored. Using a sample of immigrant hotel housekeepers, we explored the connections between these four social constructs and hypertension management. This qualitative research study was guided by critical ethnography methodology. Twenty-seven hotel room cleaners and four housemen were recruited ( N = 31) and invited to discuss their experiences with hypertension and hypertension management within the context of their work environments. Being a woman worker within the hotel industry was perceived to negatively influence participants' experience with hypertension and hypertension management. In contrast, being a woman played a protective role outside the workplace. Being an immigrant played both a positive and a negative role in hypertension and its management. Being black and from a low socioeconomic class had only adverse influences on participants' experience with hypertension and its management. Being a woman, black, lower class, and an immigrant simultaneously contribute to immigrant hotel housekeepers' health and their ability to effectively manage their hypertension. The connection between these four constructs (gender, race, class, and immigration status) and disease management must be considered during care provision. Hotel employers and policy stakeholders need to consider those constructs and how they impact workers' well-being. More studies are needed to identify what mitigates the associations between the intersectionality of these constructs and immigrant workers' health and disease management within their work environment.

Pet ownership and physical health.

Science.gov (United States)

Matchock, Robert L

2015-09-01

Pet ownership and brief human-animal interactions can serve as a form of social support and convey a host of beneficial psychological and physiological health benefits. This article critically examines recent relevant literature on the pet-health connection. Cross-sectional studies indicate correlations between pet ownership and numerous aspects of positive health outcomes, including improvements on cardiovascular measures and decreases in loneliness. Quasi-experimental studies and better controlled experimental studies corroborate these associations and suggest that owning and/or interacting with a pet may be causally related to some positive health outcomes. The value of pet ownership and animal-assisted therapy (AAT), as a nonpharmacological treatment modality, augmentation to traditional treatment, and healthy preventive behavior (in the case of pet ownership), is starting to be realized. However, more investigations that employ randomized controlled trials with larger sample sizes and investigations that more closely examine the underlying mechanism of the pet-health effect, such as oxytocin, are needed.

Bringing critical realism to nursing practice: Roy Bhaskar's contribution.

Science.gov (United States)

Williams, Lynne; Rycroft-Malone, Jo; Burton, Christopher R

2017-04-01

In the context of modern nursing practice that is embedded within complex social situations, critical discussions about the contribution of major philosophers are relevant and important. Whilst nurse theorists have advanced and shaped nursing as a discipline, other major philosophers can offer much to advance nursing enquiry. In this paper, we focus on philosopher Roy Bhaskar who, amongst others, developed critical realism, a philosophy for social science which connects with how many of us think about the world. Bhaskar's work focuses our attention on the interplay between structure and agency and on the search for the causative or generative mechanisms that explain the social world. Bhaskar was interested in human emancipation, and we suggest his work is of great importance to advance understanding of complex social situations. Critical realism has already been endorsed by a range of disciplines, especially in research which focuses on real problems and acknowledges the complexities of the social world. In recent evidence from healthcare literature, there has been a surge in research using realist methodology (realist evaluation and realist synthesis), which is underpinned by the philosophy of critical realism and which offers a different perspective to understanding nursing and healthcare problems through the realist lens. However, we suggest that sufficient attention is not always paid to the philosophical roots of this methodology. In this paper, we provide insight into Bhaskar's work and demonstrate how research positioned within critical realism and realist methodology can advance nursing and healthcare-related knowledge. Through shining a light on Bhaskar, we illustrate how critical realism philosophy is a natural fit with human and health science enquiry, including nursing. © 2016 John Wiley & Sons Ltd.

The power of social connection and support in improving health: lessons from social support interventions with childbearing women

Directory of Open Access Journals (Sweden)

Small Rhonda

2011-11-01

Full Text Available Abstract Background and objective Social support interventions have a somewhat chequered history. Despite evidence that social connection is associated with good health, efforts to implement interventions designed to increase social support have produced mixed results. The aim of this paper is to reflect on the relationship between social connectedness and good health, by examining social support interventions with mothers of young children and analysing how support was conceptualised, enacted and valued, in order to advance what we know about providing support to improve health. Context and approach First, we provide a brief recent history of social support interventions for mothers with young children and we critically examine what was intended by ‘social support’, who provided it and for which groups of mothers, how support was enacted and what was valued by women. Second, we examine the challenges and promise of lay social support approaches focused explicitly on companionship, and draw on experiences in two cluster randomised trials which aimed to improve the wellbeing of mothers. One trial involved a universal approach, providing befriending opportunities for all mothers in the first year after birth, and the other a targeted approach offering support from a ‘mentor mother’ to childbearing women experiencing intimate partner violence. Results Interventions providing social support to mothers have most often been directed to women seen as disadvantaged, or ‘at risk’. They have also most often been enacted by health professionals and have included strong elements of health education and/or information, almost always with a focus on improving parenting skills for better child health outcomes. Fewer have involved non-professional ‘supporters’, and only some have aimed explicitly to provide companionship or a listening ear, despite these aspects being what mothers receiving support have said they valued most. Our trial

The peculiarities of connection between social capital and psychological health of the people with different economic status: the analysis of research results

Directory of Open Access Journals (Sweden)

Олександра Андріївна Ніздрань

2016-10-01

Full Text Available The theoretical and methodological foundations and the organization of the empirical research of the connection between social capital and psychological health of persons with low level of economic status were proved. The peculiarities of the state of psychological health and the development of social capital constituents depending on the level of economic well-being of a person were revealed. The model of the influence of social capital as a factor of the psychological health of persons with low level of economic status was given

[Collective health, territorial and environmental conflicts: bases for a critical socio-environmental approach].

Science.gov (United States)

Porto, Marcelo Firpo de Souza; da Rocha, Diogo Ferreira; Finamore, Renan

2014-10-01

The phenomenon of globalization and the increase in neo-extractivism in the global periphery intensify the search for new territories and natural resources for the economy, resulting in significant impacts on ecosystems and on the lives of vulnerable populations. It is considered that the environmental crisis imposes new challenges and requires an updating of the theoretical and methodological foundations of collective health and the social determinants of health. The scope of this paper is to present theoretical contributions to the construction of a critical socio-environmental approach from a review of the literature structured around previous work on the mapping of environmental conflicts, and conducting empirical studies in conflicting areas. The contributions of sociology, political ecology, postcolonial studies and geography is summarized for the discussion of the socio-environmental determinants of health, as well as experiences that integrate emancipatory knowledge, political subjects, resistances and alternatives for society.

Work-related critical incidents in hospital-based health care providers and the risk of post-traumatic stress symptoms, anxiety, and depression: a meta-analysis.

Science.gov (United States)

de Boer, Jacoba; Lok, Anja; Van't Verlaat, Ellen; Duivenvoorden, Hugo J; Bakker, Arnold B; Smit, Bert J

2011-07-01

This meta-analysis reviewed existing data on the impact of work-related critical incidents in hospital-based health care professionals. Work-related critical incidents may induce post-traumatic stress symptoms or even post-traumatic stress disorder (PTSD), anxiety, and depression and may negatively affect health care practitioners' behaviors toward patients. Nurses and doctors often cope by working part time or switching jobs. Hospital administrators and health care practitioners themselves may underestimate the effects of work-related critical incidents. Relevant online databases were searched for original research published from inception to 2009 and manual searches of the Journal of Traumatic Stress, reference lists, and the European Traumatic Stress Research Database were conducted. Two researchers independently decided on inclusion and study quality. Effect sizes were estimated using standardized mean differences with 95% confidence intervals. Consistency was evaluated, using the I(2)-statistic. Meta-analysis was performed using the random effects model. Eleven studies, which included 3866 participants, evaluated the relationship between work-related critical incidents and post-traumatic stress symptoms. Six of these studies, which included 1695 participants, also reported on the relationship between work-related critical incidents and symptoms of anxiety and depression. Heterogeneity among studies was high and could not be accounted for by study quality, character of the incident, or timing of data collection. Pooled effect sizes for the impact of work-related critical incidents on post-traumatic stress symptoms, anxiety, and depression were small to medium. Remarkably, the effect was more pronounced in the longer than in the shorter term. In conclusion, this meta-analysis supports the hypothesis that work-related critical incidents are positively related to post-traumatic stress symptoms, anxiety, and depression in hospital-based health care professionals

Back- and fore-grounding ontology: exploring the linkages between critical realism, pragmatism, and methodologies in health & rehabilitation sciences.

Science.gov (United States)

DeForge, Ryan; Shaw, Jay

2012-03-01

Back- and fore-grounding ontology: exploring the linkages between critical realism, pragmatism, and methodologies in health & rehabilitation sciences As two doctoral candidates in a health and rehabilitation sciences program, we describe in this paper our respective paradigmatic locations along a quite nonlinear ontological-epistemological-axiological-methodological chain. In a turn-taking fashion, we unpack the tenets of critical realism and pragmatism, and then trace the linkages from these paradigmatic locations through to the methodological choices that address a community-based research problem. Beyond serving as an answer to calls for academics in training to demonstrate philosophical-theoretical-methodological integrity and coherence in their scholarship, this paper represents critical realism and its fore-grounding of a deeply stratified ontology in reflexive relation to pragmatism and its back-grounding of ontology. We conclude by considering the merits and challenges of conducting research from within singular versus proliferate paradigmatic perspectives. © 2011 Blackwell Publishing Ltd.

Key Theories from Critical Medical Anthropology for Public Health Research. Part II: Medicine in the Social System, Medicine as a Social System

Directory of Open Access Journals (Sweden)

Jennifer J. Carroll

2014-06-01

Full Text Available This article summarizes four significant theoretical concepts from the field of Critical Medical Anthropology in two parts: in the first part, biopower/discipline and explanatory models; in the second, structural violence, and identity politics and biological citizenship. The four subjects reviewed here have been chosen for their importance to our understanding of human behaviors related to health and illness, as well as for the impact that they can have on theory, research, and practice in the field of public health. These critical theories can provide new ways of thinking about professional roles, medical decisions, disease diagnosis and etiology, treatment adherence, prevention messaging, and all sorts of health-related behaviors and systems of understanding. They can also help public health researchers shed light on the human beliefs and activities that shape patterns of disease within and across populations. Whether a research question is being formulated or research findings are being analyzed, the critical social theories outlined here can foster a more holistic understanding of the human element in any public health project.

Social relationships and health: the relative roles of family functioning and social support.

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Franks, P; Campbell, T L; Shields, C G

1992-04-01

The associations between social relationships and health have been examined using two major research traditions. Using a social epidemiological approach, much research has shown the beneficial effect of social supports on health and health behaviors. Family interaction research, which has grown out of a more clinical tradition, has shown the complex effects of family functioning on health, particularly mental health. No studies have examined the relative power of these two approaches in explicating the connections between social relationships and health. We hypothesized that social relationships (social support and family functioning) would exert direct and indirect (through depressive symptoms) effects on health behaviors. We also hypothesized that the effects of social relationships on health would be more powerfully explicated by family functioning than by social support. We mailed a pilot survey to a random sample of patients attending a family practice center, including questions on depressive symptoms, cardiovascular health behaviors, demographics, social support using the ISEL scale, and family functioning using the FEICS scale. FEICS is a self-report questionnaire designed to assess family emotional involvement and criticism, the media elements of family expressed emotion. Eighty-three useable responses were obtained. Regression analyses and structural modelling showed both direct and indirect statistically significant paths from social relationships to health behaviors. Family criticism was directly associated (standardized coefficient = 0.29) with depressive symptoms, and family emotional involvement was directly associated with both depressive symptoms (coefficient = 0.35) and healthy cardiovascular behaviors (coefficient = 0.32). The results support the primacy of family functioning factors in understanding the associations among social relationships, mental health, and health behaviors. The contrasting relationships between emotional involvement and

A Correlational Analysis: Electronic Health Records (EHR) and Quality of Care in Critical Access Hospitals

Science.gov (United States)

Khan, Arshia A.

