Measuring progress of collaborative action in a community health effort

Directory of Open Access Journals (Sweden)

Vicki L. Collie-Akers

2013-12-01

Full Text Available OBJECTIVE: To measure the progress made by the collaborative actions of multisectorial partners in a community health effort using a systematic method to document and evaluate community/system changes over time. METHODS: This was a community-based participatory research project engaging community partners of the Latino Health for All Coalition, which based on the Health for All model, addresses health inequity in a low-income neighborhood in Kansas City, Kansas, United States of America. Guided by three research questions regarding the extent to which the Coalition catalyzed change, intensity of change, and how to visually display change, data were collected on community/system changes implemented by the community partners from 2009-2012. These changes were characterized and rated according to intensity (event duration, population reach, and strategy and by other categories, such as social determinant of health mechanism and sector. RESULTS: During the 4-year study period, the Coalition implemented 64 community/system changes. These changes were aligned with the Coalition's primary goals of healthy nutrition, physical activity, and access to health screenings. Community/system efforts improved over time, becoming longer in duration and reaching more of the population. CONCLUSIONS: Although evidence of its predictive validity awaits further research, this method for documenting and characterizing community/system changes enables community partners to see progress made by their health initiatives.

Healthy working days: The (positive) effect of work effort on occupational health from a human capital approach.

Science.gov (United States)

Urtasun, Ainhoa; Nuñez, Imanol

2018-04-01

The neoclassic economic rationale has taken for granted that the effect of effort on health is negative. However, several studies in the field of occupational health and medicine claim that working is clearly better for health than non-working or being unemployed, as some psychological and physical condition may improve with work effort. This paper analyzes the effect of work effort on occupational health. The proposed human capital approach builds upon the classic economic perspective, that assumes a negative effect of effort on health, and extends it by allowing positive effects, as suggested by occupational researchers. Using a sample from 2010 of 20,000 European workers we find that, under adequate working conditions, the level of effort (measured in working hours) at which health starts to deteriorate is very high (120 h per week). However, if working conditions are not adequate, even a moderate effort (35 h per week) can harm workers health. Copyright © 2018 Elsevier Ltd. All rights reserved.

Mental health among Norwegian priests: associations with effort-reward imbalance and overcommitment.

Science.gov (United States)

Lau, Bjørn

2018-01-01

The aim of the study was to determine the prevalence of anxiety and depression symptoms among Norwegian priests and to examine their associations with effort-reward imbalance (ERI) and overcommitment. Eight hundred four priests in the Norwegian Church completed the Hospital Anxiety and Depression Scale (HADS), the Effort-Reward Imbalance Questionnaire (ERI-Q), and the Intrinsic Effort Scale, measuring overcommitment. A significant proportion of the priests (23.4%) had HADS scores indicating a possible anxiety problem. Somewhat fewer had depression problems (9.3%). Both anxiety and depression difficulties were associated with an imbalance between effort given and rewards received at work. Priests characterized by a combination of this imbalance and high scores on overcommitment had more anxiety and depression symptoms. There is a higher occurrence of mental health challenges among priests than among the regular population. This applies in particular to anxiety symptoms measured by the HADS. These findings also indicate that it may be fruitful to explore mental health conditions among priests who report different combinations of effort-reward and overcommitment.

Current perspectives: the impact of cyberbullying on adolescent health

Directory of Open Access Journals (Sweden)

Nixon CL

2014-08-01

Full Text Available Charisse L Nixon Pennsylvania State University, the Behrend College, Erie, PA, USA Abstract: Cyberbullying has become an international public health concern among adolescents, and as such, it deserves further study. This paper reviews the current literature related to the effects of cyberbullying on adolescent health across multiple studies worldwide and provides directions for future research. A review of the evidence suggests that cyberbullying poses a threat to adolescents' health and well-being. A plethora of correlational studies have demonstrated a cogent relationship between adolescents' involvement in cyberbullying and negative health indices. Adolescents who are targeted via cyberbullying report increased depressive affect, anxiety, loneliness, suicidal behavior, and somatic symptoms. Perpetrators of cyberbullying are more likely to report increased substance use, aggression, and delinquent behaviors. Mediating/moderating processes have been found to influence the relationship between cyberbullying and adolescent health. More longitudinal work is needed to increase our understanding of the effects of cyberbullying on adolescent health over time. Prevention and intervention efforts related to reducing cyberbullying and its associated harms are discussed. Keywords: cyberbullying, adolescent health, prevention, intervention

Perceived extrinsic mortality risk and reported effort in looking after health: testing a behavioral ecological prediction.

Science.gov (United States)

Pepper, Gillian V; Nettle, Daniel

2014-09-01

Socioeconomic gradients in health behavior are pervasive and well documented. Yet, there is little consensus on their causes. Behavioral ecological theory predicts that, if people of lower socioeconomic position (SEP) perceive greater personal extrinsic mortality risk than those of higher SEP, they should disinvest in their future health. We surveyed North American adults for reported effort in looking after health, perceived extrinsic and intrinsic mortality risks, and measures of SEP. We examined the relationships between these variables and found that lower subjective SEP predicted lower reported health effort. Lower subjective SEP was also associated with higher perceived extrinsic mortality risk, which in turn predicted lower reported health effort. The effect of subjective SEP on reported health effort was completely mediated by perceived extrinsic mortality risk. Our findings indicate that perceived extrinsic mortality risk may be a key factor underlying SEP gradients in motivation to invest in future health.

The Built Environment and Child Health: An Overview of Current Evidence.

Science.gov (United States)

Gascon, Mireia; Vrijheid, Martine; Nieuwenhuijsen, Mark J

2016-09-01

Urbanization and the shaping of the built environment have provided a number of socioeconomic benefits, but they have also brought unwanted side effects on health. We aimed to review the current epidemiological evidence of the associations between the built environment, closely related exposures, and child health. We focused on growth and obesity, neuropsychological development, and respiratory and immune health. We used existing review articles and supplemented these with relevant work published and not included in existing reviews. The present review shows that there is good evidence for an association between air pollution and fetal growth restriction and respiratory health, whereas for other exposure and outcome combinations, further evidence is needed. Future studies should make efforts to integrate the different built environment features and to include the evaluation of environments other than home, as well as accessibility, qualitative and perception assessment of the built environment, and, if possible, with improved and standardized tools to facilitate comparability between studies. Efforts are also needed to conduct longitudinal and intervention studies and to understand potential mechanisms behind the associations observed. Finally, studies in low- and middle-income countries are needed.

Prevention of Fetal Alcohol Spectrum Disorder: Current Canadian Efforts and Analysis of Gaps

Directory of Open Access Journals (Sweden)

Nancy Poole

2016-01-01

Full Text Available Effective prevention of risky alcohol use in pregnancy involves much more than providing information about the risk of potential birth defects and developmental disabilities in children. To categorize the breadth of possible initiatives, Canadian experts have identified a four-part framework for fetal alcohol spectrum disorder (FASD prevention: Level 1, public awareness and broad health promotion; Level 2, conversations about alcohol with women of childbearing age and their partners; Level 3, specialized support for pregnant women; and Level 4, postpartum support for new mothers. In order to describe the level of services across Canada, 50 Canadian service providers, civil servants, and researchers working in the area of FASD prevention were involved in an online Delphi survey process to create a snapshot of current FASD prevention efforts, identify gaps, and provide ideas on how to close these gaps to improve FASD prevention. Promising Canadian practices and key areas for future action are described. Overall, Canadian FASD prevention programming reflects evidence-based practices; however, there are many opportunities to improve scope and availability of these initiatives.

Tax levy financing for local public health: fiscal allocation, effort, and capacity.

Science.gov (United States)

Riley, William J; Gearin, Kimberly J; Parrotta, Carmen D; Briggs, Jill; Gyllstrom, M Elizabeth

2013-12-01

Local health departments (LHDs) rely on a wide variety of funding sources, and the level of financing is associated with both LHD performance in essential public health services and population health outcomes. Although it has been shown that funding sources vary across LHDs, there is no evidence regarding the relationship between fiscal allocation (local tax levy); fiscal effort (tax capacity); and fiscal capacity (community wealth). The purpose of this study is to analyze local tax levy support for LHD funding. Three research questions are addressed: (1) What are tax levy trends in LHD fiscal allocation? (2) What is the role of tax levy in overall LHD financing? and (3) How do local community fiscal capacity and fiscal effort relate to LHD tax levy fiscal allocation? This study focuses on 74 LHDs eligible for local tax levy funding in Minnesota. Funding and expenditure data for 5 years (2006 to 2010) were compiled from four governmental databases, including the Minnesota Department of Health, the State Auditor, the State Demographer, and the Metropolitan Council. Trends in various funding sources and expenditures are described for the time frame of interest. Data were analyzed in 2012. During the 2006-2010 time period, total average LHD per capita expenditures increased 13%, from $50.98 to $57.63. Although the overall tax levy increase in Minnesota was 25%, the local tax levy for public health increased 5.6% during the same period. There is a direct relationship between fiscal effort and LHD expenditures. Local funding reflects LHD community priorities and the relative importance in comparison to funding other local programs with tax dollars. In Minnesota, local tax levy support for local public health services is not keeping pace with local tax support for other local government services. These results raise important questions about the relationship between tax levy resource effort, resource allocation, and fiscal capacity as they relate to public health

Biologically Hazardous Agents at Work and Efforts to Protect Workers' Health: A Review of Recent Reports

Directory of Open Access Journals (Sweden)

Kyung-Taek Rim

2014-06-01

Full Text Available Because information on biological agents in the workplace is lacking, biological hazard analyses at the workplace to securely recognize the harmful factors with biological basis are desperately needed. This review concentrates on literatures published after 2010 that attempted to detect biological hazards to humans, especially workers, and the efforts to protect them against these factors. It is important to improve the current understanding of the health hazards caused by biological factors at the workplace. In addition, this review briefly describes these factors and provides some examples of their adverse health effects. It also reviews risk assessments, protection with personal protective equipment, prevention with training of workers, regulations, as well as vaccinations.

Electronic Health Records and US Public Health: Current Realities and Future Promise

Science.gov (United States)

Parrish, R. Gibson; Ross, David A.

2013-01-01

Electronic health records (EHRs) could contribute to improving population health in the United States. Realizing this potential will require understanding what EHRs can realistically offer to efforts to improve population health, the requirements for obtaining useful information from EHRs, and a plan for addressing these requirements. Potential contributions of EHRs to improving population health include better understanding of the level and distribution of disease, function, and well-being within populations. Requirements are improved population coverage of EHRs, standardized EHR content and reporting methods, and adequate legal authority for using EHRs, particularly for population health. A collaborative national effort to address the most pressing prerequisites for and barriers to the use of EHRs for improving population health is needed to realize the EHR’s potential. PMID:23865646

Effort-reward imbalance at work and pre-clinical biological indices of ill-health: the case for salivary immunoglobulin A.

Science.gov (United States)

Bathman, Lauren Marjorie; Almond, Jacinta; Hazi, Agnes; Wright, Bradley James

2013-10-01

Physiological indices of stress and ill-health (cortisol and salivary immunoglobulin A) were assessed to determine if they were predicted by Siegrist's effort-reward imbalance model (ERI) with an aim of identifying employees at risk of illness. Male Australian dairy farmers (N=66) completed the Perceived Stress Scale, Work related Questions II & III, Eysenck Personality Questionnaire Revised--Short and demographic questions and provided morning saliva samples (at awakening and 30 min post awakening) on a working day, which were subsequently analysed for cortisol and salivary immunoglobulin A (sIgA) concentration levels. A high percentage (45.5%) of the sample reported an imbalance between efforts and rewards in the workplace that may place them 'at risk' for ill-health. After controlling for disposition, sIgA scores were more successfully predicted by the ERI than the cortisol assessments. Although both efforts and rewards were significantly associated with sIgA, efforts were most strongly associated. The dispositional trait overcommitment, did not moderate the experience of stress on the physiologic indices. The current investigation supports the continued use of sIgA in studies that use biomarkers to assess occupational stress. ERI ratio scores >1 aligned with previous findings that suggest elevated risk of illness for these employees. Copyright © 2013 Elsevier Inc. All rights reserved.

Effort-Reward Imbalance and Mental Health Problems in 1074 German Teachers, Compared with Those in the General Population.

Science.gov (United States)

Hinz, Andreas; Zenger, Markus; Brähler, Elmar; Spitzer, Silvia; Scheuch, Klaus; Seibt, Reingard

2016-08-01

High degrees of premature retirement among teachers warrant investigating the occupational burden and the mental health status of this profession. A sample of 1074 German teachers participated in this study. Two samples of the general population (N = 824 and N = 792) were used as comparison groups. Work distress was assessed with the Effort-Reward-Imbalance questionnaire, and mental health problems were measured with the General Health Questionnaire (GHQ-12). Teachers reported more effort-reward imbalance (M = 0.64) compared with the general population (M = 0.57), and they perceived more mental health problems (GHQ: M = 12.1) than the comparison group (M = 9.5). School type was not associated with work stress and mental health. Teachers with leading functions perceived high degrees of effort and reward, resulting in a moderate effort-reward ratio and no heightened mental health problems. Teachers working full time reported more effort than teachers working part time, but the reward mean values of both groups were similar. This results in a somewhat unfavourable effort-reward ratio of teachers working full time. Moreover, teachers working full time reported more mental health problems. The results support the appropriateness of the effort-reward conception, applied to the profession of teachers. The higher degree of effort-reward imbalance and the level of mental health problems warrant preventive measures. Copyright © 2014 John Wiley & Sons, Ltd. Copyright © 2014 John Wiley & Sons, Ltd.

Monitoring and evaluation of disaster response efforts undertaken by local health departments: a rapid realist review.

Science.gov (United States)

Gossip, Kate; Gouda, Hebe; Lee, Yong Yi; Firth, Sonja; Bermejo, Raoul; Zeck, Willibald; Jimenez Soto, Eliana

2017-06-29

Local health departments are often at the forefront of a disaster response, attending to the immediate trauma inflicted by the disaster and also the long term health consequences. As the frequency and severity of disasters are projected to rise, monitoring and evaluation (M&E) efforts are critical to help local health departments consolidate past experiences and improve future response efforts. Local health departments often conduct M&E work post disaster, however, many of these efforts fail to improve response procedures. We undertook a rapid realist review (RRR) to examine why M&E efforts undertaken by local health departments do not always result in improved disaster response efforts. We aimed to complement existing frameworks by focusing on the most basic and pragmatic steps of a M&E cycle targeted towards continuous system improvements. For these purposes, we developed a theoretical framework that draws on the quality improvement literature to 'frame' the steps in the M&E cycle. This framework encompassed a M&E cycle involving three stages (i.e., document and assess, disseminate and implement) that must be sequentially completed to learn from past experiences and improve future disaster response efforts. We used this framework to guide our examination of the literature and to identify any context-mechanism-outcome (CMO) configurations which describe how M&E may be constrained or enabled at each stage of the M&E cycle. This RRR found a number of explanatory CMO configurations that provide valuable insights into some of the considerations that should be made when using M&E to improve future disaster response efforts. Firstly, to support the accurate documentation and assessment of a disaster response, local health departments should consider how they can: establish a culture of learning within health departments; use embedded training methods; or facilitate external partnerships. Secondly, to enhance the widespread dissemination of lessons learned and facilitate

Predicting Consumer Effort in Finding and Paying for Health Care: Expert Interviews and Claims Data Analysis.

Science.gov (United States)

Long, Sandra; Monsen, Karen A; Pieczkiewicz, David; Wolfson, Julian; Khairat, Saif

2017-10-12

For consumers to accept and use a health care information system, it must be easy to use, and the consumer must perceive it as being free from effort. Finding health care providers and paying for care are tasks that must be done to access treatment. These tasks require effort on the part of the consumer and can be frustrating when the goal of the consumer is primarily to receive treatments for better health. The aim of this study was to determine the factors that result in consumer effort when finding accessible health care. Having an understanding of these factors will help define requirements when designing health information systems. A panel of 12 subject matter experts was consulted and the data from 60 million medical claims were used to determine the factors contributing to effort. Approximately 60 million claims were processed by the health care insurance organization in a 12-month duration with the population defined. Over 292 million diagnoses from claims were used to validate the panel input. The results of the study showed that the number of people in the consumer's household, number of visits to providers outside the consumer's insurance network, number of adjusted and denied medical claims, and number of consumer inquiries are a proxy for the level of effort in finding and paying for care. The effort level, so measured and weighted per expert panel recommendations, differed by diagnosis. This study provides an understanding of how consumers must put forth effort when engaging with a health care system to access care. For higher satisfaction and acceptance results, health care payers ideally will design and develop systems that facilitate an understanding of how to avoid denied claims, educate on the payment of claims to avoid adjustments, and quickly find providers of affordable care. ©Sandra Long, Karen A. Monsen, David Pieczkiewicz, Julian Wolfson, Saif Khairat. Originally published in JMIR Medical Informatics (http://medinform.jmir.org), 12.10.2017.

Anticipated emotions and effort allocation in weight goal striving.

Science.gov (United States)

Nelissen, Rob M A; de Vet, Emely; Zeelenberg, Marcel

2011-02-01

This study aimed to investigate the influence of anticipated emotions on preventive health behaviour if specified at the level of behavioural outcomes. Consistent with predictions from a recently developed model of goal pursuit, we hypothesized that the impact of emotions on effort levels depended on the perceived proximity to the goal. Participants with weight-loss intentions were randomly selected from an Internet panel and completed questionnaires at three points in time, baseline (T1; N= 725), 2 weeks later at T2 (N= 582) and again 2 months later at T3 (N= 528). Questionnaires assessed anticipated emotions (at T1) and experienced emotions (at T2) towards goal attainment and non-attainment. Goal proximity, goal desirability, and effort levels in striving for weight loss were assessed at both T1 and T2. Current and target weights were reported at all three assessments. In line with predictions, we found that negative anticipated emotions towards goal non-attainment resulted in increased effort but only if people perceived themselves in close proximity to their goal. Effort, in turn, predicted weight loss and goal achievement. The current data bear important practical implications as they identify anticipated emotions as targets of behaviour change interventions aimed to stimulate effort in striving for broad, health-related goals like weight loss. ©2010 The British Psychological Society.

Efforts Aimed To Reduce Attrition in Antimalarial Drug Discovery: A Systematic Evaluation of the Current Antimalarial Targets Portfolio.

Science.gov (United States)

Chaparro, María Jesús; Calderón, Félix; Castañeda, Pablo; Fernández-Alvaro, Elena; Gabarró, Raquel; Gamo, Francisco Javier; Gómez-Lorenzo, María G; Martín, Julio; Fernández, Esther

2018-04-13

Malaria remains a major global health problem. In 2015 alone, more than 200 million cases of malaria were reported, and more than 400,000 deaths occurred. Since 2010, emerging resistance to current front-line ACTs (artemisinin combination therapies) has been detected in endemic countries. Therefore, there is an urgency for new therapies based on novel modes of action, able to relieve symptoms as fast as the artemisinins and/or block malaria transmission. During the past few years, the antimalarial community has focused their efforts on phenotypic screening as a pragmatic approach to identify new hits. Optimization efforts on several chemical series have been successful, and clinical candidates have been identified. In addition, recent advances in genetics and proteomics have led to the target deconvolution of phenotypic clinical candidates. New mechanisms of action will also be critical to overcome resistance and reduce attrition. Therefore, a complementary strategy focused on identifying well-validated targets to start hit identification programs is essential to reinforce the clinical pipeline. Leveraging published data, we have assessed the status quo of the current antimalarial target portfolio with a focus on the blood stage clinical disease. From an extensive list of reported Plasmodium targets, we have defined triage criteria. These criteria consider genetic, pharmacological, and chemical validation, as well as tractability/doability, and safety implications. These criteria have provided a quantitative score that has led us to prioritize those targets with the highest probability to deliver successful and differentiated new drugs.

Cyberbullying Prevention and Intervention Efforts: Current Knowledge and Future Directions

Science.gov (United States)

Hong, Jun Sung

2016-01-01

Bullying is a serious public health concern that is associated with significant negative mental, social, and physical outcomes. Technological advances have increased adolescents’ use of social media, and online communication platforms have exposed adolescents to another mode of bullying—cyberbullying. Prevention and intervention materials, from websites and tip sheets to classroom curriculum, have been developed to help youth, parents, and teachers address cyberbullying. While youth and parents are willing to disclose their experiences with bullying to their health care providers, these disclosures need to be taken seriously and handled in a caring manner. Health care providers need to include questions about bullying on intake forms to encourage these disclosures. The aim of this article is to examine the current status of cyberbullying prevention and intervention. Research support for several school-based intervention programs is summarised. Recommendations for future research are provided. PMID:28562094

Cyberbullying Prevention and Intervention Efforts: Current Knowledge and Future Directions.

Science.gov (United States)

Espelage, Dorothy L; Hong, Jun Sung

2017-06-01

Bullying is a serious public health concern that is associated with significant negative mental, social, and physical outcomes. Technological advances have increased adolescents' use of social media, and online communication platforms have exposed adolescents to another mode of bullying- cyberbullying. Prevention and intervention materials, from websites and tip sheets to classroom curriculum, have been developed to help youth, parents, and teachers address cyberbullying. While youth and parents are willing to disclose their experiences with bullying to their health care providers, these disclosures need to be taken seriously and handled in a caring manner. Health care providers need to include questions about bullying on intake forms to encourage these disclosures. The aim of this article is to examine the current status of cyberbullying prevention and intervention. Research support for several school-based intervention programs is summarised. Recommendations for future research are provided.

Condition of Health Problems in The District Health Offi ce Parigi Moutong Central Sulawesi Province, Efforts in Response of Health Problem

Directory of Open Access Journals (Sweden)

Ahmad Erlan

2016-01-01

Full Text Available Background: District Parigi Moutong, Central Sulawesi Province is one of the Regional District Health Problems. Ranking Public Health Development Index Parigi Moutong to the level of Central Sulawesi was ranked 6 out of 9 districts/cities, while at the national level comes out to 320 of 440 districts/cities in Indonesia. The purpose of this study is to provide a picture of the health problems in Parigi Moutong. In more detail the objectives are observed after the implementation of such interventions and Booster Kalakarya prevention efforts in the area of health problems. Methods: The study is qualitative observational study of participatory design. Samples were taken by using purposive sampling to conduct in-depth interviews and document searches. Results: The results of in-depth interviews obtained information of some constraints inthe implementation of health programs, ie no actions/movements that were signifi cant in the response to the problem. Infant mortality in 2012, registered 7 cases. Substitution head of the health center too fast. This happens because the head of the health center has held PTT doctor working period of one year, which resulted in problems in sustainability programs in health centers. Internal monthly meeting at the Department of Health and the District Health Offi ce with the entire health center no. Effort or movement to address the problems associated Regional Health Problems has not be percieved. Conclusions: Implementation of Regional Booster Kalakarya and Health Troubled make changes to the head of health policy by forming groups Conscious Movement IHC and revitalization partnership TBA and midwives who are increasing numbers toddlersweighing scope and aid delivery by health personnel.

Understanding consumer preferences for communication channels to create consumer-directed health promotion efforts in psychiatric rehabilitation settings.

Science.gov (United States)

DiFranco, Evelina; Bressi, Sara K; Salzer, Mark S

2006-01-01

People with serious mental illnesses experience increased rates of physical illnesses. Drop-in centers and psychosocial rehabilitation programs can serve as important settings for health promotion efforts, but such efforts should utilize communication strategies that are used by consumers and are perceived to be reliable. Focus groups involving 23 consumers at drop-in centers in Philadelphia were conducted to assess the perceived usefulness of health information from a variety of sources. Consumers especially liked getting information from other people, including health care professionals, friends, and family, and found the information to be reliable and useful. Print literature, the Internet, and a library had various limitations. Respondents were generally unfamiliar with community health fairs and related events. Consumers considered trustworthiness, proximity and availability, and the specificity and depth of information provided by a communication source when getting health information. Implications for health promotion efforts are discussed.

Effort-reward imbalance at work and self-rated health of Las Vegas hotel room cleaners.

Science.gov (United States)

Krause, Niklas; Rugulies, Reiner; Maslach, Christina

2010-04-01

This study investigates the relationship between effort-reward-imbalance (ERI) at work and self-rated health (SF-36) among 941 Las Vegas hotel room cleaners (99% female, 84% immigrant). Logistic regression models adjust for age, health behaviors, physical workload and other potential confounders. 50% reported ERI and 60% poor or fair general health. Significant associations were found between ERI and all SF-36 health measures. Workers in the upper quartile of the efforts/rewards ratio were 2-5 times more likely to experience poor or fair general health, low physical function, high levels of pain, fatigue, and role limitations due to physical and mental health problems. The cross-sectional design limits causal interpretation of these associations. However, the development of interventions to reduce ERI and to improve general health among room cleaners deserves high priority considering that both high ERI and low self-rated health have predicted chronic diseases and mortality in prospective studies. (c) 2009 Wiley-Liss, Inc.

Zero Effort Technologies Considerations, Challenges, and Use in Health, Wellness, and Rehabilitation

CERN Document Server

Mihailidis, Alex; Hoey, Jesse

2011-01-01

This book introduces zero-effort technologies (ZETs), an emerging class of technology that requires little or no effort from the people who use it. ZETs use advanced techniques, such as computer vision, sensor fusion, decision-making and planning, and machine learning to autonomously operate through the collection, analysis, and application of data about the user and his/her context. This book gives an overview of ZETs, presents concepts in the development of pervasive intelligent technologies and environments for health and rehabilitation, along with an in-depth discussion of the design princ

Electronic Health Records: VAs Efforts Raise Concerns about Interoperability Goals and Measures, Duplication with DOD, and Future Plans

Science.gov (United States)

2016-07-13

ELECTRONIC HEALTH RECORDS VA’s Efforts Raise Concerns about Interoperability Goals and Measures, Duplication with DOD...Agencies, Committee on Appropriations, U.S. Senate July 13, 2016 ELECTRONIC HEALTH RECORDS VA’s Efforts Raise Concerns about Interoperability Goals...initiatives with the Department of Defense (DOD) that were intended to advance the ability of the two departments to share electronic health records ,

Environment Biological and Health Care Efforts Influenced of Lymfatic Filariasis Incidence, Sarmi Distric

Directory of Open Access Journals (Sweden)

Mina Sipayung

2014-05-01

District Sarmi is the most endemic area of filariasis in Papua which has rate of microfilaria (mf (47.06% up to the year 2012. In the Province Papua filarial worm is Wuchereria bancrofti and is transmitted through the bite of a mosquito vectors. Lymphatic filariasis does not cause death, but in chronic cases it causes disability, psychosocial problems, stigma, and decreased productivity. This study was aimed to analyze environment biological and health care efforts that influence the incidence of lymphatic filariasis. This study used case-control method. Samples comprised 32 case samples (mf + and 32 control samples (mf-. Primary data were collected through interviews and observation. Data were analyzed using Chi-Square and continued with multivariate Logistic Regression. Statistical analysis obtained indicated two variables on the incidence of lymphatic filariasis limfatik in District Sarmi (health care efforts pvalue = 0.002, OR: 7.779, as well as the biological environment pvalue= 0.008, OR: 5.841. Significant variables were health services with sub-variables promotion, prevention and the environmental biology. Suggestion: Mosquito bites should be avoided, the vector should be controlled through mutual cooperation and health promotion should be implemented. Keywords: Wuchereria bancrofti, lymphatic filariasis, vector, health care,                         Sarmi Distric

Overview of the current spectroscopy effort on the Livermore electron beam ion traps

International Nuclear Information System (INIS)

Beiersdorfer, P.; Lopez-Urrutia, J.C.; Brown, G.

1995-01-01

An overview is given of the current spectroscopic effort on the Livermore electron beam ion trap facilities. The effort focuses on four aspects: spectral line position, line intensity, temporal evolution, and line shape. Examples of line position measurements include studies of the K-shell transitions in heliumlike Kr 34+ and the 2s-2p intrashell transitions in lithiumlike Th 87+ and U 89+ , which provide benchmark values for testing the theory of relativistic and quantum electrodynamical contributions in high-Z ions. Examples of line intensity measurements are provided by measurements of the electron-impact excitation and dielectronic recombination cross sections of heliumlike transition-metal ions Ti 20+ through CO 25+ . A discussion of radiative lifetime measurements of metastable levels in heliumlike ions is given to illustrate the time-resolved spectroscopy techniques in the microsecond range. The authors also present a measurement of the spectral lineshape that illustrates the very low ion temperatures that can be achieved in an EBIT

Quantifying motivation with effort-based decision-making paradigms in health and disease.

Science.gov (United States)

Chong, T T-J; Bonnelle, V; Husain, M

2016-01-01

Motivation can be characterized as a series of cost-benefit valuations, in which we weigh the amount of effort we are willing to expend (the cost of an action) in return for particular rewards (its benefits). Human motivation has traditionally been measured with self-report and questionnaire-based tools, but an inherent limitation of these methods is that they are unable to provide a mechanistic explanation of the processes underlying motivated behavior. A major goal of current research is to quantify motivation objectively with effort-based decision-making paradigms, by drawing on a rich literature from nonhuman animals. Here, we review this approach by considering the development of these paradigms in the laboratory setting over the last three decades, and their more recent translation to understanding choice behavior in humans. A strength of this effort-based approach to motivation is that it is capable of capturing the wide range of individual differences, and offers the potential to dissect motivation into its component elements, thus providing the basis for more accurate taxonomic classifications. Clinically, modeling approaches might provide greater sensitivity and specificity to diagnosing disorders of motivation, for example, in being able to detect subclinical disorders of motivation, or distinguish a disorder of motivation from related but separate syndromes, such as depression. Despite the great potential in applying effort-based paradigms to index human motivation, we discuss several caveats to interpreting current and future studies, and the challenges in translating these approaches to the clinical setting. © 2016 Elsevier B.V. All rights reserved.

The global financial crisis and health: scaling up our effort.

Science.gov (United States)

Labonté, Ronald

2009-01-01

Economic events of the past year are beginning to create hardships for tens of thousands of Canadians. There are likely to be health effects as well, to the extent that unemployment and poverty rates rise. Conditions, however, will be much worse for those living in poorer countries. High-income countries are committing trillions of dollars in countercyclical spending and banking bail-outs. Poorer countries need to do the same, but lack the resources to do so. Yet foreign aid and fairer trade are widely expected to be among the first high-income country victims of the recession fallout as nations turn inwards and protectionist. This is neither good for global health nor necessary given the scale of untaxed (or unfairly taxed) wealth that could be harnessed for a truly global rescue package. Policy choices confront us. The Canadian public health community must hold our political leadership accountable for making those choices that will improve health globally and not further imperil the well-being of much of the world's population in efforts to secure our own future economic revival.

Effort-Reward Imbalance and Overcommitment in UK Academics: Implications for Mental Health, Satisfaction and Retention

Science.gov (United States)

Kinman, Gail

2016-01-01

This study utilises the effort-reward imbalance (ERI) model of job stress to predict several indices of well-being in academics in the UK: mental ill health, job satisfaction and leaving intentions. This model posits that (a) employees who believe that their efforts are not counterbalanced by sufficient rewards will experience impaired well-being…

The Cuban health care system and factors currently undermining it.

Science.gov (United States)

Nayeri, K

1995-08-01

This paper explores the dynamics of health and health care in Cuba during a period of severe crisis by placing it within its economic, social, and political context using a comparative historical approach. It outlines Cuban achievements in health care as a consequence of the socialist transformations since 1959, noting the full commitment by the Cuban state, the planned economy, mass participation, and a self-critical, working class perspective as crucial factors. The roles of two external factors, the U.S. economic embargo and the Council of Mutual Economic Cooperation (CMEA), are explored in shaping the Cuban society and economy, including its health care system. It is argued that the former has hindered health efforts in Cuba. The role of the latter is more complex. While the CMEA was an important source for economic growth, Cuban relations with the Soviet bloc had a damaging effect on the development of socialism in Cuba. The adoption of the Soviet model of economic development fostered bureaucracy and demoralization of Cuban workers. As such, it contributed to two internal factors that have undermined further social progress including in health care: low productivity of labor and the growth of bureaucracy. While the health care system is still consistently supported by public policy and its structure is sound, economic crisis undermines its material and moral foundations and threatens its achievements. The future of the current Cuban health care system is intertwined with the potentials for its socialist development.

Re-thinking global health sector efforts for HIV and tuberculosis epidemic control: promoting integration of programme activities within a strengthened health system.

Science.gov (United States)

Maher, Dermot

2010-07-05

The global financial crisis threatens global health, particularly exacerbating diseases of inequality, e.g. HIV/AIDS, and diseases of poverty, e.g. tuberculosis. The aim of this paper is to reconsider established practices and policies for HIV and tuberculosis epidemic control, aiming at delivering better results and value for money. This may be achieved by promoting greater integration of HIV and tuberculosis control programme activities within a strengthened health system. HIV and tuberculosis share many similarities in terms of their disease burden and the recommended stratagems for their control. HIV and tuberculosis programmes implement similar sorts of control activities, e.g. case finding and treatment, which depend for success on generic health system issues, including vital registration, drug procurement and supply, laboratory network, human resources, and financing. However, the current health system approach to HIV and tuberculosis control often involves separate specialised services. Despite some recent progress, collaboration between the programmes remains inadequate, progress in obtaining synergies has been slow, and results remain far below those needed to achieve universal access to key interventions. A fundamental re-think of the current strategic approach involves promoting integrated delivery of HIV and tuberculosis programme activities as part of strengthened general health services: epidemiological surveillance, programme monitoring and evaluation, community awareness of health-seeking behavior, risk behaviour modification, infection control, treatment scale-up (first-line treatment regimens), drug-resistance surveillance, containing and countering drug-resistance (second-line treatment regimens), research and development, global advocacy and global partnership. Health agencies should review policies and progress in HIV and tuberculosis epidemic control, learn mutual lessons for policy development and scaling up interventions, and identify ways

Re-thinking global health sector efforts for HIV and tuberculosis epidemic control: promoting integration of programme activities within a strengthened health system

Directory of Open Access Journals (Sweden)

Maher Dermot

2010-07-01

Full Text Available Abstract Background The global financial crisis threatens global health, particularly exacerbating diseases of inequality, e.g. HIV/AIDS, and diseases of poverty, e.g. tuberculosis. The aim of this paper is to reconsider established practices and policies for HIV and tuberculosis epidemic control, aiming at delivering better results and value for money. This may be achieved by promoting greater integration of HIV and tuberculosis control programme activities within a strengthened health system. Discussion HIV and tuberculosis share many similarities in terms of their disease burden and the recommended stratagems for their control. HIV and tuberculosis programmes implement similar sorts of control activities, e.g. case finding and treatment, which depend for success on generic health system issues, including vital registration, drug procurement and supply, laboratory network, human resources, and financing. However, the current health system approach to HIV and tuberculosis control often involves separate specialised services. Despite some recent progress, collaboration between the programmes remains inadequate, progress in obtaining synergies has been slow, and results remain far below those needed to achieve universal access to key interventions. A fundamental re-think of the current strategic approach involves promoting integrated delivery of HIV and tuberculosis programme activities as part of strengthened general health services: epidemiological surveillance, programme monitoring and evaluation, community awareness of health-seeking behavior, risk behaviour modification, infection control, treatment scale-up (first-line treatment regimens, drug-resistance surveillance, containing and countering drug-resistance (second-line treatment regimens, research and development, global advocacy and global partnership. Health agencies should review policies and progress in HIV and tuberculosis epidemic control, learn mutual lessons for policy

Social entrepreneurship in religious congregations' efforts to address health needs.

Science.gov (United States)

Werber, Laura; Mendel, Peter J; Derose, Kathryn Pitkin

2014-01-01

Examine how religious congregations engage in social entrepreneurship as they strive to meet health-related needs in their communities. Multiple case studies. Los Angeles County, California. Purposive sample of 14 congregations representing diverse races/ethnicities (African-American, Latino, and white) and faith traditions (Jewish and various Christian). Congregations were recruited based on screening data and consultation of a community advisory board. In each congregation, researchers conducted interviews with clergy and lay leaders (n = 57); administered a congregational questionnaire; observed health activities, worship services, and neighborhood context; and reviewed archival information. Interviews were analyzed by using a qualitative, code-based approach. Congregations' health-related activities tended to be episodic, small in scale, and local in scope. Trust and social capital played important roles in congregations' health initiatives, providing a safe, confidential environment and leveraging resources from-and for-faith-based and secular organizations in their community networks. Congregations also served as "incubators" for members to engage in social entrepreneurship. Although the small scale of congregations' health initiatives suggest they may not have the capacity to provide the main infrastructure for service provision, congregations can complement the efforts of health and social providers with their unique strengths. Specifically, congregations are distinctive in their ability to identify unmet local needs, and congregations' position in their communities permit them to network in productive ways.

Social Entrepreneurship in Religious Congregations’ Efforts to Address Health Needs

Science.gov (United States)

Werber, Laura; Mendel, Peter J.; Derose, Kathryn Pitkin

2013-01-01

Purpose Examine how religious congregations engage in social entrepreneurship as they strive to meet health-related needs in their communities. Design Multiple case studies. Setting Los Angeles County, California. Participants Purposive sample of 14 congregations representing diverse races-ethnicities (African American, Latino, and white) and faith traditions (Jewish and various Christian). Method Congregations were recruited based on screening data and consultation of a community advisory board. In each congregation, researchers conducted interviews with clergy and lay leaders (n=57); administered a congregational questionnaire; observed health activities, worship services, and neighborhood context; and reviewed archival information. Interviews were analyzed using a qualitative, code-based approach. Results Congregations’ health-related activities tended to be episodic, small in scale, and local in scope. Trust and social capital played important roles in congregations’ health initiatives, providing a safe, confidential environment and leveraging resources from – and for – faith-based and secular organizations in their community networks. Congregations also served as “incubators” for members to engage in social entrepreneurship. Conclusion Although the small scale of congregations’ health initiatives suggest they may not have the capacity to provide the main infrastructure for service provision, congregations can complement the efforts of health and social providers with their unique strengths. Specifically, congregations are distinctive in their ability to identify unmet local needs, and congregations’ position in their communities permit them to network in productive ways. PMID:23875986

Japan’s efforts to promote global health using satellite remote sensing data from the Japan Aerospace Exploration Agency for prediction of infectious diseases and air quality

Directory of Open Access Journals (Sweden)

Tamotsu Igarashi

2014-12-01

Full Text Available In this paper we review the status of new applications research of the Japanese Aerospace Exploration Agency (JAXA for global health promotion using information derived from Earth observation data by satellites in cooperation with inter-disciplinary collaborators. Current research effort at JAXA to promote global public health is focused primarily on the use of remote sensing to address two themes: (i prediction models for malaria and cholera in Kenya, Africa; and (ii air quality assessment of small, particulate matter (PM2.5, nitrogen dioxide (NO2 and ozone (O3. Respiratory and cardivascular diseases constitute cross-boundary public health risk issues on a global scale. The authors report here on results of current of a collaborative research to call attention to the need to take preventive measures against threats to public health using newly arising remote sensing information from space.

Cancer Disparities - Cancer Currents Blog

Science.gov (United States)

Blog posts on cancer health disparities research—including factors that influence disparities, disparities-related research efforts, and diversity in the cancer research workforce—from NCI Cancer Currents.

U.S. military enlisted accession mental health screening: history and current practice.

Science.gov (United States)

Cardona, Robert Andrew; Ritchie, Elspeth Cameron

2007-01-01

Through the stimulus of war and concerns about neuropsychiatric disability, the U.S. military developed methods to rapidly screen the mental health of World War I and II draftees. Intelligence testing and brief psychiatric screening expanded the accession physical examination and underwent revision to identify only gross mental health disability. Supplemental psychiatric evaluations and written psychological screening tools were abandoned after postwar assessments; they demonstrated poor predictive power in evaluating recruit service capacity for combat environments. Currently, only three mental health accession tools are used to screen applicants before their entrance into military service, namely, educational achievement, cognitive testing, and a cursory psychiatric evaluation. The Navy and Air Force use a fourth screening measure during entry-level training. Educational attainment with high school graduation has been the strongest predictor of finishing a service term. The purpose of this article is to provide both a historical review and a review of testing efforts.

Current state of the science: health effects and indoor environmental quality

DEFF Research Database (Denmark)

Mitchell, Clifford S; Zhang, Junfeng Jim; Sigsgaard, Torben

2007-01-01

Our understanding of the relationship between human health and the indoor environment continues to evolve. Previous research on health and indoor environments has tended to concentrate on discrete pollutant sources and exposures and on specific disease processes. Recently, efforts have been made...... environments. Advances in source characterization include a better understanding of how chemicals are transported and processed within spaces and the role that other factors such as lighting and building design may play in determining health. Efforts are under way to improve our ability to measure exposures...

A Study of National Physician Organizations’ Efforts to Reduce Racial and Ethnic Health Disparities in the United States

Science.gov (United States)

Peek, Monica E.; Wilson, Shannon C.; Bussey-Jones, Jada; Lypson, Monica; Cordasco, Kristina; Jacobs, Elizabeth A.; Bright, Cedric; Brown, Arleen F.

2012-01-01

Purpose To characterize national physician organizations’ efforts to reduce health disparities and identify organizational characteristics associated with such efforts. Method This cross-sectional study was conducted between September 2009 and June 2010. The authors used two-sample t tests and chi-square tests to compare the proportion of organizations with disparity-reducing activities between different organizational types (e.g., primary care versus subspecialty organizations, small [5,000 members]). Inclusion criteria required physician organizations to be (1) focused on physicians, (2) national in scope, and (3) membership based. Results The number of activities per organization ranged from 0 to 22. Approximately half (53%) of organizations had 0 or 1 disparity-reducing activities. Organiza-tional characteristics associated with having at least 1 disparity-reducing effort included membership size (88% of large groups versus 58% of small groups had at least 1 activity; P = .004) and the presence of a health disparities committee (95% versus 59%; P organizations and racial/ethnic minority physician organizations were more likely to have disparity-reducing efforts, although findings were not statistically significant. Common themes addressed by activities were health care access, health care disparities, workforce diversity, and language barriers. Common strategies included education of physicians/trainees and patients/general public, position statements, and advocacy. Conclusions Despite the national priority to eliminate health disparities, more than half of national physician organizations are doing little to address this problem. Primary care and minority physician organizations, and those with disparities committees, may provide leadership to extend the scope of disparity-reduction efforts. PMID:22534593

Qualitative ergonomics/human factors research in health care: Current state and future directions.

Science.gov (United States)

Valdez, Rupa Sheth; McGuire, Kerry Margaret; Rivera, A Joy

2017-07-01

The objective of this systematic review was to understand the current state of Ergonomics/Human Factors (E/HF) qualitative research in health care and to draw implications for future efforts. This systematic review identified 98 qualitative research papers published between January 2005 and August 2015 in the seven journals endorsed by the International Ergonomics Association with an impact factor over 1.0. The majority of the studies were conducted in hospitals and outpatient clinics, were focused on the work of formal health care professionals, and were classified as cognitive or organizational ergonomics. Interviews, focus groups, and observations were the most prevalent forms of data collection. Triangulation and data archiving were the dominant approaches to ensuring rigor. Few studies employed a formal approach to qualitative inquiry. Significant opportunities remain to enhance the use of qualitative research to advance systems thinking within health care. Copyright © 2017 Elsevier Ltd. All rights reserved.

The Human Resources for Health Effort Index: a tool to assess and inform Strategic Health Workforce Investments.

Science.gov (United States)

Fort, Alfredo L; Deussom, Rachel; Burlew, Randi; Gilroy, Kate; Nelson, David

2017-07-19

Despite its importance, the field of human resources for health (HRH) has lagged in developing methods to measure its status and progress in low- and middle-income countries suffering a workforce crisis. Measures of professional health worker densities and distribution are purely numerical, unreliable, and do not represent the full spectrum of workers providing health services. To provide more information on the multi-dimensional characteristics of human resources for health, in 2013-2014, the global USAID-funded CapacityPlus project, led by IntraHealth International, developed and tested a 79-item HRH Effort Index modeled after the widely used Family Planning Effort Index. The index includes seven recognized HRH dimensions: Leadership and Advocacy; Policy and Governance; Finance; Education and Training; Recruitment, Distribution, and Retention; Human Resources Management; and Monitoring, Evaluation, and Information Systems. Each item is scored from 1 to 10 and scores are averaged with equal weights for each dimension and overall. The questionnaire is applied to knowledgeable informants from public, nongovernmental organization, and private sectors in each country. A pilot test among 49 respondents in Kenya and Nigeria provided useful information to improve, combine, and streamline questions. CapacityPlus applied the revised 50-item questionnaire in 2015 in Burkina Faso, Dominican Republic, Ghana, and Mali, among 92 respondents. Additionally, the index was applied subnationally in the Dominican Republic (16 respondents) and in a consensus-building meeting in Mali (43 respondents) after the national application. The results revealed a range of scores between 3.7 and 6.2 across dimensions, for overall scores between 4.8 and 5.5. Dimensions with lower scores included Recruitment, Distribution, and Retention, while Leadership and Advocacy had higher scores. The tool proved to be well understood and provided key qualitative information on the health workforce to assist

Boosting healthy heart employer-sponsored health dissemination efforts: identification and information-sharing intentions.

Science.gov (United States)

Stephens, Keri K; Pastorek, Angie; Crook, Brittani; Mackert, Michael; Donovan, Erin E; Shalev, Heidi

2015-01-01

Health information dissemination options have expanded to include workplaces and employer-sponsored efforts. This study focuses on a core relational concept found in workplaces, organizational identification-the feeling of belongingness-and the impact of partnering with employers and health clinics in health information dissemination. We use social-identity theory and multiple identification to test our predictions from a sample of working adults representing more than 100 different employers. We found that when people strongly identify with their employer, they have increased health behavioral intentions and they intend to talk about the health information with coworkers. The significant models explain more than 50% and 30% of the variance in these two outcomes. The experimental results examining single and multiple organizational sources revealed no differences on any outcomes. These findings offer a contribution to health information dissemination research by articulating how identification with an employer functions to affect behavioral intentions.

Prognostics and Health Management of Wind Turbines: Current Status and Future Opportunities

Energy Technology Data Exchange (ETDEWEB)

Sheng, Shuangwen

2015-12-14

Prognostics and health management is not a new concept. It has been used in relatively mature industries, such as aviation and electronics, to help improve operation and maintenance (O&M) practices. In the wind industry, prognostics and health management is relatively new. The level for both wind industry applications and research and development (R&D) has increased in recent years because of its potential for reducing O&M cost of wind power, especially for turbines installed offshore. The majority of wind industry application efforts has been focused on diagnosis based on various sensing and feature extraction techniques. For R&D, activities are being conducted in almost all areas of a typical prognostics and health management framework (i.e., sensing, data collection, feature extraction, diagnosis, prognosis, and maintenance scheduling). This presentation provides an overview of the current status of wind turbine prognostics and health management that focuses on drivetrain condition monitoring through vibration, oil debris, and oil condition analysis techniques. It also discusses turbine component health diagnosis through data mining and modeling based on supervisory control and data acquisition system data. Finally, it provides a brief survey of R&D activities for wind turbine prognostics and health management, along with future opportunities.

Joint Community Health Needs Assessments as a Path for Coordinating Community-Wide Health Improvement Efforts Between Hospitals and Local Health Departments.

Science.gov (United States)

Carlton, Erik L; Singh, Simone Rauscher

2018-05-01

To examine the association between hospital-local health department (LHD) collaboration around community health needs assessments (CHNAs) and hospital investment in community health. We combined 2015 National Association of County and City Health Officials (NACCHO) Forces of Change, 2013 NACCHO Profile, and 2014-2015 Area Health Resource File data to identify a sample of LHDs (n = 439) across the United States. We included data on hospitals' community benefit from their 2014 tax filings (Internal Revenue Service Form 990, Schedule H). We used bivariate and multivariate regression analyses to examine LHDs' involvement in hospitals' CHNAs and implementation strategies and the relationship with hospital investment in community health. The LHDs that collaborated with hospitals around CHNAs were significantly more likely to be involved in joint implementation planning activities than were those that did not. Importantly, LHD involvement in hospitals' implementation strategies was associated with greater hospital investment in community health improvement initiatives. Joint CHNAs may improve coordination of community-wide health improvement efforts between hospitals and LHDs and encourage hospital investment in community health improvement activities. Public Health Implications. Policies that strengthen LHD-hospital collaboration around the CHNA may enhance hospital investments in community health.

Current research efforts of EP study in Korea

International Nuclear Information System (INIS)

Ryu, C.M.

2013-01-01

After the successful demonstration of H mode on KSTAR, the problem of fast-ion driven MHD modes such as Alfven eigenmodes (AEs) and the reverse effects on fast ions of MHD modes is under study in KSTAR. In this paper, I will briefly describe some recent efforts of KSTAR on energetic particle physics study. (J.P.N.)

Current drinking and health-risk behaviors among male high school students in central Thailand

Directory of Open Access Journals (Sweden)

Pichainarong Natchaporn

2011-04-01

Full Text Available Abstract Background Alcohol drinking is frequently related to behavioral problems, which lead to a number of negative consequences. This study was to evaluate the characteristics of male high school students who drink, the drinking patterns among them, and the associations between current drinking and other health risk behaviors which focused on personal safety, violence-related behaviors, suicide and sexual behaviors. Method A cross-sectional study was conducted to explore current alcohol drinking and health-risk behaviors among male high school students in central Thailand. Five thousand one hundred and eighty four male students were classified into 2 groups according to drinking in the previous 30 days (yes = 631, no = 4,553. Data were collected by self-administered, anonymous questionnaire which consisted of 3 parts: socio-demographic factors, health-risk behaviors and alcohol drinking behavior during the past year from December 2007 to February 2008. Results The results showed that the percent of current drinking was 12.17. Most of them were 15-17 years (50.21%. Socio-demographic factors such as age, educational level, residence, cohabitants, grade point average (GPA, having a part time job and having family members with alcohol/drug problems were significantly associated with alcohol drinking (p Conclusions An increased risk of health-risk behaviors, including driving vehicles after drinking, violence-related behaviors, sad feelings and attempted suicide, and sexual behaviors was higher among drinking students that led to significant health problems. Effective intervention strategies (such as a campaign mentioning the adverse health effects and social consequences to the risk groups, and encouraging parental and community efforts to prevent drinking among adolescents should be implemented to prevent underage drinking and adverse consequences.

