WorldWideScience

Sample records for health current efforts

  1. Linking the oceans to public health: current efforts and future directions.

    Science.gov (United States)

    Kite-Powell, Hauke L; Fleming, Lora E; Backer, Lorraine C; Faustman, Elaine M; Hoagland, Porter; Tsuchiya, Ami; Younglove, Lisa R; Wilcox, Bruce A; Gast, Rebecca J

    2008-11-07

    We review the major linkages between the oceans and public health, focusing on exposures and potential health effects due to anthropogenic and natural factors including: harmful algal blooms, microbes, and chemical pollutants in the oceans; consumption of seafood; and flooding events. We summarize briefly the current state of knowledge about public health effects and their economic consequences; and we discuss priorities for future research.We find that:* There are numerous connections between the oceans, human activities, and human health that result in both positive and negative exposures and health effects (risks and benefits); and the study of these connections comprises a new interdisciplinary area, "oceans and human health."* The state of present knowledge about the linkages between oceans and public health varies. Some risks, such as the acute health effects caused by toxins associated with shellfish poisoning and red tide, are relatively well understood. Other risks, such as those posed by chronic exposure to many anthropogenic chemicals, pathogens, and naturally occurring toxins in coastal waters, are less well quantified. Even where there is a good understanding of the mechanism for health effects, good epidemiological data are often lacking. Solid data on economic and social consequences of these linkages are also lacking in most cases.* The design of management measures to address these risks must take into account the complexities of human response to warnings and other guidance, and the economic tradeoffs among different risks and benefits. Future research in oceans and human health to address public health risks associated with marine pathogens and toxins, and with marine dimensions of global change, should include epidemiological, behavioral, and economic components to ensure that resulting management measures incorporate effective economic and risk/benefit tradeoffs.

  2. 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

  3. Shell Inspection History and Current CMM Inspection Efforts

    Energy Technology Data Exchange (ETDEWEB)

    Montano, Joshua Daniel [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2017-01-26

    The following report provides a review of past and current CMM Shell Inspection efforts. Calibration of the Sheffield rotary contour gauge has expired and the primary inspector, Matthew Naranjo, has retired. Efforts within the Inspection team are transitioning from maintaining and training new inspectors on Sheffield to off-the-shelf CMM technology. Although inspection of a shell has many requirements, the scope of the data presented in this report focuses on the inner contour, outer contour, radial wall thickness and mass comparisons.

  4. 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

  5. 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.

  6. 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.)

  7. 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.

  8. Measuring progress of collaborative action in a community health effort

    OpenAIRE

    Vicki L. Collie-Akers; Stephen B. Fawcett; Jerry A. Schultz

    2013-01-01

    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. Guid...

  9. Enteric disease surveillance under the AFHSC-GEIS: Current efforts, landscape analysis and vision forward

    Directory of Open Access Journals (Sweden)

    Kasper Matthew R

    2011-03-01

    Full Text Available Abstract The mission of the Armed Forces Health Surveillance Center, Division of Global Emerging Infections Surveillance and Response System (AFHSC-GEIS is to support global public health and to counter infectious disease threats to the United States Armed Forces, including newly identified agents or those increasing in incidence. Enteric diseases are a growing threat to U.S. forces, which must be ready to deploy to austere environments where the risk of exposure to enteropathogens may be significant and where routine prevention efforts may be impractical. In this report, the authors review the recent activities of AFHSC-GEIS partner laboratories in regards to enteric disease surveillance, prevention and response. Each partner identified recent accomplishments, including support for regional networks. AFHSC/GEIS partners also completed a Strengths, Weaknesses, Opportunities and Threats (SWOT survey as part of a landscape analysis of global enteric surveillance efforts. The current strengths of this network include excellent laboratory infrastructure, equipment and personnel that provide the opportunity for high-quality epidemiological studies and test platforms for point-of-care diagnostics. Weaknesses include inconsistent guidance and a splintered reporting system that hampers the comparison of data across regions or longitudinally. The newly chartered Enterics Surveillance Steering Committee (ESSC is intended to provide clear mission guidance, a structured project review process, and central data management and analysis in support of rationally directed enteric disease surveillance efforts.

  10. 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.

  11. Adverse health effects of high-effort/low-reward conditions.

    Science.gov (United States)

    Siegrist, J

    1996-01-01

    In addition to the person-environment fit model (J. R. French, R. D. Caplan, & R. V. Harrison, 1982) and the demand-control model (R. A. Karasek & T. Theorell, 1990), a third theoretical concept is proposed to assess adverse health effects of stressful experience at work: the effort-reward imbalance model. The focus of this model is on reciprocity of exchange in occupational life where high-cost/low-gain conditions are considered particularly stressful. Variables measuring low reward in terms of low status control (e.g., lack of promotion prospects, job insecurity) in association with high extrinsic (e.g., work pressure) or intrinsic (personal coping pattern, e.g., high need for control) effort independently predict new cardiovascular events in a prospective study on blue-collar men. Furthermore, these variables partly explain prevalence of cardiovascular risk factors (hypertension, atherogenic lipids) in 2 independent studies. Studying adverse health effects of high-effort/low-reward conditions seems well justified, especially in view of recent developments of the labor market.

  12. 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.

  13. 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

  14. 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.

  15. 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....

  16. 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

  17. 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.