2012-01-01

Driven by the compulsion to improve the evident paucity in quality of care, especially in critical access hospitals in the United States, policy makers, healthcare providers, and administrators have taken the advise of researchers suggesting the integration of technology in healthcare. The Electronic Health Record (EHR) System composed of multiple…

The role of landscape connectivity in planning and implementing conservation and restoration priorities

Science.gov (United States)

Deborah A. Rudnick; Sadie J. Ryan; Paul Beier; Samuel A. Cushman; Fred Dieffenbach; Clinton W. Epps; Leah R. Gerber; Joel Hartter; Jeff S. Jenness; Julia Kintsch; Adina M. Merenlender; Ryan M. Perkl; Damian V. Preziosi; Stephen C. Trombulak

2012-01-01

Landscape connectivity, the extent to which a landscape facilitates the movements of organisms and their genes, faces critical threats from both fragmentation and habitat loss. Many conservation efforts focus on protecting and enhancing connectivity to offset the impacts of habitat loss and fragmentation on biodiversity conservation, and to increase the resilience of...

Novel technique for airless connection of artificial heart to vascular conduits.

Science.gov (United States)

Karimov, Jamshid H; Gao, Shengqiang; Dessoffy, Raymond; Sunagawa, Gengo; Sinkewich, Martin; Grady, Patrick; Sale, Shiva; Moazami, Nader; Fukamachi, Kiyotaka

2017-12-01

Successful implantation of a total artificial heart relies on multiple standardized procedures, primarily the resection of the native heart, and exacting preparation of the atrial and vascular conduits for pump implant and activation. Achieving secure pump connections to inflow/outflow conduits is critical to a successful outcome. During the connection process, however, air may be introduced into the circulation, traveling to the brain and multiple organs. Such air emboli block blood flow to these areas and are detrimental to long-term survival. A correctly managed pump-to-conduit connection prevents air from collecting in the pump and conduits. To further optimize pump-connection techniques, we have developed a novel connecting sleeve that enables airless connection of the Cleveland Clinic continuous-flow total artificial heart (CFTAH) to the conduits. In this brief report, we describe the connecting sleeve design and our initial results from two acute in vivo implantations using a scaled-down version of the CFTAH.

[Critical aspects of the management of "hazardous" health care workers. Consensus document].

Science.gov (United States)

Magnavita, N; Cicerone, Marina; Cirese, Vania; De Lorenzo, G; Di Giannantonios, M; Fileni, A; Goggiamani, Angela; Magnavita, Giulia; Marchi, Edda; Mazzullo, D; Monami, F; Monami, S; Puro, V; Ranalletta, Dalila; Ricciardi, G; Sacco, A; Spagnolo, A; Spagnolo, A G; Squarcione, S; Zavota, Giovanna

2006-01-01

A worker is considered to be hazardous to others when, in the course of performing a specific work task, his/her health problems (e.g., substance dependence, emotional disorders, physical disability, transmissible diseases) pose a risk for other workers' or the public's health and safety, or begins to interfere with ability to function in profession life. The presence of certain illnesses or the fact that a health care worker is impaired because of them do not necessarily imply that he, or she, is hazardous for others. Working in health care increases the probability that an impaired worker being hazardous for others. Management of hazardous workers requires new techniques and procedures, and specific policies. An interdisciplinary group of experts from medical, bioethical, legal and administrative disciplines, together with trade union and employers' representatives, is currently attempting to define a way to put prevention measures into practice in accordance with state laws and individual rights. A consensus document is presented, covering critical aspects such as: social responsibility of the employer, risk management, informed consent, non compliance, confidentiality, responsibility of workers, disclosure of risk to patients, non-discrimination, counselling and recovery of impaired workers, effectiveness of international guidelines. Occupational health professionals are obliged to adhere to ethical principles in the management of "hazardous" workers; the assessment of ethical costs and benefits for the stakeholders is the basis for appropriate decisions.

Race and Culture in the Secondary School Health and Physical Education Curriculum in Ontario, Canada: A Critical Reading

Science.gov (United States)

Petherick, LeAnne

2018-01-01

Purpose: The purpose of this paper is to explore issues of race and culture in health education in the secondary school health and physical education (HPE) curriculum in Ontario, Canada. Design/methodology/approach: Using Ontario's secondary school curriculum as a point of analysis, this paper draws from critical race theory and a whiteness lens…

Laboratory equipment maintenance: a critical bottleneck for strengthening health systems in sub-Saharan Africa?

Science.gov (United States)

Fonjungo, Peter N; Kebede, Yenew; Messele, Tsehaynesh; Ayana, Gonfa; Tibesso, Gudeta; Abebe, Almaz; Nkengasong, John N; Kenyon, Thomas

2012-02-01

Properly functioning laboratory equipment is a critical component for strengthening health systems in developing countries. The laboratory can be an entry point to improve population health and care of individuals for targeted diseases - prevention, care, and treatment of TB, HIV/AIDS, and malaria, plus maternal and neonatal health - as well as those lacking specific attention and funding. We review the benefits and persistent challenges associated with sustaining laboratory equipment maintenance. We propose equipment management policies as well as a comprehensive equipment maintenance strategy that would involve equipment manufacturers and strengthen local capacity through pre-service training of biomedical engineers. Strong country leadership and commitment are needed to assure development and sustained implementation of policies and strategies for standardization of equipment, and regulation of its procurement, donation, disposal, and replacement.

m-Health: A Critical Analysis of Awareness, Perception, and Attitude of Healthcare Among Providers in Himachal Pradesh, North India.

Science.gov (United States)

Ganapathy, Krishnan; Kanwar, Vikrant; Bhatnagar, Tarun; Uthayakumaran, N

2016-08-01

Providing healthcare in remote mountainous areas is challenging. The increasing availability of mobile connectivity needs to be exploited by offering healthcare through a mobile medium, popularly known as mobile health (m-health). It is essential to understand the awareness, perception, and attitude of healthcare providers (HCPs) in deploying m-health. Their outlook on new technologies influences patient adoption. Reports on attitudes regarding healthcare through mobile phones are now confined to views from the recipient. This study from August 1 to September 30, 2014 analyzed the views of 592 HCPs (12.3% of all HCPs) in Himachal Pradesh, India. They included faculty and students of the two medical colleges, as well as HCPs from all of the 12 districts. Although Himachal Pradesh has the highest teledensity of all states in India (117.6%), only 58.8% of HCPs (of those surveyed, 72% lived in suburban areas and 24.8% in Shimla, the state capital) would easily recommend m-health. Self-perceived ability to use mobile services was 85%. Fifty-nine percent used mobile devices for social networking, and 52.4% used Wi-Fi. Sixty-one percent of those interviewed were females, and 39% were males. The transformative potential of m-health hinges on its acceptance and use by all stakeholders. The study suggests that as HCPs in Himachal Pradesh are already using mobile value added services and are highly information technology literate, addressing their specific concerns could lead to use of m-health in Himachal Pradesh. Healthcare delivery in Himachal Pradesh is still suboptimal. With increasing connectivity, awareness, and commencement of telemedicine services in Himachal Pradesh, m-health has the potential to be a reality.

Brain modularity controls the critical behavior of spontaneous activity.

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Russo, R; Herrmann, H J; de Arcangelis, L

2014-03-13

The human brain exhibits a complex structure made of scale-free highly connected modules loosely interconnected by weaker links to form a small-world network. These features appear in healthy patients whereas neurological diseases often modify this structure. An important open question concerns the role of brain modularity in sustaining the critical behaviour of spontaneous activity. Here we analyse the neuronal activity of a model, successful in reproducing on non-modular networks the scaling behaviour observed in experimental data, on a modular network implementing the main statistical features measured in human brain. We show that on a modular network, regardless the strength of the synaptic connections or the modular size and number, activity is never fully scale-free. Neuronal avalanches can invade different modules which results in an activity depression, hindering further avalanche propagation. Critical behaviour is solely recovered if inter-module connections are added, modifying the modular into a more random structure.

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

DEFF Research Database (Denmark)

Jæger, Kirsten

2012-01-01

professionals and their approach to ethnic minority patients influence the accessibility of healthcare and availability of health prevention resources of ethnic minorities. When adapting healthcare practice to minority patients, healthcare professionals draw on insights from intercultural communication...... and anthropology. However, within these disciplines such concepts as culture, interculturality, and ethnicity are subjected to contestation due to co-existing, but competing paradigms. This paper demonstrates how healthcare discourses on ethnic minority patients reflect shifting intercultural communication...... paradigms and advocates the adoption of a critical intercultural communication approach in relation to ethnicity-based health inequality....

Critical perspectives on mental health

National Research Council Canada - National Science Library

Hopton, John; Coppock, Vicki

2000-01-01

.... By evaluating the impact on psychiatric thought of the social and political movements of the 1960s and 1970s - such as anti-racism, anti-psychiatry and radical feminism - the authors argue that these movements led to challenges to the legitimacy of psychiatry. Using theoretical frameworks borrowed from critical criminology, these competing critiques ar...

Integrity of Bolted Angle Connections Subjected to Simulated Column Removal

Science.gov (United States)

Weigand, Jonathan M.; Berman, Jeffrey W.

2016-01-01

Large-scale tests of steel gravity framing systems (SGFSs) have shown that the connections are critical to the system integrity, when a column suffers damage that compromises its ability to carry gravity loads. When supporting columns were removed, the SGFSs redistributed gravity loads through the development of an alternate load path in a sustained tensile configuration resulting from large vertical deflections. The ability of the system to sustain such an alternate load path depends on the capacity of the gravity connections to remain intact after undergoing large rotation and axial extension demands, for which they were not designed. This study experimentally evaluates the performance of steel bolted angle connections subjected to loading consistent with an interior column removal. The characteristic connection behaviors are described and the performance of multiple connection configurations are compared in terms of their peak resistances and deformation capacities. PMID:27110059

Making sense of mobile health data: an open architecture to improve individual- and population-level health.

Science.gov (United States)

Chen, Connie; Haddad, David; Selsky, Joshua; Hoffman, Julia E; Kravitz, Richard L; Estrin, Deborah E; Sim, Ida

2012-08-09

Mobile phones and devices, with their constant presence, data connectivity, and multiple intrinsic sensors, can support around-the-clock chronic disease prevention and management that is integrated with daily life. These mobile health (mHealth) devices can produce tremendous amounts of location-rich, real-time, high-frequency data. Unfortunately, these data are often full of bias, noise, variability, and gaps. Robust tools and techniques have not yet been developed to make mHealth data more meaningful to patients and clinicians. To be most useful, health data should be sharable across multiple mHealth applications and connected to electronic health records. The lack of data sharing and dearth of tools and techniques for making sense of health data are critical bottlenecks limiting the impact of mHealth to improve health outcomes. We describe Open mHealth, a nonprofit organization that is building an open software architecture to address these data sharing and "sense-making" bottlenecks. Our architecture consists of open source software modules with well-defined interfaces using a minimal set of common metadata. An initial set of modules, called InfoVis, has been developed for data analysis and visualization. A second set of modules, our Personal Evidence Architecture, will support scientific inferences from mHealth data. These Personal Evidence Architecture modules will include standardized, validated clinical measures to support novel evaluation methods, such as n-of-1 studies. All of Open mHealth's modules are designed to be reusable across multiple applications, disease conditions, and user populations to maximize impact and flexibility. We are also building an open community of developers and health innovators, modeled after the open approach taken in the initial growth of the Internet, to foster meaningful cross-disciplinary collaboration around new tools and techniques. An open mHealth community and architecture will catalyze increased mHealth efficiency

[Applications and connected objects, new perspectives].

Science.gov (United States)

Trudelle, Pierre

2017-11-01

Applications and connected objects appear promising in the world of wellbeing and health. Often cheap, they offer numerous perspectives for health promotion, in targeted fields or to fulfil 'niche' needs. This growth, extremely fast over the last five years, has also given rise to potential defiance on the part of users. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Healthcare disparities in critical illness.