A Collaborative Effort to Assess Environmental Health in ...

Science.gov (United States)

The Region 3 “Making a Visible Difference in Communities” (MVD) initiative for Southeast Newport News, VA has taken a community-centric, place-based approach to identifying and delivering service to the area’s residents and the city as a whole. Beginning with a CARE (Community Action for a Renewed Environment) Level 1 cooperative agreement (a grant with substantial government involvement and required outputs) in 2011, Region 3 funding helped to establish the Southeast CARE Coalition (“the Coalition”), and quickly formed a bond with the organization. Two years later, Region 3, the US EPA Office of Research and Development (ORD) and the Coalition embarked on a scientific, socio-demographic Regional Sustainable Environmental Science (RESES) research project to assess local pollutant sources and their potential impacts to the community. These efforts helped EPA select Newport News as an MVD community, resulting in an expanded partnership that now includes the City of Newport News. Through this association and the MVD designation, the partners have identified and prioritized environmental and other concerns (e.g., improving air and water quality, adapting to extreme weather, promoting equitable development, improving transportation). Newport News has recently held workshops and training on topics such as environmental health, asthma, weather events, and equitable development, and continues to improve the community’s health, its knowledge of the relevant e

[Health education in Quebec: developments over the past decade and current prospects].

Science.gov (United States)

Gagnon, Hélène; Valentini, Hélène

2013-01-01

This study examines the views of five university professors in the province of Quebec on recent trends and developments in health education, the relative importance of health education as a health promotion strategy, and future prospects. Interviews were conducted and the participants were asked to validate the findings. Despite minor differences, the participants were found to have similar views on health education. The interviews also pointed to a significant emphasis on recent developments in our understanding of the factors influencing health behaviors and the theoretical foundations underlying processes of change. However, much remains to be done to put this knowledge into practice. In Quebec, the field of health education has involved an increasingly diverse range of actors in recent years, although nurses continue to play an important role. Some feel that the emphasis on creating supportive environments for health and public policies has had a negative impact on the development of health education in Quebec. For others, we are witnessing the emergence of a more integrated system combining different health promotion strategies. In terms of future prospects, some remain pessimistic, emphasizing the potential effects of the current economic climate or the potential negative impact of the rise of therapeutic education, which may be at the expense of a more systemic approach. Others are more optimistic, arguing that the future of health education will be a matter of political will and that it will depend on the efforts of stakeholders to promote consistent and complementary measures.

Public health information and statistics dissemination efforts for Indonesia on the Internet.

Science.gov (United States)

Hanani, Febiana; Kobayashi, Takashi; Jo, Eitetsu; Nakajima, Sawako; Oyama, Hiroshi

2011-01-01

To elucidate current issues related to health statistics dissemination efforts on the Internet in Indonesia and to propose a new dissemination website as a solution. A cross-sectional survey was conducted. Sources of statistics were identified using link relationship and Google™ search. Menu used to locate statistics, mode of presentation and means of access to statistics, and available statistics were assessed for each site. Assessment results were used to derive design specification; a prototype system was developed and evaluated with usability test. 49 sources were identified on 18 governmental, 8 international and 5 non-government websites. Of 49 menus identified, 33% used non-intuitive titles and lead to inefficient search. 69% of them were on government websites. Of 31 websites, only 39% and 23% used graph/chart and map for presentation. Further, only 32%, 39% and 19% provided query, export and print feature. While >50% sources reported morbidity, risk factor and service provision statistics, disseminate statistics in Indonesia are supported by non-governmental and international organizations and existing their information may not be very useful because it is: a) not widely distributed, b) difficult to locate, and c) not effectively communicated. Actions are needed to ensure information usability, and one of such actions is the development of statistics portal website.

California's historic effort to reduce the stigma of mental illness: the Mental Health Services Act.

Science.gov (United States)

Clark, Wayne; Welch, Stephanie N; Berry, Sandra H; Collentine, Ann M; Collins, Rebecca; Lebron, Dorthy; Shearer, Amy L

2013-05-01

In a historic effort to reduce the stigma of mental illness, California voters approved the Mental Health Services Act in 2004. The law funds a comprehensive statewide prevention initiative that places stigma and discrimination reduction at its center, with 25 projects providing interventions at the institutional, societal, and individual levels. Stakeholders selected specific strategies from the research-based California Strategic Plan on Reducing Stigma and Discrimination. Strategies range from social marketing to increase public knowledge to capacity building at the local level, including training that emphasizes participation by consumers of mental health services and cultural competence. Collectively, these strategies aim to foster permanent change in the public perception of mental illness and in the individual experience of stigma. We examined the context, planning, programming, and evaluation of this effort.

Challenges in mental health nursing: current opinion

Directory of Open Access Journals (Sweden)

Sabella D

2014-01-01

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

Association between health worker motivation and healthcare quality efforts in Ghana.

Science.gov (United States)

Alhassan, Robert Kaba; Spieker, Nicole; van Ostenberg, Paul; Ogink, Alice; Nketiah-Amponsah, Edward; de Wit, Tobias F Rinke

2013-08-14

Ghana is one of the sub-Saharan African countries making significant progress towards universal access to quality healthcare. However, it remains a challenge to attain the 2015 targets for the health related Millennium Development Goals (MDGs) partly due to health sector human resource challenges including low staff motivation. This paper addresses indicators of health worker motivation and assesses associations with quality care and patient safety in Ghana. The aim is to identify interventions at the health worker level that contribute to quality improvement in healthcare facilities. The study is a baseline survey of health workers (n = 324) in 64 primary healthcare facilities in two regions in Ghana. Data collection involved quality care assessment using the SafeCare Essentials tool, the National Health Insurance Authority (NHIA) accreditation data and structured staff interviews on workplace motivating factors. The Spearman correlation test was conducted to test the hypothesis that the level of health worker motivation is associated with level of effort by primary healthcare facilities to improve quality care and patient safety. The quality care situation in health facilities was generally low, as determined by the SafeCare Essentials tool and NHIA data. The majority of facilities assessed did not have documented evidence of processes for continuous quality improvement and patient safety. Overall, staff motivation appeared low although workers in private facilities perceived better working conditions than workers in public facilities (P motivation interventions should be integrated into quality improvement strategies especially in government-owned healthcare facilities where working conditions are perceived to be the worst.

Current stress and poor oral health.

Science.gov (United States)

Vasiliou, A; Shankardass, K; Nisenbaum, R; Quiñonez, C

2016-09-02

Psychological stress appears to contribute to poor oral health systemically in combination with other chronic diseases. Few studies directly examine this relationship. Data from a cross-sectional study of 2,412 participants between the ages of 25-64 years old living in the City of Toronto between 2009 and 2012 were used to examine the relationship between current stress and two self-rated oral health outcomes (general oral health and oral pain). Dental care utilization and access to dental insurance were examined as effect modifiers. A positive relationship between current stress and poor oral health was observed for both outcomes (oral pain coefficient 0.32, 95 % CI 0.26-0.38; general oral health coefficient 0.28, 95 % CI 0.19-0.36). Effects on oral pain were stronger for the uninsured, while effects on general oral health were stronger with decreasing socioeconomic position. Our findings suggest that individuals with greater perceived stress also report poorer oral health, and that this relationship is modified by dental insurance and socioeconomic position. These findings warrant a greater focus on the role of psychological stress in the development of oral disease, including how perceived stress contributes to health inequities in self-reported oral health status. Patients experiencing stressful lives may differentially require closer monitoring and more vigilant maintenance of their oral health, above and beyond that which is needed to achieve a state of health in the oral environment of less stressed individuals. There may be health promoting effects of addressing psychosocial concerns related to dental care - particularly for the poor and uninsured.

Current Issues in Maritime Health

DEFF Research Database (Denmark)

Wagtmann, Maria Anne

2008-01-01

 In the early part of 2008, Maria Anne Wagtmann had the opportunity to interview the former president of the International Maritime Health Association, Dr. Tim Carter, in London about a number of current maritime health issues. In this interview, Dr. Tim Carter, who is cur­rently employed...... as the Chief Medical Advisor for the British government's Department for Transport, gives his personal - and thus non-official - opinions on these issues....

Analyzing Patterns of Community Interest at a Legacy Mining Waste Site to Assess and Inform Environmental Health Literacy Efforts

Science.gov (United States)

Ramirez-Andreotta, Monica D.; Lothrop, Nathan; Wilkinson, Sarah T.; Root, Robert A.; Artiola, Janick F.; Klimecki, Walter; Loh, Miranda

2015-01-01

Understanding a community’s concerns and informational needs is crucial to conducting and improving environmental health research and literacy initiatives. We hypothesized that analysis of community inquiries over time at a legacy mining site would be an effective method for assessing environmental health literacy efforts and determining whether community concerns were thoroughly addressed. Through a qualitative analysis, we determined community concerns at the time of being listed as a Superfund site. We analyzed how community concerns changed from this starting point over the subsequent years, and whether: 1) communication materials produced by the USEPA and other media were aligned with community concerns; and 2) these changes demonstrated a progression of the community’s understanding resulting from community involvement and engaged research efforts. We observed that when the Superfund site was first listed, community members were most concerned with USEPA management, remediation, site-specific issues, health effects, and environmental monitoring efforts related to air/dust and water. Over the next five years, community inquiries shifted significantly to include exposure assessment and reduction methods and issues unrelated to the site, particularly the local public water supply and home water treatment systems. Such documentation of community inquiries over time at contaminated sites is a novel method to assess environmental health literacy efforts and determine whether community concerns were thoroughly addressed. PMID:27595054

Cancer Currents Now Available in Spanish

Science.gov (United States)

As part of our effort to more effectively reach patients, health care providers, and researchers with timely, authoritative, and scientifically accurate cancer information, we are now offering selected Cancer Currents blog posts in Spanish.

Current stress and poor oral health

OpenAIRE

Vasiliou, A.; Shankardass, K.; Nisenbaum, R.; Qui?onez, C.

2016-01-01

Background Psychological stress appears to contribute to poor oral health systemically in combination with other chronic diseases. Few studies directly examine this relationship. Methods Data from a cross-sectional study of 2,412 participants between the ages of 25?64 years old living in the City of Toronto between 2009 and 2012 were used to examine the relationship between current stress and two self-rated oral health outcomes (general oral health and oral pain). Dental care utilization and ...

Are Physicians Obliged to Lead Environmental Sustainability Efforts in Health Care Organizations?

Science.gov (United States)

Macpherson, Cheryl C; Hill, Jonathan

2017-12-01

Climate change threatens health, health care, and the industries and resources upon which these depend. The growing prevalence and severity of its health consequences and economic costs are alarming health professionals and organizations as their professional obligations, grounded in the core value of health, include protecting against these harms. One means of fulfilling these obligations is to lead or support sustainability initiatives that are built upon current, reliable, accurate, and unbiased evidence and collaboratively tailored to meet specific needs and respond to specific contexts. We consider why and how health professionals and organizations should lead or support such initiatives. © 2017 American Medical Association. All Rights Reserved.

The mismatch between high effort and low reward in household and family work predicts impaired health among mothers.

Science.gov (United States)

Sperlich, Stefanie; Arnhold-Kerri, Sonja; Siegrist, Johannes; Geyer, Siegfried

2013-10-01

So far, Siegrist's model of effort-reward imbalance (ERI) has been tested almost exclusively for paid employment. This article reports results on a newly developed questionnaire measuring ERI in unpaid household and family work. Using data of a population-based sample of 3129 German mothers, logistic regression analyses were performed to test the following three main assumptions: (i) high effort combined with low reward in household and family work increases the risk of poor health; (ii) a high level of overcommitment may enhance the risk of poor health; and (iii) mothers reporting an extrinsic high ERI and a high level of overcommitment have an even higher risk of poor health. ERI was significantly related to self-rated health, somatic complaints and mental health. A high level of overcommitment increased the risk of poor health, whereas ERI and overcommitment combined was associated with the highest risk of poor health. Statistically significant synergy effects of combined exposure of ERI and overcommitment were found for 'anxiety'. With some limitations, all three assumptions underlying the ERI model were confirmed. Thus, we conclude that ERI is applicable to domestic work and may provide an explanatory framework to assess stress experiences in mothers.

Global health goals: lessons from the worldwide effort to eradicate poliomyelitis.

Science.gov (United States)

Aylward, R Bruce; Acharya, Arnab; England, Sarah; Agocs, Mary; Linkins, Jennifer

2003-09-13

The Global Polio Eradication Initiative was launched in 1988. Assessment of the politics, production, financing, and economics of this international effort has suggested six lessons that might be pertinent to the pursuit of other global health goals. First, such goals should be based on technically sound strategies with proven operational feasibility in a large geographical area. Second, before launching an initiative, an informed collective decision must be negotiated and agreed in an appropriate international forum to keep to a minimum long-term risks in financing and implementation. Third, if substantial community engagement is envisaged, efficient deployment of sufficient resources at that level necessitates a defined, time-limited input by the community within a properly managed partnership. Fourth, although the so-called fair-share concept is arguably the best way to finance such goals, its limitations must be recognised early and alternative strategies developed for settings where it does not work. Fifth, international health goals must be designed and pursued within existing health systems if they are to secure and sustain broad support. Finally, countries, regions, or populations most likely to delay the achievement of a global health goal should be identified at the outset to ensure provision of sufficient resources and attention. The greatest threats to poliomyelitis eradication are a financing gap of US 210 million dollars and difficulties in strategy implementation in at most five countries.

Health Status of Current National Guard Members

National Research Council Canada - National Science Library

Proctor, Susan P

2005-01-01

.... The objectives are to: 1) describe the current health status of this ARNG cohort, 2) examine to what extent the job strain of ARNG service affects the relationship between Civilian job strain and health and job performance outcomes and, 3...

Establishing cause for developing and implementing a broad-based marketing effort for the health education field.

Science.gov (United States)

Stellefson, Michael; Barry, Adam; Chaney, Beth H; Chaney, J Don; Hanik, Bruce

2011-05-01

What exactly is health education? Professionals with advanced degrees in health education have most likely encountered questions such as these either during introductory coursework or from those inquiring about the field. These queries can prove quite perplexing when asked by individuals who are unaware of the health education profession. Because the act of marketing health education is crucial to the sustainability of the field, the purpose of this article is to (a) explore the issue of describing and promoting health education, (b) establish ideas that can facilitate the provision of coordinated marketing efforts, and (c) offer marketing management and implementation principles that can assist in marketing both health education and health educators. Based on this discussion, the authors suggest building mainstream consensus in regards to marketing message development and implementation to better position health education.

Health Promotion Efforts as Predictors of Physical Activity in Schools: An Application of the Diffusion of Innovations Model

Science.gov (United States)

Glowacki, Elizabeth M.; Centeio, Erin E.; Van Dongen, Daniel J.; Carson, Russell L.; Castelli, Darla M.

2016-01-01

Background: Implementing a comprehensive school physical activity program (CSPAP) effectively addresses public health issues by providing opportunities for physical activity (PA). Grounded in the Diffusion of Innovations model, the purpose of this study was to identify how health promotion efforts facilitate opportunities for PA. Methods: Physical…

The emergence of Ebola as a global health security threat: From ′lessons learned′ to coordinated multilateral containment efforts

Directory of Open Access Journals (Sweden)

Sarathi Kalra

2014-01-01

Full Text Available First reported in remote villages of Africa in the 1970s, the Ebolavirus was originally believed to be transmitted to people from wild animals. Ebolavirus (EBOV causes a severe, frequently fatal hemorrhagic syndrome in humans. Each outbreak of the Ebolavirus over the last three decades has perpetuated fear and economic turmoil among the local and regional populations in Africa. Until now it has been considered a tragic malady confined largely to the isolated regions of the African continent, but it is no longer so. The frequency of outbreaks has increased since the 1970s. The 2014 Ebola outbreak in Western Africa has been the most severe in history and was declared a public health emergency by the World Health Organization. Given the widespread use of modern transportation and global travel, the EBOV is now a risk to the entire Global Village, with intercontinental transmission only an airplane flight away. Clinically, symptoms typically appear after an incubation period of approximately 11 days. A flu-like syndrome can progress to full hemorrhagic fever with multiorgan failure, and frequently, death. Diagnosis is confirmed by detection of viral antigens or Ribonucleic acid (RNA in the blood or other body fluids. Although historically the mortality of this infection exceeded 80%, modern medicine and public health measures have been able to lower this figure and reduce the impact of EBOV on individuals and communities. The treatment involves early, aggressive supportive care with rehydration. Core interventions, including contact tracing, preventive initiatives, active surveillance, effective isolation and quarantine procedures, and timely response to patients, are essential for a successful outbreak control. These measures, combined with public health education, point-of-care diagnostics, promising new vaccine and pharmaceutical efforts, and coordinated efforts of the international community, give new hope to the Global effort to eliminate Ebola

The Emergence of Ebola as a Global Health Security Threat: From ‘Lessons Learned’ to Coordinated Multilateral Containment Efforts

Science.gov (United States)

Kalra, Sarathi; Kelkar, Dhanashree; Galwankar, Sagar C.; Papadimos, Thomas J.; Stawicki, Stanislaw P.; Arquilla, Bonnie; Hoey, Brian A.; Sharpe, Richard P.; Sabol, Donna; Jahre, Jeffrey A.

2014-01-01

First reported in remote villages of Africa in the 1970s, the Ebolavirus was originally believed to be transmitted to people from wild animals. Ebolavirus (EBOV) causes a severe, frequently fatal hemorrhagic syndrome in humans. Each outbreak of the Ebolavirus over the last three decades has perpetuated fear and economic turmoil among the local and regional populations in Africa. Until now it has been considered a tragic malady confined largely to the isolated regions of the African continent, but it is no longer so. The frequency of outbreaks has increased since the 1970s. The 2014 Ebola outbreak in Western Africa has been the most severe in history and was declared a public health emergency by the World Health Organization. Given the widespread use of modern transportation and global travel, the EBOV is now a risk to the entire Global Village, with intercontinental transmission only an airplane flight away. Clinically, symptoms typically appear after an incubation period of approximately 11 days. A flu-like syndrome can progress to full hemorrhagic fever with multiorgan failure, and frequently, death. Diagnosis is confirmed by detection of viral antigens or Ribonucleic acid (RNA) in the blood or other body fluids. Although historically the mortality of this infection exceeded 80%, modern medicine and public health measures have been able to lower this figure and reduce the impact of EBOV on individuals and communities. The treatment involves early, aggressive supportive care with rehydration. Core interventions, including contact tracing, preventive initiatives, active surveillance, effective isolation and quarantine procedures, and timely response to patients, are essential for a successful outbreak control. These measures, combined with public health education, point-of-care diagnostics, promising new vaccine and pharmaceutical efforts, and coordinated efforts of the international community, give new hope to the Global effort to eliminate Ebola as a public

Systematic review of current efforts to quantify the impacts of climate change on undernutrition.

Science.gov (United States)

Phalkey, Revati K; Aranda-Jan, Clara; Marx, Sabrina; Höfle, Bernhard; Sauerborn, Rainer

2015-08-18

Malnutrition is a challenge to the health and productivity of populations and is viewed as one of the five largest adverse health impacts of climate change. Nonetheless, systematic evidence quantifying these impacts is currently limited. Our aim was to assess the scientific evidence base for the impact of climate change on childhood undernutrition (particularly stunting) in subsistence farmers in low- and middle-income countries. A systematic review was conducted to identify peer-reviewed and gray full-text documents in English with no limits for year of publication or study design. Fifteen manuscripts were reviewed. Few studies use primary data to investigate the proportion of stunting that can be attributed to climate/weather variability. Although scattered and limited, current evidence suggests a significant but variable link between weather variables, e.g., rainfall, extreme weather events (floods/droughts), seasonality, and temperature, and childhood stunting at the household level (12 of 15 studies, 80%). In addition, we note that agricultural, socioeconomic, and demographic factors at the household and individual levels also play substantial roles in mediating the nutritional impacts. Comparable interdisciplinary studies based on primary data at a household level are urgently required to guide effective adaptation, particularly for rural subsistence farmers. Systemization of data collection at the global level is indispensable and urgent. We need to assimilate data from long-term, high-quality agricultural, environmental, socioeconomic, health, and demographic surveillance systems and develop robust statistical methods to establish and validate causal links, quantify impacts, and make reliable predictions that can guide evidence-based health interventions in the future.

Using indicators to determine the contribution of human rights to public health efforts

Science.gov (United States)

Ferguson, Laura

2009-01-01

Abstract There is general agreement on the need to integrate human rights into health policies and programmes, although there is still reluctance to go beyond rhetorical acknowledgement of their assumed significance. To determine the actual value of human rights for the effectiveness of public health efforts requires clarity about what their incorporation looks like in practice and how to assess their contribution. Despite the pervasive use of indicators in the public health field, indicators that specifically capture human rights concerns are not well developed and those that exist are inconsistently used. Even though “health and human rights indicators” are increasingly being constructed, it is often the case that health indicators are used to draw conclusions about some interaction between human rights and health; or that law and policy or other indicators, traditionally the domain of the human rights community, are used to make conclusions about health outcomes. To capture the added value that human rights bring to health, the differences in the contributions offered by these indicators need to be understood. To determine the value of different measures for advancing programme effectiveness, improving health outcomes and promoting human rights, requires questioning the intended purpose behind the construction of an indicator, who uses it, the kind of indicator it is, the extent to which it provides information about vulnerable populations, as well as how the data are collected and used. PMID:19784452

Federal health web sites: current & future roles.

Science.gov (United States)

Cronin, Carol

2002-09-01

An examination of the current and possible future roles of federal health Web sites, this paper provides an overview of site categories, functions, target audiences, marketing approaches, knowledge management, and evaluation strategies. It concludes with a look at future opportunities and challenges for the federal government in providing health information online.

Forensic mental health services: Current service provision and ...

African Journals Online (AJOL)

Forensic mental health services: Current service provision and planning for a prison mental health service in the Eastern Cape. Kiran Sukeri, Orlando A. Betancourt, Robin Emsley, Mohammed Nagdee, Helmut Erlacher ...

Integration of Mental Health into Primary Health Care in a rural ...

African Journals Online (AJOL)

Objective: Mental health has been identified as a major priority in the Ugandan Health Sector Strategic Plan. Efforts are currently underway to integrate mental health services into the Primary Health Care system. In this study, we report aspects of the integration of mental health into primary health care in one rural district in ...

Fostering reflective trust between mothers and community health nurses to improve the effectiveness of health and nutrition efforts: An ethnographic study in Ghana, West Africa.

Science.gov (United States)

Ackatia-Armah, Nana M; Addy, Nii Antiaye; Ghosh, Shibani; Dubé, Laurette

2016-06-01

As the global health agenda shifts from the Millennium Development Goals (MDGs) to Sustainable Development Goals (SDGs), the need for effective preventive health efforts has gained prominence, particularly in low-income regions with poor health and nutrition outcomes. To address needs in communities with limited access to health services and personnel, it is important to develop strategies that can improve the effectiveness of nurses as they interact with the populations they serve. We contribute to informing such strategies by explaining how mothers' "reflective trust" in community health nurses develops as a key influencer in their health-related decision-making and behavior. Between December 2012 and June 2013, our ethnographic study gathered data in three adjacent rural and semi-rural communities in Ghana's Eastern Region, using interviews with 39 nursing mothers, three focus groups - with mothers, health-workers, and community leaders - as well as 941 h of participant observation. We focused on interactions between mothers and nurses, highlighting tensions between communities' traditions and messages that nurses bring, which are often based on modern science. We also investigated how mothers come to exhibit reflective trust in the nurses to make sense of traditional and scientific knowledge on infant feeding, and integrate them into their own feeding decisions. Our findings have global implications for effectively sustaining and scaling health and nutrition efforts through community approaches. Copyright © 2016 Elsevier Ltd. All rights reserved.

Effort-reward imbalance and its association with health among permanent and fixed-term workers

Directory of Open Access Journals (Sweden)

Nishikitani Mariko

2010-11-01

Full Text Available Abstract Background In the past decade, the changing labor market seems to have rejected the traditional standards employment and has begun to support a variety of non-standard forms of work in their place. The purpose of our study was to compare the degree of job stress, sources of job stress, and association of high job stress with health among permanent and fixed-term workers. Methods Our study subjects were 709 male workers aged 30 to 49 years in a suburb of Tokyo, Japan. In 2008, we conducted a cross-sectional study to compare job stress using an effort-reward imbalance (ERI model questionnaire. Lifestyles, subjective symptoms, and body mass index were also observed from the 2008 health check-up data. Results The rate of job stress of the high-risk group measured by ERI questionnaire was not different between permanent and fixed-term workers. However, the content of the ERI components differed. Permanent workers were distressed more by effort, overwork, or job demand, while fixed-term workers were distressed more by their job insecurity. Moreover, higher ERI was associated with existence of subjective symptoms (OR = 2.07, 95% CI: 1.42-3.03 and obesity (OR = 2.84, 95% CI:1.78-4.53 in fixed-term workers while this tendency was not found in permanent workers. Conclusions Our study showed that workers with different employment types, permanent and fixed-term, have dissimilar sources of job stress even though their degree of job stress seems to be the same. High ERI was associated with existing subjective symptoms and obesity in fixed-term workers. Therefore, understanding different sources of job stress and their association with health among permanent and fixed-term workers should be considered to prevent further health problems.

Engineering youth service system infrastructure: Hawaii's continued efforts at large-scale implementation through knowledge management strategies.

Science.gov (United States)

Nakamura, Brad J; Mueller, Charles W; Higa-McMillan, Charmaine; Okamura, Kelsie H; Chang, Jaime P; Slavin, Lesley; Shimabukuro, Scott

2014-01-01

Hawaii's Child and Adolescent Mental Health Division provides a unique illustration of a youth public mental health system with a long and successful history of large-scale quality improvement initiatives. Many advances are linked to flexibly organizing and applying knowledge gained from the scientific literature and move beyond installing a limited number of brand-named treatment approaches that might be directly relevant only to a small handful of system youth. This article takes a knowledge-to-action perspective and outlines five knowledge management strategies currently under way in Hawaii. Each strategy represents one component of a larger coordinated effort at engineering a service system focused on delivering both brand-named treatment approaches and complimentary strategies informed by the evidence base. The five knowledge management examples are (a) a set of modular-based professional training activities for currently practicing therapists, (b) an outreach initiative for supporting youth evidence-based practices training at Hawaii's mental health-related professional programs, (c) an effort to increase consumer knowledge of and demand for youth evidence-based practices, (d) a practice and progress agency performance feedback system, and (e) a sampling of system-level research studies focused on understanding treatment as usual. We end by outlining a small set of lessons learned and a longer term vision for embedding these efforts into the system's infrastructure.

Current health issues in Korean adolescents

Directory of Open Access Journals (Sweden)

Chang Ho Hong

2011-10-01

Full Text Available During the adolescent period, they experience rapid physical, emotional, cognitive developments while they establish their lifestyle and habitual routines that strongly influence adult health and life. Recent rapid economic growth in Korea, and the earlier onset of physical, sexual, and psychological maturation of adolescents, has resulted in changes in the health status of adolescents from many years ago. Risk-taking behaviors such as drinking alcohol, smoking, and sexual experiences are critical issues that affect the health of, adolescents. Therefore, it is important for pediatricians to note the that risk-taking behaviors of adolescents in Korea that are caused by individual psychosocial factors. This review article illustrates the current health status of Korean adolescents and provides an overview of risktaking behaviors, to inform pediatricians about some of the key issues.

Applying the Policy Ecology Framework to Philadelphia’s Behavioral Health Transformation Efforts

Science.gov (United States)

Powell, Byron J.; Beidas, Rinad S.; Rubin, Ronnie M.; Stewart, Rebecca E.; Wolk, Courtney Benjamin; Matlin, Samantha L.; Weaver, Shawna; Hurford, Matthew O.; Evans, Arthur C.; Hadley, Trevor R.; Mandell, David S.

2016-01-01

Raghavan et al. (2008) proposed that effective implementation of evidence-based practices requires implementation strategies deployed at multiple levels of the “policy ecology,” including the organizational, regulatory or purchaser agency, political, and social levels. However, much of implementation research and practice targets providers without accounting for contextual factors that may influence provider behavior. This paper examines Philadelphia’s efforts to work toward an evidence-based and recovery-oriented behavioral health system, and uses the policy ecology framework to illustrate how multifaceted, multilevel implementation strategies can facilitate the widespread implementation of evidence-based practices. Ongoing challenges and implications for research and practice are discussed. PMID:27032411

Improving health profile of blood donors as a consequence of transfusion safety efforts

DEFF Research Database (Denmark)

Edgren, Gustaf; Tran, Trung Nam; Hjalgrim, Henrik

2007-01-01

BACKGROUND: Transfusion safety rests heavily on the health of blood donors. Although they are perceived as being healthier than average, little is known about their long-term disease patterns and to which extent the blood banks' continuous efforts to optimize donor selection has resulted...... in improvements. Mortality and cancer incidence among blood donors in Sweden and Denmark was investigated. STUDY DESIGN AND METHODS: All computerized blood bank databases were compiled into one database, which was linked to national population and health data registers. With a retrospective cohort study design, 1......,110,329 blood donors were followed for up to 35 years from first computer-registered blood donation to death, emigration, or December 31, 2002. Standardized mortality and incidence ratios expressed relative risk of death and cancer comparing blood donors to the general population. RESULTS: Blood donors had...

Reforming health care in Canada: current issues

Directory of Open Access Journals (Sweden)

Baris Enis

1998-01-01

Full Text Available This paper examines the current health care reform issues in Canada. The provincial health insurance plans of the 1960s and 1970s had the untoward effects of limiting the federal government's clout for cost control and of promoting a system centered on inpatient and medical care. Recently, several provincial commissions reported that the current governance structures and management processes are outmoded in light of new knowledge, new fiscal realities and the evolution of power among stake-holders. They recommend decentralized governance and restructuring for better management and more citizen participation. Although Canada's health care system remains committed to safeguarding its guiding principles, the balance of power may be shifting from providers to citizens and "technocrats". Also, all provinces are likely to increase their pressure on physicians by means of salary caps, by exploring payment methods such as capitation, limiting access to costly technology, and by demanding practice changes based on evidence of cost-effectiveness.

Collection development and outsourcing in academic health sciences libraries: a survey of current practices.

Science.gov (United States)

Blecic, D D; Hollander, S; Lanier, D

1999-04-01

Academic health sciences libraries in the United States and Canada were surveyed regarding collection development trends, including their effect on approval plan and blanket order use, and use of outsourcing over the past four years. Results of the survey indicate that serials market forces, budgetary constraints, and growth in electronic resources purchasing have resulted in a decline in the acquisition of print items. As a result, approval plan use is being curtailed in many academic health sciences libraries. Although use of blanket orders is more stable, fewer than one-third of academic health sciences libraries report using them currently. The decline of print collections suggests that libraries should explore cooperative collection development of print materials to ensure access and preservation. The decline of approval plan use and the need for cooperative collection development may require additional effort for sound collection development. Libraries were also surveyed about their use of outsourcing. Some libraries reported outsourcing cataloging and shelf preparation of books, but none reported using outsourcing for resource selection. The reason given most often for outsourcing was that it resulted in cost savings. As expected, economic factors are driving both collection development and outsourcing practices.

Examining human resources' efforts to develop a culturally competent workforce.

Science.gov (United States)

Whitman, Marilyn V; Valpuesta, Domingo

2010-01-01

The increasing diversification of the nation's population poses significant challenges in providing care that meets the needs of culturally diverse patients. Human resource management plays a vital role in developing a more culturally competent workforce. This exploratory study examines current efforts by human resource directors (HRDs) in Alabama's general hospitals to recruit more diverse candidates, train staff, and make language access resources available. A questionnaire was developed based on the Office of Minority Health's Culturally and Linguistically Appropriate Services standards. The HRDs of the 101 Alabama general hospitals served as the study's target population. A sample of 61 responses, or 60.4% of the population, was obtained. The findings indicate that most HRDs are focusing their efforts on recruiting racially/ethnically diverse candidates and training clerical and nursing staff to care for culturally and linguistically diverse patients. Less effort is being focused on recruiting candidates who speak a different language, and only 44.3% have a trained interpreter on the staff. The HRDs who indicated that they work closely with organizations that provide support to diverse groups were more likely to recruit diverse employees and have racially/ethnically and linguistically diverse individuals in leadership positions. It is crucial that health care organizations take the necessary steps to diversify their workforce to broaden access, improve the quality and equity of care, and capture a greater market share.

Importance of investigating epigenetic alterations for industry and regulators: An appraisal of current efforts by the Health and Environmental Sciences Institute

International Nuclear Information System (INIS)

Miousse, Isabelle R.; Currie, Richard; Datta, Kaushik; Ellinger-Ziegelbauer, Heidrun; French, John E.; Harrill, Alison H.; Koturbash, Igor; Lawton, Michael; Mann, Derek; Meehan, Richard R.; Moggs, Jonathan G.; O’Lone, Raegan; Rasoulpour, Reza J.

2015-01-01

Recent technological advances have led to rapid progress in the characterization of epigenetic modifications that control gene expression in a generally heritable way, and are likely involved in defining cellular phenotypes, developmental stages and disease status from one generation to the next. On November 18, 2013, the International Life Sciences Institute (ILSI) Health and Environmental Sciences Institute (HESI) held a symposium entitled “Advances in Assessing Adverse Epigenetic Effects of Drugs and Chemicals” in Washington, D.C. The goal of the symposium was to identify gaps in knowledge and highlight promising areas of progress that represent opportunities to utilize epigenomic profiling for risk assessment of drugs and chemicals. Epigenomic profiling has the potential to provide mechanistic information in toxicological safety assessments; this is especially relevant for the evaluation of carcinogenic or teratogenic potential and also for drugs that directly target epigenetic modifiers, like DNA methyltransferases or histone modifying enzymes. Furthermore, it can serve as an endpoint or marker for hazard characterization in chemical safety assessment. The assessment of epigenetic effects may also be approached with new model systems that could directly assess transgenerational effects or potentially sensitive stem cell populations. These would enhance the range of safety assessment tools for evaluating xenobiotics that perturb the epigenome. Here we provide a brief synopsis of the symposium, update findings since that time and then highlight potential directions for future collaborative efforts to incorporate epigenetic profiling into risk assessment

Mental and psychosocial health among current and former professional footballers.

Science.gov (United States)

Gouttebarge, V; Frings-Dresen, M H W; Sluiter, J K

2015-04-01

In common with elite athletes from other sport disciplines, severe or recurrent injuries in professional footballers are considered to be major physical and psychosocial stressors, which may predispose to mental health problems during and after their career. To determine the prevalence of mental health problems and psychosocial difficulties in current and former professional footballers, and to explore the association between psychosocial stressors and the health conditions studied. Based on validated scales, a paper and electronic questionnaire was developed for current and former professional footballers and distributed by the World Footballers' Union (FIFPro) and players' unions in six countries. Prevalence was calculated and cross-sectional analyses were conducted. The response rate was 29% with 253 responses available for analysis. The prevalence of mental health complaints ranged from 5% (burnout) to 26% (anxiety/depression) in 149 current players and from 16% (burnout) to 39% (anxiety/depression) in 104 former footballers. The prevalence of psychosocial problems ranged from 3% (low self-esteem) to 26% (adverse nutrition behaviour) in current players and from 5% (low self-esteem) to 42% (adverse nutrition behaviour) in former footballers. In both current and former players, mental health problems were significantly associated with low social support (odds ratio [OR] = 1.1) and recent life events (OR = 1.4-1.6). In former players, previous surgery was significantly associated with smoking (OR = 1.9). The prevalence of mental health problems and/or psychosocial difficulties in current and former professional footballers was found to be high. The presence of mental health problems was associated with low social support and recent life events. © The Author 2015. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

Pesantren dan Upaya Pendidikan Kesehatan Reproduksi Remaja (Pesantren and Adolescent Reproductive Health Education Effort

Directory of Open Access Journals (Sweden)

Setia Pranata

2014-04-01

Full Text Available Background: Although there was Pesantren Health Post, but the promotion and education of reproductive health did notproceed well. Students at the Pesantren are mostly teenagers, therefore sexuality and reproduction problems in pesantrenhad become potential threats. This study described there productive health education in pesantren, that focused on theeducation system, material, and factors supporting and inhibiting reproductive health education efforts. Methods: This was a qualitative study. The data were collected by means of purposive sampling. The study was conducted at two pesantrens in Sampang, Balikpapan and West Lombok regencies. Data were collected by indepth interviews to managers, teachers and students. Results: This study indicated that reproductive education was not something new to the pesantren. The Classic Buku Kuning had been the reference of reproductive education among santri. The kyai used bandongan teaching methods which tend to be monologue. Further more this method did not employ evaluation system. The large number of santri, the high commitment and responsibility of the manager of pesantren, and the availibility of 24 hours assistance were factors that supported reproductive health education in pesantren. The inhibiting factors were limited understanding of reproductive health issues, lack of transparency of the pesantren community regarding issues that were considered taboo, and limitations of supporting infrastructure. Another aspect was the lack of external support that were relevance to the issue of adolescent reproductive health services. Recomendations: It is recommended to enrich the materials on reproductive health education in pesantren,

Upending the social ecological model to guide health promotion efforts toward policy and environmental change.

Science.gov (United States)

Golden, Shelley D; McLeroy, Kenneth R; Green, Lawrence W; Earp, Jo Anne L; Lieberman, Lisa D

2015-04-01

Efforts to change policies and the environments in which people live, work, and play have gained increasing attention over the past several decades. Yet health promotion frameworks that illustrate the complex processes that produce health-enhancing structural changes are limited. Building on the experiences of health educators, community activists, and community-based researchers described in this supplement and elsewhere, as well as several political, social, and behavioral science theories, we propose a new framework to organize our thinking about producing policy, environmental, and other structural changes. We build on the social ecological model, a framework widely employed in public health research and practice, by turning it inside out, placing health-related and other social policies and environments at the center, and conceptualizing the ways in which individuals, their social networks, and organized groups produce a community context that fosters healthy policy and environmental development. We conclude by describing how health promotion practitioners and researchers can foster structural change by (1) conveying the health and social relevance of policy and environmental change initiatives, (2) building partnerships to support them, and (3) promoting more equitable distributions of the resources necessary for people to meet their daily needs, control their lives, and freely participate in the public sphere. © 2015 Society for Public Health Education.

Incorporating Reporting Efforts to Manage and Improve Health and Wellness Programs.

Science.gov (United States)

Wells, Timothy S; Ozminkowski, Ronald J; McGinn, Michael P; Hawkins, Kevin; Bhattarai, Gandhi R; Serxner, Seth A; Greame, Chris

2017-06-01

Wellness programs are designed to help individuals maintain or improve their health. This article describes how a reporting process can be used to help manage and improve a wellness program. Beginning in 2014, a wellness pilot program became available in New Jersey for individuals with an AARP Medicare Supplement Insurance plan insured by UnitedHealthcare Insurance Company. The program has since expanded to include Missouri, Texas, Alabama, and Washington. This wellness program includes an online health portal, one-on-one telephonic coaching, gym membership discounts, and local health events. To assure smooth program operations and alignment with program objectives, weekly and monthly reports are produced. The weekly report includes metrics on member engagement and utilization for the aforementioned 4 program offerings and reports on the last 4 weeks, as well as for the current month and the current year to date. The monthly report includes separate worksheets for each state and a summary worksheet that includes all states combined, and provides metrics on overall engagement as well as utilization of the 4 program components. Although the monthly reports were used to better manage the 4 program offerings, the weekly reports help management to gauge response to program marketing. Reporting can be a data-driven management tool to help manage wellness programs. Reports provide rapid feedback regarding program performance. In contrast, in-depth program evaluations serve a different purpose, such as to report program-related savings, return on investment, or to report other longer term program-related outcomes.

National nutrition surveys in Asian countries: surveillance and monitoring efforts to improve global health.

Science.gov (United States)

Song, SuJin; Song, Won O

2014-01-01

Asian regions have been suffering from growing double burden of nutritional health problems, such as undernutrition and chronic diseases. National nutrition survey plays an essential role in helping to improve both national and global health and reduce health disparities. The aim of this review was to compile and present the information on current national nutrition surveys conducted in Asian countries and suggest relevant issues in implementation of national nutrition surveys. Fifteen countries in Asia have conducted national nutrition surveys to collect data on nutrition and health status of the population. The information on national nutrition survey of each country was obtained from government documents, international organizations, survey website of governmental agencies, and publications, including journal articles, books, reports, and brochures. The national nutrition survey of each country has different variables and procedures. Variables of the surveys include sociodemographic and lifestyle variables; foods and beverages intake, dietary habits, and food security of individual or household; and health indicators, such as anthropometric and biochemical variables. The surveys have focused on collecting data about nutritional health status in children aged under five years and women of reproductive ages, nutrition intake adequacy and prevalence of obesity and chronic diseases for all individuals. To measure nutrition and health status of Asian populations accurately, improvement of current dietary assessment methods with various diet evaluation tools is necessary. The information organized in this review is important for researchers, policy makers, public health program developers, educators, and consumers in improving national and global health.

eHealth in Saudi Arabia: Current Trends, Challenges and Recommendations.

Science.gov (United States)

Alsulame, Khaled; Khalifa, Mohamed; Househ, Mowafa

2015-01-01

The purpose of this study is to explore the current status of eHealth in Saudi Arabia from the perspective of health informatics professionals. We used a case study approach and analyzed participant data using thematic analysis. The study took place between July and August 2013. Data collection included interviews with nine senior health information professionals in Saudi Arabia. The findings describe participant views on current eHealth trends in Saudi Arabia and show differences among Saudi healthcare organizations in terms of eHealth adoption. Participants also describe the challenges relating to organizational and cultural issues, end user attitudes towards eHealth projects, and the lack of specialized human resources to implement eHealth systems. Two main recommendations made by the participants were to form a new national body for eHealth and to develop a unified plan for the implementation of Saudi eHealth initiatives.

The association between current unemployment and clinically determined poor oral health.

Science.gov (United States)

Al-Sudani, Fouad Y H; Vehkalahti, Miira M; Suominen, Anna L

2015-08-01

The aim of this study was to assess whether current unemployment was associated with poor oral health and whether there was a difference in oral health according to the duration of the current unemployment. As part of the Health 2000 Survey in Finland (a nationwide comprehensive health examination survey), we used its data based on interviews, questionnaires, and clinical oral examinations of the 30- to 63-year-old respondents (n = 4773). Current employment status was measured in its dichotomous form, employed versus unemployed, and length of current unemployment was classified into four categories. We measured oral health in terms of numbers of missing teeth, of sound teeth, of filled teeth, of decayed teeth, and of teeth with deepened periodontal pockets (≥4 mm, ≥6 mm). Poisson regression models were fitted for all oral health outcomes except number of decayed teeth, for which negative binomial regression model was used. Oral health-related behaviors and sociodemographic and socioeconomic factors were added to the analyses. The unemployed subjects had higher numbers of missing teeth, of decayed teeth, and of teeth with periodontal pockets than the employed ones. The association remained consistent even after adjustments. Oral health-related behaviors seemed to mediate the association. We found no association between unemployment and number of sound teeth. Current long-term unemployment showed stronger association with poor oral health than short-term among women. The unemployed can be considered as a risk group for poor oral health. Oral healthcare should be reoriented toward those who are unemployed. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Effort-Reward Imbalance and its Association with Health among Pluckers in a Tea Plantation in South India.

Science.gov (United States)

Tomy, Chitra; Ramesh, Naveen; Fathima, Farah N; D'cunha, Rodney L; Chakravathi, Kote A

2017-01-01

Work-related stress is associated with cardiovascular diseases, musculoskeletal disorders, psychological ailments, and work-related injuries. Imbalance between high effort and low reward at work can lead to work stress among plantation workers. To assess the effort-reward imbalance (ERI) among pluckers in tea plantations in South India and its association on chronic health problems, substance abuses, and workplace injuries. A cross-sectional study was conducted among 346 tea pluckers from May to June 2015 in six selected tea plantations in Anamalai, South India. A short version of ERI questionnaire was used to assess the work-related stress among them. Along with ERI questionnaire, sociodemographic details, chronic diseases, substance abuses, and workplace injuries were ascertained. Sociodemographic variables were described as frequency and measures of central tendency. Tests of association, such as Chi-square test, were applied. Among the study population, 322 (93.1%) reported more effort, 23 (6.6%) reported more reward, and one (0.3%) had no imbalance between effort and reward. Those in older age group (≥51 years) experienced more effort compared to those in younger age group (≤50 years) (Fisher's exact = 21.905, P = 0.001). Educational status (Fisher's exact = 15.639, P = 0.027) and work experience (Fisher's exact = 23.122, P = 0.003) increased the effort rather than increasing the reward associated with work. No significant association was found between ERI and any chronic diseases, substance abuses, or injuries. Majority of pluckers in tea plantation experienced more effort compared to reward.

Current status of the MPEG-4 standardization effort

Science.gov (United States)

Anastassiou, Dimitris

1994-09-01

The Moving Pictures Experts Group (MPEG) of the International Standardization Organization has initiated a standardization effort, known as MPEG-4, addressing generic audiovisual coding at very low bit-rates (up to 64 kbits/s) with applications in videotelephony, mobile audiovisual communications, video database retrieval, computer games, video over Internet, remote sensing, etc. This paper gives a survey of the status of MPEG-4, including its planned schedule, and initial ideas about requirements and applications. A significant part of this paper is summarizing an incomplete draft version of a `requirements document' which presents specifications of desirable features on the video, audio, and system level of the forthcoming standard. Very low bit-rate coding algorithms are not described, because no endorsement of any particular algorithm, or class of algorithms, has yet been made by MPEG-4, and several seminars held concurrently with MPEG-4 meetings have not so far provided evidence that such high performance coding schemes are achievable.

A Serviced-based Approach to Connect Seismological Infrastructures: Current Efforts at the IRIS DMC

Science.gov (United States)

Ahern, Tim; Trabant, Chad

2014-05-01

As part of the COOPEUS initiative to build infrastructure that connects European and US research infrastructures, IRIS has advocated for the development of Federated services based upon internationally recognized standards using web services. By deploying International Federation of Digital Seismograph Networks (FDSN) endorsed web services at multiple data centers in the US and Europe, we have shown that integration within seismological domain can be realized. By deploying identical methods to invoke the web services at multiple centers this approach can significantly ease the methods through which a scientist can access seismic data (time series, metadata, and earthquake catalogs) from distributed federated centers. IRIS has developed an IRIS federator that helps a user identify where seismic data from global seismic networks can be accessed. The web services based federator can build the appropriate URLs and return them to client software running on the scientists own computer. These URLs are then used to directly pull data from the distributed center in a very peer-based fashion. IRIS is also involved in deploying web services across horizontal domains. As part of the US National Science Foundation's (NSF) EarthCube effort, an IRIS led EarthCube Building Block's project is underway. When completed this project will aid in the discovery, access, and usability of data across multiple geoscienece domains. This presentation will summarize current IRIS efforts in building vertical integration infrastructure within seismology working closely with 5 centers in Europe and 2 centers in the US, as well as how we are taking first steps toward horizontal integration of data from 14 different domains in the US, in Europe, and around the world.

Glass Property Models and Constraints for Estimating the Glass to be Produced at Hanford by Implementing Current Advanced Glass Formulation Efforts

Energy Technology Data Exchange (ETDEWEB)

Vienna, John D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Kim, Dong-Sang [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Skorski, Daniel C. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Matyas, Josef [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

2013-07-01

Recent glass formulation and melter testing data have suggested that significant increases in waste loading in HLW and LAW glasses are possible over current system planning estimates. The data (although limited in some cases) were evaluated to determine a set of constraints and models that could be used to estimate the maximum loading of specific waste compositions in glass. It is recommended that these models and constraints be used to estimate the likely HLW and LAW glass volumes that would result if the current glass formulation studies are successfully completed. It is recognized that some of the models are preliminary in nature and will change in the coming years. Plus the models do not currently address the prediction uncertainties that would be needed before they could be used in plant operations. The models and constraints are only meant to give an indication of rough glass volumes and are not intended to be used in plant operation or waste form qualification activities. A current research program is in place to develop the data, models, and uncertainty descriptions for that purpose. A fundamental tenet underlying the research reported in this document is to try to be less conservative than previous studies when developing constraints for estimating the glass to be produced by implementing current advanced glass formulation efforts. The less conservative approach documented herein should allow for the estimate of glass masses that may be realized if the current efforts in advanced glass formulations are completed over the coming years and are as successful as early indications suggest they may be. Because of this approach there is an unquantifiable uncertainty in the ultimate glass volume projections due to model prediction uncertainties that has to be considered along with other system uncertainties such as waste compositions and amounts to be immobilized, split factors between LAW and HLW, etc.

Effort-Based Decision-Making in Schizophrenia.

Science.gov (United States)

Culbreth, Adam J; Moran, Erin K; Barch, Deanna M

2018-08-01

Motivational impairment has long been associated with schizophrenia but the underlying mechanisms are not clearly understood. Recently, a small but growing literature has suggested that aberrant effort-based decision-making may be a potential contributory mechanism for motivational impairments in psychosis. Specifically, multiple reports have consistently demonstrated that individuals with schizophrenia are less willing than healthy controls to expend effort to obtain rewards. Further, this effort-based decision-making deficit has been shown to correlate with severity of negative symptoms and level of functioning, in many but not all studies. In the current review, we summarize this literature and discuss several factors that may underlie aberrant effort-based decision-making in schizophrenia.

Health-related quality of life in current smokers with COPD: factors associated with current smoking and new insights into sex differences

Directory of Open Access Journals (Sweden)

Cheruvu VK

2016-09-01

Full Text Available Vinay K Cheruvu,1 Lorriane A Odhiambo,1 Dana S Mowls,2 Melissa D Zullo,1 Abdi T Gudina1 1Department of Biostatistics, Environmental Health Sciences, and Epidemiology, College of Public Health, Kent State University, Kent, OH, 2Department of Biostatistics & Epidemiology, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA Abstract: Findings from studies that examined the association between health-related ­quality of life (HRQOL and smoking status among COPD patients have been mixed. Moreover, factors associated with current smoking in COPD patients and differences by sex have not been fully elucidated. Data from the 2011 and 2012 Behavioral Risk Factor Surveillance System was used in this study. Four HRQOL indicators were examined in this study: general health, physical health, mental health, and activity limitations. General health was dichotomized into two groups: “excellent/very good/good” and “fair/poor”, and the other three HRQOL indicators were dichotomized into <14 (infrequent and ≥14 (frequent unhealthy days in the past 30 days. To examine HRQOL indicators in association with current versus former smoking and identify factors associated with current smoking, logistic regression models were used. Sex differences were explored. In COPD patients, current smokers compared to former smokers had significantly poor HRQOL on all subdomains: “fair/poor” general health (adjusted odds ratio [AOR]: 1.2 [95% confidence interval {CI}: 1.1–1.5]; poor physical health (AOR: 1.3 [CI: 1.1–1.5]; poor mental health (AOR: 1.8 [CI: 1.4–2.2]; and poor activity limitations (AOR: 1.5 [CI: 1.3–1.9]. HRQOL subdomains affected by current smoking differed by sex except activity limitations. General health (AOR: 1.5 [CI: 1.1–2.0] and activity limitations (AOR: 1.6 [95% CI: 1.2–2.2] in males and physical health (AOR: 1.3 [CI: 1.0–1.6], mental health (AOR: 2.1 [CI: 1.7–2.6], and activity

Current and future impact of osteoarthritis on health care

DEFF Research Database (Denmark)

Turkiewicz, A; Petersson, I F; Björk, J

2014-01-01

OBJECTIVE: To estimate the current and future (to year 2032) impact of osteoarthritis (OA) health care seeking. METHOD: Population-based study with prospectively ascertained data from the Skåne Healthcare Register (SHR), Sweden, encompassing more than 15 million person-years of primary and specia......OBJECTIVE: To estimate the current and future (to year 2032) impact of osteoarthritis (OA) health care seeking. METHOD: Population-based study with prospectively ascertained data from the Skåne Healthcare Register (SHR), Sweden, encompassing more than 15 million person-years of primary...

Distribution of Effort-Reward Imbalance in Denmark and Its Prospective Association With a Decline in Self-Rated Health

NARCIS (Netherlands)

Rugulies, Reiner; Aust, Birgit; Siegrist, Johannes; von dem Knesebeck, Olaf; Bultmann, Ute; Bjorner, Jakob B.; Burr, Hermann

Objective: To analyze the distribution of effort-reward imbalance (ERI) and to investigate its impact on self-rated health in a representative sample of the Danish workforce. Methods: We studied 4977 employees who responded to a questionnaire in 2000, of which 3470 responded to a follow-up survey in

Effort--reward imbalance and medically certified absence for mental health problems: a prospective study of white-collar workers.

Science.gov (United States)

Ndjaboué, R; Brisson, C; Vézina, M; Blanchette, C; Bourbonnais, R

2014-01-01

Little is known about the effects of psychosocial work factors on objectively assessed mental health problems leading to medically certified absence. Only one study has evaluated the prospective effects of effort-reward imbalance (ERI) at work with regards to this outcome. The present study aimed to evaluate the effects of ERI on the incidence of medically certified absence for mental health problems. The study included 2086 white-collar workers (63.3% women) employed in public organisations in Quebec city. Participants were followed over a 9-year period. Medical absences from work were collected from employers' files and psychosocial factors were measured using the ERI questionnaire. Cox regression models were used to estimate the incidence of certified sickness absence due to mental health problems that lasted 5 workdays or more, while controlling for confounders. Workers exposed to ERI had a higher risk of a first spell of medically certified absence for mental health problems (HR=1.38, 95% CI 1.08 to 1.76) compared with unexposed workers. Low reward was significantly associated with a high risk among men (HR=2.80, 95% CI 1.34 to 5.89) but not in women. (HR=1.24, 95% CI 0.90 to 1.73). Effort at work had no effect on certified absence. All these effects were adjusted for potential confounders. ERI and low reward at work were prospectively associated with medically certified absence for mental health problems. These effects seem to differ by gender. Primary prevention that is aimed at reducing these stressors should be considered to help reduce the incidence of such severe mental health problems.

How active resisters and organizational constipators affect health care-acquired infection prevention efforts.

Science.gov (United States)

Saint, Sanjay; Kowalski, Christine P; Banaszak-Holl, Jane; Forman, Jane; Damschroder, Laura; Krein, Sarah L

2009-05-01

As of October 2008, hospitals in the United States no longer receive Medicare reimbursement for certain types of health care-associated infection (HAI), thereby heightening the need for effective prevention efforts. The mere existence of evidence-based practices, however, does not always result in the use of such practices because of the complexities inherent in translating evidence into practice. A qualitative study was conducted to determine the barriers to implementing evidence-based practices to prevent HAI, with a specific focus on the role played by hospital personnel. In-depth phone and in-person interviews were conducted between October 2006 and September 2007 with 86 participants (31 physicians) including chief executive officers, chiefs of staff, hospital epidemiologists, infection control professionals, intensive care unit directors, nurse managers, and frontline physicians and nurses, in 14 hospitals. Active resistance to evidence-based practice change was pervasive. Successful efforts to overcome active resisters included benchmarking infection rates, identifying effective champions, and participating in collaborative efforts. Organizational constipators-mid- to high-level executives who act as insidious barriers to change-also increased the difficulty in implementing change. Recognizing the presence of constipators is often the first step in addressing the problem but can be followed with including the organizational constipator early in group discussions to improve communication and obtain buy-in, working around the individual, and terminating the constipator's employment. Two types of personnel-active resistors and organizational constipators-impeded HAI prevention activities, and several approaches were used to overcome those barriers. Hospital administrators and patient safety leaders can use the findings to more successfully structure activities that prevent HAI in their hospitals.

Health and safety implications of occupational exposure to engineered nanomaterials.

Science.gov (United States)

Stebounova, Larissa V; Morgan, Hallie; Grassian, Vicki H; Brenner, Sara

2012-01-01

The rapid growth and commercialization of nanotechnology are currently outpacing health and safety recommendations for engineered nanomaterials. As the production and use of nanomaterials increase, so does the possibility that there will be exposure of workers and the public to these materials. This review provides a summary of current research and regulatory efforts related to occupational exposure and medical surveillance for the nanotechnology workforce, focusing on the most prevalent industrial nanomaterials currently moving through the research, development, and manufacturing pipelines. Their applications and usage precedes a discussion of occupational health and safety efforts, including exposure assessment, occupational health surveillance, and regulatory considerations for these nanomaterials. Copyright © 2011 Wiley Periodicals, Inc.

The current status of the Korean student health examination

Directory of Open Access Journals (Sweden)

Hye-Jung Shin

2013-08-01

Full Text Available Recent trends place an emphasis on school health care, the ultimate goal of which is to protect,maintain, and promote students’ health. School health care is a program that integrates health careservices, health education, health counseling, and local social health services. The student healthexamination (SHE system is a part of school health care and schools and communities must beavailable to provide professional health services. Pediatricians also have important roles as experts inboth school health care and the SHE system. In this article, the history of school health care, its legalbasis, and the current status of the SHE system in Korea are reviewed. Furthermore, sample surveysfrom the past few years are reviewed. Through this holistic approach, future directions are proposed forthe improvement of SHE and school health care.

The mediating effect of effort-reward imbalance in household and family work on the relationship between education and women's health.

Science.gov (United States)

Sperlich, Stefanie; Geyer, Siegfried

2015-04-01

Occupational stress as a key determinant for explaining health inequalities has been well established while the impact of stress related to family work has rarely been considered. This study investigates whether stress in household and family work may contribute to health inequalities in women. We used a population-based sample of German mothers (n = 3129) to determine the total, direct and indirect effects of education on somatic complaints by means of OLS regression-based mediation models. Inference about indirect effects was determined by 95% bias corrected bootstrap confidence intervals. Education was assessed by a measure combining school education and vocational training. Stress was measured using the adopted effort-reward-imbalance (ERI) questionnaire for household and family work. The von Zerssen list of somatic complaints was used as measure of subjective health. We found a significant total effect of education on somatic complaints (p ≤ 0.001) as well as significant indirect effects through 'effort' (p = 0.006) and 'reward' in household and family work (p ≤ 0.001). However, the subscales of ERI pointed into different directions: while levels of 'effort' increased with women's educational attainment, levels of distress related to low 'reward' decreased with higher levels of education. Our findings suggest that the effect of women's education on somatic complaints is mediated through stress related to low reward for household and family work. In particular, lack of 'societal esteem' for household and family work contributed to health disadvantages in lower educated mothers. We conclude that research on health inequality would benefit from taking stressful experiences in household and family work greater into account. Copyright © 2015 Elsevier Ltd. All rights reserved.

The Missouri River Floodplain: History of Oak Forest & Current Restoration Efforts

Science.gov (United States)

Daniel C. Dey; Dirk Burhans; John Kabrick; Brain Root; Jennifer Grabner; Mike Gold

2000-01-01

Efforts to restore floodplains are complicated by our variable understanding of history and ecology; our lack of knowledge of past environmental and vegetative conditions; and our differing viewpoints of what natural, what the role of humans is in the ecosystem, and what the desirable restored state is. Managers are challenged to decide how to restore native vegetation...

Workplace violence against nurses--prevalence and association with hospital organizational characteristics and health-promotion efforts: Cross-sectional study.

Science.gov (United States)

Wei, Ching-Yao; Chiou, Shu-Ti; Chien, Li-Yin; Huang, Nicole

2016-04-01

To determine the prevalence of workplace violence and explore the role of hospital organizational characteristics and health promotion efforts in reducing hospital violence among nurses in Taiwan. Cross-sectional survey. One hundred hospitals across Taiwan. The final sample in our study comprised responses from 26,979 nurses. The data were obtained from a nationwide hospital survey, Physical and Mental Health and Safety Needs in Full-Time Health Care Staff, which was developed and conducted by the Bureau of Health Promotion, Taiwan, in 2011. The main dependent variable was whether nurses had experienced violence within the past year. Physical violence, threatened or intimidated personal safety, verbal violence or sexual harassment were all included. Of the 26,979 nurses, 13,392 nurses (49.6%) had experienced at least one episode of any type of violence in the past year; 5150 nurses (19.1%) had been exposed to physical violence, and 12,491 nurses (46.3%) had been exposed to non-physical violence. The prevalence of having experienced any violence varied widely and ranged from the highest (55.5%) in an emergency room or intensive care unit to the lowest (28.3%) among those aged 55-65 years. After adjusting for other characteristics, younger nurses were significantly more likely to be exposed to any violent threat. Nurses working in public hospitals had a significantly higher risk of workplace violence than those working in private hospitals. Significant variations were also observed among work units. Although nurses working in a certified health promoting hospital (HPH) did not have a lower risk of workplace violence, those working in an outstanding HPH had a significantly lower risk of workplace violence. A similar pattern was observed for non-physical violence. Workplace violence is a major challenge to workplace safety for nurses in hospitals. This large scale nurse survey identified individual, work and hospital characteristics associated with workplace violence

Seeing through the Smoke: A collaborative, multidisciplinary effort to address the interplay between wildfire, climate, air quality, and health

Science.gov (United States)

Brey, S. J.; Fischer, E. V.; Pierce, J. R.; Ford, B.; Lassman, W.; Pfister, G.; Volckens, J.; Gan, R.; Magzamen, S.; Barnes, E. A.

2015-12-01

Exposure to wildfire smoke plumes represents an episodic, uncertain, and potentially growing threat to public health in the western United States. The area burned by wildfires in this region has increased over recent decades, and the future of fires within this region is largely unknown. Future fire emissions are intimately linked to future meteorological conditions, which are uncertain due to the variability of climate model outputs and differences between representative concentration pathways (RCP) scenarios. We know that exposure to wildfire smoke is harmful, particularly for vulnerable populations. However the literature on the heath effects of wildfire smoke exposure is thin, particularly when compared to the depth of information we have on the effects of exposure to smoke of anthropogenic origin. We are exploring the relationships between climate, fires, air quality and public health through multiple interdisciplinary collaborations. We will present several examples from these projects including 1) an analysis of the influence of fire on ozone abundances over the United States, and 2) efforts to use a high-resolution weather forecasting model to nail down exposure within specific smoke plumes. We will also highlight how our team works together. This discussion will include examples of the university structure that facilitates our current collaborations, and the lessons we have learned by seeking stakeholder input to make our science more useful.

[Current and future competencies for public health professionals].

Science.gov (United States)

Rodríguez, Dolors; Berenguera, Anna; Pujol-Ribera, Enriqueta; Capella, Jordina; Peray, Josep Lluís de; Roma, Josep

2013-01-01

To identify current and future competencies (managers and technicians) for public health professionals in Catalonia (Spain). Qualitative research with a phenomenological approach. Between November 2009 and February 2010, 31 semistructured interviews were completed with public health professionals working in Catalonia. We purposely used a theoretical sample to include the maximum multiplicity of discourses. We conducted a thematic content analysis. We obtained a wide range of current professional competencies, as well as those required for the future, classified according to professional profile. The participants highlighted transversal competencies, such as the importance of sharing a general theoretical framework of the discipline and the institution. Among the most frequently reported competencies were knowledge management, communication skills, teamwork, multidisciplinary and intersectoral orientation, legal knowledge, computer skills and languages, particularly English. It was also important for individual professionals to have specific skills in their areas of activity. In terms of differences between managers and technicians, the study showed that technicians prioritize management skills concerning human and material resources, while managers emphasize organizational and professional public health expertise. There is a need for transversal and specific competencies in distinct areas. Public health is a multidisciplinary field, which collaborates with a wide range of professionals and organizations. Copyright © 2012 SESPAS. Published by Elsevier Espana. All rights reserved.

Exposure information in environmental health research: Current opportunities and future directions for particulate matter, ozone, and toxic air pollutants

Energy Technology Data Exchange (ETDEWEB)

McKone, Thomas E.; Ryan, P. Barry; Ozkaynak, Haluk

2007-02-01

Understanding and quantifying outdoor and indoor sources of human exposure are essential but often not adequately addressed in health-effects studies for air pollution. Air pollution epidemiology, risk assessment, health tracking and accountability assessments are examples of health-effects studies that require but often lack adequate exposure information. Recent advances in exposure modeling along with better information on time-activity and exposure factors data provide us with unique opportunities to improve the assignment of exposures for both future and ongoing studies linking air pollution to health impacts. In September 2006, scientists from the US Environmental Protection Agency (EPA) and the Centers for Disease Control and Prevention (CDC) along with scientists from the academic community and state health departments convened a symposium on air pollution exposure and health in order to identify, evaluate, and improve current approaches for linking air pollution exposures to disease. This manuscript presents the key issues, challenges and recommendations identified by the exposure working group, who used cases studies of particulate matter, ozone, and toxic air pollutant exposure to evaluate health-effects for air pollution. One of the over-arching lessons of this workshop is that obtaining better exposure information for these different health-effects studies requires both goal-setting for what is needed and mapping out the transition pathway from current capabilities to meeting these goals. Meeting our long-term goals requires definition of incremental steps that provide useful information for the interim and move us toward our long-term goals. Another over-arching theme among the three different pollutants and the different health study approaches is the need for integration among alternate exposure assessment approaches. For example, different groups may advocate exposure indicators, biomonitoring, mapping methods (GIS), modeling, environmental media

Current status of family health in Mexico

Directory of Open Access Journals (Sweden)

Apolinar Membrillo Luna

2013-01-01

Full Text Available Family Health (FH has three main elements: individual health, life material conditions and family functioning. Its main actors are the individual, the family and society. A common framework is the basis of FH, as each one of these elements is extremely important. Currently, in Mexico two aspects are considered: epidemiological studies and those inherent to the family medicine specialty. That latter has a residency and an integrated specialty curriculum, as well as certification from the corresponding board. All of this allows us to apply the HF approach to each and every family and individual that is cared for.

Games for Health 2005

National Research Council Canada - National Science Library

Sawyer, Benjamin G

2005-01-01

Using the conference convening resources of the Games for Health Project, operated by Digital Mill, we worked to further advance TATRC goals and current efforts by helping TATRC network and exchange...

Efforts of a Kansas foundation to increase physical activity and improve health by funding community trails, 2012.

Science.gov (United States)

Heinrich, Katie M; Lightner, Joseph; Oestman, Katherine B; Hughey, S Morgan; Kaczynski, Andrew T

2014-11-26

Trails are associated with increased physical activity; however, little is known about the process of building trails by various types of organizations. From 2005 through 2012 the Sunflower Foundation: Health Care for Kansans (Sunflower) funded multiple organizations to construct 70 trails of varying lengths and surfaces in municipalities, schools, and communities across Kansas. The purpose of this study was to assess the process of developing and implementing community trail projects across Kansas with funding from a public foundation. In 2012, we stratified funded organizations by type and conducted proportional random sampling to select 20 key informants from those organizations to participate in structured telephone interviews. Interviews were recorded and transcribed verbatim. Two researchers coded interview transcripts according to issues identified by participants. Issues associated with trail-building identified as important were collaboration among groups, unexpected construction costs, champions for the project, and level of difficulty of construction. Participants indicated that trails facilitated physical activity. Trails were integrated into communities through events such as walking events and other promotional efforts; these efforts were thought to increase trail use. The perceived outcomes of building the trails included providing the community with a physical activity resource, inspiring the community to start additional trail projects, and increasing the physical activity of local residents. Sunflower's funding was instrumental in developing trail projects to provide new physical activity resources across Kansas. Public health practitioners seeking to increase physical activity should seek funding from foundations that focus on health.

Study of Grants, new Mexico, uranium miners: current status

International Nuclear Information System (INIS)

Samet, J.M.; Morgan, M.V.; Buechley, R.W.; Key, C.R.; Valdivia, A.A.

1981-01-01

The Uranium Epidemiology Study at the University of New Mexico was initiated in 1977 with the objective of assessing health effects of uranium mining in the Grants, New Mexico, area. The planned approach was a cohort study of mortality that would capitalize on the availability of health records at the Grants Clinic. The first year's work confirmed the study's feasibility (Buechley, 1979). Subsequent efforts have focused on the health and exposure data base and comprehensive follow-up. A retrospective cohort study of early miners is in progress; a prospective cohort study of miners who began working under the current federal standard is planned. This report will summarize the current status of the Uranium Epidemiology Study

The 50th Anniversary of the International Indian Ocean Expedition: An Update on Current Planning Efforts and Progress

Science.gov (United States)

Hood, Raleigh; D'Adamo, Nick; Burkill, Peter; Urban, Ed; Bhikajee, Mitrasen

2014-05-01

The International Indian Ocean Expedition (IIOE) was one of the greatest international, interdisciplinary oceanographic research efforts of all time. Planning for the IIOE began in 1959 and the project officially continued through 1965, with forty-six research vessels participating under fourteen different flags. The IIOE motivated an unprecedented number of hydrographic surveys (and repeat surveys) over the course of the expedition covering the entire Indian Ocean basin. And it was an interdisciplinary endeavor that embraced physical oceanography, chemical oceanography, meteorology, marine biology, marine geology and geophysics. The end of 2015 will mark the 50th Anniversary of the completion of the IIOE. In the 50 years since the IIOE three fundamental changes have taken place in ocean science. The first is the deployment of a broad suite of oceanographic sensors on satellites that have dramatically improved the characterization of both physical and biological oceanographic variability. The second is the emergence of new components of the ocean observing system, most notably remote sensing and Argo floats. And the third is the development of ocean modeling in all its facets from short-term forecasting to seasonal prediction to climate projections. These advances have revolutionized our understanding of the global oceans, including the Indian Ocean. Compared to the IIOE era, we now have the capacity to provide a much more integrated picture of the Indian Ocean, especially if these new technologies can be combined with targeted and well-coordinated in situ measurements. In this presentation we report on current efforts to motivate an IIOE 50th Anniversary Celebration (IIOE-2). We envision this IIOE-2 as a 5-year expedition and effort beginning in 2015 and continuing through to 2020. An important objective of our planning efforts is assessing ongoing and planned research activities in the Indian Ocean in the 2015 to 2020 time frame, with the goal of embracing and

Strategies to Build Readiness in Community Mobilization Efforts for Implementation in a Multi-Year Teen Pregnancy Prevention Initiative.

Science.gov (United States)

Bhuiya, Nazmim; House, L Duane; Desmarais, Jeffrey; Fletcher, Erica; Conlin, Maeve; Perez-McAdoo, Sarah; Waggett, Jessica; Tendulkar, Shalini A

2017-03-01

This paper describes an assessment of community readiness to implement a community-wide teen pregnancy prevention initiative, Youth First, and presents strategies used to enhance this readiness as informed by the assessment. Twenty-five community stakeholder interviews were conducted to assess four domains of readiness: (1) attitudes, perception, and knowledge of teen pregnancy; (2) perceived level of readiness; (3) resources, existing and current efforts; and (4) leadership. Interview transcripts were coded and analyzed to identify key themes. Stakeholders acknowledged teen pregnancy as an issue but lacked contextual information. They also perceived the community as ready to address the issue and recognized some organizations already championing efforts. However, many key players were not involved, and ongoing data collection to assess teen pregnancy and prevention efforts was limited. Though many stakeholders were ready to engage in teen pregnancy prevention efforts, they required additional information and training to appropriately address the issue. In response to the assessment findings, several strategies were applied to address readiness and build Youth First partners' capacity to implement the community-wide initiative. Thus, to successfully implement community-wide prevention efforts, it is valuable to assess the level of community readiness to address health issues. Copyright © 2016 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

Mapping telemedicine efforts

DEFF Research Database (Denmark)

Kierkegaard, Patrick

2015-01-01

are being utilized? What medical disciplines are being addressed using telemedicine systems? Methods: All data was surveyed from the "Telemedicinsk Landkort", a newly created database designed to provide a comprehensive and systematic overview of all telemedicine technologies in Denmark. Results......Objectives: The aim of this study is to survey telemedicine services currently in operation across Denmark. The study specifically seeks to answer the following questions: What initiatives are deployed within the different regions? What are the motivations behind the projects? What technologies......: The results of this study suggest that a growing number of telemedicine initiatives are currently in operation across Denmark but that considerable variations existed in terms of regional efforts as the number of operational telemedicine projects varied from region to region. Conclusions: The results...

Health risk factors and mental health among US women with and without chronic physical disabilities by whether women are currently pregnant.

Science.gov (United States)

Iezzoni, Lisa I; Yu, Jun; Wint, Amy J; Smeltzer, Suzanne C; Ecker, Jeffrey L

2015-06-01

Growing numbers of reproductive-age US women with chronic physical disabilities (CPD) raise questions about their pregnancy experiences. Little is known about the health risks of women with versus without CPD by current pregnancy status. We analyzed cross-sectional, nationally-representative National Health Interview Survey data from 2006 to 2011, which includes 47,629 civilian, noninstitutionalized women ages 18-49. NHIS asks about specified movement difficulties, current pregnancy, and various health and health risk indicators, including tobacco use and body mass index (BMI). We used responses from eight movement difficulty and other questions to identify women with mobility difficulties caused by chronic physical health conditions. Across all women regardless of CPD, women reporting current pregnancy are significantly less likely to currently smoke tobacco and report certain mental health problems. Among currently pregnant women only, women with CPD are more likely to smoke cigarettes every day (12.2 %) versus 6.3 % for pregnant women without CPD (p ≤ 0.001). Among currently pregnant women, 17.7 % of women with CPD have BMIs in the non-overweight range, compared with 40.1 % of women without CPD (p ≤ 0.0001). Currently pregnant women with CPD are significantly more likely to report having any mental health problems, 66.6 % compared with 29.7 % among women without CPD (p ≤ 0.0001). For all women, currently pregnant women appear to have fewer health risks and mental health concerns than nonpregnant women. Among pregnant women, women with CPD have higher rates than other women of health risk factors that could affect maternal and infant outcomes.

Quantifying commercial catch and effort of monkfish Lophius ...

African Journals Online (AJOL)

Catch-per-unit-effort (cpue) data of vessels targeting monkfish and sole (the two ... analysed using two different methods to construct indices of abundance. ... in Namibia to all tail-weight classes is not appropriate for the current fishery and needs ... Keywords: catch per unit effort, Generalized Linear Model, Lophius vaillanti, ...

Motivation and effort in individuals with social anhedonia.

Science.gov (United States)

McCarthy, Julie M; Treadway, Michael T; Blanchard, Jack J

2015-06-01

It has been proposed that anhedonia may, in part, reflect difficulties in reward processing and effortful decision making. The current study aimed to replicate previous findings of effortful decision making deficits associated with elevated anhedonia and expand upon these findings by investigating whether these decision making deficits are specific to elevated social anhedonia or are also associated with elevated positive schizotypy characteristics. The current study compared controls (n=40) to individuals elevated on social anhedonia (n=30), and individuals elevated on perceptual aberration/magical ideation (n=30) on the Effort Expenditure for Rewards Task (EEfRT). Across groups, participants chose a higher proportion of hard tasks with increasing probability of reward and reward magnitude, demonstrating sensitivity to probability and reward values. Contrary to our expectations, when the probability of reward was most uncertain (50% probability), at low and medium reward values, the social anhedonia group demonstrated more effortful decision making than either individuals high in positive schizotypy or controls. The positive schizotypy group only differed from controls (making less effortful choices than controls) when reward probability was lowest (12%) and the magnitude of reward was the smallest. Our results suggest that social anhedonia is related to intact motivation and effort for monetary rewards, but that individuals with this characteristic display a unique and perhaps inefficient pattern of effort allocation when the probability of reward is most uncertain. Future research is needed to better understand effortful decision making and the processing of reward across a range of individual difference characteristics. Copyright © 2015 Elsevier B.V. All rights reserved.

Current anti-doping policy: a critical appraisal.

Science.gov (United States)

Kayser, Bengt; Mauron, Alexandre; Miah, Andy

2007-03-29

Current anti-doping in competitive sports is advocated for reasons of fair-play and concern for the athlete's health. With the inception of the World Anti Doping Agency (WADA), anti-doping effort has been considerably intensified. Resources invested in anti-doping are rising steeply and increasingly involve public funding. Most of the effort concerns elite athletes with much less impact on amateur sports and the general public. We review this recent development of increasingly severe anti-doping control measures and find them based on questionable ethical grounds. The ethical foundation of the war on doping consists of largely unsubstantiated assumptions about fairness in sports and the concept of a "level playing field". Moreover, it relies on dubious claims about the protection of an athlete's health and the value of the essentialist view that sports achievements reflect natural capacities. In addition, costly antidoping efforts in elite competitive sports concern only a small fraction of the population. From a public health perspective this is problematic since the high prevalence of uncontrolled, medically unsupervised doping practiced in amateur sports and doping-like behaviour in the general population (substance use for performance enhancement outside sport) exposes greater numbers of people to potential harm. In addition, anti-doping has pushed doping and doping-like behaviour underground, thus fostering dangerous practices such as sharing needles for injection. Finally, we argue that the involvement of the medical profession in doping and anti-doping challenges the principles of non-maleficience and of privacy protection. As such, current anti-doping measures potentially introduce problems of greater impact than are solved, and place physicians working with athletes or in anti-doping settings in an ethically difficult position. In response, we argue on behalf of enhancement practices in sports within a framework of medical supervision. Current anti

Consumer Mobile Health Apps: Current State, Barriers, and Future Directions.

Science.gov (United States)

Kao, Cheng-Kai; Liebovitz, David M

2017-05-01

This paper discusses the current state, barriers, and future directions of consumer-facing applications (apps). There are currently more than 165,000 mobile health apps publicly available in major app stores, the vast majority of which are designed for patients. The top 2 categories are wellness management and disease management apps, whereas other categories include self-diagnosis, medication reminder, and electronic patient portal apps. Apps specific to physical medicine and rehabilitation also are reviewed. These apps have the potential to provide low-cost, around-the-clock access to high-quality, evidence-based health information to end users on a global scale. However, they have not yet lived up to their potential due to multiple barriers, including lack of regulatory oversight, limited evidence-based literature, and concerns of privacy and security. The future directions may consist of improving data integration into the health care system, an interoperable app platform allowing access to electronic health record data, cloud-based personal health record across health care networks, and increasing app prescription by health care providers. For consumer mobile health apps to fully contribute value to health care delivery and chronic disease management, all stakeholders within the ecosystem must collaborate to overcome the significant barriers. Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Global health and foreign policy.

Science.gov (United States)

Feldbaum, Harley; Lee, Kelley; Michaud, Joshua

2010-01-01

Health has long been intertwined with the foreign policies of states. In recent years, however, global health issues have risen to the highest levels of international politics and have become accepted as legitimate issues in foreign policy. This elevated political priority is in many ways a welcome development for proponents of global health, and it has resulted in increased funding for and attention to select global health issues. However, there has been less examination of the tensions that characterize the relationship between global health and foreign policy and of the potential effects of linking global health efforts with the foreign-policy interests of states. In this paper, the authors review the relationship between global health and foreign policy by examining the roles of health across 4 major components of foreign policy: aid, trade, diplomacy, and national security. For each of these aspects of foreign policy, the authors review current and historical issues and discuss how foreign-policy interests have aided or impeded global health efforts. The increasing relevance of global health to foreign policy holds both opportunities and dangers for global efforts to improve health.

Global Health and Foreign Policy

Science.gov (United States)

Feldbaum, Harley; Lee, Kelley; Michaud, Joshua

2010-01-01

Health has long been intertwined with the foreign policies of states. In recent years, however, global health issues have risen to the highest levels of international politics and have become accepted as legitimate issues in foreign policy. This elevated political priority is in many ways a welcome development for proponents of global health, and it has resulted in increased funding for and attention to select global health issues. However, there has been less examination of the tensions that characterize the relationship between global health and foreign policy and of the potential effects of linking global health efforts with the foreign-policy interests of states. In this paper, the authors review the relationship between global health and foreign policy by examining the roles of health across 4 major components of foreign policy: aid, trade, diplomacy, and national security. For each of these aspects of foreign policy, the authors review current and historical issues and discuss how foreign-policy interests have aided or impeded global health efforts. The increasing relevance of global health to foreign policy holds both opportunities and dangers for global efforts to improve health. PMID:20423936

Effect of Community Engagement Interventions on Patient Safety and Risk Reduction Efforts in Primary Health Facilities: Evidence from Ghana.

Directory of Open Access Journals (Sweden)

Robert Kaba Alhassan

Full Text Available Patient safety and quality care remain major challenges to Ghana's healthcare system. Like many health systems in Africa, this is largely because demand for healthcare is outstripping available human and material resource capacity of healthcare facilities and new investment is insufficient. In the light of these demand and supply constraints, systematic community engagement (SCE in healthcare quality assessment can be a feasible and cost effective option to augment existing quality improvement interventions. SCE entails structured use of existing community groups to assess healthcare quality in health facilities. Identified quality gaps are discussed with healthcare providers, improvements identified and rewards provided if the quality gaps are closed.This paper evaluates whether or not SCE, through the assessment of health service quality, improves patient safety and risk reduction efforts by staff in healthcare facilities.A randomized control trail was conducted in 64 primary healthcare facilities in the Greater Accra and Western regions of Ghana. Patient risk assessments were conducted in 32 randomly assigned intervention and control facilities. Multivariate multiple regression test was used to determine effect of the SCE interventions on staff efforts towards reducing patient risk. Spearman correlation test was used to ascertain associations between types of community groups engaged and risk assessment scores of healthcare facilities.Clinic staff efforts towards increasing patient safety and reducing risk improved significantly in intervention facilities especially in the areas of leadership/accountability (Coef. = 10.4, p<0.05 and staff competencies (Coef. = 7.1, p<0.05. Improvement in service utilization and health resources could not be attributed to the interventions because these were outside the control of the study and might have been influenced by institutional or national level developments between the baseline and follow-up period

Direct-to-Consumer Marketing: A Complementary Approach to Traditional Dissemination and implementation Efforts for Mental Health and Substance Abuse Interventions.

Science.gov (United States)

Becker, Sara J

2015-03-01

The overall chasm between those who need treatment for mental health and substance abuse (M/SU) and those who receive effective treatment consists of two, interrelated gaps: the research-to-practice gap and the treatment gap. Prior efforts to disseminate evidence-based practice (EBP) for M/SU have predominantly targeted the research-to-practice gap, by focusing efforts toward treatment providers. This article introduces direct-to-consumer (DTC) marketing that targets patients and caregivers as a complementary approach to existing dissemination efforts. Specific issues discussed include: rationale for DTC marketing based on the concept of push versus pull marketing; overview of key stakeholders involved in DTC marketing; and description of the Marketing Mix planning framework. The applicability of these issues to the dissemination of EBP for M/SU is discussed.

Direct-to-Consumer Marketing: A Complementary Approach to Traditional Dissemination and implementation Efforts for Mental Health and Substance Abuse Interventions

Science.gov (United States)

Becker, Sara J.

2014-01-01

The overall chasm between those who need treatment for mental health and substance abuse (M/SU) and those who receive effective treatment consists of two, interrelated gaps: the research-to-practice gap and the treatment gap. Prior efforts to disseminate evidence-based practice (EBP) for M/SU have predominantly targeted the research-to-practice gap, by focusing efforts toward treatment providers. This article introduces direct-to-consumer (DTC) marketing that targets patients and caregivers as a complementary approach to existing dissemination efforts. Specific issues discussed include: rationale for DTC marketing based on the concept of push versus pull marketing; overview of key stakeholders involved in DTC marketing; and description of the Marketing Mix planning framework. The applicability of these issues to the dissemination of EBP for M/SU is discussed. PMID:25937710

[Social and health resources in Catalonia. Current situation].

Science.gov (United States)

Bullich-Marín, Ingrid; Sánchez-Ferrín, Pau; Cabanes-Duran, Concepció; Salvà-Casanovas, Antoni

The network of social and health care has advanced since its inception. Furthermore, news services have been created and some resources have been adapted within the framework of respective health plans. This article presents the current situation of the different social and health resources in Catalonia, as well as the main changes that have occurred in recent years, more specifically in the period of the Health Plan 2011-2015. This period is characterised by an adaptation of the social and health network within the context of chronic care, for which the development of intermediate care resources has become the most relevant aspect. There is also a need to create a single long-term care sector in which the health care quality is guaranteed. Moreover, in this period, integral and cross-care level is promoted in the health system through a greater coordination between all different levels of care. The social and health network, due to its trajectory and expertise, plays a key role in the quality of care for people with social and medical needs. Copyright © 2017 SEGG. Publicado por Elsevier España, S.L.U. All rights reserved.

42 CFR 457.80 - Current State child health insurance coverage and coordination.

Science.gov (United States)

2010-10-01

... 42 Public Health 4 2010-10-01 2010-10-01 false Current State child health insurance coverage and... HEALTH AND HUMAN SERVICES (CONTINUED) STATE CHILDREN'S HEALTH INSURANCE PROGRAMS (SCHIPs) ALLOTMENTS AND GRANTS TO STATES Introduction; State Plans for Child Health Insurance Programs and Outreach Strategies...

Electronic Health Records: PHR Opportunities for Public Health – Part 2

Centers for Disease Control (CDC) Podcasts

In this podcast, Dr. Ken Mandl discusses electronic health records and personally-controlled health records. Dr. Mandl leads the IndivoHealth personally-controlled health record project, the original reference model for the Microsoft, Google, and Dossia personal health records (PHRs or PCHRs). He has successfully used PHRs for immunization and influenza, leads efforts in real-time surveillance systems, and is currently adapting personal health records for longitudinal and genomic research. The lecture was given at CDC on June 19, 2009.

Electronic Health Records: PHR Opportunities for Public Health – Part 1

Centers for Disease Control (CDC) Podcasts

In this podcast, Dr. Ken Mandl discusses electronic health records and personally-controlled health records. Dr. Mandl leads the IndivoHealth personally-controlled health record project, the original reference model for the Microsoft, Google, and Dossia personal health records (PHRs or PCHRs). He has successfully used PHRs for immunization and influenza, leads efforts in real-time surveillance systems, and is currently adapting personal health records for longitudinal and genomic research. The lecture was given at CDC on June 19, 2009.

Gratitude: A Current Issue in Mental Health

Directory of Open Access Journals (Sweden)

Ferhat Kardas

2018-03-01

Full Text Available There has been an increase in the emphasis on the positive feelings and strengths of individuals in the mental health by the emergence of positive psychology approach. Positive psychology approach points to the potential of positive emotions contributing to clients' well-being, and various studies in this framework show that gratitude as a positive feeling has become one of the tools used to improve clients’ mental health. In this review study, the concept of gratitude, which is quite old in various fields but is a current topic in the field of psychology, is handled in various dimensions and some suggestions are given for practitioners and researchers in this framework.

Food and Health Some Current Issues and Future Trends

OpenAIRE

Gormley, T. R. (Thomas Ronan)

1991-01-01

This paper deals with some of the many current issues and future trends in the area of food, diet and health in Europe. A complete coverage would be impossible in a short article in view of the extent and complexity of the food system and its major interaction with health. It is also important to stress at the outset that food/diet is only one component of health and other factors such as environment, overall lifestyle and genetics also play a major role. The genetic dimension is of particula...

Practice, science and governance in interaction: European effort for the system-wide implementation of the International Classification of Functioning, Disability and Health (ICF) in Physical and Rehabilitation Medicine.

Science.gov (United States)

Stucki, Gerold; Zampolini, Mauro; Juocevicius, Alvydas; Negrini, Stefano; Christodoulou, Nicolas

2017-04-01

Since its launch in 2001, relevant international, regional and national PRM bodies have aimed to implement the International Classification of Functioning, Disability and Health (ICF) in Physical and Rehabilitation Medicine (PRM), whereby contributing to the development of suitable practical tools. These tools are available for implementing the ICF in day-to-day clinical practice, standardized reporting of functioning outcomes in quality management and research, and guiding evidence-informed policy. Educational efforts have reinforced PRM physicians' and other rehabilitation professionals' ICF knowledge, and numerous implementation projects have explored how the ICF is applied in clinical practice, research and policy. Largely lacking though is the system-wide implementation of ICF in day-to-day practice across all rehabilitation services of national health systems. In Europe, system-wide implementation of ICF requires the interaction between practice, science and governance. Considering its mandate, the UEMS PRM Section and Board have decided to lead a European effort towards system-wide ICF implementation in PRM, rehabilitation and health care at large, in interaction with governments, non-governmental actors and the private sector, and aligned with ISPRM's collaboration plan with WHO. In this paper we present the current PRM internal and external policy agenda towards system-wide ICF implementation and the corresponding implementation action plan, while highlighting priority action steps - promotion of ICF-based standardized reporting in national quality management and assurance programs, development of unambiguous rehabilitation service descriptions using the International Classification System for Service Organization in Health-related Rehabilitation, development of Clinical Assessment Schedules, qualitative linkage and quantitative mapping of data to the ICF, and the cultural adaptation of the ICF Clinical Data Collection Tool in European languages.

Symposium: Organizational Health Intervention Research: Current Empirical Developments

DEFF Research Database (Denmark)

Ipsen, Christine; Jenny, Gregor

2014-01-01

or networks of employees. The intervention process is designed to involve the most effective set of stakeholders (leaders, management, experts, co-workers) and connect them to an efficient network of change agents. For this, the current interventions offer models, handbooks and indicators that inform...... Health Index”. The study, conducted in Switzerland, shows that the index predicts sick leave, stress symptoms, work engagement and self-rated productivity. • The fourth contribution Torsten Holstad and his colleagues present their summative evaluation of a tailor-made training program focusing on health...

Validity of the effort/reward imbalance questionnaire in health professionals from six Latin-American countries.

Science.gov (United States)

Juárez-García, Arturo; Vera-Calzaretta, Aldo; Blanco-Gomez, Gisela; Gómez-Ortíz, Viviola; Hernández-Mendoza, Elena; Jacinto-Ubillus, José; Choi, Bongkyoo

2015-06-01

This study tests the validity and the invariance of ERI questionnaire (ERIQ) data from health professionals in six different Latin-American countries. One thousand two hundred ninety-two (1292) participants who worked in hospitals in Argentina, Chile, Colombia, Mexico, Peru and Venezuela completed the ERI and GHQ questionnaires. Partial correlations were carried out as well as reliability statistics and confirmatory factor analyses to examine factor structure and invariance of ERIQ in each subsample. Overall confirmatory factor analyses confirmed the theoretical structure of the ERIQ. The effort and overcommitment scales were invariant (equivalent) across the six countries, but the reward scale was only partially invariant. Several associations between ERIQ and mental health remain significant after controlling for sociodemographic variables. Although the validity of the ERIQ' scales were generally satisfactory in most Latin-American samples, future research should examine in depth the equivalence of reward scale across Latin-American cultures. © 2015 Wiley Periodicals, Inc.

Human Capital: Additional Actions Needed to Enhance DOD’s Efforts to Address Mental Health Care Stigma

Science.gov (United States)

2016-04-01

Civilians (n=21) 6 5 8 2 h) Substance abuse (alcohol or drugs ) Servicemembers (n= 186) 43 53 82 8 Civilians (n=22) 9 8 4 1 Source: GAO | GAO...Efforts to Address Mental Health Care Stigma Why GAO Did This Study A 2010 DOD task force on suicide prevention concluded that stigma—the negative...Representatives A 2010 Department of Defense (DOD) Task Force on the Prevention of Suicide by Members of the Armed Forces concluded that

A Six-Year Predictive Test of Adolescent Family Relationship Quality and Effortful Control Pathways to Emerging Adult Social and Emotional Health

Science.gov (United States)

Fosco, Gregory M.; Caruthers, Allison S.; Dishion, Thomas J.

2012-01-01

This longitudinal study examined how a multimethod (youth report, parent report, direct observation) assessment of family relationship quality (cohesion and conflict) in adolescence (age 16 –17) predicted growth and maintenance of effortful control across ages 17, 22, and 23 years old, and, ultimately, subjective well-being, emotional distress, and aggressive behavior in emerging adulthood (23). A diverse sample of 792 youth at age 17 and their families, and youth at ages 22 and 23, were studied to examine family cohesion and conflict and the growth and maintenance of effortful control as predictors of emerging adult social and emotional health. Results indicated that family cohesion and conflict during late adolescence and mean-level effortful control at age 22 each served as unique pathways to emerging adult adjustment. These findings underscore the importance of family functioning during adolescence and the maintenance of effortful control into emerging adulthood for understanding adjustment during the emerging adulthood period. PMID:22709261

The Use of Parsimonious Questionnaires in Occupational Health Surveillance: Psychometric Properties of the Short Italian Version of the Effort/Reward Imbalance Questionnaire

Directory of Open Access Journals (Sweden)

Nicola Magnavita

2012-01-01

Full Text Available Purpose. To perform a parsimonious measurement of workplace psychosocial stress in routine occupational health surveillance, this study tests the psychometric properties of a short version of the original Italian effort-reward imbalance (ERI questionnaire. Methods. 1,803 employees (63 percent women from 19 service companies in the Italian region of Latium participated in a cross-sectional survey containing the short version of the ERI questionnaire (16 items and questions related to self-reported health, musculoskeletal complaints and job satisfaction. Exploratory factor analysis, internal consistency of scales and criterion validity were utilized. Results. The internal consistency of scales was satisfactory. Principal component analysis enabled to identify the model’s main factors. Significant associations with health and job satisfaction in the majority of cases support the notion of criterion validity. A high score on the effort-reward ratio was associated with an elevated odds ratio (OR = 2.71; 95% CI 1.86–3.95 of musculoskeletal complaints in the upper arm. Conclusions. The short form of the Italian ERI questionnaire provides a psychometrically useful tool for routine occupational health surveillance, although further validation is recommended.

The current crisis in human resources for health in Africa

African Journals Online (AJOL)

Overview. The current crisis in human resources for health in. Africa has reached a serious level in many countries. A complex set of reasons has contributed to this problem, some exogenous, such as the severe economic measures introduced by structural adjustment, which often result in cutbacks in the number of health ...

[E-health within the Dutch mental health services: what is the current situation?].

Science.gov (United States)

Smeets, Odile; Martin Abello, Katherina; Zijlstra-Vlasveld, Moniek; Boon, Brigitte

2014-01-01

The 'e-mental health' currently available, which also covers m-health and i-health, varies from psycho-education and self-tests to self-help, treatment and contact with fellow sufferers. Many programs are based on cognitive behavioural therapy, but other types of therapy are also used. Research shows that online programs for depression, alcohol problems and anxiety can reduce these symptoms and can be cost effective. This applies to both self-help and treatment programs. Many e-programs in the Netherlands have been developed for the Dutch Association of Mental Health and Addiction Care (GGZ) and for treatment of addiction problems. One problem with e-mental-health is that provision is fragmented, and there is no national overview, while insight into quality is important for patients and professionals. The quality hallmark 'Onlinehulpstempel.nl' ('Online help hallmark') provides this insight. The use of e-mental-health within Dutch healthcare services is still in its infancy. New financing methods are stimulating general practitioners to use it. The consolidation of online and face-to-face care ('blended e-health') provides an opportunity for patients and GGZ support personnel within general practice to start to use e-health.

India's Health Initiative: Financing Issues and Options

OpenAIRE

Deolalikar, Anil B.; Jamison, Dean T.; Laxminarayan, Ramanan

2007-01-01

In response to the challenge of sustaining the health gains achieved in the better-performing states and ensuring that the lagging states catch up with the rest of the country, the Indian government has launched the National Rural Health Mission. A central goal of the effort is to increase public spending on health from the current 1.1 percent of GDP to roughly 2–3 percent of GDP within the next five years. In this paper, we examine the current status of health financing in India, as well as ...

Foreword: Big Data and Its Application in Health Disparities Research.

Science.gov (United States)

Onukwugha, Eberechukwu; Duru, O Kenrik; Peprah, Emmanuel

2017-01-01

The articles presented in this special issue advance the conversation by describing the current efforts, findings and concerns related to Big Data and health disparities. They offer important recommendations and perspectives to consider when designing systems that can usefully leverage Big Data to reduce health disparities. We hope that ongoing Big Data efforts can build on these contributions to advance the conversation, address our embedded assumptions, and identify levers for action to reduce health care disparities.

The Effort Paradox: Effort Is Both Costly and Valued.

Science.gov (United States)

Inzlicht, Michael; Shenhav, Amitai; Olivola, Christopher Y

2018-04-01

According to prominent models in cognitive psychology, neuroscience, and economics, effort (be it physical or mental) is costly: when given a choice, humans and non-human animals alike tend to avoid effort. Here, we suggest that the opposite is also true and review extensive evidence that effort can also add value. Not only can the same outcomes be more rewarding if we apply more (not less) effort, sometimes we select options precisely because they require effort. Given the increasing recognition of effort's role in motivation, cognitive control, and value-based decision-making, considering this neglected side of effort will not only improve formal computational models, but also provide clues about how to promote sustained mental effort across time. Copyright © 2018 Elsevier Ltd. All rights reserved.

[Survey of current situation of schistosomiasis health education in Wuxi City].

Science.gov (United States)

Meng, Xiao-jun; Gao, Dong-lin; Zhang, Xuan; Lu, Bing

2015-04-01

To understand the current situation of schistosomiasis health education in in Wuxi City where schistosomiasis transmission has been interrupted, so as to provide the evidence for formulating the health education strategies. Face to face interviews and a professional designed questionnaire were used to collect the information of the current schistosomiasis health education and investigate the awareness of schistosomiasis knowledge in primary and middle schools and in communities. The total awareness rate of schistosomiasis knowledge was 87.7% among 873 students and the figure was 83.0% among 693 community residents. The students who studied in the schools with more than 1 class hour of schistosomiasis health education, completed schistosomiasis health education material or teaching plan, and implementing health education through multiple ways had higher knowledge awareness rates compared with the schools without (χ2 = 291.408, 709.622, 13.751, all P <0.001). The residents living in the communities with schistosomiasis health education through broadcast/TV or square propaganda had a higher knowledge awareness rate compared with the communities without (χ2= 90.772, 47.436, all P < 0.001). The awareness rates of schistosomiasis knowledge among both students and community residents in Wuxi City are low. Therefore, the schistosomiasis control health education should be strengthened.

Polio eradication efforts in regions of geopolitical strife: the Boko ...

African Journals Online (AJOL)

Polio eradication efforts in regions of geopolitical strife: the Boko Haram threat to efforts in sub-Saharan Africa. ... Targets of Boko Haram aggression in these zones include violence against polio workers, disruption of polio immunization campaigns, with consequent reduced access to health care and immunization.

Workplace High Tech Spurs Retraining Efforts.

Science.gov (United States)

Davis, Dwight B.

1984-01-01

Discusses who should provide training for displaced workers who need new skills. Areas examined include: (1) the need for retraining; (2) current corporate efforts; (3) agreements in the automotive industry; (4) job quality; (5) the federal government's role; and (6) federal legislation related to the problem. (JN)

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

Science.gov (United States)

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

2014-01-01

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

Services oriented architectures and rapid deployment of ad-hoc health surveillance systems: lessons from Katrina relief efforts.