Science.gov (United States)

Soto, Graciela J; Martin, Greg S; Gong, Michelle Ng

2013-12-01

To summarize the current literature on racial and gender disparities in critical care and the mechanisms underlying these disparities in the course of acute critical illness. MEDLINE search on the published literature addressing racial, ethnic, or gender disparities in acute critical illness, such as sepsis, acute lung injury, pneumonia, venous thromboembolism, and cardiac arrest. Clinical studies that evaluated general critically ill patient populations in the United States as well as specific critical care conditions were reviewed with a focus on studies evaluating factors and contributors to health disparities. Study findings are presented according to their association with the prevalence, clinical presentation, management, and outcomes in acute critical illness. This review presents potential contributors for racial and gender disparities related to genetic susceptibility, comorbidities, preventive health services, socioeconomic factors, cultural differences, and access to care. The data are organized along the course of acute critical illness. The literature to date shows that disparities in critical care are most likely multifactorial involving individual, community, and hospital-level factors at several points in the continuum of acute critical illness. The data presented identify potential targets as interventions to reduce disparities in critical care and future avenues for research.

A critical review of social and health inequalities in the nursing curriculum.

Science.gov (United States)

Rozendo, Célia Alves; Santos Salas, Anna; Cameron, Brenda

2017-03-01

Social and health inequalities are a reality around the world and one of the most important challenges in the current age. Nurse educators can respond to these challenges by incorporating curricular components to identify and intervene in social and health inequalities. To examine how social and health inequalities have been addressed in the nursing curriculum. Informed by the work of Paulo Freire, a critical literature review was performed to examine how social and health inequalities have been addressed in the nursing curriculum. In July 2015, we searched for articles published from 2000 to 2015 in ERIC, CINAHL, Web of Science, Scielo, MEDLINE and LILACS databases. Main search terms included "disparity" or "inequality" and "curriculum" and "nursing." We included studies published in academic journals in English, Portuguese and Spanish. A total of 20 articles were included in this review. Most of the articles (15) were from the United States and described educational experiences in implementing courses in nursing undergraduate curricula. Limited experiences with graduate nursing education were identified. Social and health inequalities were approached in these articles through elements such as social justice, cultural competence, cultural safety, and advocacy. A concern to reduce social and health disparities was noted. We identified three major themes in the articles included in this review: 1) elements in the curricula that can contribute to reducing social and health inequalities; 2) educational and research strategies used to address the theme of inequalities; 3) a focus on socially vulnerable populations to increase awareness on social and health inequalities. Findings suggest that nursing education initiatives align with the recommendations from the World Health Organization to address disparities. There is also a need to identify existing conceptual and practical content on inequalities in the nursing curriculum through future research. Copyright © 2016

Mental Health and Military-Connected Students on Campus: Culture, Challenges, and Success

Science.gov (United States)

Bonar, Ted C.

2016-01-01

This chapter provides an overview of common challenges faced by military-connected students on university campuses. The characteristics, culture, and experiences of service members and veterans are described through vignettes based on military-connected students.

Searching for scientific literacy and critical pedagogy in socioscientific curricula: A critical discourse analysis

Science.gov (United States)

Cummings, Kristina M.

, additional research is necessary to confirm the connection between the way curricula address a socioscientific issue and develop or suppress scientific literacy. Additionally, further analysis is necessary to confirm the connection between corporate-sponsored curricula and the suppression of socioscientific issues, scientific literacy, and critical pedagogy. Finally, this study addressed only the intended results of the curricula. Further research is necessary to measure the actual impacts of these curricula on students.

Politics of Ebola and the critical role of global health diplomacy for the CARICOM

Directory of Open Access Journals (Sweden)

Vijay Kumar Chattu

2017-01-01

Full Text Available The 2014 Ebola epidemic was the largest in history, affecting Guinea, Liberia, Sierra Leone, Nigeria, and Mali in West Africa. The International Health Regulations are legally binding in 194 countries including all the member states of WHO “to prevent, protect against, control, and provide a public health response to the international spread of disease.” Since the Caribbean Community region heavily depends on tourism, a single case of the disease anywhere in the region could have serious negative consequences for the rest of the region's tourism industry. Global health diplomacy brings together the disciplines of public health, international affairs, management, law, and economics and focuses on negotiations that shape and manage the global policy environment for health. The regional institutes such as Caribbean Public Health Agency should play a more proactive and pivotal role in the creation of regional response teams in all the island nations collaborating with the departments of public health and epidemiology at the regional campuses of The University of the West Indies. The role of global health diplomacy and its practice should be encouraged to reach a consensus among the stakeholders considering the threat to the health security in the region. There is a need for the cadre of global health diplomats who has a critical understanding of health and also the practice of diplomacy since such serious health issues have implications at the global level in this globalized world.

Sensitivity of marine protected area network connectivity to atmospheric variability.

Science.gov (United States)

Fox, Alan D; Henry, Lea-Anne; Corne, David W; Roberts, J Murray

2016-11-01

International efforts are underway to establish well-connected systems of marine protected areas (MPAs) covering at least 10% of the ocean by 2020. But the nature and dynamics of ocean ecosystem connectivity are poorly understood, with unresolved effects of climate variability. We used 40-year runs of a particle tracking model to examine the sensitivity of an MPA network for habitat-forming cold-water corals in the northeast Atlantic to changes in larval dispersal driven by atmospheric cycles and larval behaviour. Trajectories of Lophelia pertusa larvae were strongly correlated to the North Atlantic Oscillation (NAO), the dominant pattern of interannual atmospheric circulation variability over the northeast Atlantic. Variability in trajectories significantly altered network connectivity and source-sink dynamics, with positive phase NAO conditions producing a well-connected but asymmetrical network connected from west to east. Negative phase NAO produced reduced connectivity, but notably some larvae tracked westward-flowing currents towards coral populations on the mid-Atlantic ridge. Graph theoretical metrics demonstrate critical roles played by seamounts and offshore banks in larval supply and maintaining connectivity across the network. Larval longevity and behaviour mediated dispersal and connectivity, with shorter lived and passive larvae associated with reduced connectivity. We conclude that the existing MPA network is vulnerable to atmospheric-driven changes in ocean circulation.

Contradictory discourses of health promotion and disease prevention in the educational curriculum of Norwegian public health nursing: a critical discourse analysis.

Science.gov (United States)

Dahl, Berit Misund; Andrews, Therese; Clancy, Anne

2014-02-01

Health care is under constant change creating new and demanding tasks for public health nurses. The curriculum for public health nursing students is controlled by governmental directives that decide the structure and content of their education. This paper analyses manifest and latent discourses in the curriculum, in order to reveal underlying governmental principles for how public health nurses should promote health and prevent diseases. A critical discourse analysis of the Norwegian public health nursing curriculum was conducted. The study indicates i) 'a competing biomedical and social-scientific knowledge-discourse', with biomedical knowledge dominating the content of the curriculum; ii) 'a paternalistic meta-discourse', referring to an underlying paternalistic ideology despite a clear focus on user participation; and iii) 'a hegemonic individual discourse'. Even though the curriculum stipulates that public health nurses should work at both an individual and a societal level, there is very little population focus in the text. Recent political documents concerning public health nursing focus more on health promotion, however, this is not sufficiently explicit in the curriculum. The lack of emphasis on social scientific knowledge, and the blurred empowerment and population perspective in the curriculum, can lead to less emphasis on health promotion work in public health nursing education and practice. The curriculum should be revised in order to meet the recent governmental expectations.

Representing connectivity: quantifying effective habitat availability based on area and connectivity for conservation status assessment and recovery.

Science.gov (United States)

Neel, Maile; Tumas, Hayley R; Marsden, Brittany W

2014-01-01

We apply a comprehensive suite of graph theoretic metrics to illustrate how landscape connectivity can be effectively incorporated into conservation status assessments and in setting conservation objectives. These metrics allow conservation practitioners to evaluate and quantify connectivity in terms of representation, resiliency, and redundancy and the approach can be applied in spite of incomplete knowledge of species-specific biology and dispersal processes. We demonstrate utility of the graph metrics by evaluating changes in distribution and connectivity that would result from implementing two conservation plans for three endangered plant species (Erigeron parishii, Acanthoscyphus parishii var. goodmaniana, and Eriogonum ovalifolium var. vineum) relative to connectivity under current conditions. Although distributions of the species differ from one another in terms of extent and specific location of occupied patches within the study landscape, the spatial scale of potential connectivity in existing networks were strikingly similar for Erigeron and Eriogonum, but differed for Acanthoscyphus. Specifically, patches of the first two species were more regularly distributed whereas subsets of patches of Acanthoscyphus were clustered into more isolated components. Reserves based on US Fish and Wildlife Service critical habitat designation would not greatly contribute to maintain connectivity; they include 83-91% of the extant occurrences and >92% of the aerial extent of each species. Effective connectivity remains within 10% of that in the whole network for all species. A Forest Service habitat management strategy excluded up to 40% of the occupied habitat of each species resulting in both range reductions and loss of occurrences from the central portions of each species' distribution. Overall effective network connectivity was reduced to 62-74% of the full networks. The distance at which each CHMS network first became fully connected was reduced relative to the full

Governing citizens and health professionals at a distance: A critical discourse analysis of policies of intersectorial collaboration in Danish health-care

DEFF Research Database (Denmark)

Andersen, Anne Bendix; Frederiksen, Kirsten; Kolbæk, Raymond

2017-01-01

of intersectorial collaboration. The premises of intersectorial collaboration are maintained through a specific presentation of actors leaving little room for discussion, where professionals are constructed as actors who are expected to develop ways of collaborating according to the Triple Aim approach in order...... policies as powerful actors and explores how effects of a concrete policy are adapted for intersectorial collaboration in Danish healthcare. The paper is based on a critical discourse analysis of a central policy document in Danish health-care known as the ‘Health Agreements’. Using Fairclough’s three......-dimensional model for discourse analysis, we explored the document to clarify the construction of actors participating in intersectorial collaboration. The analysis revealed the Health Agreement as a ‘negotiated text’, appearing as an overriding document legitimising one possible discourse regarding the premises...

Interval Mathematics Applied to Critical Point Transitions

Directory of Open Access Journals (Sweden)

Benito A. Stradi

2012-03-01

Full Text Available The determination of critical points of mixtures is important for both practical and theoretical reasons in the modeling of phase behavior, especially at high pressure. The equations that describe the behavior of complex mixtures near critical points are highly nonlinear and with multiplicity of solutions to the critical point equations. Interval arithmetic can be used to reliably locate all the critical points of a given mixture. The method also verifies the nonexistence of a critical point if a mixture of a given composition does not have one. This study uses an interval Newton/Generalized Bisection algorithm that provides a mathematical and computational guarantee that all mixture critical points are located. The technique is illustrated using several example problems. These problems involve cubic equation of state models; however, the technique is general purpose and can be applied in connection with other nonlinear problems.

Tea, talk and technology: patient and public involvement to improve connected health 'wearables' research in dementia.

Science.gov (United States)

Hassan, Lamiece; Swarbrick, Caroline; Sanders, Caroline; Parker, Angela; Machin, Matt; Tully, Mary P; Ainsworth, John

2017-01-01

There are a growing number of mobile phones, watches and electronic devices which can be worn on the body to track aspects of health and well-being, such as daily steps, sleep and exercise. Dementia researchers think that these devices could potentially be used as part of future research projects, for example to help spot changes in daily activity that may signal the early symptoms of dementia. We asked a range of older people, including people living with dementia and their carers, to participate in interactive discussions about how future participants might find using these devices as part of research projects. We also invited volunteers to borrow a range of devices to test at home, giving them further insights. Discussions revealed that people were generally supportive of this type of research, provided they gave informed consent and that devices were discreet, comfortable and easy to use. They also valued technical support and regular feedback on study progress to encourage ongoing participation. These findings were used to develop a pool of devices for researchers, with computer software and written guidance to help plan, design and support studies. Our work shows that when given the right opportunities, people who are affected by dementia can provide valuable insights that can enhance the design, delivery and quality of future research. Background Increasingly, researchers are recognising the potential for connected health devices, including smartphones and smartwatches, to generate high resolution data about patterns of daily activity and health outcomes. One aim of the Dementias Platform UK (DPUK) project is to provide researchers with a secure means to collect, collate and link data generated by such devices, thereby accelerating this type of research in the field of dementia. We aimed to involve members of the public in discussions about the acceptability and feasibility of different devices and research designs to inform the development of a device pool

Understanding spatial connectivity of individuals with non-uniform population density.