Science.gov (United States)

Mirhaji, Parsa; Casscells, S Ward; Srinivasan, Arunkumar; Kunapareddy, Narendra; Byrne, Sean; Richards, David Mark; Arafat, Raouf

2006-01-01

During the Hurricane Katrina relief efforts, a new city was born overnight within the City of Houston to provide accommodation and health services for thousands of evacuees deprived of food, rest, medical attention, and sanitation. The hurricane victims had been exposed to flood water, toxic materials, physical injury, and mental stress. This scenario was an invitation for a variety of public health hazards, primarily infectious disease outbreaks. Early detection and monitoring of morbidity and mortality among evacuees due to unattended health conditions was an urgent priority and called for deployment of real-time surveillance to collect and analyze data at the scene, and to enable and guide appropriate response and planning activities. The University of Texas Health Science Center at Houston (UTHSC) and the Houston Department of Health and Human Services (HDHHS) deployed an ad hoc surveillance system overnight by leveraging Internet-based technologies and Services Oriented Architecture (SOA). The system was post-coordinated through the orchestration of Web Services such as information integration, natural language processing, syndromic case finding, and online analytical processing (OLAP). Here we will report the use of Internet-based and distributed architectures in providing timely, novel, and customizable solutions on demand for unprecedented events such as natural disasters.

The current and potential health benefits of the National Health Service Health Check cardiovascular disease prevention programme in England: A microsimulation study.

Science.gov (United States)

Mytton, Oliver T; Jackson, Christopher; Steinacher, Arno; Goodman, Anna; Langenberg, Claudia; Griffin, Simon; Wareham, Nick; Woodcock, James

2018-03-01

The National Health Service (NHS) Health Check programme was introduced in 2009 in England to systematically assess all adults in midlife for cardiovascular disease risk factors. However, its current benefit and impact on health inequalities are unknown. It is also unclear whether feasible changes in how it is delivered could result in increased benefits. It is one of the first such programmes in the world. We sought to estimate the health benefits and effect on inequalities of the current NHS Health Check programme and the impact of making feasible changes to its implementation. We developed a microsimulation model to estimate the health benefits (incident ischaemic heart disease, stroke, dementia, and lung cancer) of the NHS Health Check programme in England. We simulated a population of adults in England aged 40-45 years and followed until age 100 years, using data from the Health Survey of England (2009-2012) and the English Longitudinal Study of Aging (1998-2012), to simulate changes in risk factors for simulated individuals over time. We used recent programme data to describe uptake of NHS Health Checks and of 4 associated interventions (statin medication, antihypertensive medication, smoking cessation, and weight management). Estimates of treatment efficacy and adherence were based on trial data. We estimated the benefits of the current NHS Health Check programme compared to a healthcare system without systematic health checks. This counterfactual scenario models the detection and treatment of risk factors that occur within 'routine' primary care. We also explored the impact of making feasible changes to implementation of the programme concerning eligibility, uptake of NHS Health Checks, and uptake of treatments offered through the programme. We estimate that the NHS Health Check programme prevents 390 (95% credible interval 290 to 500) premature deaths before 80 years of age and results in an additional 1,370 (95% credible interval 1,100 to 1,690) people

Rebalancing brain drain: exploring resource reallocation to address health worker migration and promote global health.

Science.gov (United States)

Mackey, Timothy Ken; Liang, Bryan Albert

2012-09-01

Global public health is threatened by an imbalance in health worker migration from resource-poor countries to developed countries. This "brain drain" results in health workforce shortages, health system weakening, and economic loss and waste, threatening the well-being of vulnerable populations and effectiveness of global health interventions. Current structural imbalances in resource allocation and global incentive structures have resulted in 57 countries identified by WHO as having a "critical shortage" of health workers. Yet current efforts to strengthen domestic health systems have fallen short in addressing this issue. Instead, global solutions should focus on sustainable forms of equitable resource sharing. This can be accomplished by adoption of mandatory global resource and staff-sharing programs in conjunction with implementation of state-based health services corps. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

Analysis Efforts Supporting NSTX Upgrades

International Nuclear Information System (INIS)

Zhang, H.; Titus, P.; Rogoff, P.; Zolfaghari, A.; Mangra, D.; Smith, M.

2010-01-01

The National Spherical Torus Experiment (NSTX) is a low aspect ratio, spherical torus (ST) configuration device which is located at Princeton Plasma Physics Laboratory (PPPL) This device is presently being updated to enhance its physics by doubling the TF field to 1 Tesla and increasing the plasma current to 2 Mega-amperes. The upgrades include a replacement of the centerstack and addition of a second neutral beam. The upgrade analyses have two missions. The first is to support design of new components, principally the centerstack, the second is to qualify existing NSTX components for higher loads, which will increase by a factor of four. Cost efficiency was a design goal for new equipment qualification, and reanalysis of the existing components. Showing that older components can sustain the increased loads has been a challenging effort in which designs had to be developed that would limit loading on weaker components, and would minimize the extent of modifications needed. Two areas representing this effort have been chosen to describe in more details: analysis of the current distribution in the new TF inner legs, and, second, analysis of the out-of-plane support of the existing TF outer legs.

Forty Years of State Alcohol and Pregnancy Policies in the USA: Best Practices for Public Health or Efforts to Restrict Women's Reproductive Rights?

Science.gov (United States)

Roberts, Sarah C M; Thomas, Sue; Treffers, Ryan; Drabble, Laurie

2017-11-01

Alcohol consumption during pregnancy remains a public health problem despite >40 years of attention. Little is known about how state policies have evolved and whether policies represent public health goals or efforts to restrict women's reproductive rights. Our data set includes US state policies from 1970 through 2013 obtained through original legal research and from the National Institute for Alcohol Abuse and Alcoholism's (NIAAA)'s Alcohol Policy Information System. Policies were classified as punitive to women or supportive of them. The association between numbers of punitive policies and supportive policies in 2013 with a measure of state restrictions on reproductive rights and Alcohol Policy Effectiveness Scores (APS) was estimated using a Pearson's correlation. The number of states with alcohol and pregnancy policies has increased from 1 in 1974 to 43 in 2013. Through the 1980s, state policy environments were either punitive or supportive. In the 1990s, mixed punitive and supportive policy environments began to be the norm, with punitive policies added to supportive ones. No association was found between the number of supportive policies in 2013 and a measure of reproductive rights policies or the APS, nor was there an association between the number of punitive policies and the APS. The number of punitive policies was positively associated, however, with restrictions on reproductive rights. Punitive alcohol and pregnancy policies are associated with efforts to restrict women's reproductive rights rather than effective efforts to curb public health harms due to alcohol use in the general population. Future research should explore the effects of alcohol and pregnancy policies. The number of states with alcohol and pregnancy policies has increased since 1970 (1 in 1974 and 43 in 2013). Alcohol and pregnancy policies are becoming increasingly punitive. These punitive policies are associated with efforts to restrict women's reproductive rights rather than

76 FR 38399 - Assessing the Current Research, Policy, and Practice Environment in Public Health Genomics

Science.gov (United States)

2011-06-30

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Disease Control and Prevention [Docket Number CDC-2011-0008] Assessing the Current Research, Policy, and Practice Environment in Public Health... information helpful to assess the current research, policy, and practice environment in public health genomics...

Mental health among currently enrolled medical students in Germany.

Science.gov (United States)

Wege, N; Muth, T; Li, J; Angerer, P

2016-03-01

The study identifies the prevalence of common mental disorders according to the patient health questionnaire (PHQ) and the use of psychotropic substances in a sample of currently enrolled medical students. A cross-sectional survey with a self-administrated questionnaire. All newly enrolled medical students at the University of Dusseldorf, with study beginning either in 2012 or 2013, respectively, were invited to participate. The evaluation was based on 590 completed questionnaires. Mental health outcomes were measured by the PHQ, including major depression, other depressive symptoms (subthreshold depression), anxiety, panic disorders and psychosomatic complaints. Moreover, information about psychotropic substances use (including medication) was obtained. Multiple logistic regression analysis was used to estimate associations between sociodemographic and socio-economic factors and mental health outcomes. The prevalence rates, measured by the PHQ, were 4.7% for major depression, 5.8% for other depressive symptoms, 4.4% for anxiety, 1.9% for panic disorders, and 15.7% for psychosomatic complaints. These prevalence rates were higher than those reported in the general population, but lower than in medical students in the course of medical training. In all, 10.7% of the students reported regular psychotropic substance use: 5.1% of students used medication 'to calm down,' 4.6% 'to improve their sleep,' 4.4% 'to elevate mood,' and 3.1% 'to improve cognitive performance.' In the fully adjusted model, expected financial difficulties were significantly associated with poor mental health (odds ratio [OR]: 2.14; 95% confidence interval [CI]: 1.31-3.48), psychosomatic symptoms (OR:1.85; 95% CI: 1.11-3.09) and psychotropic substances use (OR: 2.68; 95% CI: 1.51-4.75). The high rates of mental disorders among currently enrolled medical students call for the promotion of mental health, with a special emphasis on vulnerable groups. Copyright © 2016 The Royal Society for Public

Paradigmatic obstacles to improving the health of populations: implications for health policy

Directory of Open Access Journals (Sweden)

McKinlay John B.

1998-01-01

Full Text Available While there are promising developments in public health, most interventions (both at the individual and community levels remain focused on "downstream" tertiary treatments or one-on-one interventions. These efforts have their origins in the biomedical paradigm and risk factor epidemiology and the behavioral science research methods that serve as their handmaidens. This paper argues for a more appropriate balance of "downstream" efforts with a more appropriate whole population public health approach to health policy -what may be termed a social policy approach to healthy lifestyles rather than the current lifestyle approach to health policy. New, more appropriate research methods must be developed and applied to match these emerging levels of whole population intervention. We must avoid any disjunction between new upstream policy level interventions and the methods used to measure their effect -appropriate unto the intervention level must be the evaluation method thereof.

Prognostics and Health Management of Wind Turbines: Current Status and Future Opportunities

Energy Technology Data Exchange (ETDEWEB)

Sheng, Shuangwen

2016-10-04

This presentation was given at the 2016 Annual Conference of the Prognostics and Health Management Society. It covers the current status and challenges and opportunities of prognostics and health management of wind turbines.

Optimizing Quality of Care and Patient Safety in Malaysia: The Current Global Initiatives, Gaps and Suggested Solutions.

Science.gov (United States)

Jarrar, Mu'taman; Abdul Rahman, Hamzah; Don, Mohammad Sobri

2015-10-20

Demand for health care service has significantly increased, while the quality of healthcare and patient safety has become national and international priorities. This paper aims to identify the gaps and the current initiatives for optimizing the quality of care and patient safety in Malaysia. Review of the current literature. Highly cited articles were used as the basis to retrieve and review the current initiatives for optimizing the quality of care and patient safety. The country health plan of Ministry of Health (MOH) Malaysia and the MOH Malaysia Annual Reports were reviewed. The MOH has set four strategies for optimizing quality and sustaining quality of life. The 10th Malaysia Health Plan promotes the theme "1 Care for 1 Malaysia" in order to sustain the quality of care. Despite of these efforts, the total number of complaints received by the medico-legal section of the MOH Malaysia is increasing. The current global initiatives indicted that quality performance generally belong to three main categories: patient; staffing; and working environment related factors. There is no single intervention for optimizing quality of care to maintain patient safety. Multidimensional efforts and interventions are recommended in order to optimize the quality of care and patient safety in Malaysia.

Optimizing Quality of Care and Patient Safety in Malaysia: The Current Global Initiatives, Gaps and Suggested Solutions

Science.gov (United States)

Jarrar, Mu’taman; Rahman, Hamzah Abdul; Don, Mohammad Sobri

2016-01-01

Background and Objective: Demand for health care service has significantly increased, while the quality of healthcare and patient safety has become national and international priorities. This paper aims to identify the gaps and the current initiatives for optimizing the quality of care and patient safety in Malaysia. Design: Review of the current literature. Highly cited articles were used as the basis to retrieve and review the current initiatives for optimizing the quality of care and patient safety. The country health plan of Ministry of Health (MOH) Malaysia and the MOH Malaysia Annual Reports were reviewed. Results: The MOH has set four strategies for optimizing quality and sustaining quality of life. The 10th Malaysia Health Plan promotes the theme “1 Care for 1 Malaysia” in order to sustain the quality of care. Despite of these efforts, the total number of complaints received by the medico-legal section of the MOH Malaysia is increasing. The current global initiatives indicted that quality performance generally belong to three main categories: patient; staffing; and working environment related factors. Conclusions: There is no single intervention for optimizing quality of care to maintain patient safety. Multidimensional efforts and interventions are recommended in order to optimize the quality of care and patient safety in Malaysia. PMID:26755459

Identifying opportunities to increase HIV testing among mexican migrants: a call to step up efforts in health care and detention settings.

Directory of Open Access Journals (Sweden)

Ana P Martínez-Donate

Full Text Available HIV testing and counseling is a critical component of HIV prevention efforts and core element of current "treatment as prevention" strategies. Mobility, low education and income, and limited access to health care put Latino migrants at higher risk for HIV and represent barriers for adequate levels of HIV testing in this population. We examined correlates of, and missed opportunities to increase, HIV testing for circular Mexican migrants in the U.S. We used data from a probability-based survey of returning Mexican migrants (N=1161 conducted in the border city of Tijuana, Mexico. We estimated last 12-months rates of HIV testing and the percentage of migrants who received other health care services or were detained in an immigration center, jail, or prison for 30 or more days in the U.S., but were not tested for HIV. Twenty-two percent of migrants received HIV testing in the last 12 months. In general, utilization of other health care services or detention for 30 or more days in the U.S. was a significant predictor of last 12-months HIV testing. Despite this association, we found evidence of missed opportunities to promote testing in healthcare and/or correctional or immigration detention centers. About 27.6% of migrants received other health care and/or were detained at least 30 days but not tested for HIV. Health care systems, jails and detention centers play an important role in increasing access to HIV testing among circular migrants, but there is room for improvement. Policies to offer opt-out, confidential HIV testing and counseling to Mexican migrants in these settings on a routine and ethical manner need to be designed and pilot tested. These policies could increase knowledge of HIV status, facilitate engagement in HIV treatment among a highly mobile population, and contribute to decrease incidence of HIV in the host and receiving communities.

Some current dimensions of the behavioral economics of health-related behavior change.

Science.gov (United States)

Bickel, Warren K; Moody, Lara; Higgins, Stephen T

2016-11-01

Health-related behaviors such as tobacco, alcohol and other substance use, poor diet and physical inactivity, and risky sexual practices are important targets for research and intervention. Health-related behaviors are especially pertinent targets in the United States, which lags behind most other developed nations on common markers of population health. In this essay we examine the application of behavioral economics, a scientific discipline that represents the intersection of economics and psychology, to the study and promotion of health-related behavior change. More specifically, we review what we consider to be some core dimensions of this discipline when applied to the study health-related behavior change. Behavioral economics (1) provides novel conceptual systems to inform scientific understanding of health behaviors, (2) translates scientific understanding into practical and effective behavior-change interventions, (3) leverages varied aspects of behavior change beyond increases or decreases in frequency, (4) recognizes and exploits trans-disease processes and interventions, and (5) leverages technology in efforts to maximize efficacy, cost effectiveness, and reach. These dimensions are overviewed and their implications for the future of the field discussed. Copyright © 2016 Elsevier Inc. All rights reserved.

Public health engineering education in India: current scenario, opportunities and challenges.

Science.gov (United States)

Hussain, Mohammad Akhtar; Sharma, Kavya; Zodpey, Sanjay

2011-01-01

Public health engineering can play an important and significant role in solving environmental health issues. In order to confront public health challenges emerging out of environmental problems we need adequately trained public health engineers / environmental engineers. Considering the current burden of disease attributable to environmental factors and expansion in scope of applications of public health / environmental engineering science, it is essential to understand the present scenario of teaching, training and capacity building programs in these areas. Against this background the present research was carried out to know the current teaching and training programs in public health engineering and related disciplines in India and to understand the potential opportunities and challenges available. A systematic, predefined approach was used to collect and assemble the data related to various teaching and training programs in public health engineering / environmental engineering in India. Public health engineering / environmental engineering education and training in the country is mainly offered through engineering institutions, as pre-service and in-service training. Pre-service programs include diploma, degree (graduate) and post-graduate courses affiliated to various state technical boards, institutes and universities, whereas in-service training is mainly provided by Government of India recognized engineering and public health training institutes. Though trainees of these programs acquire skills related to engineering sciences, they significantly lack in public health skills. The teaching and training of public health engineering / environmental engineering is limited as a part of public health programs (MD Community Medicine, MPH, DPH) in India. There is need for developing teaching and training of public health engineering or environmental engineering as an interdisciplinary subject. Public health institutes can play an important and significant role in this

Trust and Reciprocity: Are Effort and Money Equivalent?

Science.gov (United States)

Vilares, Iris; Dam, Gregory; Kording, Konrad

2011-01-01

Trust and reciprocity facilitate cooperation and are relevant to virtually all human interactions. They are typically studied using trust games: one subject gives (entrusts) money to another subject, which may return some of the proceeds (reciprocate). Currently, however, it is unclear whether trust and reciprocity in monetary transactions are similar in other settings, such as physical effort. Trust and reciprocity of physical effort are important as many everyday decisions imply an exchange of physical effort, and such exchange is central to labor relations. Here we studied a trust game based on physical effort and compared the results with those of a computationally equivalent monetary trust game. We found no significant difference between effort and money conditions in both the amount trusted and the quantity reciprocated. Moreover, there is a high positive correlation in subjects' behavior across conditions. This suggests that trust and reciprocity may be character traits: subjects that are trustful/trustworthy in monetary settings behave similarly during exchanges of physical effort. Our results validate the use of trust games to study exchanges in physical effort and to characterize inter-subject differences in trust and reciprocity, and also suggest a new behavioral paradigm to study these differences. PMID:21364931

The Current and Projected Taxpayer Shares of US Health Costs.

Science.gov (United States)

Himmelstein, David U; Woolhandler, Steffie

2016-03-01

We estimated taxpayers' current and projected share of US health expenditures, including government payments for public employees' health benefits as well as tax subsidies to private health spending. We tabulated official Centers for Medicare and Medicaid Services figures on direct government spending for health programs and public employees' health benefits for 2013, and projected figures through 2024. We calculated the value of tax subsidies for private spending from official federal budget documents and figures for state and local tax collections. Tax-funded health expenditures totaled $1.877 trillion in 2013 and are projected to increase to $3.642 trillion in 2024. Government's share of overall health spending was 64.3% of national health expenditures in 2013 and will rise to 67.1% in 2024. Government health expenditures in the United States account for a larger share of gross domestic product (11.2% in 2013) than do total health expenditures in any other nation. Contrary to public perceptions and official Centers for Medicare and Medicaid Services estimates, government funds most health care in the United States. Appreciation of government's predominant role in health funding might encourage more appropriate and equitable targeting of health expenditures.

Private Speech Moderates the Effects of Effortful Control on Emotionality

Science.gov (United States)

Day, Kimberly L.; Smith, Cynthia L.; Neal, Amy; Dunsmore, Julie C.

2018-01-01

Research Findings: In addition to being a regulatory strategy, children's private speech may enhance or interfere with their effortful control used to regulate emotion. The goal of the current study was to investigate whether children's private speech during a selective attention task moderated the relations of their effortful control to their…

Petroleum Scarcity and Public Health: Considerations for Local Health Departments

Science.gov (United States)

Parker, Cindy L.; Caine, Virginia A.; McKee, Mary; Shirley, Lillian M.; Links, Jonathan M.

2011-01-01

Recognition of petroleum as a finite global resource has spurred increasing interest in the intersection between petroleum scarcity and public health. Local health departments represent a critical yet highly vulnerable component of the public health infrastructure. These frontline agencies currently face daunting resource constraints and rely heavily on petroleum for vital population-based health services. Against this backdrop, petroleum scarcity may necessitate reconfiguring local public health service approaches. We describe the anticipated impacts of petroleum scarcity on local health departments, recommend the use of the 10 Essential Public Health Services as a framework for examining attendant operational challenges and potential responses to them, and describe approaches that local health departments and their stakeholders could consider as part of timely planning efforts. PMID:21778471

Deployment Health Centers Review, 2016-2017

Science.gov (United States)

2017-08-21

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

Concordium 2016: Data and Knowledge Transforming Health.

Science.gov (United States)

Devine, Beth

2017-04-20

Concordium 2016 celebrated the potential for data and knowledge to transform health. Through a series of plenaries, presentations, workshops and demonstrations, the conference highlighted projects among four themes: effectiveness and outcomes research, health care analytics and operations, public and population health, and quality improvement. The eight papers that comprise this special issue of eGEMs provide exemplars of solutions to the Big Data problems faced in today's healthcare environment. Several of the papers contain elements of multiple overlapping themes. We integrate these into five overlapping themes: telehealth, user-centered design/usability, clinic workflow, patient-centered care, and population health management through prediction modeling and risk adjustment. The effort to leverage all types of Big Data to improve health and healthcare is a monumental effort that will require the work of numerous stakeholders, and one that will unfold incrementally over time. This collection of eight papers reflects the current state of the art. Concordium 2017 will take a different form, inviting a small set of leaders in the field to focus on the next round of exciting and provocative research currently underway to improve the nation's health.

The contribution of childhood circumstances, current circumstances and health behaviour to educational health differences in early adulthood

Directory of Open Access Journals (Sweden)

Härkänen Tommi

2009-05-01

Full Text Available Abstract Background The life course approach emphasises the contribution of circumstances in childhood and youth to adult health inequalities. However, there is still a lot to know of the contribution of living conditions in childhood and youth to adult health inequalities and how later environmental and behavioural factors are connected with the effects of earlier circumstances. This study aims to assess a how much childhood circumstances, current circumstances and health behaviour contribute to educational health differences and b to which extent the effect of childhood circumstances on educational health differences is shared with the effects of later living conditions and health behaviour in young adults. Methods The data derived from the Health 2000 Survey represent the Finnish young adults aged 18–29 in 2000. The analyses were carried out on 68% (n = 1282 of the sample (N = 1894. The cross-sectional data based on interviews and questionnaires include retrospective information on childhood circumstances. The outcome measure was poor self-rated health. Results Poor self-rated health was much more common among subjects with primary education only than among those in the highest educational category (OR 4.69, 95% CI 2.63 to 8.62. Childhood circumstances contributed substantially (24% to the health differences between these educational groups. Nearly two thirds (63% of this contribution was shared with behavioural factors adopted by early adulthood, and 17% with current circumstances. Health behaviours, smoking especially, were strongly contributed to educational health differences. Conclusion To develop means for avoiding undesirable trajectories along which poor health and health differences develop, it is necessary to understand the pathways to health inequalities and know how to improve the living conditions of families with children.

Young adult sexual health: current and prior sexual behaviours among non-Hispanic white US college students.

Science.gov (United States)

Higgins, Jenny A; Trussell, James; Moore, Nelwyn B; Davidson, J Kenneth

2010-03-01

Less is known about the sexual health of young adults than about adolescents, despite 20 to 24-year-olds' greater risk of unintended pregnancy and sexually transmissible infections. This paper provides information on college students' prior and current sexual practices including oral sex, vaginal intercourse, anal intercourse and masturbation. We analysed data from a cross-sectional sexuality survey of students from two university campuses in the USA, one Mid-western and one South-western (n = 1504). The sample consisted of non-Hispanic white, never-married students who identified as heterosexual. Of 16 possible combinations of four sexual activities (solitary masturbation, oral sex, vaginal intercourse and anal intercourse), only four contained more than 5% of respondents: masturbation, oral sex and vaginal intercourse (37%); oral sex and vaginal intercourse only (20%); all four (14%); and none (8%). Twenty percent had ever engaged in anal intercourse. Women were significantly less likely than men to have ever masturbated (48 v. 92%). Analyses exhibited several sexual health challenges, including lack of verbal sexual consent, alcohol use proximal to sex and lack of contraceptive use. Although few young adults are substituting it for vaginal intercourse, anal intercourse is increasingly common and safer sex efforts should encourage condom use during both sexual activities. Masturbation should be encouraged as an alternative to higher risk sexual practices and an essential aspect of sexual well being. Finally, practitioners should continue to address specific threats to college students' sexual health, including alcohol use and non-verbal consent.

Continuing-education needs of the currently employed public health education workforce.

Science.gov (United States)

Allegrante, J P; Moon, R W; Auld, M E; Gebbie, K M

2001-08-01

This study examined the continuing-education needs of the currently employed public health education workforce. A national consensus panel of leading health educators from public health agencies, academic institutions, and professional organizations was convened to examine the forces creating the context for the work of public health educators and the competencies they need to practice effectively. Advocacy; business management and finance; communication; community health planning and development, coalition building, and leadership; computing and technology; cultural competency; evaluation; and strategic planning were identified as areas of critical competence. Continuing education must strengthen a broad range of critical competencies and skills if we are to ensure the further development and effectiveness of the public health education workforce.

Electronic Health Records: PHR Opportunities for Public Health – Part 2

Centers for Disease Control (CDC) Podcasts

2009-09-10

In this podcast, Dr. Ken Mandl discusses electronic health records and personally-controlled health records. Dr. Mandl leads the IndivoHealth personally-controlled health record project, the original reference model for the Microsoft, Google, and Dossia personal health records (PHRs or PCHRs). He has successfully used PHRs for immunization and influenza, leads efforts in real-time surveillance systems, and is currently adapting personal health records for longitudinal and genomic research. The lecture was given at CDC on June 19, 2009.  Created: 9/10/2009 by Coordinating Center for Health Information Service (CCHIS), Healthy Healthcare Settings Goal Team, Office of Strategy and Innovation.   Date Released: 6/3/2010.

Electronic Health Records: PHR Opportunities for Public Health – Part 1

Centers for Disease Control (CDC) Podcasts

2009-09-10

In this podcast, Dr. Ken Mandl discusses electronic health records and personally-controlled health records. Dr. Mandl leads the IndivoHealth personally-controlled health record project, the original reference model for the Microsoft, Google, and Dossia personal health records (PHRs or PCHRs). He has successfully used PHRs for immunization and influenza, leads efforts in real-time surveillance systems, and is currently adapting personal health records for longitudinal and genomic research. The lecture was given at CDC on June 19, 2009.  Created: 9/10/2009 by Coordinating Center for Health Information Service (CCHIS), Healthy Healthcare Settings Goal Team, Office of Strategy and Innovation.   Date Released: 6/3/2010.

Soil Health Assessment Approaches and the Cornell Framework

Science.gov (United States)

van Es, Harold

2016-04-01

Soil health constraints beyond nutrient limitations and excesses currently limit agroecosystem productivity and sustainability, resilience to drought and extreme rainfall, and progress in soil and water conservation. With mounting pressure to produce food, feed, fiber, and even fuel for an increasing population, the concept of soil health is gaining national and international attention. Multiple regional, national, and global efforts are now leveraging that work to reach new stakeholder audiences, so that soil health management is expanding into mainstream agriculture. Each grower is generally faced with a unique situation in the choice of management options to address soil health constraints and each system affords its own set of opportunities or limitations to soil management. A more comprehensive understanding of soil health status can better guide farmers' management decisions. Until recently, there has not been a formalized decision making process for implementing a soil health management system that alleviates field-specific constrains identified through standard measurements and then maintains improved soil health. This presentation will discuss current US-based efforts related to soil health assessment, including efforts to build national consensus on appropriate methods for simple (inexpensive) and comprehensive tests. This includes the Cornell Soil Health Management Planning and Implementation Framework. The most relevant components of the framework are 1) measurement of indicators that represent critical soil processes, 2) scoring of measured values that allows for interpretation, and 3) linkage of identified constraints with management practices. Land managers can monitor changes over time through further assessment, and adapt management practices to achieve chosen goals. We will discuss the full tests and approaches for simplification.

Health information exchange: national and international approaches.

Science.gov (United States)

Vest, Joshua R

2012-01-01

Health information exchange (HIE), the process of electronically moving patient-level information between different organizations, is viewed as a solution to the fragmentation of data in health care. This review provides a description of the current state of HIE in seven nations, as well was three international HIE efforts, with a particular focus on the relation of exchange efforts to national health care systems, common challenges, and the implications of cross-border information sharing. National and international efforts highlighted in English language informatics journals, professional associations, and government reports are described. Fully functioning HIE is not yet a common phenomenon worldwide. However, multiple nations see the potential benefits of HIE and that has led to national and international efforts of varying scope, scale, and purview. National efforts continue to work to overcome the challenges of interoperability, record linking, insufficient infrastructures, governance, and interorganizational relationships, but have created architectural strategies, oversight agencies, and incentives to foster exchange. The three international HIE efforts reviewed represent very different approaches to the same problem of ensuring the availability of health information across borders. The potential of HIE to address many cost and quality issues will ensure HIE remains on many national agendas. In many instances, health care executives and leaders have opportunities to work within national programs to help shape local exchange governance and decide technology partners. Furthermore, HIE raises policy questions concerning the role of centralized planning, national identifiers, standards, and types of information exchanged, each of which are vital issues to individual health organizations and worthy of their attention.

Forty Years of State Alcohol and Pregnancy Policies in the USA: Best Practices for Public Health or Efforts to Restrict Women's Reproductive Rights?

OpenAIRE

Roberts, SCM; Thomas, S; Treffers, R; Drabble, L

2017-01-01

Alcohol consumption during pregnancy remains a public health problem despite >40 years of attention. Little is known about how state policies have evolved and whether policies represent public health goals or efforts to restrict women's reproductive rights.Our data set includes US state policies from 1970 through 2013 obtained through original legal research and from the National Institute for Alcohol Abuse and Alcoholism's (NIAAA)'s Alcohol Policy Information System. Policies were classified...

A current perspective on medical informatics and health sciences librarianship.

Science.gov (United States)

Perry, Gerald J; Roderer, Nancy K; Assar, Soraya

2005-04-01

The article offers a current perspective on medical informatics and health sciences librarianship. The authors: (1) discuss how definitions of medical informatics have changed in relation to health sciences librarianship and the broader domain of information science; (2) compare the missions of health sciences librarianship and health sciences informatics, reviewing the characteristics of both disciplines; (3) propose a new definition of health sciences informatics; (4) consider the research agendas of both disciplines and the possibility that they have merged; and (5) conclude with some comments about actions and roles for health sciences librarians to flourish in the biomedical information environment of today and tomorrow. Boundaries are disappearing between the sources and types of and uses for health information managed by informaticians and librarians. Definitions of the professional domains of each have been impacted by these changes in information. Evolving definitions reflect the increasingly overlapping research agendas of both disciplines. Professionals in these disciplines are increasingly functioning collaboratively as "boundary spanners," incorporating human factors that unite technology with health care delivery.

Effort-reward imbalance and organisational injustice among aged nurses: a moderated mediation model.

Science.gov (United States)

Topa, Gabriela; Guglielmi, Dina; Depolo, Marco

2016-09-01

To test the effort-reward imbalance model among older nurses, expanding it to include the moderation of overcommitment and age in the stress-health complaints relationship, mediated by organisational injustice. The theoretical framework included the effort-reward imbalance, the uncertainty management and the socio-emotional selectivity models. Employing a two-wave design, the participants were 255 nurses aged 45 years and over, recruited from four large hospitals in Spain (Madrid and Basque Country). The direct effect of imbalance on health complaints was supported: it was significant when overcommitment was low but not when it was high. Organisational injustice mediated the influence of effort-reward imbalance on health complaints. The conditional effect of the mediation of organisational injustice was significant in three of the overcommitment/age conditions but it weakened, becoming non-significant, when the level of overcommitment was low and age was high. The study tested the model in nursing populations and expanded it to the settings of occupational health and safety at work. The results of this study highlight the importance of effort-reward imbalance and organisational justice for creating healthy work environments. © 2016 John Wiley & Sons Ltd.

Understanding health literacy for strategic health marketing: eHealth literacy, health disparities, and the digital divide.

Science.gov (United States)

Bodie, Graham D; Dutta, Mohan Jyoti

2008-01-01

Even despite policy efforts aimed at reducing health-related disparities, evidence mounts that population-level gaps in literacy and healthcare quality are increasing. This widening of disparities in American culture is likely to worsen over the coming years due, in part, to our increasing reliance on Internet-based technologies to disseminate health information and services. The purpose of the current article is to incorporate health literacy into an Integrative Model of eHealth Use. We argue for this theoretical understanding of eHealth literacy and propose that macro-level disparities in social structures are connected to health disparities through the micro-level conduits of eHealth literacy, motivation, and ability. In other words, structural inequities reinforce themselves and continue to contribute to healthcare disparities through the differential distribution of technologies that simultaneously enhance and impede literacy, motivation, and ability of different groups (and individuals) in the population. We conclude the article by suggesting pragmatic implications of our analysis.

Inpo/industry job and task analysis efforts

International Nuclear Information System (INIS)

Wigley, W.W.

1985-01-01

One of the goals of INPO is to develop and coordinate industrywide programs to improve the education, training and qualification of nuclear utility personnel. To accomplish this goal, INPO's Training and Education Division: conducts periodic evaluations of industry training programs; provides assistance to the industry in developing training programs; manages the accreditation of utility training programs. These efforts are aimed at satisfying the need for training programs for nuclear utility personnel to be performance-based. Performance-based means that training programs provide an incumbent with the skills and knowledge required to safely perform the job. One of the ways that INPO has provided assistance to the industry is through the industrywide job and task analysis effort. I will discuss the job analysis and task analysis processes, the current status of JTA efforts, JTA products and JTA lessons learned

Community-based child health nurses: an exploration of current practice.

Science.gov (United States)

Borrow, Stephanie; Munns, Ailsa; Henderson, Saras

2011-12-01

The purpose of this research was to define, the practice domain of community-based child health nursing in light of widespread political, economic and social changes in Western Australia. The project was conducted by a group of nurse researchers with experience in child health nursing from the School of Nursing and Midwifery at Curtin University and the Child and Adolescent Community Health Division at the Department of Health, Western Australia. The overall aim of the project was to map the scope of nursing practice in the community child health setting in Western Australia and to identify the decision making framework that underpins this nursing specialty. Given the widespread social, economic and health service management changes, it was important for nurses involved with, or contemplating a career in, community-based child health to have the role accurately defined. In addition, consumer expectations of the service needed to be explored within the current climate. A descriptive qualitative study was used for this project. A purposive sample of 60 participants was drawn from the pool of child health nurses in the South Metropolitan Community Health Service, North Metropolitan Health Service and Western Australian Country Health Service. Following ethical approval data was collected via participants keeping a 2-week work diary. The data was coded and thematic analysis was applied. Several themes emerged from the analysis which were validated by follow up focus group interviews with participants. This clearly demonstrated common, recurring issues. The results identified that the community-based child health nurses are currently undertaking a more complex and expanded child health service role for an increasingly diverse client population, over their traditional practices which are still maintained. Excessive workloads and lack of human and non human resources also presented challenges. There are increasing requirements for child health nurses to engage in

Promise and problems with supply chain management approaches to health care purchasing.

Science.gov (United States)

Ford, Eric W; Scanlon, Dennis P

2007-01-01

Double-digit health care inflation, coupled with widespread reports of poor care quality and deadly medical errors, has caused private sector employers to reevaluate their health benefits purchasing strategies, with a focus on supply chain management approaches. In other industries, this strategy has proven to be an effective method for simultaneously reducing costs and increasing quality. This article describes four current applications of supply chain management network methodologies to health care systems and identifies potential ways to improve purchasers' return on investment. In particular, information exchanges, purchase decision, and payment agreement components of integrated supply chains are described. First, visual depictions of the health care supply chain are developed from a purchaser's perspective. Next, five nationwide programs designed to realign incentives and rewards across the health care supply chain are described. Although several nationwide efforts are gaining traction in the marketplace, at this time, no cost reduction and quality improvement program initiative appears to systematically align the entire health care supply chain from providers to purchasers, raising doubt about the ability of supply chain management network techniques to significantly impact the health care marketplace in the short run. Current individual efforts to coordinate the health care supply chain do not act on all of the actors necessary to improve outcomes, promote safety, and control costs. Nevertheless, there are indications that several of the individual efforts are coming together. If national efforts touching on all critical elements can coordinate with purchasers, then the health care supply chain's performance may improve significantly.

Effort and trust: the underpinnings of active learning.

Science.gov (United States)

Adams, Seana; Bilimoria, Krish; Malhotra, Neha; Rangachari, P K

2017-09-01

Three undergraduate students and their teacher discuss two crucial issues that form the implicit basis of active learning: effort and trust. They use a single course in a Health Sciences Program to anchor their comments. Copyright © 2017 the American Physiological Society.

Oral health, general health, and quality of life in older people

DEFF Research Database (Denmark)

Kandelman, Daniel; Petersen, Poul Erik; Ueda, Hiroshi

2008-01-01

The purpose of this report is to review the interrelationship between poor oral health conditions of older people and general health. The impact of poor oral health on quality of life (QOL) is analyzed, and the implications for public health intervention and oral health care are discussed. Findings...... from the current research may lead to the following conclusions: The available scientific evidence is particularly strong for a direct relationship between diabetes and periodontal disease; the direct relationship between periodontal disease and cardiovascular disease is less convincing. General...... and associated oral health conditions have a direct influence on elder people's QOL and lifestyle. The growing number of elderly people challenges health authorities in most countries. The evidence on oral health-general health relationships is particularly important to WHO in its effort to strengthen integrated...

Pragmatic measurement of health satisfaction in people with type 2 diabetes mellitus using the Current Health Satisfaction Questionnaire

Directory of Open Access Journals (Sweden)

Traina SB

2015-03-01

Full Text Available Shana B Traina,1 Hilary H Colwell,2 Ross D Crosby,2,3 Susan D Mathias2 1Janssen Global Services, LLC, Raritan, NJ, 2Health Outcomes Solutions, Winter Park, FL, 3Neuropsychiatric Research Institute and University of North Dakota School of Medicine and Health Sciences, Fargo, ND, USA Background: The concept of diabetes-related health satisfaction encompasses issues specifically related to living with diabetes (eg, blood glucose, blood pressure levels, body weight. Health satisfaction is more specific than overall health-related quality of life because it considers disease-related factors, and is different from diabetes treatment satisfaction because it addresses issues not specifically related to treatment. Low levels of health satisfaction in people with type 2 diabetes mellitus (T2DM may negatively affect self-care behaviors and treatment outcomes; however, there are currently no instruments available to assess health satisfaction in this population. This study assessed the measurement properties of a newly constructed, 14-item Current Health Satisfaction Questionnaire (CHES-Q designed to assess diabetes-related health satisfaction and knowledge of the disease and important laboratory results. Methods: In-depth interviews were conducted in 23 adults with T2DM to confirm the content and clarity of the CHES-Q. The revised instrument was administered to 1,015 individuals with T2DM, along with supplemental questionnaires, including the Short Form-36. All subjects completed the questionnaires again 3 to 7 days later. CHES-Q test-retest reliability, construct validity, and known-groups validity were evaluated. Results: In general, respondents found the CHES-Q to be clear and comprehensive. Test-retest reliability was generally acceptable for all items (≥0.70, except for three that fell just below the widely accepted cut-point of 0.70 (range 0.63–0.69. Convergent and divergent validity was demonstrated based on hypothesized correlations with the

Mental health care in Nepal : current situation and challenges for development of a district mental health care plan

NARCIS (Netherlands)

Luitel, Nagendra P; Jordans, Mark Jd; Adhikari, Anup; Upadhaya, Nawaraj; Hanlon, Charlotte; Lund, Crick; Komproe, Ivan H

2015-01-01

BACKGROUND: Globally mental health problems are a serious public health concern. Currently four out of five people with severe mental illness in Low and Middle Income Countries (LMIC) receive no effective treatment. There is an urgent need to address this enormous treatment gap. Changing the focus

Efforts Towards The Development Of Recombinant Vaccines Against

African Journals Online (AJOL)

ABSTRACT. Hemorrhagic septicemia is caused by gram-negative bacterium of Pasteurella multocida (P. multocida) strains. Most of the current vaccines against P. multocida have shortcomings. Presently, there is increasing efforts towards construction of recombinant clone for vaccine development against P. multocida.

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.

The Estimated Health and Economic Benefits of Three Decades of Polio Elimination Efforts in India.

Science.gov (United States)

Nandi, Arindam; Barter, Devra M; Prinja, Shankar; John, T Jacob

2016-08-07

In March 2014, India, the country with historically the highest burden of polio, was declared polio free, with no reported cases since January 2011. We estimate the health and economic benefits of polio elimination in India with the oral polio vaccine (OPV) during 1982-2012. Based on a pre-vaccine incidence rate, we estimate the counterfactual burden of polio in the hypothetical absence of the national polio elimination program in India. We attribute differences in outcomes between the actual (adjusted for under-reporting) and hypothetical counterfactual scenarios in our model to the national polio program. We measure health benefits as averted polio incidence, deaths, and disability adjusted life years (DALYs). We consider two methods to measure economic benefits: the value of statistical life approach, and equating one DALY to the Gross National Income (GNI) per capita. We estimate that the National Program against Polio averted 3.94 million (95% confidence interval [CI]: 3.89-3.99 million) paralytic polio cases, 393,918 polio deaths (95% CI: 388,897- 398,939), and 1.48 billion DALYs (95% CI: 1.46-1.50 billion). We also estimate that the program contributed to a $1.71 trillion (INR 76.91 trillion) gain (95% CI: $1.69-$1.73 trillion [INR 75.93-77.89 trillion]) in economic productivity between 1982 and 2012 in our base case analysis. Using the GNI and DALY method, the economic gain from the program is estimated to be $1.11 trillion (INR 50.13 trillion) (95% CI: $1.10-$1.13 trillion [INR 49.50-50.76 trillion]) over the same period. India accrued large health and economic benefits from investing in polio elimination efforts. Other programs to control/eliminate more vaccine-preventable diseases are likely to contribute to large health and economic benefits in India.

APA efforts in promoting human rights and social justice.

Science.gov (United States)

Leong, Frederick T L; Pickren, Wade E; Vasquez, Melba J T

2017-11-01

This article reviews the American Psychological Association's (APA) efforts in promoting human rights and social justice. Beginning with a historical review of the conceptualizations of human rights and social justice, the social challenges that have faced the United States over time are discussed in relation to the APA's evolving mission and strategic initiatives enacted through its boards, committees, and directorates. From early efforts on the Board for Social and Ethical Responsibility in Psychology and the Board of Ethnic Minority Affairs to the establishment of the Public Interest Directorate, the APA's efforts to address these human rights and social justice challenges through its task force reports, guidelines, and policies are described. Specifically, issues related to diversity and underrepresentation of minority group members and perspective within the APA, as well as women's issues (prochoice, violence against women, sexualization of young girls, human trafficking) were central to these efforts. These minority groups included racial and ethnic minority groups; immigrants and refugees; lesbian, gay, bisexual, transgendered, and queer individuals; and those with disabilities. Later attention shifted to broader social justice challenges within a public health perspective, such as AIDS, obesity, and violence. Also included is a brief discussion of the Hoffman Report. The article ends with a discussion of future directions for the APA's efforts related to human rights and social justice related to health disparities, violent extremism, social inequality, migration, cultural and racial diversity, and an evidence-based approach to programming. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

The sugar-sweetened beverage wars: public health and the role of the beverage industry.

Science.gov (United States)

Welsh, Jean A; Lundeen, Elizabeth A; Stein, Aryeh D

2013-10-01

To discuss the current data on sugar-sweetened beverage (SSB) consumption trends, evidence of the health impact, and the role of industry in efforts to reduce the consumption. Previously rising SSB consumption rates have declined recently, but continue to contribute added sugars beyond the limit advised by the American Heart Association. A recent meta-analysis concluded that SSBs likely increase body weight and recent long-term studies support the previous findings of increased risk of diabetes, dyslipidemia, and hypertension. Beverage companies have played an active role in some SSB reduction efforts by reducing the sale of SSBs in schools, limiting television advertising to children, and increasing the availability of smaller portion-size options. Industry has opposed efforts to restrict the availability of large portion sizes and implement an excise tax. Current industry efforts include the promotion of alternative beverages perceived to be healthier as well as SSBs through Internet and social media. Continuing high SSB consumption and associated health risks highlight the need for further public health action. The beverage industry has supported some efforts to reduce the consumption of full sugar beverages, but has actively opposed others. The impact of industry efforts to promote beverage alternatives perceived as healthier is unknown.

The sugar-sweetened beverage wars: public health and the role of the beverage industry

Science.gov (United States)

Welsh, Jean A.; Lundeen, Elizabeth A.; Stein, Aryeh D.

2015-01-01

Purpose of review To discuss the current data on sugar-sweetened beverage (SSB) consumption trends, evidence of the health impact, and the role of industry in efforts to reduce the consumption. Recent findings Previously rising SSB consumption rates have declined recently, but continue to contribute added sugars beyond the limit advised by the American Heart Association. A recent meta-analysis concluded that SSBs likely increase body weight and recent long-term studies support the previous findings of increased risk of diabetes, dyslipidemia, and hypertension. Beverage companies have played an active role in some SSB reduction efforts by reducing the sale of SSBs in schools, limiting television advertising to children, and increasing the availability of smaller portion-size options. Industry has opposed efforts to restrict the availability of large portion sizes and implement an excise tax. Current industry efforts include the promotion of alternative beverages perceived to be healthier as well as SSBs through Internet and social media. Summary Continuing high SSB consumption and associated health risks highlight the need for further public health action. The beverage industry has supported some efforts to reduce the consumption of full sugar beverages, but has actively opposed others. The impact of industry efforts to promote beverage alternatives perceived as healthier is unknown. PMID:23974767

Effort-Reward Imbalance, Work-Privacy Conflict, and Burnout Among Hospital Employees.

Science.gov (United States)

Häusler, Nadine; Bopp, Matthias; Hämmig, Oliver

2018-04-01

Studies investigating the relative importance of effort-reward imbalance and work-privacy conflict for burnout risk between professional groups in the health care sector are rare and analyses by educational attainment within professional groups are lacking. The study population consists of 1422 hospital employees in Switzerland. Multivariate linear regression analyses with standardized coefficients were performed for the overall study population and stratified for professional groups refined for educational attainment. Work-privacy conflict is a strong predictor for burnout and more strongly associated with burnout than effort-reward imbalance in the overall study population and across all professional groups. Effort-reward imbalance only had a minor effect on burnout in tertiary-educated medical professionals. Interventions aiming at increasing the compatibility of work and private life may substantially help to decrease burnout risk of professionals working in a health care setting.

Factors influencing adult physical health after controlling for current health conditions: evidence from a british cohort.

Directory of Open Access Journals (Sweden)

Helen Cheng

Full Text Available This study explored a longitudinal data set of 6875 British adults examining the effects of parental social status (measured at birth, cognitive ability (at age 11 yrs, personality traits, education and occupational attainment on physical health and functioning (all measured at age 50 yrs, after taking account of current health conditions (number of illness. Correlation analysis showed that parental social class, childhood cognitive ability, education and occupation, and two personality traits (Emotional Stability/Neuroticism, and Conscientiousness were all significantly associated with adult physical health variables. Structural equation modelling showed that health conditions and personality traits were significantly, and inversely, associated with physical health (indicated by good daily physical functioning, relative absence of pain, perceived health, and low level of limitations at work due to physical health. Parental social status, childhood intelligence, educational and occupational attainment were all modestly, but significantly and directly, associated with adult physical health. The effect of childhood intelligence on adult physical health was, in part, mediated through Emotional Stability and Conscientiousness. After controlling for health conditions Emotional Stability was the strongest predictor of physical health. Implications and limitations are discussed.

Integrating Biopsychosocial Intervention Research in a Changing Health Care Landscape

Science.gov (United States)

Ell, Kathleen; Oh, Hyunsung; Wu, Shinyi

2016-01-01

Objective: Safety net care systems are experiencing unprecedented change from the "Affordable Care Act," Patient-Centered Medical Home (PCMH) uptake, health information technology application, and growing of mental health care integration within primary care. This article provides a review of previous and current efforts in which social…

Current status of oral health research in Africa: an overview.

Science.gov (United States)

Kanoute, Aïda; Faye, Daouda; Bourgeois, Denis

2012-12-01

Research in oral health contributes effectively to decisions and strategies aimed at improving the oral health of populations. Further contributions to enhance current knowledge of oral health in Africa are required. The principal objective of this study was to produce an analysis of oral health research published from different subregions of Africa and to estimate bilateral and multilateral international cooperation in oral health research during the period 2005-2010. The PubMed database was searched for published articles on topics related to oral health in Africa. A total of 935 oral health-related articles were retrieved during April and May 2011. Publications emanating from Nigeria and South Africa accounted for a striking 68% of all oral health-related material published from Africa during the study period. Researchers from 30 different countries had participated in collaboration on at least one published article. A total of 262 journals had published at least one item examining oral health in Africa, but only 29 journals had published more than seven articles. These 29 journals accounted for 66% of all published material and induced non-African reviews (26%) and African reviews (40%). This study shows strong variation among countries in the production of articles on oral health whereby rich countries produce greater quantities of published research and poorer nations more frequently develop research partnerships with other countries. © 2012 FDI World Dental Federation.

Aging Men’s Health-Related Behaviors

Directory of Open Access Journals (Sweden)

Terry Peak

2014-11-01

Full Text Available This conceptual review summarizes the current research on older men and their health-related behaviors with special attention given to the influence of the hegemonic masculinity framework over the life span. The authors consider whether masculinity precepts can be modified to enable men to alter their gendered morbidity/mortality factors and achieve healthier and longer lives. Also included is an overview of the gender-based research and health education efforts to persuade men to adopt more effective health-related behaviors or health practices earlier in the life span. Given the current attention being paid to men’s health, for example, their higher risk of morbidity and mortality both generally and at younger ages, and the associated health care costs tied to those risks, the ethical and economic implications of this review may prove useful.

Health outcomes in low-income children with current asthma in Canada.

Science.gov (United States)

To, T; Dell, S; Tassoudji, M; Wang, C

2009-01-01

Data collected from the Canadian National Longitudinal Survey of Children and Youth (NLSCY) in 1994/95 and 1996/97 were used to measure longitudinal health outcomes among children with asthma. Over 10 000 children aged 1 to 11 years with complete data on asthma status in both years were included. Outcomes included hospitalizations and health services use (HSU). Current asthma was defined as children diagnosed with asthma by a physician and who took prescribed inhalants regularly, had wheezing or an attack in the previous year, or had their activities limited by asthma. Children having asthma significantly increased their odds of hospitalization (OR = 2.52; 95% CI: 1.71, 3.70) and health services use (OR = 3.80; 95% CI: 2.69, 5.37). Low-income adequacy (LIA) in 1994/ 95 significantly predicts hospitalization and HSU in 1996/97 (OR = 2.68; 95% CI: 1.29, 5.59 and OR = 0.67; 95% CI: 0.45, 0.99, respectively). Our results confirmed that both having current asthma and living in low-income families had a significant impact on the health status of children in Canada. Programs seeking to decrease the economic burden of pediatric hospitalizations need to focus on asthma and low-income populations.

Overview of NASA/OAST efforts related to manufacturing technology

Science.gov (United States)

Saunders, N. T.

1976-01-01

An overview of some of NASA's current efforts related to manufacturing technology and some possible directions for the future are presented. The topics discussed are: computer-aided design, composite structures, and turbine engine components.

Efforts towards the development of recombinant Vaccines against ...

African Journals Online (AJOL)

Hemorrhagic septicemia is caused by gram-negative bacterium of Pasteurella multocida (P. multocida) strains. Most of the current vaccines against P. multocida have shortcomings. Presently, there is increasing efforts towards construction of recombinant clone for vaccine development against P. multocida. In this review an ...

Worldwide effort against smoking.

Science.gov (United States)

1986-07-01

The 39th World Health Assembly, which met in May 1986, recognized the escalating health problem of smoking-related diseases and affirmed that tobacco smoking and its use in other forms are incompatible with the attainment of "Health for All by the Year 2000." If properly implemented, antismoking campaigns can decrease the prevalence of smoking. Nations as a whole must work toward changing smoking habits, and governments must support these efforts by officially stating their stand against smoking. Over 60 countries have introduced legislation affecting smoking. The variety of policies range from adopting a health education program designed to increase peoples' awareness of its dangers to increasing taxes to deter smoking by increasing tobacco prices. Each country must adopt an antismoking campaign which works most effectively within the cultural parameters of the society. Other smoking policies include: printed warnings on cigarette packages; health messages via radio, television, mobile teams, pamphlets, health workers, clinic walls, and newspapers; prohibition of smoking in public areas and transportation; prohibition of all advertisement of cigarettes and tobacco; and the establishment of upper limits of tar and nicotine content in cigarettes. The tobacco industry spends about $2000 million annually on worldwide advertising. According to the World Health Organization (WHO), controlling this overabundance of tobacco advertisements is a major priority in preventing the spread of smoking. Cigarette and tobacco advertising can be controlled to varying degrees, e.g., over a dozen countries have enacted a total ban on advertising on television or radio, a mandatory health warning must accompany advertisements in other countries, and tobacco companies often are prohibited from sponsoring sports events. Imposing a substantial tax on cigarettes is one of the most effective means to deter smoking. However, raising taxes and banning advertisements is not enough because

Oak Ridge Health Studies Phase 1 report, Volume 2: Part D, Dose Reconstruction Feasibility Study

International Nuclear Information System (INIS)

Bruce, G.M.; Walker, L.B.; Widner, T.E.

1993-09-01

The purpose of Task 6 of Oak Ridge Phase I Health Studies is to provide summaries of current knowledge of toxic and hazardous properties of materials that are important for the Oak Ridge Reservation. The information gathered in the course of Task 6 investigations will support the task of focussing any future health studies efforts on those operations and emissions which have likely been most significant in terms of off-site health risk. The information gathered in Task 6 efforts will likely also be of value to individuals evaluating the feasibility of additional health,study efforts (such as epidemiological investigations) in the Oak Ridge area and as a resource for citizens seeking information on historical emissions

Current Efforts in European Projects to Facilitate the Sharing of Scientific Observation Data

Science.gov (United States)

Bredel, Henning; Rieke, Matthes; Maso, Joan; Jirka, Simon; Stasch, Christoph

2017-04-01

This presentation is intended to provide an overview of currently ongoing efforts in European projects to facilitate and promote the interoperable sharing of scientific observation data. This will be illustrated through two examples: a prototypical portal developed in the ConnectinGEO project for matching available (in-situ) data sources to the needs of users and a joint activity of several research projects to harmonise the usage of the OGC Sensor Web Enablement standards for providing access to marine observation data. ENEON is an activity initiated by the European ConnectinGEO project to coordinate in-situ Earth observation networks with the aim to harmonise the access to observations, improve discoverability, and identify/close gaps in European earth observation data resources. In this context, ENEON commons has been developed as a supporting Web portal for facilitating discovery, access, re-use and creation of knowledge about observations, networks, and related activities (e.g. projects). The portal is based on developments resulting from the European WaterInnEU project and has been extended to cover the requirements for handling knowledge about in-situ earth observation networks. A first prototype of the portal was completed in January 2017 which offers functionality for interactive discussion, information exchange and querying information about data delivered by different observation networks. Within this presentation, we will introduce the presented prototype and initiate a discussion about potential future work directions. The second example concerns the harmonisation of data exchange in the marine domain. There are many organisation who operate ocean observatories or data archives. In recent years, the application of the OGC Sensor Web Enablement (SWE) technology has become more and more popular to increase the interoperability between marine observation networks. However, as the SWE standards were intentionally designed in a domain independent manner

Team-based efforts to improve quality of care, the fundamental role of ethics, and the responsibility of health managers: monitoring and management strategies to enhance teamwork.

Science.gov (United States)

Kossaify, A; Hleihel, W; Lahoud, J-C

2017-12-01

Highlight the importance of teamwork in health care institutions by performing a review and discussion of the relevant literature. Review paper. A MEDLINE/Pubmed search was performed starting from 1990, and the terms 'team, teamwork, managers, healthcare, and cooperation' were searched in titles, abstracts, keywords, and conclusions; other terms 'patient safety, ethics, audits and quality of care' were specifically searched in abstracts and were used as additional filters criteria to select relevant articles. Thirty-three papers were found relevant; factors affecting the quality of care in health care institutions are multiple and varied, including issues related to individual profile, to administrative structure and to team-based effort. Issues affecting teamwork include mainly self-awareness, work environment, leadership, ethics, cooperation, communication, and competition. Moreover, quality improvement plans aiming to enhance and expand teams are essential in this context. Team monitoring and management are vital to achieve efficient teamwork with all the required qualities for a safer health system. In all cases, health managers' responsibility plays a fundamental role in creating and sustaining a teamwork atmosphere. Teamwork is known to improve outcomes in medicine, whether at the clinical, organizational, or scientific level. Teamwork in health care institutions must increasingly be encouraged, given that individual effort is often insufficient for optimal clinical outcome. Copyright © 2017 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

Reviewing efforts in global forest conservation for sustainable forest ...

African Journals Online (AJOL)

Reviewing efforts in global forest conservation for sustainable forest management: The World Wide Fund (WWF) case study. ... Global Journal of Pure and Applied Sciences. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current ...

Everglades Ecological Forecasting II: Utilizing NASA Earth Observations to Enhance the Capabilities of Everglades National Park to Monitor & Predict Mangrove Extent to Aid Current Restoration Efforts

Science.gov (United States)

Kirk, Donnie; Wolfe, Amy; Ba, Adama; Nyquist, Mckenzie; Rhodes, Tyler; Toner, Caitlin; Cabosky, Rachel; Gotschalk, Emily; Gregory, Brad; Kendall, Candace

2016-01-01

Mangroves act as a transition zone between fresh and salt water habitats by filtering and indicating salinity levels along the coast of the Florida Everglades. However, dredging and canals built in the early 1900s depleted the Everglades of much of its freshwater resources. In an attempt to assist in maintaining the health of threatened habitats, efforts have been made within Everglades National Park to rebalance the ecosystem and adhere to sustainably managing mangrove forests. The Everglades Ecological Forecasting II team utilized Google Earth Engine API and satellite imagery from Landsat 5, 7, and 8 to continuously create land-change maps over a 25 year period, and to allow park officials to continue producing maps in the future. In order to make the process replicable for project partners at Everglades National Park, the team was able to conduct a supervised classification approach to display mangrove regions in 1995, 2000, 2005, 2010 and 2015. As freshwater was depleted, mangroves encroached further inland and freshwater marshes declined. The current extent map, along with transition maps helped create forecasting models that show mangrove encroachment further inland in the year 2030 as well. This project highlights the changes to the Everglade habitats in relation to a changing climate and hydrological changes throughout the park.

Mental health of adolescents with currently and formerly incarcerated parents.

Science.gov (United States)

Davis, Laurel; Shlafer, Rebecca J

2017-01-01

Reliable information about children of incarcerated people is difficult to obtain, and major gaps exist in our understanding of their well-being. This study aims to determine whether adolescents with incarcerated parents report higher levels of mental health problems than those without an incarcerated parent, and whether the relationship between parental incarceration and adolescent mental health is moderated by parent-child relationships. Using a statewide survey from one US state, we compared adolescents with a currently incarcerated parent to those with a formerly incarcerated parent and those with no history of parental incarceration on self-reported indicators of mental health, and examined whether strong parent-child relationships were protective against mental health concerns. Results indicate that adolescents with incarcerated parents are at elevated risk for mental health problems, and strong parent-child relationships partially buffer children from risk. Findings underscore the need for more investment in effective early interventions for adolescents in highly adverse contexts. Copyright © 2016 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

Current status of environmental, health, and safety issues of electrochemical capacitors for advanced vehicle applications

Energy Technology Data Exchange (ETDEWEB)

Vimmerstedt, L J; Hammel, C J

1997-04-01

Electrochemical capacitors are a candidate for traction power assists in hybrid electric vehicles (HEVs). Other advanced automotive applications, while not the primary focus of current development efforts, are also possible. These include load leveling high-energy batteries, power conditioning electronics, electrically hated catalysts, electric power steering, and engine starter power. Higher power and longer cycle life are expected for electrochemical capacitors than for batteries. Evaluation of environmental, health, and safety (EH and S) issues of electrochemical capacitors is an essential part of the development and commercialization of electrochemical capacitors for advanced vehicles. This report provides an initial EH and S assessment. This report presents electrochemical capacitor electrochemistry, materials selection, intrinsic material hazards, mitigation of those hazards, environmental requirements, pollution control options, and shipping requirements. Most of the information available for this assessment pertains to commercial devices intended for application outside the advanced vehicle market and to experiment or prototype devices. Electrochemical capacitors for power assists in HEVs are not produced commercially now. Therefore, materials for advanced vehicle electrochemical capacitors may change, and so would the corresponding EH and S issues. Although changes are possible, this report describes issues for likely electrochemical capacitor designs.

Technical Limitations of Electronic Health Records in Community Health Centers: Implications on Ambulatory Care Quality

Science.gov (United States)

West, Christopher E.

2010-01-01

Research objectives: This dissertation examines the state of development of each of the eight core electronic health record (EHR) functionalities as described by the IOM and describes how the current state of these functionalities limit quality improvement efforts in ambulatory care settings. There is a great deal of literature describing both the…

The impact of effort-reward imbalance on quality of life among Japanese working men.

Science.gov (United States)

Watanabe, Mayumi; Tanaka, Katsutoshi; Aratake, Yutaka; Kato, Noritada; Sakata, Yumi

2008-07-01

Health-related quality of life (HRQL) is an important measure of health outcome in working and healthy populations. Here, we investigated the impact of effort-reward imbalance (ERI), a representative work-stress model, on HRQL of Japanese working men. The study targeted 1,096 employees from a manufacturing plant in Japan. To assess HRQL and ERI, participants were surveyed using the Japanese version of the Short-Form 8 Health Survey (SF-8) and effort-reward imbalance model. Of the 1,096 employees, 1,057 provided valid responses to the questionnaire. For physical summary scores, the adjusted effort-reward imbalance odds ratios of middle vs. bottom and top vs. bottom tertiles were 0.24 (95% confidence interval, 0.08-0.70) and 0.09 (95% confidence interval, 0.03-0.28), respectively. For mental summary scores, ratios were 0.21 (95% confidence interval, 0.07-0.63) and 0.07 (95% confidence interval, 0.02-0.25), respectively. These findings demonstrate that effort-reward imbalance is independently associated with HRQL among Japanese employees.

Detection of suboptimal effort with symbol span: development of a new embedded index.

Science.gov (United States)

Young, J Christopher; Caron, Joshua E; Baughman, Brandon C; Sawyer, R John

2012-03-01

Developing embedded indicators of suboptimal effort on objective neurocognitive testing is essential for detecting increasingly sophisticated forms of symptom feigning. The current study explored whether Symbol Span, a novel Wechsler Memory Scale-fourth edition measure of supraspan visual attention, could be used to discriminate adequate effort from suboptimal effort. Archival data were collected from 136 veterans classified into Poor Effort (n = 42) and Good Effort (n = 94) groups based on symptom validity test (SVT) performance. The Poor Effort group had significantly lower raw scores (p Span test. A raw score cutoff of Span can effectively differentiate veterans with multiple failures on established free-standing and embedded SVTs.

Wildfire smoke exposure and human health: Significant gaps in research for a growing public health issue.

Science.gov (United States)

Black, Carolyn; Tesfaigzi, Yohannes; Bassein, Jed A; Miller, Lisa A

2017-10-01

Understanding the effect of wildfire smoke exposure on human health represents a unique interdisciplinary challenge to the scientific community. Population health studies indicate that wildfire smoke is a risk to human health and increases the healthcare burden of smoke-impacted areas. However, wildfire smoke composition is complex and dynamic, making characterization and modeling difficult. Furthermore, current efforts to study the effect of wildfire smoke are limited by availability of air quality measures and inconsistent air quality reporting among researchers. To help address these issues, we conducted a substantive review of wildfire smoke effects on population health, wildfire smoke exposure in occupational health, and experimental wood smoke exposure. Our goal was to evaluate the current literature on wildfire smoke and highlight important gaps in research. In particular we emphasize long-term health effects of wildfire smoke, recovery following wildfire smoke exposure, and health consequences of exposure in children. Copyright © 2017 Elsevier B.V. All rights reserved.

Community Assessment: A Current Essential Need

Directory of Open Access Journals (Sweden)

Mohammad Hassan Lotfi

2014-07-01

Full Text Available Health; as a basic right of the people and essential demand; should be considered as a joint responsibility of the government and people of a community. As much as the people of a community aware and involved in the individual health promotion and problem solving of their community in all dimensions, the probability of reaching to favorable health measurements is also increased. Community assessment is considered as a foundation for health improving and promoting the community members. The main objectives of community assessment are; to identify factors that affect the health of a population and determine the availability of resources within the community to adequately address these factors. In this Vera, community leaders, public health agencies, businesses, hospitals, private practitioners, and academic centers have each one a defined role. These groups can begin to answer key questions such as (a “What are the strengths in our community?” (b “What health concerns do community members have?” and (c “What resources are available and what do we need in the community to address these concerns? An important use of a community health assessment is to create Community Health Action to develop effective community health strategies. The health reform plan of Islamic Republic of Iran, started at the earlier months of the current year (2014, with establishing of the family physician program begun firstly at the level of rural regions, then will developed to cities with population 20000 to 500000 also borderlines of metropolitans cities and finally in the future, covering all urban eras of cities in the country aimed to executive the referral system with all its attributes. Being a full time physician along with a comprehensive teamwork including different prestigious health workers prepare a gold opportunity for implementation of community assessment in these regions. Although, some efforts have been accomplished in some parts of country by

Innovation Efforts in Education and School Administration: Views of Turkish School Administrators

Science.gov (United States)

Akin, Ugur

2016-01-01

Problem Statement: In the current information era, nearly all organizations make efforts to make innovations in the fields of information, communication, technology, etc. Educational organizations are no exception to this trend. Moreover, it can be argued that educational institutions make a particular effort to rapidly keep pace with change. In…

Reasons for current E-cigarette use among U.S. adults

Science.gov (United States)

Patel, Deesha; Davis, Kevin C.; Cox, Shanna; Bradfield, Brian; King, Brian A.; Shafer, Paul; Caraballo, Ralph; Bunnell, Rebecca

2017-01-01

E-cigarette use has increased rapidly among U.S. adults. However, reasons for use among adults are unclear. We assessed reasons for e-cigarette use among a national sample of U.S. adults. Data were collected via online surveys among U.S. adults aged 18 or older from April through June 2014. Descriptive and multivariate regression analyses were conducted to assess reasons for e-cigarette use among 2448 current e-cigarette users, by sociodemographic characteristics and product type. Assessed reasons included cessation/health, consideration of others, convenience, cost, curiosity, flavoring, and simulation of conventional cigarettes. Among current e-cigarette users, 93% were also current cigarette smokers. The most common reasons for e-cigarette use were cessation/health (84.5%), consideration of others (71.5%), and convenience (56.7%). The prevalence of citing convenience (adjusted prevalence ratio [aPR] = 1.49) and curiosity (aPR = 1.54) as reasons for e-cigarette use were greater among current cigarette smokers than nonsmokers (P e-cigarette use among adults, and flavorings are more commonly cited by younger adults. Efforts are warranted to provide consumers with accurate information on the health effects of e-cigarettes and to ensure that flavoring and other unregulated features do not promote nicotine addiction, particularly among young adults. PMID:27612572

Physics Education Research efforts to promote diversity: Challenges and opportunities

Science.gov (United States)

Brahmia, Suzanne

2015-04-01

We begin this talk with a brief description of the gender and ethnic diversity of the physics community. We then discuss several current efforts within Physics Education Research that have the potential to further our understanding of issues surrounding underrepresentation. These efforts include research into (1) the role of community and strategies for developing effective communities; (2) physics identity and self-efficacy; (3) the affordances that students from underrepresented groups bring to physics learning; (4) socioeconomics and its impact on mathematization. One of the challenges to conducting this research is the relatively small proportion of underrepresented minority students in current physics classes, and the small number of women in physics and engineering majors. In collaboration with Stephen Kanim, New Mexico State University.

Mental health care in Nepal: current situation and challenges for development of a district mental health care plan.

Science.gov (United States)

Luitel, Nagendra P; Jordans, Mark Jd; Adhikari, Anup; Upadhaya, Nawaraj; Hanlon, Charlotte; Lund, Crick; Komproe, Ivan H

2015-01-01

Globally mental health problems are a serious public health concern. Currently four out of five people with severe mental illness in Low and Middle Income Countries (LMIC) receive no effective treatment. There is an urgent need to address this enormous treatment gap. Changing the focus of specialist mental health workers (psychiatrists and psychologists) from only service delivery to also designing and managing mental health services; building clinical capacity of the primary health care (PHC) workers, and providing supervision and quality assurance of mental health services may help in scaling up mental health services in LMICs. Little is known however, about the mental health policy and services context for these strategies in fragile-state settings, such as Nepal. A standard situation analysis tool was developed by the PRogramme for Improving Mental health carE (PRIME) consortium to systematically analyze and describe the current gaps in mental health care in Nepal, in order to inform the development of a district level mental health care plan (MHCP). It comprised six sections; general information (e.g. population, socio-economic conditions); mental health policies and plans; mental health treatment coverage; district health services; and community services. Data was obtained from secondary sources, including scientific publications, reports, project documents and hospital records. Mental health policy exists in Nepal, having been adopted in 1997, but implementation of the policy framework has yet to begin. In common with other LMICs, the budget allocated for mental health is minimal. Mental health services are concentrated in the big cities, with 0.22 psychiatrists and 0.06 psychologists per 100,000 population. The key challenges experienced in developing a district level MHCP included, overburdened health workers, lack of psychotropic medicines in the PHC, lack of mental health supervision in the existing system, and lack of a coordinating body in the Ministry

Young adult sexual health: current and prior sexual behaviors among non-Hispanic white U.S. college students

Science.gov (United States)

Higgins, Jenny A.; Trussell, James; Moore, Nelwyn B.; Davidson, J. Kenneth

2013-01-01

Objective Less is known about the sexual health of young adults compared to adolescents, despite 20-24 year olds' greater risk of unintended pregnancy and sexually transmitted infections. This paper provides information on college students' prior and current sexual practices, including oral sex, vaginal intercourse, anal intercourse, and masturbation. Methods We analyzed data from a cross-sectional sexuality survey of students from two university campuses in the USA, one Midwestern and one Southwestern (N=1504). The sample consisted of non-Hispanic white, never-married students who identified as heterosexual. Results Of 16 possible combinations of four sexual activities (solitary masturbation, oral sex, vaginal intercourse, and anal intercourse), only four contained more than 5% of respondents: masturbation, oral sex, and vaginal intercourse (37%); oral sex and vaginal intercourse only (20%); all four (14%); and none (8%). Twenty percent had ever engaged in anal intercourse. Women were significantly less likely than men to have ever masturbated (48% versus 92%). Analyses exhibited several sexual health challenges, including lack of verbal sexual consent, alcohol use proximal to sex, and lack of contraceptive use. Conclusions Although few young adults are substituting it for vaginal intercourse, anal intercourse is increasingly common, and safer sex efforts should encourage condom use during both sexual activities. Masturbation should be encouraged as an alternative to higher risk sexual practices and an essential aspect of sexual well-being. Finally, practitioners should continue to address specific threats to college students' sexual health, including alcohol use and nonverbal consent. PMID:20152094

Adaptation to climate change in the Ontario public health sector

Directory of Open Access Journals (Sweden)

Paterson Jaclyn A

2012-06-01

Full Text Available Abstract Background Climate change is among the major challenges for health this century, and adaptation to manage adverse health outcomes will be unavoidable. The risks in Ontario – Canada’s most populous province – include increasing temperatures, more frequent and intense extreme weather events, and alterations to precipitation regimes. Socio-economic-demographic patterns could magnify the implications climate change has for Ontario, including the presence of rapidly growing vulnerable populations, exacerbation of warming trends by heat-islands in large urban areas, and connectedness to global transportation networks. This study examines climate change adaptation in the public health sector in Ontario using information from interviews with government officials. Methods Fifty-three semi-structured interviews were conducted, four with provincial and federal health officials and 49 with actors in public health and health relevant sectors at the municipal level. We identify adaptation efforts, barriers and opportunities for current and future intervention. Results Results indicate recognition that climate change will affect the health of Ontarians. Health officials are concerned about how a changing climate could exacerbate existing health issues or create new health burdens, specifically extreme heat (71%, severe weather (68% and poor air-quality (57%. Adaptation is currently taking the form of mainstreaming climate change into existing public health programs. While adaptive progress has relied on local leadership, federal support, political will, and inter-agency efforts, a lack of resources constrains the sustainability of long-term adaptation programs and the acquisition of data necessary to support effective policies. Conclusions This study provides a snapshot of climate change adaptation and needs in the public health sector in Ontario. Public health departments will need to capitalize on opportunities to integrate climate change into

Adaptation to climate change in the Ontario public health sector

Science.gov (United States)

2012-01-01

Background Climate change is among the major challenges for health this century, and adaptation to manage adverse health outcomes will be unavoidable. The risks in Ontario – Canada’s most populous province – include increasing temperatures, more frequent and intense extreme weather events, and alterations to precipitation regimes. Socio-economic-demographic patterns could magnify the implications climate change has for Ontario, including the presence of rapidly growing vulnerable populations, exacerbation of warming trends by heat-islands in large urban areas, and connectedness to global transportation networks. This study examines climate change adaptation in the public health sector in Ontario using information from interviews with government officials. Methods Fifty-three semi-structured interviews were conducted, four with provincial and federal health officials and 49 with actors in public health and health relevant sectors at the municipal level. We identify adaptation efforts, barriers and opportunities for current and future intervention. Results Results indicate recognition that climate change will affect the health of Ontarians. Health officials are concerned about how a changing climate could exacerbate existing health issues or create new health burdens, specifically extreme heat (71%), severe weather (68%) and poor air-quality (57%). Adaptation is currently taking the form of mainstreaming climate change into existing public health programs. While adaptive progress has relied on local leadership, federal support, political will, and inter-agency efforts, a lack of resources constrains the sustainability of long-term adaptation programs and the acquisition of data necessary to support effective policies. Conclusions This study provides a snapshot of climate change adaptation and needs in the public health sector in Ontario. Public health departments will need to capitalize on opportunities to integrate climate change into policies and programs

Efforts in Public Relations on Fusion in Europe

Science.gov (United States)

Ongena, J.; van Oost, G.

2001-10-01

An overview will be given of different published materials currently in use in Europe for public relations on fusion. We will also present a CD-ROM for individual and classroom use, containing (i) a general background on different energy forms, (ii) general principles of fusion, (iii) current research efforts and (iv) future prospects of fusion. This CD-ROM is currently in English, German, French, Spanish, Portuguese and Italian. Fusion posters developed in collaboration with CPEP in Dutch, French, German, Italian, Spanish and Portuguese will be shown. Several new brochures and leaflets intended to increase the public awareness on fusion in Europe will be on display.

Effort reward imbalance is associated with vagal withdrawal in Danish public sector employees

DEFF Research Database (Denmark)

Eller, Nanna Hurwitz; Blønd, Morten; Nielsen, Martin

2011-01-01

The current study analyzed the relationship between psychosocial work environment assessed by the Effort Reward Imbalance Model (ERI-model) and heart rate variability (HRV) measured at baseline and again, two years later, as this relationship is scarcely covered by the literature.......The current study analyzed the relationship between psychosocial work environment assessed by the Effort Reward Imbalance Model (ERI-model) and heart rate variability (HRV) measured at baseline and again, two years later, as this relationship is scarcely covered by the literature....

Africanizing the social determinants of health: embedded structural inequalities and current health outcomes in sub-Saharan Africa.

Science.gov (United States)

Ichoku, Hyacinth Eme; Mooney, Gavin; Ataguba, John Ele-Ojo

2013-01-01

There is a growing interest in health policy in the social determinants of health. This has increased the demand for a paradigm shift within the discipline of health economics from health care economics to health economics. While the former involves what is essentially a medical model that emphasizes the maximization of individual health outcomes and considers the social organization of the health system as merely instrumental, the latter emphasizes that health and its distribution result from political, social, economic, and cultural structures. The discipline of health economics needs to refocus its energy on the social determinants of health but, in doing so, must dig deeper into the reasons for structurally embedded inequalities that give rise to inequalities in health outcomes. Especially is this the case in Africa and other low- and middle-income regions. This article seeks to provide empirical evidence from sub-Saharan Africa, including Ghana and Nigeria, on why such inequalities exist, arguing that these are in large part a product of hangovers from historically entrenched institutions. It argues that there is a need for research in health economics to embrace the social determinants of health, especially inequality, and to move away from its current mono-cultural focus.

Understanding value in health data ecosystems: A review of current evidence and ways forward.

Science.gov (United States)

Sonja, Marjanovic; Ioana, Ghiga; Miaoqing, Yang; Anna, Knack

2018-01-01

The potential of health data to improve the efficiency and effectiveness of health research and development, healthcare delivery, and health systems more widely is substantial. There are many initiatives across the EU that are experimenting with ways to capture value and address the nexus of technical, legal, ethics-related, governance and data protection-related, and cultural challenges to delivering potential benefits for society and the economy. The field of health data research and policy is highly dynamic and there is a need for further reflection, thematic learning and evaluation to better understand how to create and connect receptive places, to inform future interventions and to identify transferable lessons. Our research emphasises that realising the benefits of health data at scale will require: a simultaneous focus on the technological and structural conditions that are required; collaboration and coordination to transform working cultures and build health and care workforce and citizen capacity to engage with data; and efforts to ensure that policy, industry, and research communities respond to public concerns, needs, and expectations in a timely and sustained manner. The global community of individuals and organisations with a stake in health data will also need to consider how progress can benefit different populations across the world in an equitable manner.

[Problems of work world and its impact on health. Current financial crisis].

Science.gov (United States)

Tomasina, Fernando

2012-06-01

Health and work are complex processes. Besides, they are multiple considering the forms they take. These two processes are linked to each other and they are influenced by each other. According to this, it is possible to establish that work world is extremely complex and heterogeneous. In this world, "old" or traditional risks coexist with "modern risks", derived from the new models of work organization and the incorporation of new technologies. Unemployment, work relationships precariousness and work risks outsourcing are results of neoliberal strategies. Some negative results of health-sickness process derived from transformation in work world and current global economic crisis have been noticed in current work conditions. Finally, the need for reconstructing policies focusing on this situation derived from work world is suggested.

The Affordable Care Act and Health Insurance Exchanges: Advocacy Efforts for Children's Oral Health.

Science.gov (United States)

Orynich, C Ashley; Casamassimo, Paul S; Seale, N Sue; Litch, C Scott; Reggiardo, Paul

2015-01-01

To evaluate legislative differences in defining the Affordable Care Act's (ACA) pediatric dental benefit and the role of pediatric advocates across states with different health insurance Exchanges. Data were collected through public record investigation and confidential health policy expert interviews conducted at the state and federal level. Oral health policy change by the pediatric dental profession requires advocating for the mandatory purchase of coverage through the Exchange, tax subsidy contribution toward pediatric dental benefits, and consistent regulatory insurance standards for financial solvency, network adequacy and provider reimbursement. The pediatric dental profession is uniquely positioned to lead change in oral health policy amidst health care reform through strengthening state-level formalized networks with organized dentistry and commercial insurance carriers.

Baby walkers--health visitors' current practice, attitudes and knowledge.

Science.gov (United States)

Kendrick, Denise; Illingworth, Rachel; Hapgood, Rhydian; Woods, Amanda J; Collier, Jacqueline

2003-09-01

Baby walkers are a commonly used item of nursery equipment. Between 12% and 50% of parents whose infant uses a walker report that their child has suffered a walker-related injury. Health visitors' knowledge, attitudes and practice with regard to walkers and related health education has not been explored so far. The aim of the study was to describe health visitors' knowledge of walkers and walker-related injuries, their attitudes towards walkers and current practice with regard to walker health education, and to examine the relationship between knowledge and attitudes and knowledge and practice. A survey was carried out with 64 health visitors prior to participation in a randomized controlled trial assessing the effectiveness of an educational package in reducing baby walker use. The response rate was 95%. Half of the health visitors always discussed walkers postnatally, most frequently at the 6-9 month check. Most did not usually discuss the frequency of walker-related injuries. Most had negative attitudes towards walkers, but believed that parents hold positive attitudes to them and that it is hard to persuade parents not to use them. Health visitors had a limited knowledge of walker use and walker-related injuries. Those giving advice on walkers most often had higher knowledge scores than those giving advice less often (P = 0.03). Those with higher knowledge scores held more negative attitudes towards walkers (rs = 0.29, P = 0.023) and believed parents to have more positive attitudes towards walkers (rs = -0.49, P negotiating alternatives to their use. The provision of audio-visual aids for discussing walkers might also be helpful.

Using Web 2.0 for health promotion and social marketing efforts: lessons learned from Web 2.0 experts.

Science.gov (United States)

Dooley, Jennifer Allyson; Jones, Sandra C; Iverson, Don

2014-01-01

Web 2.0 experts working in social marketing participated in qualitative in-depth interviews. The research aimed to document the current state of Web 2.0 practice. Perceived strengths (such as the viral nature of Web 2.0) and weaknesses (such as the time consuming effort it took to learn new Web 2.0 platforms) existed when using Web 2.0 platforms for campaigns. Lessons learned were identified--namely, suggestions for engaging in specific types of content creation strategies (such as plain language and transparent communication practices). Findings present originality and value to practitioners working in social marketing who want to effectively use Web 2.0.

Anticipated emotions and effort allocation in weight goal striving

NARCIS (Netherlands)

Nelissen, R.M.A.; de Vet, H.C.W.; Zeelenberg, M.

2011-01-01

Objective. This study aimed to investigate the influence of anticipated emotions on preventive health behaviour if specified at the level of behavioural outcomes. Consistent with predictions from a recently developed model of goal pursuit, we hypothesized that the impact of emotions on effort levels

The Thalassemia International Federation: a global public health paradigm

Directory of Open Access Journals (Sweden)

Elpidoforos S. Soteriades

2014-09-01

Full Text Available Many international organizations are struggling today to coordinate limited economic and human resources in support of governments’ efforts to advance public health around the world. The United Nations and the World Health Organization, along with others play a pivotal role in this global effort. Furthermore, during the past few decades an increasingly higher percentage of global efforts on public health are carried out by specific health initiatives, international projects and non-governmental patient-oriented organizations. The Thalassemia International Federation (TIF is one such organization focusing on the control of thalassemia around the world. The current paper aims at presenting a comprehensive overview of the mission, goals, objectives and activities of this organization. Our ultimate goal is to highlight TIF’s public health paradigm and diffuse its success at an international levels for others to follow. TIF is devoted to disseminating information, knowledge, experience and best practices around the world to empower patients with thalassemia and their relatives, support health professionals providing care to such patients and promote national and international policies, which secure equal access to quality care for all patients with thalassemia.

Gender relations and health research: a review of current practices

Directory of Open Access Journals (Sweden)

Bottorff Joan L

2011-12-01

Full Text Available Abstract Introduction The importance of gender in understanding health practices and illness experiences is increasingly recognized, and key to this work is a better understanding of the application of gender relations. The influence of masculinities and femininities, and the interplay within and between them manifests within relations and interactions among couples, family members and peers to influence health behaviours and outcomes. Methods To explore how conceptualizations of gender relations have been integrated in health research a scoping review of the existing literature was conducted. The key terms gender relations, gender interactions, relations gender, partner communication, femininities and masculinities were used to search online databases. Results Through analysis of this literature we identified two main ways gender relations were integrated in health research: a as emergent findings; and b as a basis for research design. In the latter, gender relations are included in conceptual frameworks, guide data collection and are used to direct data analysis. Conclusions Current uses of gender relations are typically positioned within intimate heterosexual couples whereby single narratives (i.e., either men or women are used to explore the influence and/or impact of intimate partner gender relations on health and illness issues. Recommendations for advancing gender relations and health research are discussed. This research has the potential to reduce gender inequities in health.

Integrated primary health care in Greece, a missing issue in the current health policy agenda: a systematic review

Directory of Open Access Journals (Sweden)

Christos Lionis

2009-07-01

Full Text Available Background: Over the past years, Greece has undergone several endeavors aimed at modernizing and improving national health care services with a focus on PHC. However, the extent to which integrated primary health care has been achieved is still questioned. Purpose: This paper explores the extent to which integrated primary health care (PHC is an issue in the current agenda of policy makers in Greece, reporting constraints and opportunities and highlighting the need for a policy perspective in developing integrated PHC in this Southern European country. Methods: A systematic review in PubMed/Medline and SCOPUS, along with a hand search in selected Greek biomedical journals was undertaken to identify key papers, reports, editorials or opinion letters relevant to integrated health care. Results: Our systematic review identified 198 papers and 161 out of them were derived from electronic search. Fifty-three papers in total served the scope of this review and are shortly reported. A key finding is that the long-standing dominance of medical perspectives in Greek health policy has been paving the way towards vertical integration, pushing aside any discussions about horizontal or comprehensive integration of care. Conclusion: Establishment of integrated PHC in Greece is still at its infancy, requiring major restructuring of the current national health system, as well as organizational culture changes. Moving towards a new policy-based model would bring this missing issue on the discussion table, facilitating further development.

[Capital accumulation patterns: capital and services in the current transformations of the health system].

Science.gov (United States)

de Andreazzi, Maria de Fátima Siliansky; Kornis, George Edward Machado

2008-01-01

The purpose of this article is to introduce elements of the capitalist society economic reproduction to the discussion around the current dynamics of health accumulation. It identifies the direction and significance of capital accumulation in the health area as well as the characteristics of the economic environment where the competition currently takes place. The hypothetic hypertrophy of the financial sphere is seen as a means for structuring the capitalist economy since the late twentieth century. The former delimitations between industrial production and service delivery are blurred and weakened; the competition process shows new features and the contradictions - internally between the different elements of the health industry and externally with other sectors - are changing. This article aggregates elements for a contemporary analysis of the "medical-industrial complex" on the basis of a theoretical-historical-conceptual approach. We identify changes in the capital dynamics of this complex at international and national level and stress the increasing role of the health services as a forefront of capital accumulation. The new approach is based on the economic thinking of Marx in addition to the current discussions about the theory of financial capital accumulation and the new productive configurations of the large corporations.

Current design efforts for the gas-cooled fast reactor (GFR)

International Nuclear Information System (INIS)

Weaver, K.D.

2005-01-01

Current research and development on the Gas-Cooled Fast Reactor (GCFR) has focused on the design of safety systems that will remove the decay heat during accident conditions, ion irradiations of candidate ceramic materials, joining studies of oxide dispersion strengthened alloys; and within the Advanced Fuel Cycle Initiative (AFC I) the fabrication of carbide fuels and ceramic fuel matrix materials, development of non-halide precursor low density and high density ceramic coatings, and neutron irradiation of candidate ceramic fuel matrix and metallic materials. The vast majority of this work has focused on the reference design for the GCFR: a helium-cooled, direct Brayton cycle power conversion system that will operate with an outlet temperature of 850 C at 7 MPa. In addition to the work being performed in the United States, seven international partners under the Generation IV International Forum (GIF) have identified their interest in participating in research related to the development of the GCFR. These are EURATOM (European Commission), France, Japan, South Africa, South Korea, Switzerland, and the United Kingdom. Of these, EURATOM (including the United Kingdom), France, Japan, and Switzerland have active research activities with respect to the GCFR. The research includes GCFR design and safety, and fuels/in-core materials/fuel cycle projects. This paper outlines the current design status of the GCFR, and includes work done in the areas mentioned above. (Author)

Current Technology Trends and Issues among Health and Physical Education Professionals

Science.gov (United States)

Krause, Jennifer M.; Franks, Hillary; Lynch, Brandy

2017-01-01

Health and physical education professionals who implement technology appropriately can contribute to helping students become physically educated individuals (NASPE, 2009). It is imperative that professionals be knowledgeable and resourceful in how to integrate technology effectively, but it is unclear what current challenges professionals face in…

Rethinking school-based health centers as complex adaptive systems: maximizing opportunities for the prevention of teen pregnancy and sexually transmitted infections.

Science.gov (United States)

Daley, Alison Moriarty

2012-01-01

This article examines school-based health centers (SBHCs) as complex adaptive systems, the current gaps that exist in contraceptive access, and the potential to maximize this community resource in teen pregnancy and sexually transmitted infection (STI) prevention efforts. Adolescent pregnancy is a major public health challenge for the United States. Existing community resources need to be considered for their potential to impact teen pregnancy and STI prevention efforts. SBHCs are one such community resource to be leveraged in these efforts. They offer adolescent-friendly primary care services and are responsive to the diverse needs of the adolescents utilizing them. However, current restrictions on contraceptive availability limit the ability of SBHCs to maximize opportunities for comprehensive reproductive care and create missed opportunities for pregnancy and STI prevention. A clinical case explores the current models of health care services related to contraceptive care provided in SBHCs and the ability to meet or miss the needs of an adolescent seeking reproductive care in a SBHC.

The importance of health advocacy in Canadian postgraduate medical education: current attitudes and issues

Directory of Open Access Journals (Sweden)

Alexander Poulton

2015-12-01

Full Text Available Background: Health advocacy is currently a key component of medical education in North America. In Canada, Health Advocate is one of the seven roles included in the Royal College of Physicians and Surgeons of Canada’s CanMEDS competency framework. Method: A literature search was undertaken to determine the current state of health advocacy in Canadian postgraduate medical education and to identify issues facing educators and learners with regards to health advocacy training. Results:  The literature revealed that the Health Advocate role is considered among the least relevant to clinical practice by educators and learners and among the most challenging to teach and assess. Furthermore learners feel their educational needs are not being met in this area. A number of key barriers affecting health advocacy education were identified including limited published material on the subject, lack of clarity within the role, insufficient explicit role modeling in practice, and lack of a gold standard for assessment. Health advocacy is defined and its importance to medical practice is highlighted, using pediatric emergency medicine as an example. Conclusions: Increased published literature and awareness of the role, along with integration of the new 2015 CanMEDS framework, are important going forward to address concerns regarding the quality of postgraduate health advocacy education in Canada.

The importance of health advocacy in Canadian postgraduate medical education: current attitudes and issues.

Science.gov (United States)

Poulton, Alexander; Rose, Heather

2015-01-01

Health advocacy is currently a key component of medical education in North America. In Canada, Health Advocate is one of the seven roles included in the Royal College of Physicians and Surgeons of Canada's CanMEDS competency framework. A literature search was undertaken to determine the current state of health advocacy in Canadian postgraduate medical education and to identify issues facing educators and learners with regards to health advocacy training. The literature revealed that the Health Advocate role is considered among the least relevant to clinical practice by educators and learners and among the most challenging to teach and assess. Furthermore learners feel their educational needs are not being met in this area. A number of key barriers affecting health advocacy education were identified including limited published material on the subject, lack of clarity within the role, insufficient explicit role modeling in practice, and lack of a gold standard for assessment. Health advocacy is defined and its importance to medical practice is highlighted, using pediatric emergency medicine as an example. Increased published literature and awareness of the role, along with integration of the new 2015 CanMEDS framework, are important going forward to address concerns regarding the quality of postgraduate health advocacy education in Canada.

California's "5 a day--for better health!" campaign: an innovative population-based effort to effect large-scale dietary change.

Science.gov (United States)

Foerster, S B; Kizer, K W; Disogra, L K; Bal, D G; Krieg, B F; Bunch, K L

1995-01-01

The annual toll of diet-related diseases in the United States is similar to that taken by tobacco, but less progress has been achieved in reaching the Public Health Service's Healthy People 2000 objectives for improving food consumption than for reducing tobacco use. In 1988, the California Department of Health Services embarked upon an innovative multi-year social marketing program to increase fruit and vegetable consumption. The 5 a Day--for Better Health! Campaign had several distinctive features, including its simple, positive, behavior-specific message to eat 5 servings of fruits and vegetables every day as part of a low-fat, high fiber diet; its use of mass media; its partnership between the state health department and the produce and supermarket industries; and its extensive use of point-of-purchase messages. Over its nearly three years of operation in California, the 5 a Day Campaign appears to have raised public awareness that fruits and vegetables help reduce cancer risk, increased fruit and vegetable consumption in major population segments, and created an ongoing partnership between public health and agribusiness that has allowed extension of the campaign to other population segments, namely children and Latino adults. In 1991 the campaign was adopted as a national initiative by the National Cancer Institute and the Produce for Better Health Foundation. By 1994, over 700 industry organizations and 48 states, territories, and the District of Columbia were licensed to participate. Preventive medicine practitioners and others involved in health promotion may build upon the 5 a Day Campaign experience in developing and implementing efforts to reach the nation's dietary goals.

Status and future of the forest health indicators program of the USA

Science.gov (United States)

Christopher William Woodall; Michael C. Amacher; William A. Bechtold; John W. Coulston; Sarah Jovan; Charles H. Perry; KaDonna C. Randolph; Beth K. Schulz; Gretchen C. Smith; Susan. Will-Wolf

2011-01-01

For two decades, the US Department of Agriculture, Forest Service, has been charged with implementing a nationwide field-based forest health monitoring effort. Given its extensive nature, the monitoring program has been gradually implemented across forest health indicators and inventoried states. Currently, the Forest Service's Forest Inventory and Analysis...

[Smart cards in health services].

Science.gov (United States)

Rienhoff, O

2001-10-01

Since the early 1980-ties it has been tried to utilise smart cards in health care. All industrialised countries participated in those efforts. The most sustainable analyses took place in Europe--specifically in the United Kingdom, France, and Germany. The first systems installed (the service access cards in F and G, the Health Professional Card in F) are already conceptionally outdated today. The senior understanding of the great importance of smart cards for security of electronic communication in health care does contrast to a hesitating behaviour of the key players in health care and health politics in Germany. There are clear hints that this may relate to the low informatics knowledge of current senior management.

Workdays, in-between workdays and the weekend: A diary study on effort and recovery

NARCIS (Netherlands)

Hooff, M.L.M.; Geurts, S.A.E.; Kompier, M.A.J.; Taris, T.W.

2007-01-01

Objectives: Effort-recovery theory (Meijman and Mulder in Handbook of work and organizational psychology, Psychology Press/Erlbaum, Hove, pp 5-33, 1998 proposes that effort expenditure may have adverse consequences for health in the absence of sufficient recovery opportunities. Thus, insight in the

Current practice and developmental efforts for leak detection in US reactor primary systems

International Nuclear Information System (INIS)

Kupperman, D.S.; Claytor, T.N.

1985-07-01

Current leak detection practices in 74 operating nuclear reactors have been reviewed. Existing leak detection systems are adequate to ensure a leak-before-break scenario in most situations, but no currently available, single method combines optimal leakage detection sensitivity, leak-locating ability, and leakage measurement accuracy. Simply tightening current leakage limits may produce an unacceptably large number of unnecessary shutdowns. The use of commercially available acoustic monitoring systems or moisture-sensitive tape may improve leak detection capability at specific sites. However, neither of these methods currently provides source discrimination (e.g., to distinguish between leaks from pipe cracks and valves) or leak-rate information (a small leak may saturate the system). A field-implementable acoustic leak detection system is being developed to address these limitations. 5 refs., 3 figs

CURRENT ENVIRONMENT FOR INTRODUCING HEALTH TECHNOLOGY ASSESSMENT IN GREECE.

Science.gov (United States)

Kani, Chara; Kourafalos, Vasilios; Litsa, Panagiota

2017-01-01

The aim of this study was to describe the current regulatory environment in Greece to evaluate the potential introduction of health technology assessment (HTA) for medicinal products for human use. Data sources consist of national legislation on pricing and reimbursement of health technologies to identify the potential need of establishing HTA and its relevant structure. The pricing procedure regarding medicinal products for human use is based on an external reference pricing mechanism which considers the average of the three lowest Euorpean Union prices. Currently, a formal HTA procedure has not been applied in Greece, and the only prerequisite used for the reimbursement of medicinal products for human use is their inclusion in the Positive Reimbursement List. To restrict pharmaceutical expenditure, a variety of measures-such as clawback mechanisms, rebates, monthly budget caps per physician, generics penetration targeting-have been imposed, aiming mainly to regulate the price level rather than control the introduction of medicinal products for human use in the Greek pharmaceutical market. Greece has the opportunity to rapidly build capacity, implement, and take advantage of the application of HTA mechanisms by clearly defining the goals, scope, systems, context, stakeholders, and methods that will be involved in the local HTA processes, taking into account the country's established e-prescription system and the recently adapted legislative framework.

Health Information System Role-Based Access Control Current Security Trends and Challenges.

Science.gov (United States)

de Carvalho Junior, Marcelo Antonio; Bandiera-Paiva, Paulo

2018-01-01

This article objective is to highlight implementation characteristics, concerns, or limitations over role-based access control (RBAC) use on health information system (HIS) using industry-focused literature review of current publishing for that purpose. Based on the findings, assessment for indication of RBAC is obsolete considering HIS authorization control needs. We have selected articles related to our investigation theme "RBAC trends and limitations" in 4 different sources related to health informatics or to the engineering technical field. To do so, we have applied the following search query string: "Role-Based Access Control" OR "RBAC" AND "Health information System" OR "EHR" AND "Trends" OR "Challenges" OR "Security" OR "Authorization" OR "Attacks" OR "Permission Assignment" OR "Permission Relation" OR "Permission Mapping" OR "Constraint". We followed PRISMA applicable flow and general methodology used on software engineering for systematic review. 20 articles were selected after applying inclusion and exclusion criteria resulting contributions from 10 different countries. 17 articles advocate RBAC adaptations. The main security trends and limitations mapped were related to emergency access, grant delegation, and interdomain access control. Several publishing proposed RBAC adaptations and enhancements in order to cope current HIS use characteristics. Most of the existent RBAC studies are not related to health informatics industry though. There is no clear indication of RBAC obsolescence for HIS use.

Reasons for current E-cigarette use among U.S. adults.

Science.gov (United States)

Patel, Deesha; Davis, Kevin C; Cox, Shanna; Bradfield, Brian; King, Brian A; Shafer, Paul; Caraballo, Ralph; Bunnell, Rebecca

2016-12-01

E-cigarette use has increased rapidly among U.S. adults. However, reasons for use among adults are unclear. We assessed reasons for e-cigarette use among a national sample of U.S. adults. Data were collected via online surveys among U.S. adults aged 18 or older from April through June 2014. Descriptive and multivariate regression analyses were conducted to assess reasons for e-cigarette use among 2448 current e-cigarette users, by sociodemographic characteristics and product type. Assessed reasons included cessation/health, consideration of others, convenience, cost, curiosity, flavoring, and simulation of conventional cigarettes. Among current e-cigarette users, 93% were also current cigarette smokers. The most common reasons for e-cigarette use were cessation/health (84.5%), consideration of others (71.5%), and convenience (56.7%). The prevalence of citing convenience (adjusted prevalence ratio [aPR]=1.49) and curiosity (aPR=1.54) as reasons for e-cigarette use were greater among current cigarette smokers than nonsmokers (Preason for use was greater among adults aged 18 to 24 (aPR=2.02) than 55 or older (Preason except convenience and curiosity. Cessation- and health-related factors are primary reasons cited for e-cigarette use among adults, and flavorings are more commonly cited by younger adults. Efforts are warranted to provide consumers with accurate information on the health effects of e-cigarettes and to ensure that flavoring and other unregulated features do not promote nicotine addiction, particularly among young adults. Published by Elsevier Inc.

Current pulse: can a production system reduce medical errors in health care?