Science.gov (United States)

Wang, Pu; González, Marta C

2009-08-28

We construct a two-dimensional geometric graph connecting individuals placed in space within a given contact distance. The individuals are distributed using a measured country's density of population. We observe that while large clusters (group of individuals connected) emerge within some regions, they are trapped in detached urban areas owing to the low population density of the regions bordering them. To understand the emergence of a giant cluster that connects the entire population, we compare the empirical geometric graph with the one generated by placing the same number of individuals randomly in space. We find that, for small contact distances, the empirical distribution of population dominates the growth of connected components, but no critical percolation transition is observed in contrast to the graph generated by a random distribution of population. Our results show that contact distances from real-world situations as for WIFI and Bluetooth connections drop in a zone where a fully connected cluster is not observed, hinting that human mobility must play a crucial role in contact-based diseases and wireless viruses' large-scale spreading.

Ageing, Learning and Health: Making Connections

Science.gov (United States)

Mestheneos, Elizabeth; Withnall, Alexandra

2016-01-01

The health of ageing populations is a real concern across the world so that the concept of active ageing has been advocated as a framework for appropriate educational policies and programmes to support people as they grow older. The other elements discussed here are health and healthy life expectancy (HLE) acknowledging that as people age, they…

The Significant Surface-Water Connectivity of “Geographically Isolated Wetlands”

Science.gov (United States)

We evaluated the current literature, coupled with our collective research expertise, on surface-water connectivity of wetlands considered to be “geographically isolated” (sensu Tiner Wetlands 23:494–516, 2003a) to critically assess the scientific foundation of g...

A critical look at health

African Journals Online (AJOL)

University of the Western Cape, Private Bag X17, Bellville 7535 ... progressive definition of health conceptualises health more holistically and views it as a state of complete ... Measuring quality of life in developing world contexts is crucial.

Theory of Mind and Sensitivity to Teacher and Peer Criticism among Japanese Children

Science.gov (United States)

Mizokawa, Ai

2015-01-01

This study investigated sensitivity to teacher and peer criticism among 89 Japanese 6-year-olds and examined the connection between sensitivity to criticism and first-order and second-order theory of mind separately. Participants completed a common test battery that included tasks assessing sensitivity to criticism (teacher or peer condition), the…

Towards a Critical Health Equity Research Stance: Why Epistemology and Methodology Matter More than Qualitative Methods

Science.gov (United States)

Bowleg, Lisa

2017-01-01

Qualitative methods are not intrinsically progressive. Methods are simply tools to conduct research. Epistemology, the justification of knowledge, shapes methodology and methods, and thus is a vital starting point for a critical health equity research stance, regardless of whether the methods are qualitative, quantitative, or mixed. In line with…

Investigating the Correlation Between Pharmacy Student Performance on the Health Science Reasoning Test and a Critical Thinking Assignment

OpenAIRE

Nornoo, Adwoa O.; Jackson, Jonathan; Axtell, Samantha

2017-01-01

Objective. To determine whether there is a correlation between pharmacy students? scores on the Health Science Reasoning Test (HSRT) and their grade on a package insert assignment designed to assess critical thinking.

Electrification: Connecting the Pieces in the Broader View

Energy Technology Data Exchange (ETDEWEB)

Gearhart, Chris C [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

2017-11-28

Presented at the SELECT Annual Meeting on September 26, 2017, this PowerPoint presentation gives an overview of connectivity and automation and how these new technologies will impact society in both known and unknown ways. Electrification challenges and opportunities are also outlined as without electrification, connectivity and automation will just magnify the negative health, climate and economic problems of the current transportation systems. Electrification can provide benefits while mitigating the negative consequences. And with careful connection of all of the pieces from materials up through controls, a sustainable transportation eco-system is attainable.

The MomConnect helpdesk: how an interactive mobile messaging programme is used by mothers in South Africa.

Science.gov (United States)

Xiong, Khou; Kamunyori, Joy; Sebidi, Jane

2018-01-01

South Africa's MomConnect mobile messaging programme, which aims to promote safe motherhood and improve pregnancy outcomes for South African women, includes a helpdesk feature which allows women registered on the system to ask maternal and child health (MCH)-related questions and to provide feedback on health services received at public health clinics. Messages sent to the helpdesk are answered by staff located at the National Department of Health. We examined event data from the MomConnect helpdesk database to identify any patterns in messages received, such as correlation of frequency or types of messages with location. We also explored what these data could tell us about the helpdesk's effectiveness in improving health service delivery at public health clinics. We found that approximately 8% of registered MomConnect users used the helpdesk, and that usage was generally proportional to the use of antenatal care (ANC) services in provinces (as indicated by number of ANC first visits and number of MomConnect registrations), except in two provinces. Language, category and key topics of helpdesk messages were correlated with provinces. Most users accessed the helpdesk to seek maternal information, and where feedback about health services was provided, there were significantly more compliments than complaints. The MomConnect helpdesk is an important resource providing expectant mothers and mothers of infants with an interactive option for accessing MCH-related information-above that included in the standard MomConnect messages-and advances achievement of the health goals of the MomConnect programme.

Connecting science, policy, and implementation for landscape-scale habitat connectivity.

Science.gov (United States)

Brodie, Jedediah F; Paxton, Midori; Nagulendran, Kangayatkarasu; Balamurugan, G; Clements, Gopalasamy Reuben; Reynolds, Glen; Jain, Anuj; Hon, Jason

2016-10-01

We examined the links between the science and policy of habitat corridors to better understand how corridors can be implemented effectively. As a case study, we focused on a suite of landscape-scale connectivity plans in tropical and subtropical Asia (Malaysia, Singapore, and Bhutan). The process of corridor designation may be more efficient if the scientific determination of optimal corridor locations and arrangement is synchronized in time with political buy-in and establishment of policies to create corridors. Land tenure and the intactness of existing habitat in the region are also important to consider because optimal connectivity strategies may be very different if there are few, versus many, political jurisdictions (including commercial and traditional land tenures) and intact versus degraded habitat between patches. Novel financing mechanisms for corridors include bed taxes, payments for ecosystem services, and strategic forest certifications. Gaps in knowledge of effective corridor design include an understanding of how corridors, particularly those managed by local communities, can be protected from degradation and unsustainable hunting. There is a critical need for quantitative, data-driven models that can be used to prioritize potential corridors or multicorridor networks based on their relative contributions to long-term metacommunity persistence. © 2016 Society for Conservation Biology.

Computational Approach for Securing Radiology-Diagnostic Data in Connected Health Network using High-Performance GPU-Accelerated AES.

Science.gov (United States)

Adeshina, A M; Hashim, R

2017-03-01

Diagnostic radiology is a core and integral part of modern medicine, paving ways for the primary care physicians in the disease diagnoses, treatments and therapy managements. Obviously, all recent standard healthcare procedures have immensely benefitted from the contemporary information technology revolutions, apparently revolutionizing those approaches to acquiring, storing and sharing of diagnostic data for efficient and timely diagnosis of diseases. Connected health network was introduced as an alternative to the ageing traditional concept in healthcare system, improving hospital-physician connectivity and clinical collaborations. Undoubtedly, the modern medicinal approach has drastically improved healthcare but at the expense of high computational cost and possible breach of diagnosis privacy. Consequently, a number of cryptographical techniques are recently being applied to clinical applications, but the challenges of not being able to successfully encrypt both the image and the textual data persist. Furthermore, processing time of encryption-decryption of medical datasets, within a considerable lower computational cost without jeopardizing the required security strength of the encryption algorithm, still remains as an outstanding issue. This study proposes a secured radiology-diagnostic data framework for connected health network using high-performance GPU-accelerated Advanced Encryption Standard. The study was evaluated with radiology image datasets consisting of brain MR and CT datasets obtained from the department of Surgery, University of North Carolina, USA, and the Swedish National Infrastructure for Computing. Sample patients' notes from the University of North Carolina, School of medicine at Chapel Hill were also used to evaluate the framework for its strength in encrypting-decrypting textual data in the form of medical report. Significantly, the framework is not only able to accurately encrypt and decrypt medical image datasets, but it also

Headaches and Hormones: What's the Connection?

Science.gov (United States)

Headaches and hormones: What's the connection? Being female has some real health advantages, but not when it comes to headaches — particularly ... a relationship between headaches and hormonal changes. The hormones estrogen (ES-truh-jen) and progesterone (pro-JES- ...

Wiki Activities in Blended Learning for Health Professional Students: Enhancing Critical Thinking and Clinical Reasoning Skills

Science.gov (United States)

Snodgrass, Suzanne

2011-01-01

Health professionals use critical thinking, a key problem solving skill, for clinical reasoning which is defined as the use of knowledge and reflective inquiry to diagnose a clinical problem. Teaching these skills in traditional settings with growing class sizes is challenging, and students increasingly expect learning that is flexible and…

Genetics Home Reference: critical congenital heart disease

Science.gov (United States)

... Facebook Twitter Home Health Conditions Critical congenital heart disease Critical congenital heart disease Printable PDF Open All Close All ... for Disease Control and Prevention: Congenital Heart Defects Disease InfoSearch: Congenital Heart Defects KidsHealth from Nemours Lucile Packard Children's ...

A secure and efficient uniqueness-and-anonymity-preserving remote user authentication scheme for connected health care.

Science.gov (United States)

Das, Ashok Kumar; Goswami, Adrijit

2013-06-01

Connected health care has several applications including telecare medicine information system, personally controlled health records system, and patient monitoring. In such applications, user authentication can ensure the legality of patients. In user authentication for such applications, only the legal user/patient himself/herself is allowed to access the remote server, and no one can trace him/her according to transmitted data. Chang et al. proposed a uniqueness-and-anonymity-preserving remote user authentication scheme for connected health care (Chang et al., J Med Syst 37:9902, 2013). Their scheme uses the user's personal biometrics along with his/her password with the help of the smart card. The user's biometrics is verified using BioHashing. Their scheme is efficient due to usage of one-way hash function and exclusive-or (XOR) operations. In this paper, we show that though their scheme is very efficient, their scheme has several security weaknesses such as (1) it has design flaws in login and authentication phases, (2) it has design flaws in password change phase, (3) it fails to protect privileged insider attack, (4) it fails to protect the man-in-the middle attack, and (5) it fails to provide proper authentication. In order to remedy these security weaknesses in Chang et al.'s scheme, we propose an improvement of their scheme while retaining the original merit of their scheme. We show that our scheme is efficient as compared to Chang et al.'s scheme. Through the security analysis, we show that our scheme is secure against possible attacks. Further, we simulate our scheme for the formal security verification using the widely-accepted AVISPA (Automated Validation of Internet Security Protocols and Applications) tool to ensure that our scheme is secure against passive and active attacks. In addition, after successful authentication between the user and the server, they establish a secret session key shared between them for future secure communication.