Science.gov (United States)

Printezis, Antonios; Gopalakrishnan, Mohan

2007-01-01

One of the reasons for rising health care costs is medical errors, a majority of which result from faulty systems and processes. Health care in the past has used process-based initiatives such as Total Quality Management, Continuous Quality Improvement, and Six Sigma to reduce errors. These initiatives to redesign health care, reduce errors, and improve overall efficiency and customer satisfaction have had moderate success. Current trend is to apply the successful Toyota Production System (TPS) to health care since its organizing principles have led to tremendous improvement in productivity and quality for Toyota and other businesses that have adapted them. This article presents insights on the effectiveness of TPS principles in health care and the challenges that lie ahead in successfully integrating this approach with other quality initiatives.

The current state of Lean implementation in health care: literature review.

Science.gov (United States)

Poksinska, Bozena

2010-01-01

The purpose of this article is to discuss the current state of implementation of Lean production in health care. The study focuses on the definition of Lean in health care and implementation process, barriers, challenges, enablers, and outcomes of implementing Lean production methods in health care. A comprehensive search of the literature concerning the implementation of Lean production in health care was used to generate a synthesis of the literature around the chosen research questions. Lean production in health care is mostly used as a process improvement approach and focuses on 3 main areas: (1) defining value from the patient point of view, (2) mapping value streams, and (3) eliminating waste in an attempt to create continuous flow. Value stream mapping is the most frequently applied Lean tool in health care. The usual implementation steps include conducting Lean training, initiating pilot projects, and implementing improvements using interdisciplinary teams. One of the barriers is lack of educators and consultants who have their roots in the health care sector and can provide support by sharing experience and giving examples from real-life applications of Lean in health care. The enablers of Lean in health care seem not to be different from the enablers of any other change initiative. The outcomes can be divided into 2 broad areas: the performance of the health care system and the development of employees and work environment.

The association between alcohol exposure and self-reported health status: the effect of separating former and current drinkers.

Directory of Open Access Journals (Sweden)

Wenbin Liang

Full Text Available To investigate the direction and degree of potential bias introducedto analyses of drinking and health status which exclude former drinkers from exposure groups.Pooled analysis of 14 waves (1997-2010 of the U.S. National Health Interview Survey (NHIS.General population-based study.404,462 participants, from 14 waves of the NHIS, who had knownself-reported health status and alcohol consumption status.Self-reported health status was used as the indicatorof health. Two approaches were used to classify alcohol consumption: (i separation of former drinkers and current drinkers, and (ii combined former and current drinkers. The prevalence of fair/poor health by alcohol use, gender and age with 95% confidence intervals was estimated. The difference in prevalence of fair/poor health status for lifetime abstainers, former drinkers, current drinkers and drinkers (former drinkers and current drinkers combined were compared using Poisson regression with robust estimations of variance.Excluding former drinkers from drinker groups exaggerates the difference in health status between abstainers and drinkers, especially for males.In cohort study analyses, former drinkers should be assigned to a drinking category based on their previous alcohol consumption patterns and not treated as a discrete exposure group.

Current status of Crimean-Congo haemorrhagic fever in the World Health Organization Eastern Mediterranean Region: issues, challenges, and future directions.

Science.gov (United States)

Al-Abri, Seif S; Abaidani, Idris Al; Fazlalipour, Mehdi; Mostafavi, Ehsan; Leblebicioglu, Hakan; Pshenichnaya, Natalia; Memish, Ziad A; Hewson, Roger; Petersen, Eskild; Mala, Peter; Nhu Nguyen, Tran Minh; Rahman Malik, Mamunur; Formenty, Pierre; Jeffries, Rosanna

2017-05-01

Crimean-Congo haemorrhagic fever (CCHF) is the most widespread, tick-borne viral disease affecting humans. The disease is endemic in many regions, such as Africa, Asia, Eastern and Southern Europe, and Central Asia. Recently, the incidence of CCHF has increased rapidly in the countries of the World Health Organization Eastern Mediterranean Region (WHO EMR), with sporadic human cases and outbreaks of CCHF being reported from a number of countries in the region. Despite the rapidly growing incidence of the disease, there are currently no accurate data on the burden of the disease in the region due to the different surveillance systems used for CCHF in these countries. In an effort to increase our understanding of the epidemiology and risk factors for the transmission of the CCHF virus (CCHFV; a Nairovirus of the family Bunyaviridae) in the WHO EMR, and to identify the current knowledge gaps that are hindering effective control interventions, a sub-regional meeting was organized in Muscat, Oman, from December 7 to 9, 2015. This article summarizes the current knowledge of the disease in the region, identifies the knowledge gaps that present challenges for the prevention and control of CCHFV, and details a strategic framework for research and development activities that would be necessary to curb the ongoing and new threats posed by CCHFV. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

Current status of Crimean-Congo haemorrhagic fever in the World Health Organization Eastern Mediterranean Region: issues, challenges, and future directions

Directory of Open Access Journals (Sweden)

Seif S. Al-Abri

2017-05-01

Full Text Available Crimean-Congo haemorrhagic fever (CCHF is the most widespread, tick-borne viral disease affecting humans. The disease is endemic in many regions, such as Africa, Asia, Eastern and Southern Europe, and Central Asia. Recently, the incidence of CCHF has increased rapidly in the countries of the World Health Organization Eastern Mediterranean Region (WHO EMR, with sporadic human cases and outbreaks of CCHF being reported from a number of countries in the region. Despite the rapidly growing incidence of the disease, there are currently no accurate data on the burden of the disease in the region due to the different surveillance systems used for CCHF in these countries. In an effort to increase our understanding of the epidemiology and risk factors for the transmission of the CCHF virus (CCHFV; a Nairovirus of the family Bunyaviridae in the WHO EMR, and to identify the current knowledge gaps that are hindering effective control interventions, a sub-regional meeting was organized in Muscat, Oman, from December 7 to 9, 2015. This article summarizes the current knowledge of the disease in the region, identifies the knowledge gaps that present challenges for the prevention and control of CCHFV, and details a strategic framework for research and development activities that would be necessary to curb the ongoing and new threats posed by CCHFV.

Child and Adolescent Mental Health Care in Iran: Current Status and Future Directions.

Science.gov (United States)

Sharifi, Vandad; Mojtabai, Ramin; Shahrivar, Zahra; Alaghband-Rad, Javad; Zarafshan, Hadi; Wissow, Lawrence

2016-11-01

The need for mental health care among children and adolescents in Iran, as in other low and middle income countries (LAMIC) remains mostly unmet. In this paper, we sought to provide an overview of the extent of unmet need and mental health services in Iran. We also aimed to propose approaches to address this gap. We reviewed the published epidemiologic studies of child and adolescent mental and behavioral health problems in Iran. We also examined the current status of child mental health services and the gaps between current needs and available services based on published literature that included papers published in scientific journals, as well as governmental and other administrative reports. The contextual issues relevant to child mental health care were also explored, as well as the possibilities to introduce new or scale up promising services. Child and adolescent mental and behavioral health problems are highly prevalent in Iran. Different studies have estimated that 16.7% to 36.4% of children and adolescents suffer from one or more mental health problems. However, there is a serious scarcity of resources to meet this need. Available services are delivered by independent public organizations (e.g., Ministry of Health, Welfare Organization, and Ministry of Education) or private sector with inefficient communication and collaboration among them and no mandatory national mental health policy. Available specialized child and adolescent services are mostly confined to small inpatient units and university outpatient facilities in larger cities, and there is a scarce evidence for  the effectiveness of the available services. Expansion of primary care's role in timely detection and management of child and adolescent mental health problems, implementation of task-shifting and -sharing initiatives, as well as improved collaboration among responsible governmental and non-governmental sectors are some of the most promising future venues to improve mental health care for

Reducing hazardous cleaning product use: a collaborative effort.

Science.gov (United States)

Pechter, Elise; Azaroff, Lenore S; López, Isabel; Goldstein-Gelb, Marcy

2009-01-01

Workplace hazards affecting vulnerable populations of low-wage and immigrant workers present a special challenge to the practice of occupational health. Unions, Coalition for Occupational Safety and Health (COSH) groups, and other organizations have developed worker-led approaches to promoting safety. Public health practitioners can provide support for these efforts. This article describes a successful multiyear project led by immigrant cleaning workers with their union, the Service Employees International Union (SEIU) Local 615, and with support from the Massachusetts COSH (MassCOSH) to address exposure to hazardous chemicals. After the union had identified key issues and built a strategy, the union and MassCOSH invited staff from the Massachusetts Department of Public Health's Occupational Health Surveillance Program (OHSP) to provide technical information about health effects and preventive measures. Results included eliminating the most hazardous chemicals, reducing the number of products used, banning mixing products, and improving safety training. OHSP's history of public health practice regarding cleaning products enabled staff to respond promptly. MassCOSH's staff expertise and commitment to immigrant workers allowed it to play a vital role.

Advancing organizational health literacy in health care organizations serving high-needs populations: a case study.

Science.gov (United States)

Weaver, Nancy L; Wray, Ricardo J; Zellin, Stacie; Gautam, Kanak; Jupka, Keri

2012-01-01

Health care organizations, well positioned to address health literacy, are beginning to shift their systems and policies to support health literacy efforts. Organizations can identify barriers, emphasize and leverage their strengths, and initiate activities that promote health literacy-related practices. The current project employed an open-ended approach to conduct a needs assessment of rural federally qualified health center clinics. Using customized assessment tools, the collaborators were then able to determine priorities for changing organizational structures and policies in order to support continued health literacy efforts. Six domains of organizational health literacy were measured with three methods: environmental assessments, patient interviews, and key informant interviews with staff and providers. Subsequent strategic planning was conducted by collaborators from the academic and clinic teams and resulted in a focused, context-appropriate action plan. The needs assessment revealed several gaps in organizational health literacy practices, such as low awareness of health literacy within the organization and variation in perceived values of protocols, interstaff communication, and patient communication. Facilitators included high employee morale and patient satisfaction. The resulting targeted action plan considered the organization's culture as revealed in the interviews, informing a collaborative process well suited to improving organizational structures and systems to support health literacy best practices. The customized needs assessment contributed to an ongoing collaborative process to implement organizational changes that aided in addressing health literacy needs.

Job stress and mental health of permanent and fixed-term workers measured by effort-reward imbalance model, depressive complaints, and clinic utilization.

Science.gov (United States)

Inoue, Mariko; Tsurugano, Shinobu; Yano, Eiji

2011-01-01

The number of workers with precarious employment has increased globally; however, few studies have used validated measures to investigate the relationship of job status to stress and mental health. Thus, we conducted a study to compare differential job stress experienced by permanent and fixed-term workers using an effort-reward imbalance (ERI) model questionnaire, and by evaluating depressive complaints and clinic utilization. Subjects were permanent or fixed-term male workers at a Japanese research institute (n=756). Baseline data on job stress and depressive complaints were collected in 2007. We followed up with the same population over a 1-year period to assess their utilization of the company clinic for mental health concerns. The ERI ratio was higher among permanent workers than among fixed-term workers. More permanent workers presented with more than two depressive complaints, which is the standard used for the diagnosis of depression. ERI scores indicated that the effort component of permanent work was associated with distress, whereas distress in fixed-term work was related to job promotion and job insecurity. Moreover, over the one-year follow-up period, fixed-term workers visited the on-site clinic for mental concerns 4.04 times more often than permanent workers even after adjusting for age, lifestyle, ERI, and depressive complaints. These contrasting findings reflect the differential workloads and working conditions encountered by permanent and fixed-term workers. The occupational setting where employment status was intermingled, may have contributed to the high numbers of mental health-related issues experienced by workers with different employment status.

The RBANS Effort Index: base rates in geriatric samples.

Science.gov (United States)

Duff, Kevin; Spering, Cynthia C; O'Bryant, Sid E; Beglinger, Leigh J; Moser, David J; Bayless, John D; Culp, Kennith R; Mold, James W; Adams, Russell L; Scott, James G

2011-01-01

The Effort Index (EI) of the RBANS was developed to assist clinicians in discriminating patients who demonstrate good effort from those with poor effort. However, there are concerns that older adults might be unfairly penalized by this index, which uses uncorrected raw scores. Using five independent samples of geriatric patients with a broad range of cognitive functioning (e.g., cognitively intact, nursing home residents, probable Alzheimer's disease), base rates of failure on the EI were calculated. In cognitively intact and mildly impaired samples, few older individuals were classified as demonstrating poor effort (e.g., 3% in cognitively intact). However, in the more severely impaired geriatric patients, over one third had EI scores that fell above suggested cutoff scores (e.g., 37% in nursing home residents, 33% in probable Alzheimer's disease). In the cognitively intact sample, older and less educated patients were more likely to have scores suggestive of poor effort. Education effects were observed in three of the four clinical samples. Overall cognitive functioning was significantly correlated with EI scores, with poorer cognition being associated with greater suspicion of low effort. The current results suggest that age, education, and level of cognitive functioning should be taken into consideration when interpreting EI results and that significant caution is warranted when examining EI scores in elders suspected of having dementia.

HIPAA, HIPAA, Hooray?: Current Challenges and Initiatives in Health Informatics in the United States.

Science.gov (United States)

Joshi, Sanjaya

2008-01-01

A review of the current challenges, trends and initiatives around the various regulations as related to Health Informatics in the United States is presented. A summary of the functions in a workflow-based approach organized into the process and compliance for HIPAA, secure email and fax communications interfaces, e-prescriptions and patient safety and the health information technology savings claims versus costs follows: HIPAA compliance is complex; data interoperability and integration remains difficult.Email and faxing is possible with current over-the-shelf technologies within the purview of the HIPAA Security and Privacy rule.Integration of e-prescribing and NPI data is an area where health informatics can make a real difference.Medical errors remain high.There are no real savings yet from the usage of health information technologies; the costs for implementation remain high, and the business model has not evolved to meet the needs.Health Information Technology (Health IT) projects continue to have a significant failure rate; Open Source technologies are a viable alternative both for cost reduction and scalability. A discussion on the macro view of health informatics is also presented within the context of healthcare models and a comparison of the U.S. system against other countries.

HIPAA, HIPAA, Hooray? Current Challenges and Initiatives in Health Informatics in the United States

Directory of Open Access Journals (Sweden)

Sanjaya Joshi

2008-01-01

Full Text Available A review of the current challenges, trends and initiatives around the various regulations as related to Health Informatics in the United States is presented.A summary of the functions in a workflow-based approach organized into the process and compliance for HIPAA, secure email and fax communications interfaces, e-prescriptions and patient safety and the health information technology savings claims versus costs follows: * HIPAA compliance is complex; data interoperability and integration remains difficult. * Email and faxing is possible with current over-the-shelf technologies within the purview of the HIPAA Security and Privacy rule. * Integration of e-prescribing and NPI data is an area where health informatics can make a real difference. * Medical errors remain high. * There are no real savings yet from the usage of health information technologies; the costs for implementation remain high, and the business model has not evolved to meet the needs. * Health Information Technology (Health IT projects continue to have a significant failure rate; Open Source technologies are a viable alternative both for cost reduction and scalability.A discussion on the macro view of health informatics is also presented within the context of healthcare models and a comparison of the U.S. system against other countries.

The organizational work factors' effect on mental health among hospital workers is mediated by perceived effort-reward imbalance: result of a longitudinal study.

Science.gov (United States)

Lamy, Sébastien; De Gaudemaris, Régis; Lepage, Benoit; Sobaszek, Annie; Caroly, Sandrine; Kelly-Irving, Michelle; Lang, Thierry

2013-07-01

This longitudinal study aimed to test the hypothesis that organizational work factors (OWFs) may be related to depressive symptoms through an increased effort-reward imbalance (ERI) ratio among registered nurses (RNs) and nursing assistants working in hospitals. We studied 2117 female RNs and nursing assistants who stayed in the same work unit and position during the follow-up from the ORSOSA (ORganisation des SOins-SAnté) longitudinal study. The work characteristics and workers' health were assessed in 2006 and 2008. We confirmed our hypothesis of both direct and mediated effects of OWFs on workers' health. We showed that issues about patient-related information exchanges increased RNs' depressive disorders by increasing first a perceived ERI. Our results advocate integrating both the work organizational level and the individual level into preventive actions to improve workers' mental health.

Using human rights to improve maternal and neonatal health: history, connections and a proposed practical approach.

Science.gov (United States)

Gruskin, Sofia; Cottingham, Jane; Hilber, Adriane Martin; Kismodi, Eszter; Lincetto, Ornella; Roseman, Mindy Jane

2008-08-01

We describe the historical development of how maternal and neonatal mortality in the developing world came to be seen as a public-health concern, a human rights concern, and ultimately as both, leading to the development of approaches using human rights concepts and methods to advance maternal and neonatal health. We describe the different contributions of the international community, women's health advocates and human rights activists. We briefly present a recent effort, developed by WHO with the Harvard Program on International Health and Human Rights, that applies a human rights framework to reinforce current efforts to reduce maternal and neonatal mortality.

HEALTH OF ENVIRONMENT AND HEALTH OF ECONOMY

Directory of Open Access Journals (Sweden)

Cîrnu Doru

2013-12-01

Full Text Available The central idea of this paper is that meeting human needs and achieving material and social well-being can not be reduced by simple accumulation of goods and money with the price of compromising the possibilities of future generations to meet their own needs. This requires profound changes in current mentality that will lead to replacing immediate economic interests with healthy economic interest which involves submission of a determined effort on heritage protection and conservation of future generations to save both human health and existence of planet itself.

Perspective: Improving nutritional guidelines for sustainable health policies: Current status and perspectives

DEFF Research Database (Denmark)

Magni, Paolo; Bier, Dennis M; Pecorelli, Sergio

2017-01-01

a constructive coalition among scientists, policy makers, and communication professionals for sustainable health and nutritional policies. Currently, a strong rationale and available data support a personalized dietary approach according to personal variables, including sex and age, circulating metabolic...

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

Science.gov (United States)

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

2017-11-01

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

Regular-fat dairy and human health

DEFF Research Database (Denmark)

Astrup, Arne; Bradley, Beth H Rice; Brenna, J Thomas

2016-01-01

In recent history, some dietary recommendations have treated dairy fat as an unnecessary source of calories and saturated fat in the human diet. These assumptions, however, have recently been brought into question by current research on regular fat dairy products and human health. In an effort to......, cheese and yogurt, can be important components of an overall healthy dietary pattern. Systematic examination of the effects of dietary patterns that include regular-fat milk, cheese and yogurt on human health is warranted....

Self-regulating the effortful "social dos".

Science.gov (United States)

Cortes, Kassandra; Kammrath, Lara K; Scholer, Abigail A; Peetz, Johanna

2014-03-01

In the current research, we explored differences in the self-regulation of the personal dos (i.e., engaging in active and effortful behaviors that benefit the self) and in the self-regulation of the social dos (engaging in those same effortful behaviors to benefit someone else). In 6 studies, we examined whether the same trait self-control abilities that predict task persistence on personal dos would also predict task persistence on social dos. That is, would the same behavior, such as persisting through a tedious and attentionally demanding task, show different associations with trait self-control when it is framed as benefitting the self versus someone else? In Studies 1-3, we directly compared the personal and social dos and found that trait self-control predicted self-reported and behavioral personal dos but not social dos, even when the behaviors were identical and when the incentives were matched. Instead, trait agreeableness--a trait linked to successful self-regulation within the social domain--predicted the social dos. Trait self-control did not predict the social dos even when task difficulty increased (Study 4), but it did predict the social don'ts, consistent with past research (Studies 5-6). The current studies provide support for the importance of distinguishing different domains of self-regulated behaviors and suggest that social dos can be successfully performed through routes other than traditional self-control abilities. (PsycINFO Database Record (c) 2014 APA, all rights reserved).

Effort sharing in ambitious, global climate change mitigation scenarios

International Nuclear Information System (INIS)

Ekholm, Tommi; Soimakallio, Sampo; Moltmann, Sara; Hoehne, Niklas; Syri, Sanna; Savolainen, Ilkka

2010-01-01

The post-2012 climate policy framework needs a global commitment to deep greenhouse gas emission cuts. This paper analyzes reaching ambitious emission targets up to 2050, either -10% or -50% from 1990 levels, and how the economic burden from mitigation efforts could be equitably shared between countries. The scenarios indicate a large low-cost mitigation potential in electricity and industry, while reaching low emission levels in international transportation and agricultural emissions might prove difficult. The two effort sharing approaches, Triptych and Multistage, were compared in terms of equitability and coherence. Both approaches produced an equitable cost distribution between countries, with least developed countries having negative or low costs and more developed countries having higher costs. There is, however, no definitive solution on how the costs should be balanced equitably between countries. Triptych seems to be yet more coherent than other approaches, as it can better accommodate national circumstances. Last, challenges and possible hindrances to effective mitigation and equitable effort sharing are presented. The findings underline the significance of assumptions behind effort sharing on mitigation potentials and current emissions, the challenge of sharing the effort with uncertain future allowance prices and how inefficient markets might undermine the efficiency of a cap-and-trade system.

Effort sharing in ambitious, global climate change mitigation scenarios

Energy Technology Data Exchange (ETDEWEB)

Ekholm, Tommi [TKK Helsinki University of Technology, Espoo (Finland); Soimakallio, Sampo; Syri, Sanna; Savolainen, Ilkka [VTT Technical Research Centre of Finland, P.O. Box 1000, FIN-02044 VTT (Finland); Moltmann, Sara; Hoehne, Niklas [Ecofys Germany GmbH, Cologne (Germany)

2010-04-15

The post-2012 climate policy framework needs a global commitment to deep greenhouse gas emission cuts. This paper analyzes reaching ambitious emission targets up to 2050, either or from 1990 levels, and how the economic burden from mitigation efforts could be equitably shared between countries. The scenarios indicate a large low-cost mitigation potential in electricity and industry, while reaching low emission levels in international transportation and agricultural emissions might prove difficult. The two effort sharing approaches, Triptych and Multistage, were compared in terms of equitability and coherence. Both approaches produced an equitable cost distribution between countries, with least developed countries having negative or low costs and more developed countries having higher costs. There is, however, no definitive solution on how the costs should be balanced equitably between countries. Triptych seems to be yet more coherent than other approaches, as it can better accommodate national circumstances. Last, challenges and possible hindrances to effective mitigation and equitable effort sharing are presented. The findings underline the significance of assumptions behind effort sharing on mitigation potentials and current emissions, the challenge of sharing the effort with uncertain future allowance prices and how inefficient markets might undermine the efficiency of a cap-and-trade system. (author)

Environmental and occupational exposures in immigrant health.

Science.gov (United States)

Eamranond, Pracha P; Hu, Howard

2008-09-23

Immigrants comprise vulnerable populations that are frequently exposed to a multitude of environmental and occupational hazards. The historical context behind state and federal legislation has helped to foster an environment that is particularly hostile toward caring for immigrant health. Current hazards include toxic exposures, air and noise pollution, motor vehicle accidents, crowded living and work environments with inadequate ventilation, poor sanitation, mechanical injury, among many others. Immigrants lack the appropriate training, materials, health care access, and other resources to reduce their exposure to preventable environmental and occupational health risks. This dilemma is exacerbated by current anti-immigrant sentiments, miscommunication between native and immigrant populations, and legislation denying immigrants access to publicly funded medical care. Given that current health policy has failed to address immigrant health appropriately and political impetus is lacking, efforts should also focus on alternative solutions, including organized labor. Labor unions that serve to educate workers, survey work environments, and defend worker rights will greatly alleviate and prevent the burden of disease incurred by immigrants. The nation's health will benefit from improved regulation of living and workplace environments to improve the health of immigrants, regardless of legal status.

Environmental and Occupational Exposures in Immigrant Health

Directory of Open Access Journals (Sweden)

Pracha P. Eamranond

2008-01-01

Full Text Available Immigrants comprise vulnerable populations that are frequently exposed to a multitude of environmental and occupational hazards. The historical context behind state and federal legislation has helped to foster an environment that is particularly hostile toward caring for immigrant health. Current hazards include toxic exposures, air and noise pollution, motor vehicle accidents, crowded living and work environments with inadequate ventilation, poor sanitation, mechanical injury, among many others. Immigrants lack the appropriate training, materials, health care access, and other resources to reduce their exposure to preventable environmental and occupational health risks. This dilemma is exacerbated by current anti-immigrant sentiments, miscommunication between native and immigrant populations, and legislation denying immigrants access to publicly funded medical care. Given that current health policy has failed to address immigrant health appropriately and political impetus is lacking, efforts should also focus on alternative solutions, including organized labor. Labor unions that serve to educate workers, survey work environments, and defend worker rights will greatly alleviate and prevent the burden of disease incurred by immigrants. The nation’s health will benefit from improved regulation of living and workplace environments to improve the health of immigrants, regardless of legal status.

Using posts to an online social network to assess fishing effort

Science.gov (United States)

Martin, Dustin R.; Chizinski, Christopher J.; Eskridge, Kent M.; Pope, Kevin L

2014-01-01

Fisheries management has evolved from reservoir to watershed management, creating a need to simultaneously gather information within and across interacting reservoirs. However, costs to gather information on the fishing effort on multiple reservoirs using traditional creel methodology are often prohibitive. Angler posts about reservoirs online provide a unique medium to test hypotheses on the distribution of fishing pressure. We show that the activity on an online fishing social network is related to fishing effort and can be used to facilitate management goals. We searched the Nebraska Fish and Game Association Fishing Forum for all references from April 2009 to December 2010 to 19 reservoirs that comprise the Salt Valley regional fishery in southeastern Nebraska. The number of posts was positively related to monthly fishing effort on a regional scale, with individual reservoirs having the most annual posts also having the most annual fishing effort. Furthermore, this relationship held temporally. Online fishing social networks provide the potential to assess effort on larger spatial scales than currently feasible.

Smart wearable systems: current status and future challenges.

Science.gov (United States)

Chan, Marie; Estève, Daniel; Fourniols, Jean-Yves; Escriba, Christophe; Campo, Eric

2012-11-01

Extensive efforts have been made in both academia and industry in the research and development of smart wearable systems (SWS) for health monitoring (HM). Primarily influenced by skyrocketing healthcare costs and supported by recent technological advances in micro- and nanotechnologies, miniaturisation of sensors, and smart fabrics, the continuous advances in SWS will progressively change the landscape of healthcare by allowing individual management and continuous monitoring of a patient's health status. Consisting of various components and devices, ranging from sensors and actuators to multimedia devices, these systems support complex healthcare applications and enable low-cost wearable, non-invasive alternatives for continuous 24-h monitoring of health, activity, mobility, and mental status, both indoors and outdoors. Our objective has been to examine the current research in wearable to serve as references for researchers and provide perspectives for future research. Herein, we review the current research and development of and the challenges facing SWS for HM, focusing on multi-parameter physiological sensor systems and activity and mobility measurement system designs that reliably measure mobility or vital signs and integrate real-time decision support processing for disease prevention, symptom detection, and diagnosis. For this literature review, we have chosen specific selection criteria to include papers in which wearable systems or devices are covered. We describe the state of the art in SWS and provide a survey of recent implementations of wearable health-care systems. We describe current issues, challenges, and prospects of SWS. We conclude by identifying the future challenges facing SWS for HM. Copyright © 2012 Elsevier B.V. All rights reserved.

Realizing universal health coverage for maternal health services in the Republic of Guinea: the use of workforce projections to design health labor market interventions

Directory of Open Access Journals (Sweden)

Jansen C

2014-11-01

Full Text Available Christel Jansen,1 Laurence Codjia,2 Giorgio Cometto,3 Mohamed Lamine Yansané,4 Marjolein Dieleman1 1Health Unit, Royal Tropical Institute, Amsterdam, the Netherlands; 2Health Workforce, World Health Organization, Geneva, Switzerland; 3Global Health Workforce Alliance, World Health Organization, Geneva, Switzerland; 4Health Focus GmbH, Conakry, Guinea Background: Universal health coverage requires a health workforce that is available, accessible, and well-performing. This article presents a critical analysis of the health workforce needs for the delivery of maternal and neonatal health services in Guinea, and of feasible and relevant interventions to improve the availability, accessibility, and performance of the health workforce in the country. Methods: A needs-based approach was used to project human resources for health (HRH requirements. This was combined with modeling of future health sector demand and supply. A baseline scenario with disaggregated need and supply data for the targeted health professionals per region and setting (urban or rural informed the identification of challenges related to the availability and distribution of the workforce between 2014 and 2024. Subsequently, the health labor market framework was used to identify interventions to improve the availability and distribution of the health workforce. These interventions were included in the supply side modeling, in order to create a “policy rich” scenario B which allowed for analysis of their potential impact. Results: In the Republic of Guinea, only 44% of the nurses and 18% of the midwives required for maternal and neonatal health services are currently available. If Guinea continues on its current path without scaling up recruitment efforts, the total stock of HRH employed by the public sector will decline by 15% between 2014 and 2024, while HRH needs will grow by 22% due to demographic trends. The high density of HRH in urban areas and the high number of auxiliary

Pediatric multiple sclerosis: current perspectives on health behaviors

Directory of Open Access Journals (Sweden)

Sikes EM

2018-03-01

. Discussion: Participation in health behaviors, particularly physical activity, diet, and sleep, may have benefits for POMS. Nevertheless, there are currently no interventions targeting promotion of these behaviors and examining the benefits of managing the primary and secondary manifestations of POMS. Keywords: POMS, health promotion, physical activity, diet, sleep

Comparison of cardiovascular response to combined static-dynamic effort, postprandial dynamic effort and dynamic effort alone in patients with chronic ischemic heart disease

International Nuclear Information System (INIS)

Hung, J.; McKillip, J.; Savin, W.; Magder, S.; Kraus, R.; Houston, N.; Goris, M.; Haskell, W.; DeBusk, R.

1982-01-01

The cardiovascular responses to combined static-dynamic effort, postprandial dynamic effort and dynamic effort alone were evaluated by upright bicycle ergometry during equilibrium-gated blood pool scintigraphy in 24 men, mean age 59 +/- 8 years, with chronic ischemic heart disease. Combined static-dynamic effort and the postprandial state elicited a peak cardiovascular response similar to that of dynamic effort alone. Heart rate, intraarterial systolic and diastolic pressures, rate-pressure product and ejection fraction were similar for the three test conditions at the onset of ischemia and at peak effort. The prevalence and extent of exercise-induced ischemic left ventricular dysfunction, ST-segment depression, angina pectoris and ventricular ectopic activity were also similar during the three test conditions. Direct and indirect measurements of systolic and diastolic blood pressure were highly correlated. The onset of ischemic ST-segment depression and angina pectoris correlated as strongly with heart rate alone as with the rate-pressure product during all three test conditions. The cardiovascular response to combined static-dynamic effort and to postprandial dynamic effort becomes more similar to that of dynamic effort alone as dynamic effort reaches a symptom limit. If significant ischemic and arrhythmic abnormalities are absent during symptom-limited dynamic exercise testing, they are unlikely to appear during combined static-dynamic or postprandial dynamic effort

Integrating qualitative research methods into care improvement efforts within a learning health system: addressing antibiotic overuse.

Science.gov (United States)

Munoz-Plaza, Corrine E; Parry, Carla; Hahn, Erin E; Tang, Tania; Nguyen, Huong Q; Gould, Michael K; Kanter, Michael H; Sharp, Adam L

2016-08-15

Despite reports advocating for integration of research into healthcare delivery, scant literature exists describing how this can be accomplished. Examples highlighting application of qualitative research methods embedded into a healthcare system are particularly needed. This article describes the process and value of embedding qualitative research as the second phase of an explanatory, sequential, mixed methods study to improve antibiotic stewardship for acute sinusitis. Purposive sampling of providers for in-depth interviews improved understanding of unwarranted antibiotic prescribing and elicited stakeholder recommendations for improvement. Qualitative data collection, transcription and constant comparative analyses occurred iteratively. Emerging themes and sub-themes identified primary drivers of unwarranted antibiotic prescribing patterns and recommendations for improving practice. These findings informed the design of a health system intervention to improve antibiotic stewardship for acute sinusitis. Core components of the intervention are also described. Qualitative research can be effectively applied in learning healthcare systems to elucidate quantitative results and inform improvement efforts.

Herbal extracts in oral health care - A review of the current scenario and its future needs.

Science.gov (United States)

Chandra Shekar, Byalakere Rudraiah; Nagarajappa, Ramesh; Suma, Shankarappa; Thakur, Rupesh

2015-01-01

Oral diseases are among the major public health problems and the commonest of chronic diseases that affect mankind. The application of natural products for the control of oral diseases is considered as an interesting alternative to synthetic antimicrobials due to their lower negative impact, and for the effort to overcome primary or secondary resistance to the drug during therapy. To review the current evidence on the antimicrobial efficacy of 10 plant extracts on dental caries and plaque microorganisms. A comprehensive literature search was made by one of the authors for 2 months in PubMed, PubMed Central, MEDLINE, LILACS/BBO, Cochrane database of systematic reviews, SCIENCE DIRECT, and Google scholar databases. The results from the relevant published literatures are discussed. The extracts of Azadirachta Indica, Ocimum sanctum, Murraya koenigii L., Acacia nilotica, Eucalyptus camaldulensis, Hibiscus sabdariffa, Mangifera indica, Psidium guajava, Rosa indica, and Aloe barbadensis Miller have all been found to inhibit certain dental caries and periodontal pathogens. The current evidence is on individual plant extracts against bacteria involved in either caries or periodontitis. "Herbal shotgun" or "synergistic multitarget effects" are the terms used for the strategy of combining different extracts. The research assessing the antimicrobial efficacy of a combination of these plant extracts against dental caries and periodontal pathogens is the need of the hour, and such research will aid in the development of a novel, innovative method that can simultaneously inhibit two of the most common dental diseases of mankind, besides slowing the development of drug resistance.

Herbal extracts in oral health care - A review of the current scenario and its future needs

Science.gov (United States)

Chandra Shekar, Byalakere Rudraiah; Nagarajappa, Ramesh; Suma, Shankarappa; Thakur, Rupesh

2015-01-01

Background: Oral diseases are among the major public health problems and the commonest of chronic diseases that affect mankind. The application of natural products for the control of oral diseases is considered as an interesting alternative to synthetic antimicrobials due to their lower negative impact, and for the effort to overcome primary or secondary resistance to the drug during therapy. Objective: To review the current evidence on the antimicrobial efficacy of 10 plant extracts on dental caries and plaque microorganisms. Materials and Methods: A comprehensive literature search was made by one of the authors for 2 months in PubMed, PubMed Central, MEDLINE, LILACS/BBO, Cochrane database of systematic reviews, SCIENCE DIRECT, and Google scholar databases. The results from the relevant published literatures are discussed. Summary and Conclusion: The extracts of Azadirachta Indica, Ocimum sanctum, Murraya koenigii L., Acacia nilotica, Eucalyptus camaldulensis, Hibiscus sabdariffa, Mangifera indica, Psidium guajava, Rosa indica, and Aloe barbadensis Miller have all been found to inhibit certain dental caries and periodontal pathogens. The current evidence is on individual plant extracts against bacteria involved in either caries or periodontitis. “Herbal shotgun” or “synergistic multitarget effects” are the terms used for the strategy of combining different extracts. The research assessing the antimicrobial efficacy of a combination of these plant extracts against dental caries and periodontal pathogens is the need of the hour, and such research will aid in the development of a novel, innovative method that can simultaneously inhibit two of the most common dental diseases of mankind, besides slowing the development of drug resistance. PMID:26392704

Effort in Multitasking: Local and Global Assessment of Effort.

Science.gov (United States)

Kiesel, Andrea; Dignath, David

2017-01-01

When performing multiple tasks in succession, self-organization of task order might be superior compared to external-controlled task schedules, because self-organization allows optimizing processing modes and thus reduces switch costs, and it increases commitment to task goals. However, self-organization is an additional executive control process that is not required if task order is externally specified and as such it is considered as time-consuming and effortful. To compare self-organized and externally controlled task scheduling, we suggest assessing global subjective and objectives measures of effort in addition to local performance measures. In our new experimental approach, we combined characteristics of dual tasking settings and task switching settings and compared local and global measures of effort in a condition with free choice of task sequence and a condition with cued task sequence. In a multi-tasking environment, participants chose the task order while the task requirement of the not-yet-performed task remained the same. This task preview allowed participants to work on the previously non-chosen items in parallel and resulted in faster responses and fewer errors in task switch trials than in task repetition trials. The free-choice group profited more from this task preview than the cued group when considering local performance measures. Nevertheless, the free-choice group invested more effort than the cued group when considering global measures. Thus, self-organization in task scheduling seems to be effortful even in conditions in which it is beneficiary for task processing. In a second experiment, we reduced the possibility of task preview for the not-yet-performed tasks in order to hinder efficient self-organization. Here neither local nor global measures revealed substantial differences between the free-choice and a cued task sequence condition. Based on the results of both experiments, we suggest that global assessment of effort in addition to

Peruvian Mental Health Reform: A Framework for Scaling-up Mental Health Services

Science.gov (United States)

Toyama, Mauricio; Castillo, Humberto; Galea, Jerome T.; Brandt, Lena R.; Mendoza, María; Herrera, Vanessa; Mitrani, Martha; Cutipé, Yuri; Cavero, Victoria; Diez-Canseco, Francisco; Miranda, J. Jaime

2017-01-01

Background: Mental, neurological, and substance (MNS) use disorders are a leading cause of disability worldwide; specifically in Peru, MNS affect 1 in 5 persons. However, the great majority of people suffering from these disorders do not access care, thereby making necessary the improvement of existing conditions including a major rearranging of current health system structures beyond care delivery strategies. This paper reviews and examines recent developments in mental health policies in Peru, presenting an overview of the initiatives currently being introduced and the main implementation challenges they face. Methods: Key documents issued by Peruvian governmental entities regarding mental health were reviewed to identify and describe the path that led to the beginning of the reform; how the ongoing reform is taking place; and, the plan and scope for scale-up. Results: Since 2004, mental health has gained importance in policies and regulations, resulting in the promotion of a mental health reform within the national healthcare system. These efforts crystallized in 2012 with the passing of Law 29889 which introduced several changes to the delivery of mental healthcare, including a restructuring of mental health service delivery to occur at the primary and secondary care levels and the introduction of supporting services to aid in patient recovery and reintegration into society. In addition, a performance-based budget was approved to guarantee the implementation of these changes. Some of the main challenges faced by this reform are related to the diversity of the implementation settings, eg, isolated rural areas, and the limitations of the existing specialized mental health institutes to substantially grow in parallel to the scaling-up efforts in order to be able to provide training and clinical support to every region of Peru. Conclusion: Although the true success of the mental healthcare reform will be determined in the coming years, thus far, Peru has achieved a

Peruvian Mental Health Reform: A Framework for Scaling-up Mental Health Services

Directory of Open Access Journals (Sweden)

Mauricio Toyama

2017-09-01

Full Text Available Background Mental, neurological, and substance (MNS use disorders are a leading cause of disability worldwide; specifically in Peru, MNS affect 1 in 5 persons. However, the great majority of people suffering from these disorders do not access care, thereby making necessary the improvement of existing conditions including a major rearranging of current health system structures beyond care delivery strategies. This paper reviews and examines recent developments in mental health policies in Peru, presenting an overview of the initiatives currently being introduced and the main implementation challenges they face. Methods Key documents issued by Peruvian governmental entities regarding mental health were reviewed to identify and describe the path that led to the beginning of the reform; how the ongoing reform is taking place; and, the plan and scope for scale-up. Results Since 2004, mental health has gained importance in policies and regulations, resulting in the promotion of a mental health reform within the national healthcare system. These efforts crystallized in 2012 with the passing of Law 29889 which introduced several changes to the delivery of mental healthcare, including a restructuring of mental health service delivery to occur at the primary and secondary care levels and the introduction of supporting services to aid in patient recovery and reintegration into society. In addition, a performance-based budget was approved to guarantee the implementation of these changes. Some of the main challenges faced by this reform are related to the diversity of the implementation settings, eg, isolated rural areas, and the limitations of the existing specialized mental health institutes to substantially grow in parallel to the scaling-up efforts in order to be able to provide training and clinical support to every region of Peru. Conclusion Although the true success of the mental healthcare reform will be determined in the coming years, thus far, Peru

42 CFR 137.203 - May a Self-Governance Tribe participate in a voluntary national uniform data collection effort...

Science.gov (United States)

2010-10-01

...-Governance Tribe participate in a voluntary national uniform data collection effort with the IHS? Yes, in... 42 Public Health 1 2010-10-01 2010-10-01 false May a Self-Governance Tribe participate in a voluntary national uniform data collection effort with the IHS? 137.203 Section 137.203 Public Health PUBLIC...

Do Haphazard Reviews Provide Sound Directions for Dissemination Efforts?

Science.gov (United States)

Gambrill, Eileen; Littell, Julia H.

2010-01-01

Comments on The dissemination and implementation of evidence-based psychological treatments: A review of current efforts by Kathryn R. McHugh and David H. Barlow. The lead article in the February-March issue by McHugh and Barlow (2010) emphasized the need for "dissemination and implementation of evidence-based psychological treatments."…

Pharmacy travel health services: current perspectives and future prospects

Directory of Open Access Journals (Sweden)

Houle SKD

2018-03-01

Full Text Available Sherilyn KD HouleSchool of Pharmacy, University of Waterloo, Waterloo, ON, CanadaAbstract: Rates of international travel are increasing annually, with particular growth observed in travel to Southeast Asia and to emerging economies. While all patients traveling across geographic regions are recommended to receive a pre-travel consultation to consider their individual risks, many do not, or receive care and recommendations that are not consistent with current evidence-based guidelines. As experts in drug therapy, and given the largely preventive nature of most travel health recommendations, pharmacists are well suited to help address this need. Pharmacists generally possess a high degree of knowledge and confidence with more commonly observed travel health topics in community practice such as travelers’ diarrhea; however, training in more specialized travel health topics such as travel vaccinations and traveling at altitude has generally been lacking from pharmacy curricula. Pharmacists with an interest in providing pre-travel consultations are encouraged to pursue additional training in this specialty and to consider Certificate in Travel Health designation from the International Society of Travel Medicine. Future roles for pharmacists to include the prescribing of medications and vaccines for travel and the in-pharmacy administration of travel vaccinations may improve patient access to pre-travel consultations and recommended preventive measures, improving the health of travelers and potentially reducing the burden of communicable disease worldwide. Pharmacists providing travel care to patients are also reminded to consider noninfectious risks of illness and injury abroad and to counsel patients on strategies to minimize these risks in addition to providing drug and vaccine recommendations.Keywords: pharmacist, community pharmacy, travel, vaccination

Estimation of inspection effort

International Nuclear Information System (INIS)

Mullen, M.F.; Wincek, M.A.

1979-06-01

An overview of IAEA inspection activities is presented, and the problem of evaluating the effectiveness of an inspection is discussed. Two models are described - an effort model and an effectiveness model. The effort model breaks the IAEA's inspection effort into components; the amount of effort required for each component is estimated; and the total effort is determined by summing the effort for each component. The effectiveness model quantifies the effectiveness of inspections in terms of probabilities of detection and quantities of material to be detected, if diverted over a specific period. The method is applied to a 200 metric ton per year low-enriched uranium fuel fabrication facility. A description of the model plant is presented, a safeguards approach is outlined, and sampling plans are calculated. The required inspection effort is estimated and the results are compared to IAEA estimates. Some other applications of the method are discussed briefly. Examples are presented which demonstrate how the method might be useful in formulating guidelines for inspection planning and in establishing technical criteria for safeguards implementation

Effect of effort-reward imbalance and burnout on infection control among Ecuadorian nurses.

Science.gov (United States)

Colindres, C V; Bryce, E; Coral-Rosero, P; Ramos-Soto, R M; Bonilla, F; Yassi, A

2018-06-01

Nurses are frequently exposed to transmissible infections, yet adherence to infection control measures is suboptimal. There has been inadequate research into how the psychosocial work environment affects compliance with infection control measures, especially in low- and middle-income countries. To examine the association between effort-reward imbalance, burnout and adherence to infection control measures among nurses in Ecuador. A cross-sectional study linking psychosocial work environment indicators to infection control adherence. The study was conducted among 333 nurses in four Ecuadorian hospitals. Self-administered questionnaires assessed demographic variables, perceived infection risk, effort-reward imbalance, burnout and infection control adherence. Increased effort-reward imbalance was found to be a unique incremental predictor of exposure to burnout, and burnout was a negative unique incremental predictor of nurses' self-reported adherence with infection control measures. Results suggest an effort-reward imbalance-burnout continuum, which, at higher levels, contributes to reduce adherence to infection control. The Ecuadorean government has made large efforts to improve universal access to health care, yet this study suggests that workplace demands on nurses remain problematic. This study highlights the contribution of effort-reward-imbalance-burnout continuum to the chain of infection by decreased adherence to infection control of nurses. Health authorities should closely monitor the effect of new policies on psychosocial work environment, especially when expanding services and increasing public accessibility with limited resources. Additionally, organizational and psychosocial interventions targeting effort-reward imbalance and burnout in nurses should be considered part of a complete infection prevention and control strategy. Further study is warranted to identify interventions that best ameliorate effort-reward imbalance and burnout in low- and middle

Racializing drug design: implications of pharmacogenomics for health disparities.

Science.gov (United States)

Lee, Sandra Soo-Jin

2005-12-01

Current practices of using "race" in pharmacogenomics research demands consideration of the ethical and social implications for understandings of group difference and for efforts to eliminate health disparities. This discussion focuses on an "infrastructure of racialization" created by current trajectories of research on genetic differences among racially identified groups, the use of race as a proxy for risk in clinical practice, and increasing interest in new market niches by the pharmaceutical industry. The confluence of these factors has resulted in the conflation of genes, disease, and race. I argue that public investment in pharmacogenomics requires careful consideration of current inequities in health status and social and ethical concerns over reifying race and issues of distributive justice.

Impacts of Climate Change on Human Health in the United ...

Science.gov (United States)

Climate change threatens human health and well-being in the United States. To address this growing threat, the Interagency Group on Climate Change and Human Health (CCHHG), a working group of the U.S. Global Change Research Program’s (USGCRP), has developed this assessment as part of the ongoing efforts of the USGCRP’s National Climate Assessment (NCA) and as called for under the President’s Climate Action Plan. The authors of this assessment have compiled and assessed current research on human health impacts of climate change and summarized the current “state of the science” for a number of key impact areas. This assessment provides a comprehensive update to the most recent detailed technical assessment for the health impacts of climate change, 2008 Synthesis and Assessment Product 4.6 (SAP 4.6) Analyses of the Effects of Global Change on Human Health and Welfare and Human Systems (CCSP 2008). It also updates and builds upon the health chapter of the third NCA (Melillo et al. 2014). The lead and coordinating Federal agencies for the USGCRP Climate and Health Assessment are the Centers for Disease Control and Prevention (CDC), Environmental Protection Agency (EPA), National Institute of Health (NIH), and National Oceanic and Atmospheric Administration (NOAA). Available at https://health2016.globalchange.gov/ The interagency U.S. Global Change Research Program (USGCRP) has developed this assessment as part of the ongoing efforts of their National C

Environmental Impacts of the U.S. Health Care System and Effects on Public Health.

Science.gov (United States)

Eckelman, Matthew J; Sherman, Jodi

2016-01-01

The U.S. health care sector is highly interconnected with industrial activities that emit much of the nation's pollution to air, water, and soils. We estimate emissions directly and indirectly attributable to the health care sector, and potential harmful effects on public health. Negative environmental and public health outcomes were estimated through economic input-output life cycle assessment (EIOLCA) modeling using National Health Expenditures (NHE) for the decade 2003-2013 and compared to national totals. In 2013, the health care sector was also responsible for significant fractions of national air pollution emissions and impacts, including acid rain (12%), greenhouse gas emissions (10%), smog formation (10%) criteria air pollutants (9%), stratospheric ozone depletion (1%), and carcinogenic and non-carcinogenic air toxics (1-2%). The largest contributors to impacts are discussed from both the supply side (EIOLCA economic sectors) and demand side (NHE categories), as are trends over the study period. Health damages from these pollutants are estimated at 470,000 DALYs lost from pollution-related disease, or 405,000 DALYs when adjusted for recent shifts in power generation sector emissions. These indirect health burdens are commensurate with the 44,000-98,000 people who die in hospitals each year in the U.S. as a result of preventable medical errors, but are currently not attributed to our health system. Concerted efforts to improve environmental performance of health care could reduce expenditures directly through waste reduction and energy savings, and indirectly through reducing pollution burden on public health, and ought to be included in efforts to improve health care quality and safety.

Environmental Impacts of the U.S. Health Care System and Effects on Public Health.

Directory of Open Access Journals (Sweden)

Matthew J Eckelman

Full Text Available The U.S. health care sector is highly interconnected with industrial activities that emit much of the nation's pollution to air, water, and soils. We estimate emissions directly and indirectly attributable to the health care sector, and potential harmful effects on public health. Negative environmental and public health outcomes were estimated through economic input-output life cycle assessment (EIOLCA modeling using National Health Expenditures (NHE for the decade 2003-2013 and compared to national totals. In 2013, the health care sector was also responsible for significant fractions of national air pollution emissions and impacts, including acid rain (12%, greenhouse gas emissions (10%, smog formation (10% criteria air pollutants (9%, stratospheric ozone depletion (1%, and carcinogenic and non-carcinogenic air toxics (1-2%. The largest contributors to impacts are discussed from both the supply side (EIOLCA economic sectors and demand side (NHE categories, as are trends over the study period. Health damages from these pollutants are estimated at 470,000 DALYs lost from pollution-related disease, or 405,000 DALYs when adjusted for recent shifts in power generation sector emissions. These indirect health burdens are commensurate with the 44,000-98,000 people who die in hospitals each year in the U.S. as a result of preventable medical errors, but are currently not attributed to our health system. Concerted efforts to improve environmental performance of health care could reduce expenditures directly through waste reduction and energy savings, and indirectly through reducing pollution burden on public health, and ought to be included in efforts to improve health care quality and safety.

Miniature Biosensor with Health Risk Assessment Feedback

Science.gov (United States)

Hanson, Andrea; Downs, Meghan; Kalogera, Kent; Buxton, Roxanne; Cooper, Tommy; Cooper, Alan; Cooper, Ross

2016-01-01

Heart rate (HR) monitoring is a medical requirement during exercise on the International Space Station (ISS), fitness tests, and extravehicular activity (EVA); however, NASA does not currently have the technology to consistently and accurately monitor HR and other physiological data during these activities. Performance of currently available HR monitor technologies is dependent on uninterrupted contact with the torso and are prone to data drop-out and motion artifact. Here, we seek an alternative to the chest strap and electrode based sensors currently in use on ISS today. This project aims to develop a high performance, robust earbud based biosensor with focused efforts on improved HR data quality during exercise or EVA. A health risk assessment algorithm will further advance the goals of autonomous crew health care for exploration missions.

78 FR 56903 - Office of the Director, National Institutes of Health; Notice of Meeting

Science.gov (United States)

2013-09-16

... scope of research on women's health and the influence of sex and gender on human health, efforts to understand the issues related to women in biomedical careers and their needs, and the current status of... business or professional affiliation of the interested person. In the interest of security, NIH has...

[Blood transfusion in the Democratic Republic of Congo: efforts and challenges].

Science.gov (United States)

Kabinda Maotela, J; Ramazani, S Y; Misingi, P; Dramaix-Wilmet, M

2015-01-01

The authors trace the history of blood transfusion in the Democratic Republic of Congo, as inherited through the colonial organization of the health system. The current configuration of transfusion system begins with the drafting of the national blood transfusion policy and the establishment of a national technical office within the Ministry of Health to coordinate transfusion activities and of its agents in each province. Despite countless difficulties, several positive points were noted. These involve essentially the drafting of all the necessary documents and standards and the integration of the blood safety system into the country's health system. Initially, the blood transfusion system applied a vertical approach, but with the reform of the country's health system, the performance of blood safety became transversal. In the 12 years from 2001 to 2012, it mobilized 112,882 volunteer blood donors; more than 80% of blood products were checked for safety and covered all blood needs; and 81,806 HIV infections were avoided by routine testing of blood products. During the same period, 7560 people were trained in blood transfusion. The prevalence of viral markers among donors has diminished sharply. Thus, HIV prevalence decreased from 4.7% to 2.1% between 2001 and 2012 that of hepatitis B dropped from 7.1% to 3.5% during the same period, and hepatitis C from 11.8% to 2.3% from 2004 to 2012. Despite this performance, enormous efforts are still required, for the organization of blood safety monitoring, the establishment of a safe supply of reagents and supplies, for sustaining the dynamics of voluntary associations of blood donors, and finally for providing stable funding for these blood safety activities.

Effortful echolalia.

Science.gov (United States)

Hadano, K; Nakamura, H; Hamanaka, T

1998-02-01

We report three cases of effortful echolalia in patients with cerebral infarction. The clinical picture of speech disturbance is associated with Type 1 Transcortical Motor Aphasia (TCMA, Goldstein, 1915). The patients always spoke nonfluently with loss of speech initiative, dysarthria, dysprosody, agrammatism, and increased effort and were unable to repeat sentences longer than those containing four or six words. In conversation, they first repeated a few words spoken to them, and then produced self initiated speech. The initial repetition as well as the subsequent self initiated speech, which were realized equally laboriously, can be regarded as mitigated echolalia (Pick, 1924). They were always aware of their own echolalia and tried to control it without effect. These cases demonstrate that neither the ability to repeat nor fluent speech are always necessary for echolalia. The possibility that a lesion in the left medial frontal lobe, including the supplementary motor area, plays an important role in effortful echolalia is discussed.

Peers, Regulators, and Professions: The Influence of Organizations in Health Information Technology Adoption

OpenAIRE

Campion, Thomas R.; Gadd, Cynthia S.

2010-01-01

According to the U.S. National Research Council, current health information technology (HIT) efforts are insufficient and arguably detrimental to healthcare transformation. Many hospitals have already implemented HIT, and federal stimulus funding will further adoption efforts. Organizations become more similar through the adoption of innovations like HIT, but the effects of the changes do not necessarily improve efficiency. This view from sociology and organizational studies, called instituti...

Neglected health literacy undermining fluorosis control efforts: A pilot study among schoolchildren in an endemic village of rural Rajasthan, India

Directory of Open Access Journals (Sweden)

Neeti Rustagi

2017-01-01

Full Text Available Background: Ingestion of excess fluoride can cause fluorosis which adversely affects teeth and bones. Fluorosis is a major public health problem in the state of Rajasthan with all its 32 districts having variable fluoride contamination, and many initiatives are currently implemented in this region to mitigate the fluorosis burden. Objective: The objective of this study was to assess fluorosis, its risk factors, and the awareness among school students and teachers in endemic villages of Jodhpur district, Rajasthan. Materials and Methods: A representative sample of 300 students of age 12–15 years were enrolled for cross-sectional study in selected villages. Data were collected regarding awareness, behavioral and preventive practices about fluorosis and clinical assessment and fluoride estimation in water and urine samples was done. Results: Dental fluorosis through Dean's index was observed in 24.5% of students. The awareness and practices for fluorosis prevention and its risk factors were poor among both students and teachers. Intake of piped water supply was reported by majority of students (95.8%. High fluoride concentration was found in 35 (81.3% out of 43 urine samples. Conclusion: Improvement in drinking water supply in the endemic village of Rajasthan has decreased the burden of fluorosis, but low level of awareness and prevailing dietary and behavioral practices still pose them at risk of high fluoride intake. This signifies the need to address nonconventional sources of fluoride intake (diet and toothpaste and early screening of disease by involving teachers and family physicians in fluoride mitigation efforts.

Air Pollution Exposure and Physical Activity in China: Current Knowledge, Public Health Implications, and Future Research Needs

Directory of Open Access Journals (Sweden)

Jiaojiao Lü

2015-11-01

Full Text Available Deteriorating air quality in China has created global public health concerns in regard to health and health-related behaviors. Although emerging environmental regulations address ambient air pollution in China, the level of enforcement and long-term impact of these measures remain unknown. Exposure to air pollution has been shown to lead to multiple adverse health outcomes, including increased rates of heart disease and mortality. However, a lesser-known but increasingly significant concern is the relationship between air pollution and its effects on outdoor exercise. This is especially important in China, which has a culturally rooted lifestyle that encourages participation in outdoor physical activity. This article evaluates the intersection of air pollution and outdoor exercise and provides a discussion of issues related to its public health impact in China, where efforts to promote a healthy lifestyle may be adversely affected by the ambient air pollution that has accompanied rapid economic development and urbanization.

Air Pollution Exposure and Physical Activity in China: Current Knowledge, Public Health Implications, and Future Research Needs.

Science.gov (United States)

Lü, Jiaojiao; Liang, Leichao; Feng, Yi; Li, Rena; Liu, Yu

2015-11-20

Deteriorating air quality in China has created global public health concerns in regard to health and health-related behaviors. Although emerging environmental regulations address ambient air pollution in China, the level of enforcement and long-term impact of these measures remain unknown. Exposure to air pollution has been shown to lead to multiple adverse health outcomes, including increased rates of heart disease and mortality. However, a lesser-known but increasingly significant concern is the relationship between air pollution and its effects on outdoor exercise. This is especially important in China, which has a culturally rooted lifestyle that encourages participation in outdoor physical activity. This article evaluates the intersection of air pollution and outdoor exercise and provides a discussion of issues related to its public health impact in China, where efforts to promote a healthy lifestyle may be adversely affected by the ambient air pollution that has accompanied rapid economic development and urbanization.

Current practice and developmental efforts for leak detection in U.S. reactor primary systems

International Nuclear Information System (INIS)

Kupperman, D.S.; Claytor, T.N.

1986-01-01

Current leak detection practices in 74 operating nuclear reactors have been reviewed. Existing leak detection systems are adequate to ensure a leak-before-break scenario in most situations, but no currently available, single method combines optimal leakage detection sensitivity, leak-locating ability, and leakage measurement accuracy. Simply tightening current leakage limits may produce an unacceptably large number of unnecessary shutdowns. The use of commercially available acoustic monitoring systems or moisture-sensitive tape may improve leak detection capability at specific sites. However, neither of these methods currently provides source discrimination (e.g., to distinguish between leaks from pipe cracks and valves) or leak-rate information (a small leak may saturate the system). A field-implementable acoustic leak detection system is being developed to address these limitations. 5 refs.

Associations of Extrinsic and Intrinsic Components of Work Stress with Health: A Systematic Review of Evidence on the Effort-Reward Imbalance Model.

Science.gov (United States)

Siegrist, Johannes; Li, Jian

2016-04-19

Mainstream psychological stress theory claims that it is important to include information on people's ways of coping with work stress when assessing the impact of stressful psychosocial work environments on health. Yet, some widely used respective theoretical models focus exclusively on extrinsic factors. The model of effort-reward imbalance (ERI) differs from them as it explicitly combines information on extrinsic and intrinsic factors in studying workers' health. As a growing number of studies used the ERI model in recent past, we conducted a systematic review of available evidence, with a special focus on the distinct contribution of its intrinsic component, the coping pattern "over-commitment", towards explaining health. Moreover, we explore whether the interaction of intrinsic and extrinsic components exceeds the size of effects on health attributable to single components. Results based on 51 reports document an independent explanatory role of "over-commitment" in explaining workers' health in a majority of studies. However, support in favour of the interaction hypothesis is limited and requires further exploration. In conclusion, the findings of this review support the usefulness of a work stress model that combines extrinsic and intrinsic components in terms of scientific explanation and of designing more comprehensive worksite stress prevention programs.

Associations of Extrinsic and Intrinsic Components of Work Stress with Health: A Systematic Review of Evidence on the Effort-Reward Imbalance Model

Directory of Open Access Journals (Sweden)

Johannes Siegrist

2016-04-01

Full Text Available Mainstream psychological stress theory claims that it is important to include information on people’s ways of coping with work stress when assessing the impact of stressful psychosocial work environments on health. Yet, some widely used respective theoretical models focus exclusively on extrinsic factors. The model of effort-reward imbalance (ERI differs from them as it explicitly combines information on extrinsic and intrinsic factors in studying workers’ health. As a growing number of studies used the ERI model in recent past, we conducted a systematic review of available evidence, with a special focus on the distinct contribution of its intrinsic component, the coping pattern “over-commitment”, towards explaining health. Moreover, we explore whether the interaction of intrinsic and extrinsic components exceeds the size of effects on health attributable to single components. Results based on 51 reports document an independent explanatory role of “over-commitment” in explaining workers’ health in a majority of studies. However, support in favour of the interaction hypothesis is limited and requires further exploration. In conclusion, the findings of this review support the usefulness of a work stress model that combines extrinsic and intrinsic components in terms of scientific explanation and of designing more comprehensive worksite stress prevention programs.

Associations of Extrinsic and Intrinsic Components of Work Stress with Health: A Systematic Review of Evidence on the Effort-Reward Imbalance Model

Science.gov (United States)

Siegrist, Johannes; Li, Jian

2016-01-01

Mainstream psychological stress theory claims that it is important to include information on people’s ways of coping with work stress when assessing the impact of stressful psychosocial work environments on health. Yet, some widely used respective theoretical models focus exclusively on extrinsic factors. The model of effort-reward imbalance (ERI) differs from them as it explicitly combines information on extrinsic and intrinsic factors in studying workers’ health. As a growing number of studies used the ERI model in recent past, we conducted a systematic review of available evidence, with a special focus on the distinct contribution of its intrinsic component, the coping pattern “over-commitment”, towards explaining health. Moreover, we explore whether the interaction of intrinsic and extrinsic components exceeds the size of effects on health attributable to single components. Results based on 51 reports document an independent explanatory role of “over-commitment” in explaining workers’ health in a majority of studies. However, support in favour of the interaction hypothesis is limited and requires further exploration. In conclusion, the findings of this review support the usefulness of a work stress model that combines extrinsic and intrinsic components in terms of scientific explanation and of designing more comprehensive worksite stress prevention programs. PMID:27104548

Obesity stigma: important considerations for public health.

Science.gov (United States)

Puhl, Rebecca M; Heuer, Chelsea A

2010-06-01

Stigma and discrimination toward obese persons are pervasive and pose numerous consequences for their psychological and physical health. Despite decades of science documenting weight stigma, its public health implications are widely ignored. Instead, obese persons are blamed for their weight, with common perceptions that weight stigmatization is justifiable and may motivate individuals to adopt healthier behaviors. We examine evidence to address these assumptions and discuss their public health implications. On the basis of current findings, we propose that weight stigma is not a beneficial public health tool for reducing obesity. Rather, stigmatization of obese individuals threatens health, generates health disparities, and interferes with effective obesity intervention efforts. These findings highlight weight stigma as both a social justice issue and a priority for public health.

Recessions and seniors' health, health behaviors, and healthcare use: analysis of the Medicare Current Beneficiary Survey.

Science.gov (United States)

McInerney, Melissa; Mellor, Jennifer M

2012-09-01

A number of studies report that U.S. state mortality rates, particularly for the elderly, decline during economic downturns. Further, several prior studies use microdata to show that as state unemployment rates rise, physical health improves, unhealthy behaviors decrease, and medical care use declines. We use data on elderly mortality rates and data from the Medicare Current Beneficiary Survey from a time period that encompasses the start of the Great Recession. We find that elderly mortality is countercyclical during most of the 1994-2008 period. Further, as unemployment rates rise, seniors report worse mental health and are no more likely to engage in healthier behaviors. We find suggestive evidence that inpatient utilization increases perhaps because of an increased physician willingness to accept Medicare patients. Our findings suggest that either elderly individuals respond differently to recessions than do working age adults, or that the relationship between unemployment and health has changed. Copyright © 2012 Elsevier B.V. All rights reserved.

Health promotion and health systems: some unfinished business.

Science.gov (United States)

Ziglio, Erio; Simpson, Sarah; Tsouros, Agis

2011-12-01

One of the five action domains in the Ottawa Charter was Reorienting Health Services. In this paper, we reflect on why progress in this domain has been somewhat lethargic, particularly compared with some of the other action domains, and why now it is important to renew our commitment to this domain. Reorienting health services has been largely overlooked and opportunities missed, although good exceptions do exist. The occasion of the 25th anniversary of the Ottawa Charter represents an important opportunity for health promotion to: (i) renew its active voice in current policy debate and action and (ii) enhance achievements made to date by improving our efforts to advocate, enable and mediate for the reorientation of health services and systems. We outline six steps to reactivate and invest more in this action domain so as to be in a better position to promote health equitably and sustainably in today's fast changing world. Though our experience is mainly based in the European context, we hope that our reflections will be of some value to countries outside of this region.

Understanding the current status and exploring the potential for distance education in public health in India.

Science.gov (United States)

Sharma, Kavya; George, Sunil; Zodpey, Sanjay

2011-01-01

Continuing education of health care providers plays an important role in producing a health work force that is efficient and effective. In India public health education has primarily relied on conventional methods of training. However, such methods have limitations in equipping the health workforce of a vast and varied country like India. This paper analyzes the current status of distance education in public health and lists the various courses that are presently available in India through the distance education mode. Presently 25 institutions in India are offering 69 courses in various domains of public health through distance education. The providers of these programs comprised both government and private educational institutions. This paper also points out the role and importance of various stakeholders in the design and delivery of distance education programs in public health and raises key areas that need attention in the governance of such programs. It urges the use of digital technology in the delivery of distance education programs and points out how distance education that is designed and delivered using the latest technology could address the current gap in training human resources for health in India.

Attempts at strategic thinking in occupational public health: the Lucas Lecture of 1987

Energy Technology Data Exchange (ETDEWEB)

Millar, J D

1987-05-06

This lecture on strategic thinking in occupational public health stressed that attention must be directed toward the prevention of occupational diseases and injuries through an organized community effort. According to the speaker, such an aim encompasses the various disciplines involved in occupational medicine, safety, and nursing to include such avenues as clinical and social medicine and general public-health practice. A summary was offered of the development of public health and occupational health in the United States, as it grew from the level of state and local responsibility to become a concern of the Federal Government. Occupational medicine also grew at the business sector level with surgical services being established for injured workers at the job site and concerns over toxic exposures growing. The passage of the Occupational Safety and Health Act of 1970 is discussed along with a brief review of new Federal agencies formed by the act. New efforts are being directed at hazard identification and risk assessment, and also at controlling the exposures through preventive or protective measures. Additional efforts are currently being made in the educational field.

The current situation of human resources for health in the province of Cabinda in Angola: is it a limitation to provide universal access to healthcare?

Science.gov (United States)

Macaia, Damas; Lapão, Luís Velez

2017-12-28

significant HRH management efforts contributing to this result. Whereas HRH are financed by the State General Budget, the majority of health facilities are still dependent on the Provincial Health Secretariat budget. The study provides a broader view of the current HRH situation in Cabinda Province. Geographical imbalances and other issues with impact in delivering universal access to healthcare are highlighted.

Taking stock of Myanmar's progress toward the health-related Millennium Development Goals: current roadblocks, paths ahead.

Science.gov (United States)

Saw, Yu Mon; Win, Khine Lae; Shiao, Laura Wen-Shuan; Thandar, Moe Moe; Amiya, Rachel M; Shibanuma, Akira; Tun, Soe; Jimba, Masamine

2013-09-11

Myanmar is a developing country with considerable humanitarian needs, rendering its pursuit of the Millennium Development Goals (MDGs) an especially high priority. Yet progress to date remains under-examined on key fronts. Particularly within the three health-related MDGs (MDGs 4, 5, and 6), the limited data reported point to patchy levels of achievement. This study was undertaken to provide an overview and assessment of Myanmar's progress toward the health-related MDGs, along with possible solutions for accelerating health-related development into 2015 and beyond. The review highlights off-track progress in the spheres of maternal and child health (MDGs 4 and 5). It also shows Myanmar's achievements toward MDG 6 targets--in the areas of HIV/AIDS, malaria, and tuberculosis. Such achievements are especially notable in that Myanmar has been receiving the lowest level of official development assistance among all of the least developed countries in Asia. However, to make similar progress in MDGs 4 and 5, Myanmar needs increased investment and commitment in health. Toward moving forward with the post-2015 development agenda, Myanmar's government also needs to take the lead in calling for attention from the World Health Organization and its global development partners to address the stagnation in health-related development progress within the country. In particular, Myanmar's government should invest greater efforts into health system strengthening to pave the road to universal health coverage.

[History of occupational health physician and industrial safety and health law].

Science.gov (United States)

Horie, Seichi

2013-10-01

In Japan, an employer of a workplace with 50 or more employees is legally required to assign an occupational health physician. The assignment rate in 2010 was reported as 87.0%. This policy started with the provision of "factory physician"in the Factory Law in 1938, then the Labour Standard Law stipulated "physician hygienist" in 1947, and finally the Industrial Safety and Health Law defined "occupational health physician" in 1972. In 1996, a revision of the law then required those physicians to complete training courses in occupational medicine, as designated by an ordinance. Historically, an on-site physician was expected to cure injuries and to prevent communicable diseases of factory workers. The means of occupational hygienic management by working environment measurements, etc., and of health management by health examinations, etc., were developed. Localized exhaust ventilation and personal protection equipment became widely utilized. Qualification systems for non-medical experts in occupational hygiene were structured, and relationships between employers and occupational health physicians were stipulated in the legislative documents. Currently, the Japan Medical Association and the University of Occupational and Environmental Health, Japan educate and train occupational health physicians, and the Japan Society for Occupational Health maintains a specialized board certification system for these physicians. In the future, additional efforts should be made to strengthen the expertise of occupational health physicians, to define and recognize the roles of non-medical experts in occupational hygiene, to incorporate occupational health services in small enterprises, to promote occupational health risk assessment in the workplace, and to reorganize the current legislation, amended repeatedly over the decades.

eHealth in Treatment of Offenders in Forensic Mental Health: A Review of the Current State.

Science.gov (United States)

Kip, Hanneke; Bouman, Yvonne H A; Kelders, Saskia M; van Gemert-Pijnen, Lisette J E W C

2018-01-01

Treatment of offenders in forensic mental health is complex. Often, these in- or outpatients have low treatment motivation, suffer from multiple disorders, and have poor literacy skills. eHealth may be able to improve treatment outcomes because of its potential to increase motivation and engagement, and it can overcome the predominant one-size-fits-all approach by being tailored to individual patients. To examine its potential, this systematic review studies the way that eHealth has been used and studied in forensic mental health and identifies accompanying advantages and disadvantages for both patients and treatment, including effectiveness. A systematic search in Scopus, PsycINFO, and Web of Science was performed up until December 2017. Studies were included if they focused on technological interventions to improve the treatment of forensic psychiatric patients. The search resulted in 50 studies in which eHealth was used for treatment purposes. Multiple types of studies and technologies were identified, such as virtual reality, web-based interventions, and videoconferencing. The results confirmed the benefits of technology, for example, the acquisition of unique information about offenders, effectiveness, and tailoring to specific characteristics, but indicated that these are not fully taken advantage of. To overcome the barriers and obtain the benefits, eHealth has to have a good fit with patients and the forensic psychiatric context. It has to be seamlessly integrated in existing care and should not be added as an isolated element. To bridge the gap between the current situation and eHealth's potential, further research on development, implementation, and evaluation should be conducted.

The effect of effort-reward imbalance on the health of childcare workers in Hamburg: a longitudinal study.

Science.gov (United States)

Koch, Peter; Kersten, Jan Felix; Stranzinger, Johanna; Nienhaus, Albert

2017-01-01

The prevalence of effort-reward imbalance (ERI) among qualified childcare workers in Germany is currently estimated at around 65%. High rates of burnout and musculoskeletal symptoms (MS) have also been reported for this group. Previous longitudinal studies show inconsistent results with regard to the association between ERI and MS. As yet, no longitudinal studies have been conducted to investigate the association between ERI and burnout or MS in childcare workers. This study aims to investigate the extent to which a relationship between ERI and MS or burnout can be observed in childcare workers in Germany on a longitudinal basis. In 2014 childcare workers ( N  = 199, response rate: 57%) of a provider of facilities for children and youth in Hamburg were asked about stress and health effects in the workplace. Follow-up was completed one year later ( N  = 106, follow-up rate: 53%) For the baseline assessment, ERI was determined as the primary influencing factor. Data on MS was recorded using the Nordic questionnaire, and burnout using the personal burnout scale of the Copenhagen Burnout Inventory (CBI). The statistical analysis was carried out using multivariate linear and logistic regression. At baseline ERI was present in 65% of the sample population. The mean burnout score at the time of follow-up was 53.7 (SD: 20.7); the prevalence of MS was between 19% and 62%. ERI was identified as a statistically significant factor for MS, after adjusting especially for physical stress (lower back: OR 4.2; 95% CI: 1.14 to 15.50, neck: OR 4.3; 95% CI: 1.25 to 15.0, total MS: OR 4.0; 95% CI: 1.20 to 13.49). With regard to burnout, a relative increase of 10% in the ERI ratio score increased the burnout score by 1.1 points ( p  = 0.034). ERI was revealed to be a major factor in relation to MS and burnout in childcare workers. Based on this observation worksite interventions on the individual and organizational level should be introduced in order to prevent ERI.

[Current status of occupational health and related countermeasures in Guangzhou, China].

Science.gov (United States)

Zeng, W F; Wu, S H; Wang, Z; Liu, Y M

2016-02-20

To investigate the current status of occupational health and related countermeasures in Guangzhou, China. Related data were collected from occupational poisoning accident investigation, diagnosis and identification of occupational diseases, and the occupational disease hazard reporting system, and the statistical data of occupational health in Guangzhou were analyzed retrospectively. The number of enterprises reporting for occupational disease hazards in Guangzhou was 20 890, and the total number of workers was 1 457 583. The number of workers exposed to occupational hazards was 284 233, and the cumulative number of workers with occupational diseases was 1 502. There were many risk factors for occupational diseases in enterprises, and there were a large number of workers with occupational diseases, as well as newly diagnosed cases. From 2001 to 2014, the total number of cases of occupational diseases was 958. The situation for the prevention and control of occupational diseases is grim in Guangzhou. Occupational health supervision and law enforcement should be enhanced, the three-level supervision system should be established and perfected, and the occupational health supervision system with a combination of "prevention, treatment, and protection" should be established and promoted, so as to gradually establish a technical service support system for occupational health.

Transboundary protected area proposals along the Southern Andes of Chile and Argentina: Status of current efforts

Science.gov (United States)

Peter Keller

2007-01-01

An evolving network of protected areas along the southern Andes of Chile and Argentina-the heart of Patagonia-are in various stages of evaluation and potential Transboundary Protected Area designations. This paper examines three such efforts. The first proposal is the North Andean-Patagonia Regional Eco-Corridor, which was the subject of a recent bilateral meeting...

Water-Food-Nutrition-Health Nexus: Linking Water to Improving Food, Nutrition and Health in Sub-Saharan Africa.

Science.gov (United States)

Mabhaudhi, Tafadzwanashe; Chibarabada, Tendai; Modi, Albert

2016-01-06

Whereas sub-Saharan Africa's (SSA) water scarcity, food, nutrition and health challenges are well-documented, efforts to address them have often been disconnected. Given that the region continues to be affected by poverty and food and nutrition insecurity at national and household levels, there is a need for a paradigm shift in order to effectively deliver on the twin challenges of food and nutrition security under conditions of water scarcity. There is a need to link water use in agriculture to achieve food and nutrition security outcomes for improved human health and well-being. Currently, there are no explicit linkages between water, agriculture, nutrition and health owing to uncoordinated efforts between agricultural and nutrition scientists. There is also a need to develop and promote the use of metrics that capture aspects of water, agriculture, food and nutrition. This review identified nutritional water productivity as a suitable index for measuring the impact of a water-food-nutrition-health nexus. Socio-economic factors are also considered as they influence food choices in rural communities. An argument for the need to utilise the region's agrobiodiversity for addressing dietary quality and diversity was established. It is concluded that a model for improving nutrition and health of poor rural communities based on the water-food-nutrition-health nexus is possible.

Health Security and Risk Aversion.

Science.gov (United States)

Herington, Jonathan

2016-09-01

Health security has become a popular way of justifying efforts to control catastrophic threats to public health. Unfortunately, there has been little analysis of the concept of health security, nor the relationship between health security and other potential aims of public health policy. In this paper I develop an account of health security as an aversion to risky policy options. I explore three reasons for thinking risk avoidance is a distinctly worthwhile aim of public health policy: (i) that security is intrinsically valuable, (ii) that it is necessary for social planning and (iii) that it is an appropriate response to decision-making in contexts of very limited information. Striking the right balance between securing and maximizing population health thus requires a substantive, and hitherto unrecognized, value judgment. Finally, I critically evaluate the current health security agenda in light of this new account of the concept and its relationship to the other aims of public health policy. © 2016 John Wiley & Sons Ltd.

Predicting Personal Healthcare Management: Impact of Individual Characteristics on Patient Use of Health Information Technology

Science.gov (United States)

Sandefer, Ryan Heath

2017-01-01

The use of health information and health information technology by consumers is a major factor in the current healthcare systems' effort to address issues related to quality, cost, and access. Patient engagement in the healthcare process through access to information related to diagnoses, procedures, and treatment has the potential to improve…

On the efforts (man-day) concerned with inspection in uranium fuel fabrication facility

International Nuclear Information System (INIS)

Watanabe, T.; Tanaka, T.; Seki, Y.

1990-01-01

Taking notice of inspection efforts (man·day) of STA·IAEA and those of MNF concerned with them, their change and various factors affecting the change have been studied. Namely, first, main topics concerning inspection in our Tokai plant are mentioned and secondly the relation between the inspection efforts and such factors as PIV period, number of items, number of DA sampling and NDA measurements, and so forth is studied. According to our study, though efforts of STA·IAEA and MNF required for both routine FLOW inspection and PIT have been nearly unchanged each year, our efforts for PIV have been increasing gradually. The factors relating to this increase of our efforts are the PIV period, inspection efforts of STA·IAEA for PIV and the number of DA sampling and NDA measurements. Finally, a suggestion on the future inspection system has been mentioned and then some items for improvement under the current inspection system have been exemplified. (author)

Global health education in Germany: an analysis of current capacity, needs and barriers.

Science.gov (United States)

Kaffes, Ioannis; Moser, Fabian; Pham, Miriam; Oetjen, Aenne; Fehling, Maya

2016-11-25

In times of increasing global challenges to health, it is crucial to create a workforce capable of tackling these complex issues. Even though a lack of GHE in Germany is perceived by multiple stakeholders, no systematic analysis of the current landscape exists. The aim of this study is to provide an analysis of the global health education (GHE) capacity in Germany as well as to identify gaps, barriers and future strategies. An online search in combination with information provided by student representatives, course coordinators and lecturers was used to create an overview of the current GHE landscape in Germany. Additionally, a semi-structured questionnaire was sent to GHE educators and students engaged in global health (GH) to assess the capacity of German GHE, its barriers and suggested strategies for the future. A total of 33 GHE activities were identified at 18 German universities. Even though medical schools are the main provider of GHE (42%), out of 38 medical schools, only 13 (34%) offer any kind of GHE. Modules offered for students of other health-related professions constitute 27% of all activities. Most survey respondents (92%, n = 48) consider current GHE activities in Germany insufficient. Suggested formats were GHE as part of medical curricula (82%, n = 45) and dual degree MD/MPH or PhD programs. Most important barriers mentioned were low priority of GH at faculties and academic management levels (n = 41, 75%) as well as lack of necessary institutional structures (n = 33, 60%). Despite some innovative academic approaches, there is clearly a need for more systematic GHE in Germany. GHE educators and students can take an important role advocating for more awareness at university management level and suggesting ways to institutionalize GHE to overcome barriers. This study provides key evidence, relevant perceptions and suggestions to strengthen GHE in Germany.

Maximum effort in the minimum-effort game

Czech Academy of Sciences Publication Activity Database

Engelmann, Dirk; Normann, H.-T.

2010-01-01

Roč. 13, č. 3 (2010), s. 249-259 ISSN 1386-4157 Institutional research plan: CEZ:AV0Z70850503 Keywords : minimum-effort game * coordination game * experiments * social capital Subject RIV: AH - Economics Impact factor: 1.868, year: 2010

Income Inequality and Health Status in the United States: Evidence from the Current Population Survey.

Science.gov (United States)

Mellor, Jennifer M.; Milyo, Jeffrey

2002-01-01

Current Population Survey data on self-reported health status and income for the general population and those in poverty were analyzed. No consistent association was found between income inequality and individual health status. Previous findings of such an association were attributed to ecological fallacy or failure to control for individual…

75 FR 51831 - Request for Measures of Health Plan Efforts To Address Health Plan Members' Health Literacy Needs

Science.gov (United States)

2010-08-23

... and health plans. The results of the planned survey may become an important source of information for... services and nurse advice lines, the quality and accessibility of health plan information on coverage...

E-cigarettes in patients with COPD: current perspectives.

Science.gov (United States)

Morjaria, J B; Mondati, E; Polosa, R

2017-01-01

Conventional cigarette smoking is known to result in significant COPD morbidity and mortality. Strategies to reduce and/or stop smoking in this highly vulnerable patient group are key public health priorities to reduce COPD morbidity and mortality. Unfortunately, smoking cessation efforts in patients with COPD are poor and there is a compelling need for more efficient approaches to cessation for patients with COPD. Electronic cigarettes (ECs) are devices that use batteries to vaporize nicotine. They may facilitate quit attempts and cessation in many smokers. Although they are not risk free, ECs are much less harmful than tobacco smoking. Hence, the use of ECs in vulnerable groups and in patients with challenges to abstain or multiple relapses to this habit may be promising. To date, little is known about health consequences of EC use among COPD smokers and whether their regular use has any effects on subjective and objective COPD outcomes. In the current review, we discuss the current perspectives and literature on the role of ECs in abstaining from conventional smoking and the effects of ECs on the respiratory tract in patients with COPD.

[Limit of therapeutic effort in Spanish medical journals].

Science.gov (United States)

Solís García Del Pozo, Julián; Gómez Pérez, Ignacio

2012-01-01

In this paper we review articles concerning the limits of therapeutic effort that have been published in the past decade in journals directed at health professionals. Most of these articles are opinion pieces in which the influence of principlism is clear, even going so far as to justify the right to terminate life based on patient autonomy. It is time for personalistic bioethics to transmit its approaches in medical journals that are not specialized in bioethics.

Management strategies of enterovirus D68 outbreaks: current perspectives

Directory of Open Access Journals (Sweden)

Milhano N

2018-03-01

Full Text Available Natacha Milhano, Kaja Sverdrup Borge, Karoline Bragstad, Susanne G Dudman Domain for Environmental Health and Infectious Disease Control, Norwegian Institute of Public Health, Oslo, Norway Abstract: Following its discovery in California in 1962, enterovirus D68 (EV-D68 was reported only sporadically around the world. In August 2014, a marked increase of EV-D68 cases in young children with severe respiratory infections was reported in the USA and Canada and later in Europe and Asia. Some of these cases were also found to be associated with acute flaccid paralysis, which exacerbated public health concern, and has since triggered international efforts to strengthen both EV-D68 and acute flaccid paralysis surveillance systems. This review summarizes the current knowledge on EV-D68, offering an overview of EV-D68 epidemiology, clinical presentations, diagnostic methodologies, and treatment strategies, as well as surveillance and outbreak management. Keywords: enterovirus D68, AFP, diagnostics, treatment, surveillance, outbreak 

[Psychosocial factors at work and cardiovascular diseases: contribution of the Effort-Reward Imbalance model].

Science.gov (United States)

Niedhammer, I; Siegrist, J

1998-11-01

The effect of psychosocial factors at work on health, especially cardiovascular health, has given rise to growing concern in occupational epidemiology over the last few years. Two theoretical models, Karasek's model and the Effort-Reward Imbalance model, have been developed to evaluate psychosocial factors at work within specific conceptual frameworks in an attempt to take into account the serious methodological difficulties inherent in the evaluation of such factors. Karasek's model, the most widely used model, measures three factors: psychological demands, decision latitude and social support at work. Many studies have shown the predictive effects of these factors on cardiovascular diseases independently of well-known cardiovascular risk factors. More recently, the Effort-Reward Imbalance model takes into account the role of individual coping characteristics which was neglected in the Karasek model. The effort-reward imbalance model focuses on the reciprocity of exchange in occupational life where high-cost/low-gain conditions are considered particularly stressful. Three dimensions of rewards are distinguished: money, esteem and gratifications in terms of promotion prospects and job security. Some studies already support that high-effort/low reward-conditions are predictive of cardiovascular diseases.

The Evolving Academic Health Center: Challenges and Opportunities for Psychiatry

Science.gov (United States)

Mirin, Steven; Summergrad, Paul

2011-01-01

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

Changing reproductive effort within a semelparous reproductive episode.

Science.gov (United States)

Hughes, P William; Simons, Andrew M

2014-08-01

• Life-history theory predicts a trade-off between current and future reproduction for iteroparous organisms-as individuals age, the expected value of future reproduction declines, and thus reproductive effort is expected to be higher in later clutches than in earlier. In contrast, models explaining the evolution of semelparity treat semelparous reproduction as instantaneous, with no scope for intraindividual variation. However, semelparous reproduction is also extended, but over shorter time scales; whether there are similar age- or stage-specific changes in reproductive effort within a semelparous episode is unclear. In this study, we assessed whether semelparous individuals increase reproductive effort as residual reproductive value declines by comparing the reproductive phenotype of flowers at five different floral positions along a main inflorescence.• Using the herbaceous monocarp Lobelia inflata, we conducted a longitudinal study of 409 individuals including both laboratory and field populations over three seasons. We recorded six reproductive traits-including the length of three phenological intervals as well as fruit size, seed size, and seed number-for all plants across floral positions produced throughout the reproductive episode.• We found that while the rate of flower initiation did not change, flowers at distal (late) floral positions developed more quickly and contained larger seed than flowers at basal (early) floral positions did.• Our results were consistent with the hypothesis that, like iteroparous organisms, L. inflata increases reproductive effort in response to low residual reproductive value. © 2014 Botanical Society of America, Inc.

The current and ideal state of mental health training: pediatric resident perspectives.

Science.gov (United States)

Hampton, Elisa; Richardson, Joshua E; Bostwick, Susan; Ward, Mary J; Green, Cori

2015-01-01

PHENOMENON: Mental health (MH) problems are prevalent in the pediatric population, and in a setting of limited resources, pediatricians need to provide MH care in the primary medical home yet are uncomfortable doing so citing a lack of training during residency as one barrier. The purpose of this study is to describe pediatric residents' experiences and perspectives on the current and ideal states of MH training and ideas for curriculum development to bridge this gap. A qualitative study using focus groups of pediatric residents from an urban academic medical center was performed. Audio recordings were transcribed and analyzed using a grounded theory approach. Twenty-six residents participated in three focus groups, which is when thematic saturation was achieved. The team generated five major themes: capabilities, comfort, organizational capacity, coping, and education. Residents expressed uncertainty at every step of an MH visit. Internal barriers identified included low levels of comfort and negative emotional responses. External barriers included a lack of MH resources and mentorship in MH care, or an inadequate organizational capacity. These internal and external barriers resulted in a lack of perceived capability in handling MH issues. In response, residents reported inadequate coping strategies, such as ignoring MH concerns. To build knowledge and skills, residents prefer educational modalities including didactics, experiential learning through collaborations with MH specialists, and tools built into patient care flow. Insights: Pediatric residency programs need to evolve in order to improve resident training in MH care. The skills and knowledge requested by residents parallel the American Academy of Pediatrics statement on MH competencies. Models of collaborative care provide similar modalities of learning requested by residents. These national efforts have not been operationalized in training programs yet may be useful for curriculum development and

Support for school-based obesity prevention efforts: attitudes among administrators at nationally representative samples of US elementary schools.

Science.gov (United States)

Turner, Lindsey; Slater, Sandy J; Chaloupka, Frank J

2013-08-01

With the continued threat of childhood obesity, many public health intervention efforts focus on school settings. The current study sought to document administrator attitudes regarding obesity and interest in improving relevant school practices (i.e., nutrition and physical activity) in elementary schools. Mail-back surveys were used to gather data from public and private elementary schools during the 2006-2007, 2007-2008, 2008-2009, and 2010-2011 school years. In each year, a different set of items pertaining to administrator attitudes was included. Numbers of responding schools annually ranged from 259 to 336 private schools, and from 578 to 748 public schools. The vast majority of elementary school administrators (>90%) agreed that schools can play a role in addressing childhood obesity, physical education improves a variety of academic outcomes, and they were interested in improving practices at their school. Concern about childhood obesity and perceiving that schools can play a role in addressing obesity were both associated with more interest in improving school practices. However, only one-third of administrators agreed that parents were interested in participating in improving nutrition and physical activity practices, suggesting opportunities for efforts to improve collaboration. Administrators are generally very supportive of school-based efforts to improve nutrition and physical activity practices and see the value in doing so. Given the amount of time children spend in school, schools are an essential venue for efforts to address childhood obesity.

Association between health worker motivation and healthcare quality efforts in Ghana

OpenAIRE

Alhassan, Robert Kaba; Spieker, Nicole; van Ostenberg, Paul; Ogink, Alice; Nketiah-Amponsah, Edward; de Wit, Tobias F Rinke

2013-01-01

Background Ghana is one of the sub-Saharan African countries making significant progress towards universal access to quality healthcare. However, it remains a challenge to attain the 2015 targets for the health related Millennium Development Goals (MDGs) partly due to health sector human resource challenges including low staff motivation. Purpose This paper addresses indicators of health worker motivation and assesses associations with quality care and patient safety in Ghana. The aim is to i...

Rift Valley fever: current challenges and future prospects

Directory of Open Access Journals (Sweden)

Himeidan YE

2016-03-01

Full Text Available Yousif E Himeidan Vector Control Unit, Africa Technical Research Centre, Vector Health International, Arusha, Tanzania Abstract: Rift Valley fever (RVF is a zoonotic, mosquito-borne viral disease that affects human health and causes significant losses in the livestock industry. Recent outbreaks have led to severe human infections with high mortality rates. There are many challenges to applying effective preventive and control measures, including weak infrastructure of health facilities, lack of capacity and support systems for field logistics and communication, access to global expert organizations, and insufficient information on the epidemiological and reservoir status of the RVF virus. The health systems in East African countries are underdeveloped, with gaps in adaptability to new, more accurate and rapid techniques, and well-trained staff that affect their capacity to monitor and evaluate the disease. Surveillance and response systems are inadequate in providing accurate information in a timely manner for decision making to deal with the scope of interrupting the disease transmission by applying mass animal vaccination, and other preventive measures at the early stage of an outbreak. The historical vaccines are unsuitable for use in newborn and gestating livestock, and the recent ones require a booster and annual revaccination. Future live-attenuated RVF vaccines should possess lower safety concerns regardless of the physiologic state of the animal, and provide rapid and long-term immunity after a single dose of vaccination. In the absence of an effective vaccination program, prevention and control measures must be immediately undertaken after an alert is generated. These measures include enforcing and adapting standard protocols for animal trade and movement, extensive vector control, safe disposal of infected animals, and modification of human–animal contact behavior. Directing control efforts on farmers and workers who deal with

The influence of health disparities on targeting cancer prevention efforts.

Science.gov (United States)

Zonderman, Alan B; Ejiogu, Ngozi; Norbeck, Jennifer; Evans, Michele K

2014-03-01

Despite the advances in cancer medicine and the resultant 20% decline in cancer death rates for Americans since 1991, there remain distinct cancer health disparities among African Americans, Hispanics, Native Americans, and the those living in poverty. Minorities and the poor continue to bear the disproportionate burden of cancer, especially in terms of stage at diagnosis, incidence, and mortality. Cancer health disparities are persistent reminders that state-of-the-art cancer prevention, diagnosis, and treatment are not equally effective for and accessible to all Americans. The cancer prevention model must take into account the phenotype of accelerated aging associated with health disparities as well as the important interplay of biological and sociocultural factors that lead to disparate health outcomes. The building blocks of this prevention model will include interdisciplinary prevention modalities that encourage partnerships across medical and nonmedical entities, community-based participatory research, development of ethnically and racially diverse research cohorts, and full actualization of the prevention benefits outlined in the 2010 Patient Protection and Affordable Care Act. However, the most essential facet should be a thoughtful integration of cancer prevention and screening into prevention, screening, and disease management activities for hypertension and diabetes mellitus because these chronic medical illnesses have a substantial prevalence in populations at risk for cancer disparities and cause considerable comorbidity and likely complicate effective treatment and contribute to disproportionate cancer death rates. Published by Elsevier Inc.

Assessing and Evaluating Department of Defense Efforts to Inform, Influence, and Persuade: Desk Reference

Science.gov (United States)

2015-01-01

Matter campaign, and, in turn, “the impact of people’s attitudes and knowledge about women’s health during pregnancy .”173 In the evaluation of the HIV...behaviors for the purpose of promoting social good. For example, health-promotion efforts often uti - lize social marketing.86 To improve effectiveness

[The current state of health education in France: cause or consequence of the lack of political commitment?].

Science.gov (United States)

Demeulemeester, René

2013-01-01

Fifteen years ago, the limited resources allocated to health education in France were due to a lack of legitimacy compounded by a lack of professional recognition, in addition to a lack of research and a state of methodological anarchy. A national health education program was launched in 2001 to address this issue. However, the program was only partially implemented. Recent reforms have strengthened the national structure and promoted health communication campaigns. Therapeutic patient education has also been legally recognized. However, the resources allocated to community health education have steadily declined, despite efforts to promote training, quality improvement and rationalization. Health promotion--without which health education activities cannot be developed--is still struggling to gain recognition. Investments in health promotion have not increased as a result of the demonstrable effectiveness and professionalization of the sector and of the quality of its services. Indeed, the reverse may be true. In other words, investments in this area may promote the development of research, assessment and quality, while also highlighting the impact on the determinants of health and well-being. Ultimately, there is evidence to suggest that investments in this area can help to reduce premature mortality rates and the number of preventable deaths.

Context-aware QoS provisioning for an M-health service platform

OpenAIRE

Wac, K.E.; Delgado Kloos, C.; Larrabeiti, D.; van Halteren, Aart; Bults, Richard G.A.; Lopez, A.M.; Broens, T.H.F.

2007-01-01

Inevitably, healthcare goes mobile. Recently developed mobile healthcare (i.e., m-health) services allow healthcare professionals to monitor mobile patient’s vital signs and provide feedback to this patient anywhere at any time. Due to the nature of current supporting mobile service platforms, m-health services are delivered with a best-effort, i.e., there are no guarantees on the delivered Quality of Service (QoS). In this paper, we argue that the use of context information in an m-health se...

Plastics, the environment and human health: current consensus and future trends

OpenAIRE

Thompson, Richard C.; Moore, Charles J.; vom Saal, Frederick S.; Swan, Shanna H.

2009-01-01

Plastics have transformed everyday life; usage is increasing and annual production is likely to exceed 300 million tonnes by 2010. In this concluding paper to the Theme Issue on Plastics, the Environment and Human Health, we synthesize current understanding of the benefits and concerns surrounding the use of plastics and look to future priorities, challenges and opportunities. It is evident that plastics bring many societal benefits and offer future technological and medical advances. However...

A framework for current public mental health care practice in South Africa.

Science.gov (United States)

Janse Van Rensburg, A B

2007-11-01

One of the main aims of the new Mental Health Care Act, Act No. 17 of 2002 (MHCA) is to promote the human rights of people with mental disabilities in South Africa. However, the upholding of these rights seems to be subject to the availability of resources. Chapter 2 of the MHCA clarifies the responsibility of the State to provide infrastructure and systems. Chapters 5, 6 and 7 of the Act define and regulate the different categories of mental health care users, clarify the procedures around these categories and spell out mental health practitioners' roles and responsibilities in this regard. Also according to the National Health Act No. 61 of 2003, the State remains the key role player in mental health care provision, being responsible for adequate mental health infrastructure and resource allocation. Due to "limited resources" practitioners however often work in environments where staff ratios may be fractional of what should be expected and in units of which the physical structure and security is totally inadequate. The interface between professional responsibility of clinical workers versus the inadequacy of clinical interventions resulting from infrastructure and staffing constraints needs to be defined. This paper considered recent legislation currently relevant to mental health care practice in order to delineate the legal, ethical and labour framework in which public sector mental health practitioners operate as state employees. These included the Mental Health Care Act, No.17 of 2002; the National Health Act, No. 61 of 2003 and the proposed Traditional Health Practitioners Act, No. 35 of 2004. Formal legal review of and advice on this legislation as it pertains to public sector mental health practitioners as state employees, is necessary and should form the basis of the principles and standards for care endorsed by organized mental health care practitioner groups such as the South African Society of Psychiatrists (SASOP).

[Psychosocial stress and disease risks in occupational life. Results of international studies on the demand-control and the effort-reward imbalance models].

Science.gov (United States)

Siegrist, J; Dragano, N

2008-03-01

Given the far-reaching changes of modern working life, psychosocial stress at work has received increased attention. Its influence on stress-related disease risks is analysed with the help of standardised measurements based on theoretical models. Two such models have gained special prominence in recent years, the demand-control model and the effort-reward imbalance model. The former model places its emphasis on a distinct combination of job characteristics, whereas the latter model's focus is on the imbalance between efforts spent and rewards received in turn. The predictive power of these models with respect to coronary or cardiovascular disease and depression was tested in a number of prospective epidemiological investigations. In summary, twofold elevated disease risks are observed. Effects on cardiovascular disease are particularly pronounced among men, whereas no gender differences are observed for depression. Additional evidence derived from experimental and ambulatory monitoring studies supplements this body of findings. Current scientific evidence justifies an increased awareness and assessment of these newly discovered occupational risks, in particular by occupational health professionals. Moreover, structural and interpersonal measures of stress prevention and health promotion at work are warranted, with special emphasis on gender differences.

CURRENT ISSUES ON JOB STRESS IN JAPAN AND WORKSITE MENTAL HEALTH APPLICATION AMONG JAPANESE COMPANY A Case Study Analysis

Directory of Open Access Journals (Sweden)

S Purnawati

2013-05-01

Full Text Available Background: Issues about job stress is more popular in the world currently. Not just for Japan, Korea and Taiwan, but also an important issue in EU countries, especially the UK and Finland Increase of awareness about job stress effects on work performance, productivity and mental health is as onereason of the phenomenon.Objective: The present study aimed to explore the issue of job stress in Japan for the reference of good practices to Indonesia.Methods: This study, based on observationalstudies in the period of September-December in year 2010 in Tokyo, Kawasaki and Kitakyushu Japan. Observations on Japanese Company and discussions with experts, such as: occupational physician of Riken Company, experts from: Tokyo University and Tokyo University’s occupational physician, Department of ergonomics, the Institute of Industrial Ecological Sciences UOEH (University ofOccupational and Environmental Health, Institute for Science of Labor, and researcher of Japan NIOSH. Two stress management training and occupational mental health’ application program were observed in the period of October-December.Result: The trend of current occupational mental health research in Japan has being moved from job stress to more advanced issues of work engagement andwork-life balance. There are three approaches to prevention of job stress. Considering the three approach could improve of worker productivity and well-being. The training for Tokyo University’s staffs was as one session of individual-oriented stress prevention approach. It was conducted in very interactive class lecture. During 2 hours session, the participants learned some knowledge about job stress and its risk factors, exercised to construct better cognitive for stress prevention and productivity, practiced of progressive muscle relaxation technique, group work, did some home works and filled an evaluation sheet after the session was finish. We also observed the occupational mental

Daily recovery from work: the role of activities, effort and pleasure

NARCIS (Netherlands)

van Hooff, M.L.M.; Geurts, S.A.E.; Beckers, D.G.J.; Kompier, M.A.J.

2011-01-01

Knowledge of the cycle of work and recovery is crucial for protecting employee health and well-being and preserving working capabilities. However, the daily process of effort and recovery is not well understood. This study investigated how the time spent on activities in the work and off-job

Information and communication technology demands at work: the association with job strain, effort-reward imbalance and self-rated health in different socio-economic strata.