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

Science.gov (United States)

Leung, Zee; Middleton, Dean; Morrison, Karen

2012-05-16

There is a growing recognition that many public health issues are complex and can be best understood by examining the relationship between human health and the health of the ecosystems in which people live. Two approaches, One Health and Ecosystem Approaches to Health (EcoHealth), can help us to better understand these intricate and complex connections, and appear to hold great promise for tackling many modern public health dilemmas. Although both One Health and EcoHealth have garnered recognition from numerous health bodies in Canada and abroad, there is still a need to better understand how these approaches are shaping the practice of public health in Ontario.The purpose of this study was to characterize how public health actors in Ontario are influenced by the holistic principles which underlie One Health and EcoHealth, and to identify important lessons from their experiences. Ten semi-structured interviews were conducted with ten participants from the public health sphere in Ontario. Participants encompassed diverse perspectives including infectious disease, food systems, urban agriculture, and environmental health. Interviews were recorded, transcribed and analyzed using qualitative content analysis to identify major themes and patterns. Four major themes emerged from the interviews: the importance of connecting human health with the environment; the role of governance in promoting these ideas; the value of partnerships and collaborations in public health practice; and the challenge of operationalizing holistic approaches to public health. Overall study participants were found to be heavily influenced by concepts couched in EcoHealth and One Health literature, despite a lack of familiarity with these fields. Although One Health and EcoHealth are lesser known approaches in the public health sphere, their holistic and systems-based principles were found to influence the thoughts, values and experiences of public health actors interviewed in this study. This

Connecting Productivity, Nutrition and Health

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

Because animal protein is an integral part of a diverse diet, the project ... sufficient to feed 70 animals. The project has ... ability to address food security and health problems related to ... St. Kitts and Nevis: Ministry of Agriculture and Marine.

Access to health care as a human right in international policy: critical reflections and contemporary challenges.

Science.gov (United States)

Castillo, Camilo Hernán Manchola; Garrafa, Volnei; Cunha, Thiago; Hellmann, Fernando

2017-07-01

Using the United Nations (UN) and its subordinate body, the World Health Organization (WHO), as a frame of reference, this article explores access to healthcare as a human right in international intergovernmental policies. First, we look at how the theme of health is treated within the UN, focusing on the concept of global health. We then discuss the concept of global health from a human rights perspective and go on to outline the debate surrounding universal coverage versus universal access as a human right, addressing some important ethical questions. Thereafter, we discuss universal coverage versus universal access using the critical and constructivist theories of international relations as a frame of reference. Finally, it is concluded that, faced with the persistence of huge global health inequalities, the WHO began to reshape itself, leaving behind the notion of health as a human right and imposing the challenge of reducing the wide gap that separates international intergovernmental laws from reality.

ASIC-based design of NMR system health monitor for mission/safety?critical applications

OpenAIRE

Balasubramanian, P.

2016-01-01

N-modular redundancy (NMR) is a generic fault tolerance scheme that is widely used in safety?critical circuit/system designs to guarantee the correct operation with enhanced reliability. In passive NMR, at least a majority (N?+?1)/2 out of N function modules is expected to operate correctly at any time, where N is odd. Apart from a conventional realization of the NMR system, it would be useful to provide a concurrent indication of the system?s health so that an appropriate remedial action may...

Connecting through Comics: Expanding Opportunities for Teaching and Learning

Science.gov (United States)

Bolton-Gary, Cynthia

2012-01-01

When students are faced with learning abstract contents, creating meaningful teaching and learning opportunities is a challenge for many educators. Concerns for how to get students to connect theoretical constructs and apply them to the "real world" is especially critical for those students studying to be teachers. This descriptive study…

Training public health superheroes: five talents for public health leadership.

Science.gov (United States)

Day, Matthew; Shickle, Darren; Smith, Kevin; Zakariasen, Ken; Moskol, Jacob; Oliver, Thomas

2014-12-01

Public health leaders have been criticized for their policy stances, relationships with governments and failure to train the next generation. New approaches to the identification and training of public health leaders may be required. To inform these, lessons can be drawn from public health 'superheroes'; public health leaders perceived to be the most admired and effective by their peers. Members and Fellows of the UK Faculty of Public Health were contacted via e-newsletter and magazine and asked to nominate their 'Public Health Superhero'. Twenty-six responses were received, nominating 40 different people. Twelve semi-structured interviews were conducted. Thematic analysis, based on 'grounded theory', was conducted. Five leadership 'talents' for public health were identified: mentoring-nurturing, shaping-organizing, networking-connecting, knowing-interpreting and advocating-impacting. Talent-based approaches have been effective for leadership development in other sectors. These talents are the first specific to the practice of public health and align with some aspects of existing frameworks. An increased focus on identifying and developing talents during public health training, as opposed to 'competency'-based approaches, may be effective in strengthening public health leadership. Further research to understand the combination and intensity of talents across a larger sample of public health leaders is required. © The Author 2014. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

A Critical Review of Studies on Health Needs Assessment of Elderly in the World

Directory of Open Access Journals (Sweden)

Sima Ghasemi

2017-06-01

Full Text Available Introduction: Health improvement, control of communicable diseases and increase in life expectancy among the elderly of developed and developing countries has greatly increased. Since the health care and social needs of older adults differ from that of other adults, it is necessary to identify the needs of the elderly in order to make proper plans that will promote their health. The aim of this paper is to critically review these researches. Methods: A comprehensive literature review on the needs assessment of elderly health was applied searching English and Persian databases in Pub Med, Science Direct, ProQuest, Elsevier, Magiran, ISC and using key words including, Health need, Assessment, Elderly, Aging, Older adults, Aged and Health care needs. Results: Initial search yielded 745 references, considering the inclusion criteria, 21 papers were reviewed. Results revealed that in conducting needs assessment, various methods and procedures in various health dimensions including physical health, mental health, emotional, care, social, cultural, economic, nutritional, service, security, legal and educational needs have been utilized. Some of the dimensions had been more explored and some rarely. Conclusion: Most of the conducted studies had mainly focused on the elderly physical health needs and had neglected to take in to account other needs such as social and health care needs. In order to comprehensively recognize the health needs of the elderly, identifying their health care and care services is also important. Furthermore, in addition to quantitative studies, discovering the older adults’ perceptions of their own health needs is also necessary. It seems that the challenge ahead of managers, experts and researchers on elderly health is trying to design comprehensive mechanisms of health need assessment and considering it as a reference for any future planning.

Health security as a public health concept: a critical analysis.

Science.gov (United States)

Aldis, William

2008-11-01

There is growing acceptance of the concept of health security. However, there are various and incompatible definitions, incomplete elaboration of the concept of health security in public health operational terms, and insufficient reconciliation of the health security concept with community-based primary health care. More important, there are major differences in understanding and use of the concept in different settings. Policymakers in industrialized countries emphasize protection of their populations especially against external threats, for example terrorism and pandemics; while health workers and policymakers in developing countries and within the United Nations system understand the term in a broader public health context. Indeed, the concept is used inconsistently within the UN agencies themselves, for example the World Health Organization's restrictive use of the term 'global health security'. Divergent understandings of 'health security' by WHO's member states, coupled with fears of hidden national security agendas, are leading to a breakdown of mechanisms for global cooperation such as the International Health Regulations. Some developing countries are beginning to doubt that internationally shared health surveillance data is used in their best interests. Resolution of these incompatible understandings is a global priority.

Exploring Vaccine Hesitancy Through an Artist-Scientist Collaboration : Visualizing Vaccine-Critical Parents' Health Beliefs.

Science.gov (United States)

Koski, Kaisu; Holst, Johan

2017-09-01

This project explores vaccine hesitancy through an artist-scientist collaboration. It aims to create better understanding of vaccine hesitant parents' health beliefs and how these influence their vaccine-critical decisions. The project interviews vaccine-hesitant parents in the Netherlands and Finland and develops experimental visual-narrative means to analyse the interview data. Vaccine-hesitant parents' health beliefs are, in this study, expressed through stories, and they are paralleled with so-called illness narratives. The study explores the following four main health beliefs originating from the parents' interviews: (1) perceived benefits of illness, (2) belief in the body's intelligence and self-healing capacity, (3) beliefs about the "inside-outside" flow of substances in the body, and (4) view of death as a natural part of life. These beliefs are interpreted through arts-based diagrammatic representations. These diagrams, merging multiple aspects of the parents' narratives, are subsequently used in a collaborative meaning-making dialogue between the artist and the scientist. The resulting dialogue contrasts the health beliefs behind vaccine hesitancy with scientific knowledge, as well as the authors' personal, and differing, attitudes toward these.

Connectivity inference from neural recording data: Challenges, mathematical bases and research directions.

Science.gov (United States)

Magrans de Abril, Ildefons; Yoshimoto, Junichiro; Doya, Kenji

2018-06-01

This article presents a review of computational methods for connectivity inference from neural activity data derived from multi-electrode recordings or fluorescence imaging. We first identify biophysical and technical challenges in connectivity inference along the data processing pipeline. We then review connectivity inference methods based on two major mathematical foundations, namely, descriptive model-free approaches and generative model-based approaches. We investigate representative studies in both categories and clarify which challenges have been addressed by which method. We further identify critical open issues and possible research directions. Copyright © 2018 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Mean-field behavior for the survival probability and the point-to-surface connectivity

CERN Document Server

Sakai, A

2003-01-01

We consider the critical survival probability for oriented percolation and the contact process, and the point-to-surface connectivity for critical percolation. By similarity, let \\rho denote the critical expoents for both quantities. We prove in a unified fashion that, if \\rho exists and if both two-point function and its certain restricted version exhibit the same mean-field behavior, then \\rho=2 for percolation with d>7 and \\rho=1 for the time-oriented models with d>4.

Public Health Autonomy: A Critical Reappraisal.

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Zimmerman, Frederick J

2017-11-01

The ethical principle of autonomy is among the most fundamental in ethics, and it is particularly salient for those in public health, who must constantly balance the desire to improve health outcomes by changing behavior with respect for individual freedom. Although there are some areas in which there is a genuine tension between public health and autonomy-childhood vaccine mandates, for example-there are many more areas where not only is there no tension, but public health and autonomy come down to the same thing. These areas of overlap are often rendered invisible by a thin understanding of autonomy. Better integrating newer theoretical insights about autonomy into applied ethics can make discussions of public health ethics more rigorous, incisive, and effective. Even more importantly, bringing modern concepts of autonomy into public health ethics can showcase the many areas in which public health and autonomy have the same goals, face the same threats, and can be mutually advanced by the same kinds of solutions. This article provides a schema for relational autonomy in a public health context and gives concrete examples of how autonomy can be served through public-health interventions. It marshals insights from sociology, psychology, and philosophy to advance a theory of autonomy and coercion that recognizes three potential threats to autonomy: threats to choice sets, threats to knowledge, and threats to preferences. © 2017 The Hastings Center.

How spatio-temporal habitat connectivity affects amphibian genetic structure.

Science.gov (United States)

Watts, Alexander G; Schlichting, Peter E; Billerman, Shawn M; Jesmer, Brett R; Micheletti, Steven; Fortin, Marie-Josée; Funk, W Chris; Hapeman, Paul; Muths, Erin; Murphy, Melanie A

2015-01-01

Heterogeneous landscapes and fluctuating environmental conditions can affect species dispersal, population genetics, and genetic structure, yet understanding how biotic and abiotic factors affect population dynamics in a fluctuating environment is critical for species management. We evaluated how spatio-temporal habitat connectivity influences dispersal and genetic structure in a population of boreal chorus frogs (Pseudacris maculata) using a landscape genetics approach. We developed gravity models to assess the contribution of various factors to the observed genetic distance as a measure of functional connectivity. We selected (a) wetland (within-site) and (b) landscape matrix (between-site) characteristics; and (c) wetland connectivity metrics using a unique methodology. Specifically, we developed three networks that quantify wetland connectivity based on: (i) P. maculata dispersal ability, (ii) temporal variation in wetland quality, and (iii) contribution of wetland stepping-stones to frog dispersal. We examined 18 wetlands in Colorado, and quantified 12 microsatellite loci from 322 individual frogs. We found that genetic connectivity was related to topographic complexity, within- and between-wetland differences in moisture, and wetland functional connectivity as contributed by stepping-stone wetlands. Our results highlight the role that dynamic environmental factors have on dispersal-limited species and illustrate how complex asynchronous interactions contribute to the structure of spatially-explicit metapopulations.

How spatio-temporal habitat connectivity affects amphibian genetic structure

Science.gov (United States)

Watts, Alexander G.; Schlichting, P; Billerman, S; Jesmer, B; Micheletti, S; Fortin, M.-J.; Funk, W.C.; Hapeman, P; Muths, Erin L.; Murphy, M.A.

2015-01-01

Heterogeneous landscapes and fluctuating environmental conditions can affect species dispersal, population genetics, and genetic structure, yet understanding how biotic and abiotic factors affect population dynamics in a fluctuating environment is critical for species management. We evaluated how spatio-temporal habitat connectivity influences dispersal and genetic structure in a population of boreal chorus frogs (Pseudacris maculata) using a landscape genetics approach. We developed gravity models to assess the contribution of various factors to the observed genetic distance as a measure of functional connectivity. We selected (a) wetland (within-site) and (b) landscape matrix (between-site) characteristics; and (c) wetland connectivity metrics using a unique methodology. Specifically, we developed three networks that quantify wetland connectivity based on: (i) P. maculata dispersal ability, (ii) temporal variation in wetland quality, and (iii) contribution of wetland stepping-stones to frog dispersal. We examined 18 wetlands in Colorado, and quantified 12 microsatellite loci from 322 individual frogs. We found that genetic connectivity was related to topographic complexity, within- and between-wetland differences in moisture, and wetland functional connectivity as contributed by stepping-stone wetlands. Our results highlight the role that dynamic environmental factors have on dispersal-limited species and illustrate how complex asynchronous interactions contribute to the structure of spatially-explicit metapopulations.

Functional Connectivity Alterations between Networks and Associations with Infant Immune Health within Networks in HIV Infected Children on Early Treatment: A Study at 7 Years

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Jadrana T. F. Toich

2018-01-01

Full Text Available Although HIV has been shown to impact brain connectivity in adults and youth, it is not yet known to what extent long-term early antiretroviral therapy (ART may alter these effects, especially during rapid brain development in early childhood. Using both independent component analysis (ICA and seed-based correlation analysis (SCA, we examine the effects of HIV infection in conjunction with early ART on resting state functional connectivity (FC in 7 year old children. HIV infected (HIV+ children were from the Children with HIV Early Antiretroviral Therapy (CHER trial and all initiated ART before 18 months; uninfected children were recruited from an interlinking vaccine trial. To better understand the effects of current and early immune health on the developing brain, we also investigated among HIV+ children the association of FC at 7 years with CD4 count and CD4%, both in infancy (6–8 weeks and at scan. Although we found no differences within any ICA-generated resting state networks (RSNs between HIV+ and uninfected children (27 HIV+, 18 uninfected, whole brain connectivity to seeds located at RSN connectivity peaks revealed several loci of FC differences, predominantly from seeds in midline regions (posterior cingulate cortex, paracentral lobule, cuneus, and anterior cingulate. Reduced long-range connectivity and increased short-range connectivity suggest developmental delay. Within the HIV+ children, clinical measures at age 7 years were not associated with FC values in any of the RSNs; however, poor immune health during infancy was associated with localized FC increases in the somatosensory, salience and basal ganglia networks. Together these findings suggest that HIV may affect brain development from its earliest stages and persist into childhood, despite early ART.

Implementation of information and communication technologies for health in Bangladesh.

Science.gov (United States)

Islam, Sheik Mohammed Shariful; Tabassum, Reshman

2015-11-01

Bangladesh has yet to develop a fully integrated health information system infrastructure that is critical to guiding policy development and planning. Initial pilot telemedicine and eHealth programmes were not coordinated at national level. However, in 2011, a national eHealth policy was implemented. Bangladesh has made substantial improvements to its health system. However, the country still faces public health challenges with limited and inequitable access to health services and lack of adequate resources to meet the demands of the population. In 2008, eHealth services were introduced, including computerization of health facilities at sub-district levels, internet connections, internet servers and an mHealth service for communicating with health-care providers. Health facilities at sub-district levels were provided with internet connections and servers. In 482 upazila health complexes and district hospitals, an mHealth service was set-up where an on-duty doctor is available for patients at all hours to provide consultations by mobile phone. A government operated telemedicine service was initiated and by 2014, 43 fully equipped centres were in service. These centres provide medical consultations by qualified physicians to patients visiting rural and remote community clinics and union health centres. Despite early pilot interventions and successful implementation, progress in adopting eHealth strategies in Bangladesh has been slow. There is a lack of common standards on information technology for health, which causes difficulties in data management and sharing among different databases. Limited internet bandwidth and the high cost of infrastructure and software development are barriers to adoption of these technologies.

Scaling identity connects human mobility and social interactions.

Science.gov (United States)

Deville, Pierre; Song, Chaoming; Eagle, Nathan; Blondel, Vincent D; Barabási, Albert-László; Wang, Dashun

2016-06-28

Massive datasets that capture human movements and social interactions have catalyzed rapid advances in our quantitative understanding of human behavior during the past years. One important aspect affecting both areas is the critical role space plays. Indeed, growing evidence suggests both our movements and communication patterns are associated with spatial costs that follow reproducible scaling laws, each characterized by its specific critical exponents. Although human mobility and social networks develop concomitantly as two prolific yet largely separated fields, we lack any known relationships between the critical exponents explored by them, despite the fact that they often study the same datasets. Here, by exploiting three different mobile phone datasets that capture simultaneously these two aspects, we discovered a new scaling relationship, mediated by a universal flux distribution, which links the critical exponents characterizing the spatial dependencies in human mobility and social networks. Therefore, the widely studied scaling laws uncovered in these two areas are not independent but connected through a deeper underlying reality.

IoT and Connected Insurance Reshaping The Health Insurance Industry. A Customer-centric “From Cure To Care” Approach

Directory of Open Access Journals (Sweden)

A. Silvello

2017-12-01

Full Text Available An increasing global population, the rise in number of chronic disease patients and the threat of global epidemics have made the way for technology as a potential answer to many of these problems. Health insurance can contribute to the resolution of some of these issues but insurers need to transition from simple “Payers” to “Players” in order to achieve that. They need to become points of reference on which the customer and the health care system can count on. This is possible and is strictly related to connected insurance and in particular to wearables and devices that are able to gather vital data from patients and share them with the care givers.

Extra-team connections for knowledge transfer between staff teams

Science.gov (United States)

Ramanadhan, Shoba; Wiecha, Jean L.; Emmons, Karen M.; Gortmaker, Steven L.; Viswanath, Kasisomayajula

2009-01-01

As organizations implement novel health promotion programs across multiple sites, they face great challenges related to knowledge management. Staff social networks may be a useful medium for transferring program-related knowledge in multi-site implementation efforts. To study this potential, we focused on the role of extra-team connections (ties between staff members based in different site teams) as potential channels for knowledge sharing. Data come from a cross-sectional study of afterschool childcare staff implementing a health promotion program at 20 urban sites of the Young Men's Christian Association of Greater Boston. We conducted a sociometric social network analysis and attempted a census of 91 program staff members. We surveyed 80 individuals, and included 73 coordinators and general staff, who lead and support implementation, respectively, in this study. A multiple linear regression model demonstrated a positive relationship between extra-team connections (β = 3.41, P knowledge transfer. We also found that intra-team connections (within-team ties between staff members) were also positively related to skill receipt. Connections between teams appear to support knowledge transfer in this network, but likely require greater active facilitation, perhaps via organizational changes. Further research on extra-team connections and knowledge transfer in low-resource, high turnover environments is needed. PMID:19528313

Comparison between “Problem-Based Learning” and “Question & Answer” Educational Methods on Environmental Health Students’ Attitude to Critical Thinking

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Salehi L

2015-04-01

Full Text Available  Aims: Critical thinking has the 2 aspects skill and attitude. The skill aspect will not take place without the attitude to critical thinking. The aim of this study was to compare between problem-based and question-answer learning methods on critical thinking attitude of environmental health students.  Instrument & Methods: In this quasi-experimental study all 27 environmental health students of Alborz University of Medical Sciences were entered the study by census method. Critical thinking attitudes’ parameters were studied by the California critical thinking disposition inventory (CCTDI before and after the intervention. The problem-based learning group (14 persons held some scenarios for studying and investigating and question-answer group (13 persons held 4 questioning sessions. Data were collected and analyzed by SPSS 17 using independent- and paired-T tests.  Findings: There were no significant differences between the average of CCTDI scores for problem-based learning group before (278.00±28.14 and after (309.29±13.80 the intervention and also between the average of CCTDI scores for question-answer group before (276.00±7.12 and after (306.62±16.32 the intervention (p>0.05. Both methods caused a significant increase in analytic power, information categorization and self-confidence of students (p<0.05.  Conclusion: Using both question-answer and problem-based educational methods can improve the attitude to critical thinking in students.

Investigating the Correlation Between Pharmacy Student Performance on the Health Science Reasoning Test and a Critical Thinking Assignment.

Science.gov (United States)

Nornoo, Adwoa O; Jackson, Jonathan; Axtell, Samantha

2017-03-25

Objective. To determine whether there is a correlation between pharmacy students' scores on the Health Science Reasoning Test (HSRT) and their grade on a package insert assignment designed to assess critical thinking. Methods. The HSRT was administered to first-year pharmacy students during a critical-thinking course in the spring semester. In the same semester, a required package insert assignment was completed in a pharmacokinetics course. To determine whether there was a relationship between HSRT scores and grades on the assignment, a Spearman's rho correlation test was performed. Results. A very weak but significant positive correlation was found between students' grades on the assignment and their overall HSRT score (r=0.19, p critical-thinking skills in pharmacy students.

Critical thinking in nurse managers.

Science.gov (United States)

Zori, Susan; Morrison, Barbara

2009-01-01

Formal education and support is needed for nurse managers to effectively function in their role in the current health care environment. Many nurse managers assume their positions based on expertise in a clinical role with little expertise in managerial and leadership skills. Operating as a manager and leader requires ongoing development of critical thinking skills and the inclination to use those skills. Critical thinking can have a powerful influence on the decision making and problem solving that nurse managers are faced with on a daily basis. The skills that typify critical thinking include analysis, evaluation, inference, and deductive and inductive reasoning. It is intuitive that nurse managers require both the skills and the dispositions of critical thinking to be successful in this pivotal role at a time of transformation in health care. Incorporating critical thinking into education and support programs for the nurse manager is necessary to position the nurse manager for success.

Geographic Hotspots of Critical National Infrastructure.

Science.gov (United States)

Thacker, Scott; Barr, Stuart; Pant, Raghav; Hall, Jim W; Alderson, David

2017-12-01

Failure of critical national infrastructures can result in major disruptions to society and the economy. Understanding the criticality of individual assets and the geographic areas in which they are located is essential for targeting investments to reduce risks and enhance system resilience. Within this study we provide new insights into the criticality of real-life critical infrastructure networks by integrating high-resolution data on infrastructure location, connectivity, interdependence, and usage. We propose a metric of infrastructure criticality in terms of the number of users who may be directly or indirectly disrupted by the failure of physically interdependent infrastructures. Kernel density estimation is used to integrate spatially discrete criticality values associated with individual infrastructure assets, producing a continuous surface from which statistically significant infrastructure criticality hotspots are identified. We develop a comprehensive and unique national-scale demonstration for England and Wales that utilizes previously unavailable data from the energy, transport, water, waste, and digital communications sectors. The testing of 200,000 failure scenarios identifies that hotspots are typically located around the periphery of urban areas where there are large facilities upon which many users depend or where several critical infrastructures are concentrated in one location. © 2017 Society for Risk Analysis.

Well Connected, a platform for safe online communication and therapy

NARCIS (Netherlands)

Postel, Marloes Gerda; van Regteren, B.J.