Science.gov (United States)

Stadin, Magdalena; Nordin, Maria; Broström, Anders; Magnusson Hanson, Linda L; Westerlund, Hugo; Fransson, Eleonor I

2016-10-01

The use of information and communication technology (ICT) is common in modern working life. ICT demands may give rise to experience of work-related stress. Knowledge about ICT demands in relation to other types of work-related stress and to self-rated health is limited. Consequently, the aim of this study was to examine the association between ICT demands and two types of work-related stress [job strain and effort-reward imbalance (ERI)] and to evaluate the association between these work-related stress measures and self-rated health, in general and in different SES strata. This study is based on cross-sectional data from the Swedish Longitudinal Occupational Survey of Health collected in 2014, from 14,873 gainfully employed people. ICT demands, job strain, ERI and self-rated health were analysed as the main measures. Sex, age, SES, lifestyle factors and BMI were used as covariates. ICT demands correlated significantly with the dimensions of the job strain and ERI models, especially with the demands (r = 0.42; p work-related stress in modern working life.

Veterinary public health in India: current status and future needs.

Science.gov (United States)

Ghatak, S; Singh, B B

2015-12-01

Veterinary public health (VPH) assumes huge significance in developing countries such as India. However, the implementation of VPH services throughout the country is still in its infancy. From 1970 onwards, many institutes, national and international organisations, professional societies, policies and personalities have contributed towards the development of VPH in India. Nevertheless, there is an urgent need to develop VPH still further as there are many issues, such as high population density, the re-emergence of zoonotic pathogens, environmental pollution and antimicrobial resistance, that require attention. The time has surely come to involve all stakeholders, ranging from primary producers (e.g., farmers) to policy-makers, so as to garner support for the holistic implementation of VPH services in India. To improve VPH activities and services, science-based policies enforced through stringent regulation are required to improve human, animal and environmental health. The emergence of the 'One Health' concept has ushered in new hopes for the resurrection of VPH in India. Applying tools such as the World Organisation for Animal Health (OlE) Day One Competencies and the OlE Tool for the Evaluation of Performance of Veterinary Services (PVS Tool) is essential to improve the quality of national Veterinary Services and to identify gaps and weaknesses in service provision, which can be remedied to comply with the OlE international standards. VPH initiatives started modestly but they continue to grow. The present review is focused on the current status and future needs of VPH in India.

U.S., Russia join efforts to clean up nuclear sites

International Nuclear Information System (INIS)

Richard Seltzer.

1993-01-01

U.S. and Russian scientists are stepping up their cooperative efforts to deal with a vexing and controversial problem in both nations--cleanup of radioactive wastes at former nuclear weapons production sites. Last month, a top-level delegation of Russian officials and scientists came to the U.S. for two weeks. They visited Washington, D.C., and the Department of Energy's (DOE) Hanford site in Washington State, studying U.S. cleanup activities and providing information on Russian problems and efforts. The visit was part of a program of exchanges in the areas of environmental restoration and waste management called for by a 1990 memorandum of cooperation between DOE and the Russian Ministry of Atomic Energy. The memo helps implement a U.S.-Russian collaborative agreement on peaceful uses of atomic energy. Currently, cooperation under the memo exists in four areas: vitrification, waste separation, contaminant transport modeling, and student-scientist exchanges. The paper summarizes the visit to the Hanford Reservation and describes the cleanup efforts there

International conference. Mental health consequences of the Chernobyl disaster: current state and future prospects

International Nuclear Information System (INIS)

Nyagu, A.I.

1995-01-01

Proceedings of the International Conference on the mental health consequences of the Chernobyl disaster: current state and future prospects was introduced.The questions connected with: 1. Mental health disorders biological basis after ionizing radiation influence; 2. Psychiatric aspects of the Chernobyl disaster; 3. Social stress following contradictory information: ways for its overcoming; 4. Rehabilitation and prophylactic measures for mental and nervous disorders. Psycho social rehabilitation of survivors; 5. Psychosomatic effects and somato-neurological consequences of the Chernobyl disaster; 6. Psychosomatic health of children and adolescents survivors of the Chernobyl disaster; 7. Brain damage as result of prenatal irradiation

Respiratory effort from the photoplethysmogram.

Science.gov (United States)

Addison, Paul S

2017-03-01

The potential for a simple, non-invasive measure of respiratory effort based on the pulse oximeter signal - the photoplethysmogram or 'pleth' - was investigated in a pilot study. Several parameters were developed based on a variety of manifestations of respiratory effort in the signal, including modulation changes in amplitude, baseline, frequency and pulse transit times, as well as distinct baseline signal shifts. Thirteen candidate parameters were investigated using data from healthy volunteers. Each volunteer underwent a series of controlled respiratory effort maneuvers at various set flow resistances and respiratory rates. Six oximeter probes were tested at various body sites. In all, over three thousand pleth-based effort-airway pressure (EP) curves were generated across the various airway constrictions, respiratory efforts, respiratory rates, subjects, probe sites, and the candidate parameters considered. Regression analysis was performed to determine the existence of positive monotonic relationships between the respiratory effort parameters and resulting airway pressures. Six of the candidate parameters investigated exhibited a distinct positive relationship (poximeter probe and an ECG (P2E-Effort) and the other using two pulse oximeter probes placed at different peripheral body sites (P2-Effort); and baseline shifts in heart rate, (BL-HR-Effort). In conclusion, a clear monotonic relationship was found between several pleth-based parameters and imposed respiratory loadings at the mouth across a range of respiratory rates and flow constrictions. The results suggest that the pleth may provide a measure of changing upper airway dynamics indicative of the effort to breathe. Copyright © 2017 The Author. Published by Elsevier Ltd.. All rights reserved.

Racial disparities in smoking knowledge among current smokers: data from the health information national trends surveys.

Science.gov (United States)

Reimer, Rachel Ann; Gerrard, Meg; Gibbons, Frederick X

2010-10-01

Although African-Americans (Blacks) smoke fewer cigarettes per day than European-Americans (Whites), there is ample evidence that Blacks are more susceptible to smoking-related health consequences. A variety of behavioural, social and biological factors have been linked to this increased risk. There has been little research, however, on racial differences in smoking-related knowledge and perceived risk of lung cancer. The primary goal of the current study was to evaluate beliefs and knowledge that contribute to race disparities in lung cancer risk among current smokers. Data from two separate nationally representative surveys (the Health Information National Trends surveys 2003 and 2005) were analysed. Logistic and hierarchical regressions were conducted; gender, age, education level, annual household income and amount of smoking were included as covariates. In both studies, Black smokers were significantly more likely to endorse inaccurate statements than were White smokers, and did not estimate their lung cancer risk to be significantly higher than Whites. Results highlight an important racial disparity in public health knowledge among current smokers.

Chile: perspectives in school health.

Science.gov (United States)

Langdon, M C; Gazmuri, C; Venegas, L

1990-09-01

The leading health problems of children and adolescents in Chile is reviewed. The Chilean educational system and how the system addresses its principal health problems are described. A school health program is described as well as other educational programs designed and developed by nongovernmental institutions which have a smaller coverage. Current research studies regarding growth and development, child morbidity, nutritional level, and mental health studies are reviewed. In addition, principal challenges that include developing more efficient ways of referring children, enriching the curriculum and teacher training, assigning school hours for health teachers, and enlarging coverage of the health care evaluation programs are outlined. Of special importance is developing prevention programs for parents and children using school and community leaders to prevent health problems in areas such as human sexuality education, decision-making, social abilities, and alcohol and drug abuse. Main efforts should be directed toward low-income families and children to improve life conditions.

Telemedicine expanding the scope of health care information.

Science.gov (United States)

Balch, D C; Tichenor, J M

1997-01-01

The definition of health information is growing to include multimedia audio, video, and high-resolution still images. This article describes the telemedicine program at East Carolina University School of Medicine, including the telemedicine applications presently in use and the virtual reality applications currently under development' Included are the major design criteria that shape the telemedicine network some of the lessons learned in developing the network, and a discussion of the future of telemedicine, including efforts to incorporate telemedicine within a fully integrated health information system.

Nudging for Prevention in Occupational Health and Safety in South Africa Using Fiscal Policies.

Science.gov (United States)

de Jager, Pieter; Rees, David; Kisting, Sophia; Kgalamono, Spo; Ndaba, Mpume; Stacey, Nicolas; Tugendhaft, Aviva; Hofman, Karen

2017-08-01

Currently, in some countries occupational health and safety policy and practice have a bias toward secondary prevention and workers' compensation rather than primary prevention. Particularly, in emerging economies, research has not adequately contributed to effective interventions and improvements in workers' health. This article, using South Africa as a case study, describes a methodology for identifying candidate fiscal policy interventions and describes the policy interventions selected for occupational health and safety. It is argued that fiscal policies are well placed to deal with complex intersectoral health problems and to focus efforts on primary prevention. A major challenge is the lack of empirical evidence to support the effectiveness of fiscal policies in improving workers' health. A second challenge is the underprioritization of occupational health and safety partly due to the relatively small burden of disease attributed to occupational exposures. Both challenges can and should be overcome by (i) conducting policy-relevant research to fill the empirical gaps and (ii) reconceptualizing, both for policy and research purposes, the role of work as a determinant of population health. Fiscal policies to prevent exposure to hazards at work have face validity and are thus appealing, not as a replacement for other efforts to improve health, but as part of a comprehensive effort toward prevention.

What we need to improve the Public Health Workforce in Europe?

Directory of Open Access Journals (Sweden)

Vesna Bjegovic-Mikanovic

2015-12-01

multidisciplinary public health workforce is needed, supported by new skills and expertise. It has been demonstrated that public health education needs to include a wider range of health related professionals including: managers, health promotion specialists, health economists, lawyers and pharmacists. In the future, public health professionals will increasingly require enhanced communication and leadership skills, as well as a broad, interdisciplinary focus, if they are to truly impact upon the health of the population and compete successfully in today‘s job market. New developments comprise flexible academic programmes, lifelong learning, employability, and accreditation. In Europe‘s current climate of extreme funding constraints, the need for upgrading public health training and education is more important than ever. The broad supportive environment and context for change are in place. By focusing on assessment and evaluation of the current context, coordination and joint efforts to promote competency-based education, and support and growth of new developments, a stronger, more versatile and much needed workforce will be developed.

The influence of music on mental effort and driving performance.

Science.gov (United States)

Ünal, Ayça Berfu; Steg, Linda; Epstude, Kai

2012-09-01

The current research examined the influence of loud music on driving performance, and whether mental effort mediated this effect. Participants (N=69) drove in a driving simulator either with or without listening to music. In order to test whether music would have similar effects on driving performance in different situations, we manipulated the simulated traffic environment such that the driving context consisted of both complex and monotonous driving situations. In addition, we systematically kept track of drivers' mental load by making the participants verbally report their mental effort at certain moments while driving. We found that listening to music increased mental effort while driving, irrespective of the driving situation being complex or monotonous, providing support to the general assumption that music can be a distracting auditory stimulus while driving. However, drivers who listened to music performed as well as the drivers who did not listen to music, indicating that music did not impair their driving performance. Importantly, the increases in mental effort while listening to music pointed out that drivers try to regulate their mental effort as a cognitive compensatory strategy to deal with task demands. Interestingly, we observed significant improvements in driving performance in two of the driving situations. It seems like mental effort might mediate the effect of music on driving performance in situations requiring sustained attention. Other process variables, such as arousal and boredom, should also be incorporated to study designs in order to reveal more on the nature of how music affects driving. Copyright © 2012 Elsevier Ltd. All rights reserved.

Health and health promotion

NARCIS (Netherlands)

Kingma, E.M.

2012-01-01

Much of our social and political effort, including a portion of the research in this university, is directed towards the promotion of one goal: health. But what is health? Or rather, how should we define health so that it is an identifiable goalpost for our social policies and technological

New insights from direct monitoring of turbidity currents; and a proposal for co-ordinating international efforts at a series of global "turbidity current test sites"

Science.gov (United States)

Talling, Peter

2015-04-01

Turbidity currents, and other types of submarine sediment density flow, arguably redistribute more sediment across the surface of the Earth than any other flow process. It is now over 60 years since the seminal publication of Kuenen and Migliorini (1950) in which they made the link between sequences of graded bedding and turbidity currents. The deposits of submarine sediment density flows have been described in numerous locations worldwide, and this might lead to the view that these flows are well understood. However, it is sobering to note quite how few direct measurements we have from these submarine flows in action. Sediment concentration is the critical parameter controlling such flows, yet it has never been measured directly for flows that reach and build submarine fans. How then do we know what type of flow to model in flume tanks, or which assumptions to use to formulate numerical simulations or analytical models? It is proposed here that international efforts are needed for an initiative to monitor active turbidity currents at a series of 'test sites' where flows occur frequently. The flows evolve significantly, such that source to sink data are needed. We also need to directly monitor flows in different settings with variable triggering factors and flow path morphologies because their character can vary significantly. Such work should integrate numerical and physical modelling with the collection of field observations in order to understand the significance of field observations. Such an international initiative also needs to include coring of deposits to link flow processes to deposit character, because in most global locations flow behaviour must be inferred from deposits alone. Collection of seismic datasets is also crucial for understanding the larger-scale evolution and resulting architecture of these systems, and to link with studies of subsurface reservoirs. Test site datasets should thus include a wide range of data types, not just from direct flow

Building diversity in a complex academic health center.

Science.gov (United States)

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

2013-09-01

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

Do efforts to standardize, assess and improve the quality of health service provision to adolescents by government-run health services in low and middle income countries, lead to improvements in service-quality and service-utilization by adolescents?

Science.gov (United States)

Chandra-Mouli, Venkatraman; Chatterjee, Subidita; Bose, Krishna

2016-02-06

Researchers and implementers working in adolescent health, and adolescents themselves question whether government-run health services in conservative and resource-constrained settings can be made adolescent friendly. This paper aims to find out what selected low and middle income country (LMIC) governments have set out to do to improve the quality of health service provision to adolescents; whether their efforts led to measurable improvements in quality and to increased health service-utilization by adolescents. We gathered normative guidance and reports from eight LMICs in Asia, Africa, Central and Eastern Europe and the Western Pacific. We analysed national quality standards for adolescent friendly health services, findings from the assessments of the quality of health service provision, and findings on the utilization of health services. Governments of LMICs have set out to improve the accessibility, acceptability, equity, appropriateness and effectiveness of health service provision to adolescents by defining standards and actions to achieve them. Their actions have led to measurable improvements in quality and to increases in health service utilisation by adolescents. With support, government-run health facilities in LMICs can improve the quality of health services and their utilization by adolescents.

Effort-Based Decision-Making Paradigms for Clinical Trials in Schizophrenia: Part 1—Psychometric Characteristics of 5 Paradigms.

Science.gov (United States)

Reddy, L Felice; Horan, William P; Barch, Deanna M; Buchanan, Robert W; Dunayevich, Eduardo; Gold, James M; Lyons, Naomi; Marder, Stephen R; Treadway, Michael T; Wynn, Jonathan K; Young, Jared W; Green, Michael F

2015-09-01

Impairments in willingness to exert effort contribute to the motivational deficits characteristic of the negative symptoms of schizophrenia. The current study evaluated the psychometric properties of 5 new or adapted paradigms to determine their suitability for use in clinical trials of schizophrenia. This study included 94 clinically stable participants with schizophrenia and 40 healthy controls. The effort-based decision-making battery was administered twice to the schizophrenia group (baseline, 4-week retest) and once to the control group. The 5 paradigms included 1 that assesses cognitive effort, 1 perceptual effort, and 3 that assess physical effort. Each paradigm was evaluated on (1) patient vs healthy control group differences, (2) test-retest reliability, (3) utility as a repeated measure (ie, practice effects), and (4) tolerability. The 5 paradigms showed varying psychometric strengths and weaknesses. The Effort Expenditure for Rewards Task showed the best reliability and utility as a repeated measure, while the Grip Effort Task had significant patient-control group differences, and superior tolerability and administration duration. The other paradigms showed weaker psychometric characteristics in their current forms. These findings highlight challenges in adapting effort and motivation paradigms for use in clinical trials. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center 2015.

eHealth in Treatment of Offenders in Forensic Mental Health: A Review of the Current State

Directory of Open Access Journals (Sweden)

Hanneke Kip

2018-02-01

Full Text Available BackgroundTreatment of offenders in forensic mental health is complex. Often, these in- or outpatients have low treatment motivation, suffer from multiple disorders, and have poor literacy skills. eHealth may be able to improve treatment outcomes because of its potential to increase motivation and engagement, and it can overcome the predominant one-size-fits-all approach by being tailored to individual patients.ObjectiveTo examine its potential, this systematic review studies the way that eHealth has been used and studied in forensic mental health and identifies accompanying advantages and disadvantages for both patients and treatment, including effectiveness.MethodsA systematic search in Scopus, PsycINFO, and Web of Science was performed up until December 2017. Studies were included if they focused on technological interventions to improve the treatment of forensic psychiatric patients.ResultsThe search resulted in 50 studies in which eHealth was used for treatment purposes. Multiple types of studies and technologies were identified, such as virtual reality, web-based interventions, and videoconferencing. The results confirmed the benefits of technology, for example, the acquisition of unique information about offenders, effectiveness, and tailoring to specific characteristics, but indicated that these are not fully taken advantage of.DiscussionTo overcome the barriers and obtain the benefits, eHealth has to have a good fit with patients and the forensic psychiatric context. It has to be seamlessly integrated in existing care and should not be added as an isolated element. To bridge the gap between the current situation and eHealth’s potential, further research on development, implementation, and evaluation should be conducted.

Improving Outreach and Surveillance Efforts Following a Large-Scale Carbon Monoxide Poisoning in Wisconsin.

Science.gov (United States)

Creswell, Paul D; Vogt, Christy M; Wozniak, Ryan J; Camponeschi, Jenny; Werner, Mark A; Meiman, Jonathan G

In December 2014, the largest carbon monoxide (CO) poisoning in Wisconsin's history occurred at an ice arena. Following this event, the Wisconsin Environmental Public Health Tracking (WI EPHT) Program sought to improve outreach and surveillance efforts. WI EPHT designed and distributed educational materials on CO poisoning prevention and surveyed stakeholders to gauge the effectiveness of outreach efforts. To enhance surveillance, WI EPHT utilized data from the Wisconsin Poison Center (WPC) to generate real-time alerts of anomalous numbers of CO-related calls. WI EPHT found that 42% of stakeholders reviewed the outreach materials, and 1 ice arena had installed a CO detector as a result. CO alerts were developed using WPC data and are now routinely used in statewide public health surveillance. WI EPHT staff improved CO poisoning prevention outreach and saw a positive response among stakeholders. This work demonstrates ways that health agencies can improve outreach and surveillance for CO poisoning. Improvements in these areas can bolster public health response and may prevent CO-related illness and injury.

Cognitive effort: A neuroeconomic approach

Science.gov (United States)

Braver, Todd S.

2015-01-01

Cognitive effort has been implicated in numerous theories regarding normal and aberrant behavior and the physiological response to engagement with demanding tasks. Yet, despite broad interest, no unifying, operational definition of cognitive effort itself has been proposed. Here, we argue that the most intuitive and epistemologically valuable treatment is in terms of effort-based decision-making, and advocate a neuroeconomics-focused research strategy. We first outline psychological and neuroscientific theories of cognitive effort. Then we describe the benefits of a neuroeconomic research strategy, highlighting how it affords greater inferential traction than do traditional markers of cognitive effort, including self-reports and physiologic markers of autonomic arousal. Finally, we sketch a future series of studies that can leverage the full potential of the neuroeconomic approach toward understanding the cognitive and neural mechanisms that give rise to phenomenal, subjective cognitive effort. PMID:25673005

Maternal sensitivity and latency to positive emotion following challenge: pathways through effortful control.

Science.gov (United States)

Conway, Anne; McDonough, Susan C; Mackenzie, Michael; Miller, Alison; Dayton, Carolyn; Rosenblum, Katherine; Muzik, Maria; Sameroff, Arnold

2014-01-01

The ability to self-generate positive emotions is an important component of emotion regulation. In this study, we focus on children's latency to express positive emotions following challenging situations and assess whether this ability operates through early maternal sensitivity and children's effortful control. Longitudinal relations between maternal sensitivity, infant negative affect, effortful control, and latency to positive emotion following challenge were examined in 156 children who were 33 months of age. Structural equation models supported the hypothesis that maternal sensitivity during infancy predicted better effortful control and, in turn, shorter latencies to positive emotions following challenge at 33 months. Directions for future research are discussed. © 2014 Michigan Association for Infant Mental Health.

The current child and adolescent health screening system: an assessment and proposal for an early and periodic check-up program

Directory of Open Access Journals (Sweden)

Baik-Lin Eun

2010-03-01

Full Text Available Purpose : Recent changes in the population structure of Korea, such as rapid decline in birth rate and exponential increase in old-aged people, prompted us to prepare a new health improvement program in children and adolescents. Methods : We reviewed current health screenings applied for children and adolescents in Korea and other developed countries. We collected and reviewed population-based data focused on mortality and morbidity, and other health-related statistical data. We generated problem lists in current systems and developed new principles. Results : Current health screening programs for children and adolescents were usually based on laboratory tests, such as blood tests, urinalysis, and radiologic tests. Almost all of these programs lacked evidence based on population data or controlled studies. In most developed countries, laboratory tests are used only very selectively, and they usually focus on primary prevention of diseases and health improvement using anticipatory guidance. In Korea, statistics on mortality and morbidity reveal that diseases related to lifestyle, such as obesity and metabolic syndrome, are increasing in all generations. Conclusion : We recommend a periodic health screening program with anticipatory guidance, which is focused on growth and developmental surveillance in infants and children. We no longer recommend old programs that are based on laboratory and radiologic examinations. School health screening programs should also be changed to meet current health issues, such as developing a healthier lifestyle to minimize risk behaviors&#8212;for example, good mental health, balanced nutrition, and more exercise.

Association between health worker motivation and healthcare quality efforts in Ghana

NARCIS (Netherlands)

Alhassan, Robert Kaba; Spieker, Nicole; van Ostenberg, Paul; Ogink, Alice; Nketiah-Amponsah, Edward; Rinke de Wit, Tobias F.

2013-01-01

Ghana is one of the sub-Saharan African countries making significant progress towards universal access to quality healthcare. However, it remains a challenge to attain the 2015 targets for the health related Millennium Development Goals (MDGs) partly due to health sector human resource challenges

Current Situation in Occupational Health and Safety Education in Higher Education Institutions of Turkey

Directory of Open Access Journals (Sweden)

Osman SİVRİKAYA

2016-10-01

Full Text Available During recent years, “the occupational health and safety” topic, which has gained importance in different countries in the world, has got attention in Turkey as well. The importance of human life and health is being increased in the world especially in the developed countries. As a result of this, in order to prevent the work accidents involving death or personal injury in the work life, the importance of the “occupational health and safety” is increasing gradually. In Turkey, the regulation studies are being carried out on this topic with the successive regulations especially during recent years. The application aspect of the topic, which is related to employers on the occasion of legal liabilities in accordance with the regulations, and for the graduates who are seeking for a job and especially want to be occupational safety specialists, it is popular from the point of view to be hope for a job. However, due to the difficulties to follow the rapidly changing developments, efficient awareness about the topic is not possible. It is possible that to get true and current information about the topic is possible by showing necessary sensitivity about occupational health and safety education. The graduates from different departments wonder the topics such as what is “occupational health and safety” education and “what kind of an education is necessary to become an occupational safety specialist”. Hence, in this article, by giving current information about occupational health and safety education and their content in the higher education institutions in Turkey, the points, which have had improvements compared to the past, are considered, and certain suggestions are presented to have better occupational health and safety education.

Effort-Based Decision Making: A Novel Approach for Assessing Motivation in Schizophrenia.

Science.gov (United States)

Green, Michael F; Horan, William P; Barch, Deanna M; Gold, James M

2015-09-01

Because negative symptoms, including motivational deficits, are a critical unmet need in schizophrenia, there are many ongoing efforts to develop new pharmacological and psychosocial interventions for these impairments. A common challenge of these studies involves how to evaluate and select optimal endpoints. Currently, all studies of negative symptoms in schizophrenia depend on ratings from clinician-conducted interviews. Effort-based decision-making tasks may provide a more objective, and perhaps more sensitive, endpoint for trials of motivational negative symptoms. These tasks assess how much effort a person is willing to exert for a given level of reward. This area has been well-studied with animal models of effort and motivation, and effort-based decision-making tasks have been adapted for use in humans. Very recently, several studies have examined physical and cognitive types of effort-based decision-making tasks in cross-sectional studies of schizophrenia, providing evidence for effort-related impairment in this illness. This article covers the theoretical background on effort-based decision-making tasks to provide a context for the subsequent articles in this theme section. In addition, we review the existing literature of studies using these tasks in schizophrenia, consider some practical challenges in adapting them for use in clinical trials in schizophrenia, and discuss interpretive challenges that are central to these types of tasks. © The Author 2015. Published by Oxford University Press on behalf of the Maryland Psychiatric Research Center. All rights reserved. For permissions, please email: journals.permissions@oup.com.

Looking beyond "affordable" health care: cultural understanding and sensitivity-necessities in addressing the health care disparities of the U.S. Hispanic population.

Science.gov (United States)

Askim-Lovseth, Mary K; Aldana, Adriana

2010-10-01

Health disparities are pervasive in the United States; but among Hispanics, access to health care is encumbered by poverty, lack of insurance, legal status, and racial or minority status. Research has identified certain aspects of Hispanic culture, values, and traditions contributing to the nature of the Hispanic patient-doctor relationship and the quality of the health care service. Current educational efforts by nonprofit organizations, government, health professionals, and pharmaceutical manufacturers fail to address the needs for accessible and appropriately culture-sensitive information when approaching the diverse Hispanic community. Understanding Hispanics' consumptive practices and expectations surrounding medications is critical to the success of many treatment regimens. Recommendations are presented to address this health care issue.

Water-Food-Nutrition-Health Nexus: Linking Water to Improving Food, Nutrition and Health in Sub-Saharan Africa

Directory of Open Access Journals (Sweden)

Tafadzwanashe Mabhaudhi

2016-01-01

Full Text Available Whereas sub-Saharan Africa’s (SSA water scarcity, food, nutrition and health challenges are well-documented, efforts to address them have often been disconnected. Given that the region continues to be affected by poverty and food and nutrition insecurity at national and household levels, there is a need for a paradigm shift in order to effectively deliver on the twin challenges of food and nutrition security under conditions of water scarcity. There is a need to link water use in agriculture to achieve food and nutrition security outcomes for improved human health and well-being. Currently, there are no explicit linkages between water, agriculture, nutrition and health owing to uncoordinated efforts between agricultural and nutrition scientists. There is also a need to develop and promote the use of metrics that capture aspects of water, agriculture, food and nutrition. This review identified nutritional water productivity as a suitable index for measuring the impact of a water-food-nutrition-health nexus. Socio-economic factors are also considered as they influence food choices in rural communities. An argument for the need to utilise the region’s agrobiodiversity for addressing dietary quality and diversity was established. It is concluded that a model for improving nutrition and health of poor rural communities based on the water-food-nutrition-health nexus is possible.

Public behavioral health care reform in North Carolina: will we get it right this time around?

Science.gov (United States)

Swartz, Marvin; Morrissey, Joseph

2012-01-01

North Carolina seeks to provide affordable and high-quality care for people with mental health, developmental disabilities and substance abuse conditions by reforming its behavioral health care system. This article presents an overview of current efforts to achieve that goal and discusses the challenges that must be overcome if reform is to be effective.

Information and communication technology demands at work : the association with job strain, effort-reward imbalance and self-rated health in different socio-economic strata

OpenAIRE

Stadin, Magdalena; Nordin, Maria; Broström, Anders; Magnusson Hanson, Linda L.; Westerlund, Hugo; Fransson, Eleonor I.

2016-01-01

The use of information and communication technology (ICT) is common in modern working life. ICT demands may give rise to experience of work-related stress. Knowledge about ICT demands in relation to other types of work-related stress and to self-rated health is limited. Consequently, the aim of this study was to examine the association between ICT demands and two types of work-related stress [job strain and effort-reward imbalance (ERI)] and to evaluate the association between these work-rela...

A health-promoting community dental service in Melbourne, Victoria, Australia: protocol for the North Richmond model of oral health care.

Science.gov (United States)

Hall, Martin; Christian, Bradley

2017-10-01

Despite the best efforts and commitment of oral health programs, there is no evidence that the current surgical output-based model of oral health care is delivering better oral health outcomes to the community. In fact, Australian evidence indicates the oral health of the community could be getting worse. It is now well-understood that this traditional surgical model of oral health care will never successfully manage the disease itself. It is proposed that a health-promoting, minimally invasive oral disease management model of care may lead to a sustainable benefit to the oral health status of the individual and community groups. The aim of this paper is to describe such a model of oral health care (MoC) currently being implemented by the North Richmond Community Health Oral Health (NRCH-OH) program in Melbourne, Victoria, Australia; this model may serve as a template for other services to re-orient their healthcare delivery towards health promotion and prevention. The paper describes the guiding principles and theories for the model and also its operational components, which are: pre-engagement while on the waitlist; client engagement at the reception area; the assessment phase; oral health education (high-risk clients only); disease management; and reviews and recall.

Partnering Against Cancer Today: A Blueprint for Coordinating Efforts Through Communication Science

Science.gov (United States)

2013-01-01

One of the hallmarks of the communication revolution over the past decade has been its support for participation, whether that be in the active engagement of patients searching the Web for answers to vital health questions, or in the collective energies of self-organizing communities through social media. At the same time, some of the major obstacles to achieving a full and equitable reach of evidence-based cancer control knowledge have been traced back to discontinuities in communication either within clinical care or the broader public awareness system. Communication scientists from the National Cancer Institute, the Centers for Disease Control and Prevention, and the American Cancer Society joined forces in 2010 to investigate ways in which communication science can be used to improve coordination and enhance participation in cancer control for the nation. From 2010 to 2013, the three organizations worked together in 1) convening two meetings designed to assess the status of funded research in communication science, 2) completing a systematic review of literature published over the previous 10 years, and 3) authoring a blueprint for coordinated efforts using the implications of communication science. The blueprint consists of three major goals: first, to identify high-yield targets of opportunity using the health impact pyramid articulated by Centers for Disease Control and Prevention Director, Thomas Frieden; second, to leverage opportunities within the new communication environment, including the opportunities catalyzed by national efforts to create an infrastructure for evidence implementation through health information technology; and third, to assist in coordinating efforts across collaborative entities through participative media. PMID:24395998

A model to estimate cost-savings in diabetic foot ulcer prevention efforts.

Science.gov (United States)

Barshes, Neal R; Saedi, Samira; Wrobel, James; Kougias, Panos; Kundakcioglu, O Erhun; Armstrong, David G

2017-04-01

Sustained efforts at preventing diabetic foot ulcers (DFUs) and subsequent leg amputations are sporadic in most health care systems despite the high costs associated with such complications. We sought to estimate effectiveness targets at which cost-savings (i.e. improved health outcomes at decreased total costs) might occur. A Markov model with probabilistic sensitivity analyses was used to simulate the five-year survival, incidence of foot complications, and total health care costs in a hypothetical population of 100,000 people with diabetes. Clinical event and cost estimates were obtained from previously-published trials and studies. A population without previous DFU but with 17% neuropathy and 11% peripheral artery disease (PAD) prevalence was assumed. Primary prevention (PP) was defined as reducing initial DFU incidence. PP was more than 90% likely to provide cost-savings when annual prevention costs are less than $50/person and/or annual DFU incidence is reduced by at least 25%. Efforts directed at patients with diabetes who were at moderate or high risk for DFUs were very likely to provide cost-savings if DFU incidence was decreased by at least 10% and/or the cost was less than $150 per person per year. Low-cost DFU primary prevention efforts producing even small decreases in DFU incidence may provide the best opportunity for cost-savings, especially if focused on patients with neuropathy and/or PAD. Mobile phone-based reminders, self-identification of risk factors (ex. Ipswich touch test), and written brochures may be among such low-cost interventions that should be investigated for cost-savings potential. Published by Elsevier Inc.

A Review on Microdialysis Calibration Methods: the Theory and Current Related Efforts.

Science.gov (United States)

Kho, Chun Min; Enche Ab Rahim, Siti Kartini; Ahmad, Zainal Arifin; Abdullah, Norazharuddin Shah

2017-07-01

Microdialysis is a sampling technique first introduced in the late 1950s. Although this technique was originally designed to study endogenous compounds in animal brain, it is later modified to be used in other organs. Additionally, microdialysis is not only able to collect unbound concentration of compounds from tissue sites; this technique can also be used to deliver exogenous compounds to a designated area. Due to its versatility, microdialysis technique is widely employed in a number of areas, including biomedical research. However, for most in vivo studies, the concentration of substance obtained directly from the microdialysis technique does not accurately describe the concentration of the substance on-site. In order to relate the results collected from microdialysis to the actual in vivo condition, a calibration method is required. To date, various microdialysis calibration methods have been reported, with each method being capable to provide valuable insights of the technique itself and its applications. This paper aims to provide a critical review on various calibration methods used in microdialysis applications, inclusive of a detailed description of the microdialysis technique itself to start with. It is expected that this article shall review in detail, the various calibration methods employed, present examples of work related to each calibration method including clinical efforts, plus the advantages and disadvantages of each of the methods.

Marketing in current financial crisis

OpenAIRE

Mariánek, Lukáš

2009-01-01

The paper is describing the effects of recessions and current financial crisis on companies and their marketing. The topic covers the history of marketing throughout the world biggest recessions and describes the current marketing efforts of Czech companies under the current financial crisis. A strategical analysis with the impacts of crisis on long-term strategy planning is provided at the end of the paper.

Current models of positive mental health

Directory of Open Access Journals (Sweden)

Stanojević Dragana Z.

2012-01-01

Full Text Available The concept of positive mental health represents not merely the absence of mental disease but presence of high level of happiness and well-being. In this paper we mentioned shortly the earliest concept of mental health, presented by Marie Jahoda in the mid-twentieth century. After that, we described two traditions in understanding and researching of subjective well-being: hedonic and eudaimonic approach. First approach focuses on investigation of positive affects and happiness as emotional and life satisfaction as cognitive component of subjective well-being. Second tradition emphasizes potentials and competences that person develops to the highest level, in personal and social area. Both psychological and social well-being are core concept of positive mental health psychology, designated together as positive functioning. The psychological well-being comprises six dimensions: self-acceptance, positive relations with others, environmental mastery, autonomy, purpose of life and personal growth. Social well-being consists of five dimensions: social integration, social acceptance, social contribution, social actualization and social coherence. By integrating hedonic and eudaimonic well-being as well as absence of mental disease, Corey Keyes introduced concept of complete mental health. People with complete mental health have reported absence of disease during past year and presence of high level of emotional, psychological and social well-being (flourishing. People with incomplete mental health have also reported absence of mental disease but low level of positive functioning (languishing. Keyes thought there are people with complete and incomplete mental illness; both groups report presence of mental disease, but second group has high level of positive functioning. Models of positive mental health are widely used in research studies as well as in programs for prevention and promotion of mental health. .

Oak Ridge Health Studies Phase 1 report, Volume 2: Part D, Dose Reconstruction Feasibility Study. Tasks 6, Hazard summaries for important materials at the Oak Ridge Reservation

Energy Technology Data Exchange (ETDEWEB)

Bruce, G.M.; Walker, L.B.; Widner, T.E.

1993-09-01

The purpose of Task 6 of Oak Ridge Phase I Health Studies is to provide summaries of current knowledge of toxic and hazardous properties of materials that are important for the Oak Ridge Reservation. The information gathered in the course of Task 6 investigations will support the task of focussing any future health studies efforts on those operations and emissions which have likely been most significant in terms of off-site health risk. The information gathered in Task 6 efforts will likely also be of value to individuals evaluating the feasibility of additional health,study efforts (such as epidemiological investigations) in the Oak Ridge area and as a resource for citizens seeking information on historical emissions.

Effort-Reward Imbalance and Burnout Among ICU Nursing Staff: A Cross-Sectional Study.

Science.gov (United States)

Padilla Fortunatti, Cristobal; Palmeiro-Silva, Yasna K

Occupational stress is commonly observed among staff in intensive care units (ICUs). Sociodemographic, organizational, and job-related factors may lead to burnout among ICU health workers. In addition, these factors could modify the balance between efforts done and rewards perceived by workers; consequently, this imbalance could increase levels of emotional exhaustion and depersonalization and decrease a sense of personal accomplishment. The purpose of this study was to analyze the relationship between effort-reward imbalance and burnout dimensions (emotional exhaustion, depersonalization, and personal accomplishment) among ICU nursing staff in a university hospital in Santiago, Chile. A convenience sample of 36 registered nurses and 46 nurse aides answered the Maslach Burnout Inventory and Effort-Reward Imbalance Questionnaire and provided sociodemographic and work-related data. Age and effort-reward imbalance were significantly associated with emotional exhaustion in both registered nurses and nurse aides; age was negatively correlated with emotional exhaustion, whereas effort-reward imbalance was positively correlated. Age was negatively associated with depersonalization. None of the predictors were associated with personal accomplishment. This study adds valuable information about relationships of sociodemographic factors and effort-reward imbalance and their impact on dimensions of burnout, particularly on emotional exhaustion.

Promoting health equity: WHO health inequality monitoring at global and national levels

Science.gov (United States)

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

2015-01-01

Background Health equity is a priority in the post-2015 sustainable development agenda and other major health initiatives. The World Health Organization (WHO) has a history of promoting actions to achieve equity in health, including efforts to encourage the practice of health inequality monitoring. Health inequality monitoring systems use disaggregated data to identify disadvantaged subgroups within populations and inform equity-oriented health policies, programs, and practices. Objective This paper provides an overview of a number of recent and current WHO initiatives related to health inequality monitoring at the global and/or national level. Design We outline the scope, content, and intended uses/application of the following: Health Equity Monitor database and theme page; State of inequality: reproductive, maternal, newborn, and child health report; Handbook on health inequality monitoring: with a focus on low- and middle-income countries; Health inequality monitoring eLearning module; Monitoring health inequality: an essential step for achieving health equity advocacy booklet and accompanying video series; and capacity building workshops conducted in WHO Member States and Regions. Conclusions The paper concludes by considering how the work of the WHO can be expanded upon to promote the establishment of sustainable and robust inequality monitoring systems across a variety of health topics among Member States and at the global level. PMID:26387506

Promoting health equity: WHO health inequality monitoring at global and national levels.

Science.gov (United States)

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

2015-01-01

Health equity is a priority in the post-2015 sustainable development agenda and other major health initiatives. The World Health Organization (WHO) has a history of promoting actions to achieve equity in health, including efforts to encourage the practice of health inequality monitoring. Health inequality monitoring systems use disaggregated data to identify disadvantaged subgroups within populations and inform equity-oriented health policies, programs, and practices. This paper provides an overview of a number of recent and current WHO initiatives related to health inequality monitoring at the global and/or national level. We outline the scope, content, and intended uses/application of the following: Health Equity Monitor database and theme page; State of inequality: reproductive, maternal, newborn, and child health report; Handbook on health inequality monitoring: with a focus on low- and middle-income countries; Health inequality monitoring eLearning module; Monitoring health inequality: an essential step for achieving health equity advocacy booklet and accompanying video series; and capacity building workshops conducted in WHO Member States and Regions. The paper concludes by considering how the work of the WHO can be expanded upon to promote the establishment of sustainable and robust inequality monitoring systems across a variety of health topics among Member States and at the global level.

Promoting health equity: WHO health inequality monitoring at global and national levels

Directory of Open Access Journals (Sweden)

Ahmad Reza Hosseinpoor

2015-09-01

Full Text Available Background: Health equity is a priority in the post-2015 sustainable development agenda and other major health initiatives. The World Health Organization (WHO has a history of promoting actions to achieve equity in health, including efforts to encourage the practice of health inequality monitoring. Health inequality monitoring systems use disaggregated data to identify disadvantaged subgroups within populations and inform equity-oriented health policies, programs, and practices. Objective: This paper provides an overview of a number of recent and current WHO initiatives related to health inequality monitoring at the global and/or national level. Design: We outline the scope, content, and intended uses/application of the following: Health Equity Monitor database and theme page; State of inequality: reproductive, maternal, newborn, and child health report; Handbook on health inequality monitoring: with a focus on low- and middle-income countries; Health inequality monitoring eLearning module; Monitoring health inequality: an essential step for achieving health equity advocacy booklet and accompanying video series; and capacity building workshops conducted in WHO Member States and Regions. Conclusions: The paper concludes by considering how the work of the WHO can be expanded upon to promote the establishment of sustainable and robust inequality monitoring systems across a variety of health topics among Member States and at the global level.

Measuring cognitive load: performance, mental effort and simulation task complexity.

Science.gov (United States)

Haji, Faizal A; Rojas, David; Childs, Ruth; de Ribaupierre, Sandrine; Dubrowski, Adam

2015-08-01

Interest in applying cognitive load theory in health care simulation is growing. This line of inquiry requires measures that are sensitive to changes in cognitive load arising from different instructional designs. Recently, mental effort ratings and secondary task performance have shown promise as measures of cognitive load in health care simulation. We investigate the sensitivity of these measures to predicted differences in intrinsic load arising from variations in task complexity and learner expertise during simulation-based surgical skills training. We randomly assigned 28 novice medical students to simulation training on a simple or complex surgical knot-tying task. Participants completed 13 practice trials, interspersed with computer-based video instruction. On trials 1, 5, 9 and 13, knot-tying performance was assessed using time and movement efficiency measures, and cognitive load was assessed using subjective rating of mental effort (SRME) and simple reaction time (SRT) on a vibrotactile stimulus-monitoring secondary task. Significant improvements in knot-tying performance (F(1.04,24.95)  = 41.1, p cognitive load (F(2.3,58.5)  = 57.7, p load among novices engaged in simulation-based learning. These measures can be used to track cognitive load during skills training. Mental effort ratings are also sensitive to small differences in intrinsic load arising from variations in the physical complexity of a simulation task. The complementary nature of these subjective and objective measures suggests their combined use is advantageous in simulation instructional design research. © 2015 John Wiley & Sons Ltd.

Effort rights-based management

DEFF Research Database (Denmark)

Squires, Dale; Maunder, Mark; Allen, Robin

2017-01-01

Effort rights-based fisheries management (RBM) is less widely used than catch rights, whether for groups or individuals. Because RBM on catch or effort necessarily requires a total allowable catch (TAC) or total allowable effort (TAE), RBM is discussed in conjunction with issues in assessing fish...... populations and providing TACs or TAEs. Both approaches have advantages and disadvantages, and there are trade-offs between the two approaches. In a narrow economic sense, catch rights are superior because of the type of incentives created, but once the costs of research to improve stock assessments...

Integrating multiple distribution models to guide conservation efforts of an endangered toad

Science.gov (United States)

Treglia, Michael L.; Fisher, Robert N.; Fitzgerald, Lee A.

2015-01-01

Species distribution models are used for numerous purposes such as predicting changes in species’ ranges and identifying biodiversity hotspots. Although implications of distribution models for conservation are often implicit, few studies use these tools explicitly to inform conservation efforts. Herein, we illustrate how multiple distribution models developed using distinct sets of environmental variables can be integrated to aid in identification sites for use in conservation. We focus on the endangered arroyo toad (Anaxyrus californicus), which relies on open, sandy streams and surrounding floodplains in southern California, USA, and northern Baja California, Mexico. Declines of the species are largely attributed to habitat degradation associated with vegetation encroachment, invasive predators, and altered hydrologic regimes. We had three main goals: 1) develop a model of potential habitat for arroyo toads, based on long-term environmental variables and all available locality data; 2) develop a model of the species’ current habitat by incorporating recent remotely-sensed variables and only using recent locality data; and 3) integrate results of both models to identify sites that may be employed in conservation efforts. We used a machine learning technique, Random Forests, to develop the models, focused on riparian zones in southern California. We identified 14.37% and 10.50% of our study area as potential and current habitat for the arroyo toad, respectively. Generally, inclusion of remotely-sensed variables reduced modeled suitability of sites, thus many areas modeled as potential habitat were not modeled as current habitat. We propose such sites could be made suitable for arroyo toads through active management, increasing current habitat by up to 67.02%. Our general approach can be employed to guide conservation efforts of virtually any species with sufficient data necessary to develop appropriate distribution models.

Comparative evaluation of a mixed-fisheries effort-management system based on the Faroe Islands example

DEFF Research Database (Denmark)

Baudron, Alan; Ulrich, Clara; Nielsen, J. Rasmus

2010-01-01

-specific measures may not be appropriate for such fisheries. A management strategy evaluation model was developed to compare an effort-management system based on the Faroese example with a TAC system as currently applied in EU fisheries. Results show that when stocks are considered in isolation, a total allowable...... effort system does not necessarily perform better than a TAC one. It depends on stock status and dynamics, the level of uncertainty, and the reactivity of the system to changes in scientific advice. When the stocks are considered together in mixed fisheries, effort management seems, however...

The American Society of Clinical Oncology's Efforts to Support Global Cancer Medicine

Science.gov (United States)

El-Saghir, Nagi S.; Cufer, Tanja; Cazap, Eduardo; de Guzman, Roselle; Othieno-Abinya, Nicholas Anthony; Sanchez, Jose Angel; Pyle, Doug

2016-01-01

Despite much progress in the management of malignant diseases, the number of new cases and cancer-related deaths continues to rise around the world. More than half of new cases occur in economically developing countries, where more than two thirds of cancer deaths are expected. However, implementation of all necessary steps to accomplish the dissemination of state-of-the-art prevention, diagnosis, and management will require increased allocation of resources, and, more importantly, harmonization of the efforts of hundreds of national and international public health agencies, policy-setting bodies, governments, pharmaceutical companies, and philanthropic organizations. More than 30% of the members of the American Society of Clinical Oncology (ASCO) reside and practice outside US borders, and more than half of attendees at all of the scientific congresses and symposia organized by ASCO are international. As cancer has become an increasingly global disease, ASCO has evolved as a global organization. The ASCO Board of Directors currently includes members from France, Brazil, and Canada. In 2013, the ASCO Board of Directors identified a number of strategic priorities for the future. Recognizing the importance of non-US members to the society, their first strategic priority was improving the society's service to non-US members and defining these members' identity in the international oncology community. This article reviews current ASCO activities in the international arena and its future plans in global oncology. PMID:26578614

Reported Systems Changes and Sustainability Perceptions of Three State Departments of Health Implementing Multi-Faceted Evidence-Based Fall Prevention Efforts

Directory of Open Access Journals (Sweden)

Matthew Lee Smith

2017-06-01

Full Text Available Although the concepts of systems change and sustainability are not new, little is known about the factors associated with systems change sustaining multi-state, multi-level fall prevention efforts. This exploratory study focuses on three State Departments of Health (DOH that were awarded 5-year funding from the Centers for Disease Control and Prevention to simultaneously implement four separate yet related evidence-based fall prevention initiatives at the clinical, community, and policy level. The purpose of this study was to examine changes in partnerships and collaborative activities that occurred to accomplish project goals (examining changes in the context of “before funding” and “after funding was received”. Additionally, this study explored changes in State DOH perceptions about action related to sustainability indicators in the context of “during funding” and “after funding ends.” Findings from this study document the partnership and activity changes necessary to achieve defined fall prevention goals after funding is received, and that the importance of sustainability indicator documentation is seen as relevant during funding, but less so after the funding ends. Findings from this study have practice and research implications that can inform future funded efforts in terms of sector and stakeholder engagement necessary for initiating, implementing, and sustaining community- and clinical-based fall prevention interventions.

PROBABILISTIC RISK ANALYSIS OF REMEDIATION EFFORTS IN NAPL SITES

Science.gov (United States)

Fernandez-Garcia, D.; de Vries, L.; Pool, M.; Sapriza, G.; Sanchez-Vila, X.; Bolster, D.; Tartakovsky, D. M.

2009-12-01

The release of non-aqueous phase liquids (NAPLs) such as petroleum hydrocarbons and chlorinated solvents in the subsurface is a severe source of groundwater and vapor contamination. Because these liquids are essentially immiscible due to low solubility, these contaminants get slowly dissolved in groundwater and/or volatilized in the vadoze zone threatening the environment and public health over a long period. Many remediation technologies and strategies have been developed in the last decades for restoring the water quality properties of these contaminated sites. The failure of an on-site treatment technology application is often due to the unnoticed presence of dissolved NAPL entrapped in low permeability areas (heterogeneity) and/or the remaining of substantial amounts of pure phase after remediation efforts. Full understanding of the impact of remediation efforts is complicated due to the role of many interlink physical and biochemical processes taking place through several potential pathways of exposure to multiple receptors in a highly unknown heterogeneous environment. Due to these difficulties, the design of remediation strategies and definition of remediation endpoints have been traditionally determined without quantifying the risk associated with the failure of such efforts. We conduct a probabilistic risk assessment of the likelihood of success of an on-site NAPL treatment technology that easily integrates all aspects of the problem (causes, pathways, and receptors). Thus, the methodology allows combining the probability of failure of a remediation effort due to multiple causes, each one associated to several pathways and receptors.

Achieving Workplace Health through Application of Wellness Strategies

Science.gov (United States)

Robinson, Judith L.

2008-01-01

Purpose: 1) Understand and measure JSC workplace health: a) levels, sources, indicators & effects of negative, work-related stress; b) define leading indicators of emerging issues. 2 Provide linkage to outcomes: a) Focus application of wellness strategies & HR tools; b) Increase quality of work life and productivity. 3) Current effort will result in: a) Online assessment tool; b) Assessment of total JSC population (civil service & contractors); c) Application of mitigation tools and strategies. 4) Product of the JSC Employee Wellness Program. 5) Collaboration with Corporate Health Improvement Program/University of Arizona.

Marginal socio-economic effects of an employer's efforts to improve the work environment.