2012-01-01

Well Connected, a platform for safe online communication and therapy Introduction Well Connected is a flexible, safe and user friendly e-health platform with a wide range of applications. Over the last 7 years 5000 patients were treated or a variety of addiction related problems. Besides creating an

Population Connectivity Measures of Fishery-Targeted Coral Reef Species to Inform Marine Reserve Network Design in Fiji.

Science.gov (United States)

Eastwood, Erin K; López, Elora H; Drew, Joshua A

2016-01-25

Coral reef fish serve as food sources to coastal communities worldwide, yet are vulnerable to mounting anthropogenic pressures like overfishing and climate change. Marine reserve networks have become important tools for mitigating these pressures, and one of the most critical factors in determining their spatial design is the degree of connectivity among different populations of species prioritized for protection. To help inform the spatial design of an expanded reserve network in Fiji, we used rapidly evolving mitochondrial genes to investigate connectivity patterns of three coral reef species targeted by fisheries in Fiji: Epinephelus merra (Serranidae), Halichoeres trimaculatus (Labridae), and Holothuria atra (Holothuriidae). The two fish species, E. merra and Ha. trimaculatus, exhibited low genetic structuring and high amounts of gene flow, whereas the sea cucumber Ho. atra displayed high genetic partitioning and predominantly westward gene flow. The idiosyncratic patterns observed among these species indicate that patterns of connectivity in Fiji are likely determined by a combination of oceanographic and ecological characteristics. Our data indicate that in the cases of species with high connectivity, other factors such as representation or political availability may dictate where reserves are placed. In low connectivity species, ensuring upstream and downstream connections is critical.

30 CFR 7.85 - Critical characteristics.

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Critical characteristics. 7.85 Section 7.85 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR TESTING, EVALUATION, AND... Underground Coal Mines § 7.85 Critical characteristics. The following critical characteristics shall be...

30 CFR 7.65 - Critical characteristics.

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Critical characteristics. 7.65 Section 7.65 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR TESTING, EVALUATION, AND... Critical characteristics. The following critical characteristics shall be inspected or tested on each...

Reliability-based fatigue life estimation of shear riveted connections considering dependency of rivet hole failures

Directory of Open Access Journals (Sweden)

Leonetti* Davide

2018-01-01

Full Text Available Standards and guidelines for the fatigue design of riveted connections make use of a stress range-endurance (S-N curve based on the net section stress range regardless of the number and the position of the rivets. Almost all tests on which S-N curves are based, are performed with a minimum number of rivets. However, the number of rivets in a row is expected to increase the fail-safe behaviour of the connection, whereas the number of rows is supposed to decrease the theoretical stress concentration at the critical locations, and hence these aspects are not considered in the S-N curves. This paper presents a numerical model predicting the fatigue life of riveted connections by performing a system reliability analysis on a double cover plated riveted butt joint. The connection is considered in three geometries, with different number of rivets in a row and different number of rows. The stress state in the connection is evaluated using a finite element model in which the friction coefficient and the clamping force in the rivets are considered in a deterministic manner. The probability of failure is evaluated for the main plate, and fatigue failure is assumed to be originating at the sides of the rivet holes, the critical locations, or hot-spots. The notch stress approach is applied to assess the fatigue life, considered to be a stochastic quantity. Unlike other system reliability models available in the literature, the evaluation of the probability of failure takes into account the stochastic dependence between the failures at each critical location modelled as a parallel system, which means considering the change of the state of stress in the connection when a ligament between two rivets fails. A sensitivity study is performed to evaluate the effect of the pretension in the rivet and the friction coefficient on the fatigue life.

Here Comes the Hyper-Connected Augmented Consumer

Directory of Open Access Journals (Sweden)

Stephen Andrew T.

2017-11-01

Full Text Available Consumers have become always on and constantly connected. Search costs have plummeted, individuals’ abilities to digitally express themselves and their opinions increased, and the opportunities for superior business and market intelligence for companies have skyrocketed. This has given rise to more, richer, and new sources of consumer data that marketers can leverage, and has fueled the data-driven insights revolution in marketing. But there is more to come very soon. In marketing, we are quickly moving from the age of the connected consumer to the age of the augmented consumer. New technologies like wearable devices, smart sensors, consumer IoT devices, smart homes, and, critically, artificial intelligence ecosystems will not only connect, but will substantially and meaningfully augment the consumer in terms of their thoughts and behaviors. The biggest challenge for marketers will lie in how they approach marketing to this new type of consumer, particularly personal artificial intelligence ecosystems. This means marketing to algorithms, instead of people, and that is very different to how most marketing work is currently done.

The relationship between critical thinking skills and self-efficacy beliefs in mental health nurses.

Science.gov (United States)

Gloudemans, Henk A; Schalk, René M J D; Reynaert, Wouter

2013-03-01

In the Netherlands, the distinction between Bachelor degree and diploma nursing educational levels remains unclear. The added value of Bachelor degree nurses and how they develop professionally after graduation are subject to debate. The aim of this study is to investigate whether Bachelor degree nurses have higher critical thinking skills than diploma nurses do and whether there is a positive relationship between higher critical thinking skills and self-efficacy beliefs. Outcomes might provide instruments that are helpful in positioning of nursing levels in education and practice. Questionnaire data were used of a sample of 95 registered mental health staff nurses (62 diploma nurses and 33 Bachelor degree nurses). First, ANOVA was performed to test whether the two groups were comparable with respect to elements of work experience. Second, t-tests were conducted to compare the two groups of nurses on self-efficacy, perceived performance and critical thinking outcomes. Third, relationships between the study variables were investigated. Finally, structural equation modelling using AMOS was applied to test the relationships. The hypothesis that Bachelor degree nurses are better critical thinkers than diploma nurses was supported (p<0.01). Years in function turned out to be positively related to self-efficacy beliefs (p<0.01). No significant relation was found between the level of education and self-efficacy beliefs. The results of this study support career development and facilitate more efficient positioning of nursing levels. Copyright © 2012 Elsevier Ltd. All rights reserved.

Spatial assessment of landscape ecological connectivity in different urban gradient.

Science.gov (United States)

Park, Sohyun

2015-07-01

Urbanization has resulted in remnant natural patches within cities that often have no connectivity among themselves and to natural reserves outside the urban area. Protecting ecological connectivity in fragmented urban areas is becoming crucial in maintaining urban biodiversity and securing critical habitat levels and configurations under continual development pressures. Nevertheless, few studies have been undertaken for urban landscapes. This study aims to assess ecological connectivity for a group of species that represent the urban desert landscape in the Phoenix metropolitan area and to compare the connectivity values along the different urban gradient. A GIS-based landscape connectivity model which relies upon ecological connectivity index (ECI) was developed and applied to this region. A GIS-based concentric buffering technique was employed to delineate conceptual boundaries for urban, suburban, and rural zones. The research findings demonstrated that urban habitats and potential habitat patches would be significantly influenced by future urban development. Particularly, the largest loss of higher connectivity would likely to be anticipated in the "in-between areas" where urban, suburban, and rural zones overlap one another. The connectivity maps would be useful to provide spatial identification regarding connectivity patterns and vulnerability for urban and suburban activities in this area. This study provides planners and landscape architects with a spatial guidance to minimize ecological fragmentation, which ultimately leads to urban landscape sustainability. This study suggests that conventional planning practices which disregard the ecological processes in urban landscapes need to integrate landscape ecology into planning and design strategies.

Incorporation of an Explicit Critical-Thinking Curriculum to Improve Pharmacy Students’ Critical-Thinking Skills

OpenAIRE

Cone, Catherine; Godwin, Donald; Salazar, Krista; Bond, Rucha; Thompson, Megan; Myers, Orrin

2016-01-01

Objective. The Health Sciences Reasoning Test (HSRT) is a validated instrument to assess critical-thinking skills. The objective of this study was to determine if HSRT results improved in second-year student pharmacists after exposure to an explicit curriculum designed to develop critical-thinking skills.

Finite Blaschke products and their connections

CERN Document Server

Garcia, Stephan Ramon; Ross, William T

2018-01-01

This monograph offers an introduction to finite Blaschke products and their connections to complex analysis, linear algebra, operator theory, matrix analysis, and other fields. Old favorites such as the Carathéodory approximation and the Pick interpolation theorems are featured, as are many topics that have never received a modern treatment, such as the Bohr radius and Ritt's theorem on decomposability. Deep connections to hyperbolic geometry are explored, as are the mapping properties, zeros, residues, and critical points of finite Blaschke products. In addition, model spaces, rational functions with real boundary values, spectral mapping properties of the numerical range, and the Darlington synthesis problem from electrical engineering are also covered. Topics are carefully discussed, and numerous examples and illustrations highlight crucial ideas. While thorough explanations allow the reader to appreciate the beauty of the subject, relevant exercises following each chapter improve technical fluency with t...

Flexible Mode Control of Grid Connected Wind Energy Conversion System Using Wavelet

OpenAIRE

Jain, Bhavna; Singh, Sameer; Jain, Shailendra; Nema, R. K.

2015-01-01

Small wind turbine systems offer services to critical loads during grid faults and also connected back to grid in normal condition. The connection of a wind energy conversion system to the grid requires a robust phase locked loop (PLL) and continuous monitoring of the grid conditions such as overvoltage, undervoltage, overfrequency, underfrequency, and grid outages. This paper describes a flexible control operation to operate a small wind turbine in both stand-alone mode via planned islanding...

Ethics as a Form of Critical and Rhetorical Inquiry in the Writing Classroom

Science.gov (United States)

Henning, Teresa

2011-01-01

To define ethics as a mode of inquiry, it is first important to consider how ethics relates to critical thinking. Put simply, ethical inquiry is one type of inquiry required to think critically. A connection between critical thinking and ethics is only possible, however, when ethics is defined not as a static list of rules but as a "mode of…

Food as a Theme in Social Studies Classes: Connecting Daily Life to Technology, Economy, and Culture

Science.gov (United States)

Resor, Cynthia Williams

2010-01-01

Connecting wider economic, technological, or cultural trends to the everyday life of students can be a challenge. Food can serve as a course-long theme that helps students comprehend the essential connection between personal actions and national or international trends and develop skills of critical analysis. The author describes four activities…

Brit Crit: Turning Points in British Rock Criticism 1960-1990

DEFF Research Database (Denmark)

Gudmundsson, Gestur; Lindberg, U.; Michelsen, M.

2002-01-01

had national specific traits and there have been more profound paradigm shifts than in American rock criticism. This is primarily explained by the fact that American rock criticism is more strongly connected to general cultural history, while the UK rock criticism has been more alienated from dominant......The article examines the development of rock criticism in the United Kingdom from the perspective of a Bourdieuan field-analysis. Early British rock critics, like Nik Cohn, were international pioneers, a few years later there was a strong American influence, but British rock criticism has always...... culture and more linked to youth culture. However, also in the UK rock criticism has been part and parcel of the legitimation of rock culture and has moved closer to dominant fields and positions in the cultural hierarchy....

Critical Revolutionary Pedagogy Spiced by Pedagogical Love

Science.gov (United States)

FitzSimmons, Robert; Uusiautti, Satu

2013-01-01

The latest incidents demonstrating human beings' inhumanity to their fellow human beings have given impetus to dissect the connection between critical revolutionary pedagogy and the idea of pedagogical love. In this essay we attempt to answer the following questions: How do these two pedagogies complement each other? What can they offer for…

Critical incidents and assistance-seeking behaviors of White mental health practitioners: A transtheoretical framework for understanding multicultural counseling competency.

Science.gov (United States)

Delsignore, Ann Marie; Petrova, Elena; Harper, Amney; Stowe, Angela M; Mu'min, Ameena S; Middleton, Renée A

2010-07-01

An exploratory qualitative analysis of the critical incidents and assistance-seeking behaviors of White mental health psychologists and professional counselors was performed in an effort to examine a theoretical supposition presented within a Person(al)-as-Profession(al) transtheoretical framework (P-A-P). A concurrent nested strategy was used in which both quantitative and qualitative data were collected simultaneously (Creswell, 2003). In this nested strategy, qualitative data was embedded in a predominant (quantitative) method of analysis from an earlier study (see Middleton et al., 2005). Critical incidents categorized as informal (i.e., personal) experiences were cited more often than those characterized as formal (i.e., professional) experiences as influencing the professional perspectives of White mental health practitioners regarding multicultural diversity. Implications for the counseling and psychology professions are discussed.

The NIH Cognitive and Emotional Health Project. Report of the Critical Evaluation Study Committee.

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Hendrie, Hugh C; Albert, Marilyn S; Butters, Meryl A; Gao, Sujuan; Knopman, David S; Launer, Lenore J; Yaffe, Kristine; Cuthbert, Bruce N; Edwards, Emmeline; Wagster, Molly V

2006-01-01

The Cognitive and Emotional Health Project (CEHP) seeks to identify the demographic, social, and biological determinants of cognitive and emotional health in the older adult. As part of the CEHP, a critical evaluation study committee was formed to assess the state of epidemiological research on demographic, social, and biological determinants of cognitive and emotional health. Criteria for inclusion in the survey were large cohort studies, longitudinal in design, participants predominantly 65 years or older, with measurements of both cognition and emotion, and information on a wide variety of demographic, psychosocial, and biological factors. North American and European studies, which met these criteria, were selected for the review. Outcome measures included cognition, cognitive decline, and cognitive function. For emotion, symptoms included depression and anxiety, positive and negative affect, subjective well being, mastery, and resilience. Ninety-six papers were identified that addressed cognitive and emotional outcomes. A large variety of risk factors were consistently identified with cognitive outcomes, particularly those previously associated with increased risk of cardiovascular disease. There was considerable overlap between risk factors for cognitive and emotional outcomes. This review identifies a large number of lifestyle and health behaviors that alter the risk for maintenance of cognitive and emotional health. Large longitudinal cohort studies are a unique source to explore factors associated with cognitive and emotional health. Secondary analyses of these studies should be encouraged as should the development of standardized questionnaires to measure cognitive and emotional health. Future research in this field should study cognitive and emotional health simultaneously.

Stress Analysis for the Critical Metal Structure of Bridge Crane

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Ling, Zhangwei; Wang, Min; Xia, Junfang; Wang, Songhua; Guo, Xiaolian

2018-01-01

Based on the type of connection between the main girder and end beam of electrical single beam crane, the finite element analysis model of a full portal crane was established. The stress distribution of the critical structure under different loading conditions was analyzed. The results shown that the maximum Mises stress and deflection of the main girder were within the allowable range. And the connecting location between end beam web and main girder had higher stress than other region, especially at the lower edge and upper edge of the end beam web and the area near the bolt hole of upper wing panel. Therefore it is important to inspect the connection status, the stress condition and the crack situation nearing connection location during the regular inspection process to ensure the safety of the connection between the main girder and end beam.

Navigating Critical Theory and Postmodernism: Social Justice and Therapist Power in Family Therapy.

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D'Arrigo-Patrick, Justine; Hoff, Chris; Knudson-Martin, Carmen; Tuttle, Amy

2017-09-01

The family therapy field encourages commitment to diversity and social justice, but offers varying ideas about how to attentively consider these issues. Critical informed models advocate activism, whereas postmodern informed models encourage multiple perspectives. It is often not clear how activism and an emphasis on multiple perspectives connect, engendering the sense that critical and postmodern practices may be disparate. To understand how therapists negotiate these perspectives in practice, this qualitative grounded theory analysis drew on interviews with 11 therapists, each known for their work from both critical and postmodern perspectives. We found that these therapists generally engage in a set of shared constructionist practices while also demonstrating two distinct forms of activism: activism through countering and activism through collaborating. Ultimately, decisions made about how to navigate critical and postmodern influences were connected to how therapists viewed ethics and the ways they were comfortable using their therapeutic power. The findings illustrate practice strategies through which therapists apply each approach. © 2016 Family Process Institute.

'Only connect': the case for public health humanities.

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Saffran, Lise

2014-12-01

Humanities in health has until now been primarily understood to mean humanities in medicine and has generally failed to include public health. I will argue in this paper that the common justifications for the former--including increased empathy among practitioners--are at least as applicable, if not more, to the latter. Growing emphasis on the social determinants of health and cultural competency in public health require public health students and professionals to develop a nuanced understanding of the influence of social context on health behaviour and to empathise with people in difficult circumstances. Literary fiction has been demonstrated to have an impact on skills related to empathy and social intelligence. Further, translating epidemiological evidence into public policy is a core task of public health and there is a growing body of research to indicate that statistical evidence is more persuasive when combined with narrative evidence. In this article I explore similarities and differences between proposed humanities in public health and programmes in humanities in medicine and highlight research gaps and possible implications of a more expansive view of humanities in health. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Economic Power Dispatch of Distributed Generators in a Grid-Connected Microgrid

DEFF Research Database (Denmark)

Hernández, Adriana Carolina Luna; Aldana, Nelson Leonardo Diaz; Andrade, Fabio

2015-01-01

Grid-connected microgrids with storage systems are reliable configurations for critical loads which can not tolerate interruptions of energy supply. In such cases, some of the energy resources should be scheduled in order to coordinate optimally the power generation according to a defined objective...

Mission Profile Translation to Capacitor Stresses in Grid-Connected Photovoltaic Systems

DEFF Research Database (Denmark)

Yang, Yongheng; Ma, Ke; Wang, Huai

2014-01-01

DC capacitors are widely adopted in grid-connected PhotoVoltaic(PV) systems for power stabilization and control decoupling. They have become one of the critical components in grid-connected PV inverters in terms of cost, reliability and volume. The electrical and thermal stresses of the DC...... stresses of the DC capacitors under both normal and abnormal grid conditions. As a consequence, this investigation provides new insights into the sizing and reliability prediction of those capacitors with respect to priorart studies. Two study cases on a single-stage PV inverter and a two-stage PV inverter...

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

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

2010-01-01

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

Social Network Analysis of Elders' Health Literacy and their Use of Online Health Information.

Science.gov (United States)

Jang, Haeran; An, Ji-Young

2014-07-01

Utilizing social network analysis, this study aimed to analyze the main keywords in the literature regarding the health literacy of and the use of online health information by aged persons over 65. Medical Subject Heading keywords were extracted from articles on the PubMed database of the National Library of Medicine. For health literacy, 110 articles out of 361 were initially extracted. Seventy-one keywords out of 1,021 were finally selected after removing repeated keywords and applying pruning. Regarding the use of online health information, 19 articles out of 26 were selected. One hundred forty-four keywords were initially extracted. After removing the repeated keywords, 74 keywords were finally selected. Health literacy was found to be strongly connected with 'Health knowledge, attitudes, practices' and 'Patient education as topic.' 'Computer literacy' had strong connections with 'Internet' and 'Attitude towards computers.' 'Computer literacy' was connected to 'Health literacy,' and was studied according to the parameters 'Attitude towards health' and 'Patient education as topic.' The use of online health information was strongly connected with 'Health knowledge, attitudes, practices,' 'Consumer health information,' 'Patient education as topic,' etc. In the network, 'Computer literacy' was connected with 'Health education,' 'Patient satisfaction,' 'Self-efficacy,' 'Attitude to computer,' etc. Research on older citizens' health literacy and their use of online health information was conducted together with study of computer literacy, patient education, attitude towards health, health education, patient satisfaction, etc. In particular, self-efficacy was noted as an important keyword. Further research should be conducted to identify the effective outcomes of self-efficacy in the area of interest.

Health Monitoring of Bolted Spherical Joint Connection Based on Active Sensing Technique Using Piezoceramic Transducers

Directory of Open Access Journals (Sweden)

Jing Xu

2018-05-01

Full Text Available Bolted spherical joints are widely used to form space steel structures. The stiffness and load capacity of the structures are affected by the looseness of bolted spherical joint connections in the structures. The looseness of the connections, which can be caused by fabrication error, low modeling accuracy, and “false twist” in the installation process, may negatively impact the load capacity of the structure and even lead to severe accidents. Furthermore, it is difficult to detect bolted spherical joint connection looseness from the outside since the bolts connect spheres with rods together from the inside. Active sensing methods are proposed in this paper to monitor the tightness status of the bolted spherical connection using piezoceramic transducers. A triangle-on-triangle offset grid composed of bolted spherical joints and steel tube bars was fabricated as the specimen and was used to validate the active sensing methods. Lead Zirconate Titanate (PZT patches were used as sensors and actuators to monitor the bolted spherical joint tightness status. One PZT patch mounted on the central bolted sphere at the upper chord was used as an actuator to generate a stress wave. Another PZT patch mounted on the bar was used as a sensor to detect the propagated waves through the bolted spherical connection. The looseness of the connection can impact the energy of the stress wave propagated through the connection. The wavelet packet analysis and time reversal (TR method were used to quantify the energy of the transmitted signal between the PZT patches by which the tightness status of the connection can be detected. In order to verify the effectiveness, repeatability, and consistency of the proposed methods, the experiments were repeated six times in different bolted spherical connection positions. The experimental results showed that the wavelet packet analysis and TR method are effective in detecting the tightness status of the connections. The

Connectivity patterns in cognitive control networks predict naturalistic multitasking ability.

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Wen, Tanya; Liu, De-Cyuan; Hsieh, Shulan

2018-06-01

Multitasking is a fundamental aspect of everyday life activities. To achieve a complex, multi-component goal, the tasks must be subdivided into sub-tasks and component steps, a critical function of prefrontal networks. The prefrontal cortex is considered to be organized in a cascade of executive processes from the sensorimotor to anterior prefrontal cortex, which includes execution of specific goal-directed action, to encoding and maintaining task rules, and finally monitoring distal goals. In the current study, we used a virtual multitasking paradigm to tap into real-world performance and relate it to each individual's resting-state functional connectivity in fMRI. While did not find any correlation between global connectivity of any of the major networks with multitasking ability, global connectivity of the lateral prefrontal cortex (LPFC) was predictive of multitasking ability. Further analysis showed that multivariate connectivity patterns within the sensorimotor network (SMN), and between-network connectivity of the frontoparietal network (FPN) and dorsal attention network (DAN), predicted individual multitasking ability and could be generalized to novel individuals. Together, these results support previous research that prefrontal networks underlie multitasking abilities and show that connectivity patterns in the cascade of prefrontal networks may explain individual differences in performance. Copyright © 2018 The Authors. Published by Elsevier Ltd.. All rights reserved.

Empowerment and the ecological determinants of health: three critical capacities for practitioners.

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Williams, Lewis

2017-08-01

Human agency or the expression of intentionality towards some form of betterment has long occupied human imagination and creativity. The ways in which we express such aspirations are fundamentally informed by our beliefs about the nature of reality, meanings of human well-being and progress, and the ways in which our social locations shape our interests. Within Western health-promoting discourse and practice, such processes have largely been expressed through the construct of empowerment. To date, like health, much empowerment practice has been implicitly rooted in Cartesianism, has tended towards anthropocentrism and in cases where it has engaged with environmental issues, has mirrored environmentalism's focus on externalities and objectivity. These tendencies coupled with the increasing complexity of global, ecological, human well-being issues call empowerment practitioners to integrate new kinds of capacities more suited to addressing the ecological determinants of health. Drawing in part on the author's empowerment research over more than a decade, this article distinguishes between a range of epistemological perspectives underlying contemporary empowerment practices while fore-grounding the concepts of place-based agency and social-ecological resilience. These constructs in turn form the basis for three capacities considered critical for practitioners addressing human-ecological well-being. © The Author 2016. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Cooperative Learning and Web 2.0: A Social Perspective on Critical Thinking