  18. Recent sexually transmitted disease prevention efforts and their implications for AIDS health education.

    Science.gov (United States)

    Solomon, M Z; DeJong, W

    1986-01-01

    In the absence of a cure or vaccine for acquired immune deficiency syndrome (AIDS) educational and social marketing efforts to reduce the transmission of Human T-lymphotropic type III/lymphadenopathy-associated virus (HTLV-III/LAV) are currently our best hope for controlling the disease. Since 1983, the Centers for Disease Control (CDC) has funded a series of research studies to determine whether education efforts can successfully motivate the adoption of key behaviors relevant to the control of a variety of sexually transmitted diseases (STDs). Analysis of the first two studies which are now completed, and preliminary data from a third study, have documented dramatic changes in behavior, knowledge, and attitudes among clients in inner-city public health clinics. The authors describe the principles and underlying assumptions that have guided the design of their STD initiatives, drawing special attention to the implications for AIDS health education efforts.

  19. Guiding health promotion efforts with urban Inuit: a community-specific perspective on health information sources and dissemination strategies.

    Science.gov (United States)

    McShane, Kelly E; Smylie, Janet K; Hastings, Paul D; Martin, Carmel M

    2006-01-01

    To develop a community-specific perspective of health information sources and dissemination strategies of urban Inuit to better guide health promotion efforts. Through a collaborative partnership with the Tungasuvvingat Inuit Family Resource Centre, a series of key informant interviews and focus groups were conducted to gather information on specific sources of health information, strategies of health information dissemination, and overall themes in health information processes. Distinct patterns of health information sources and dissemination strategies emerged from the data. Major themes included: the importance of visual learning, community Elders, and cultural interpreters; community cohesion; and the Inuit and non-Inuit distinction. The core sources of health information are family members and sources from within the Inuit community. The principal dissemination strategy for health information was direct communication, either through one-on-one interactions or in groups. This community-specific perspective of health information sources and dissemination strategies shows substantial differences from current mainstream models of health promotion and knowledge translation. Health promotion efforts need to acknowledge the distinct health information processes of this community, and should strive to integrate existing health information sources and strategies of dissemination with those of the community.

  20. [Effort-reward imbalance at work and depression: current research evidence].

    Science.gov (United States)

    Siegrist, J

    2013-01-01

    In view of highly prevalent stressful conditions in modern working life, in particular increasing work pressure and job insecurity, it is of interest to know whether specific constellations of an adverse psychosocial work environment increase the risk of depressive disorder among employed people. This contribution gives a short overview of current research evidence based on an internationally established work stress model of effort-reward imbalance. Taken together, results from seven prospective epidemiological investigations demonstrate a two-fold elevated relative risk of incident depressive disorder over a mean observation period of 2.7 years among exposed versus non-exposed employees. Additional findings from experimental and quasi-experimental studies point to robust associations of effort-reward imbalance at work with proinflammatory cytokines and markers of reduced immune competence. These latter markers may indicate potential psychobiological pathways. In conclusion, incorporating this new knowledge into medical treatment and preventive efforts seems well justified.

  1. Investigation of Psychological Health and Migraine Headaches Among Personnel According to Effort-Reward Imbalance Model

    Directory of Open Access Journals (Sweden)

    Z. Darami

    2012-05-01

    Full Text Available Background and aims: The relationship between physical-mental health and Migraine headaches and stress, especially job stress, is known. Many factors can construct job stress in work settings. The factor that has gained much attention recently is inequality (imbalance of employees’ effort versus the reward they gain. The aim of the current attempt was to investigate the validity of effort-reward imbalance model and indicate the relation of this model with migraine headaches and psychological well-being among subjects in balance and imbalance groups. Methods: Participants were 180 personnel of Oil distribution company located in Isfahan city, and instruments used were General health questionnaire (Goldberg & Hilier, Social Re-adjustment Rating Scale (Holmes & Rahe, Ahvaz Migraine Questionnaire (Najariyan and Effort-reward imbalance scale (Van Vegchel & et al.   Results: The result of exploratory and confirmatory factor analysis for investigating the Construct validity of the effort-reward imbalance model showed that in both analyses, the two factor model was confirmed. Moreover, findings indicate that balance group was in better psychological (p<0/01 and physical (migraine (p<0/05 status comparing to the imbalance group. These findings indicate the significance of justice to present appropriate reward relative to personnel performance on their health.   Conclusion: Implication of these findings can improve Iranian industrial personnel health from both physical and psychological aspects.  

  2. Resident assistant training program for increasing alcohol, other drug, and mental health first-aid efforts.

    Science.gov (United States)

    Thombs, Dennis L; Gonzalez, Jennifer M Reingle; Osborn, Cynthia J; Rossheim, Matthew E; Suzuki, Sumihiro

    2015-05-01

    In college and university residence halls, resident assistants (RAs) are expected to serve as first-aid providers to students who may have alcohol, other drug, mental health, and academic problems. Despite this responsibility, evidence-based, first-aid programs have not been developed and tested for the RA workforce. The current study examined effects of an investigational first-aid program designed specifically for RAs. The online Peer Hero Training program is a novel approach to RA training in its use of interactive video dramatizations of incidents involving substance-using or distressed residents. A 9-month randomized trial conducted on eight US campuses compared RAs who participated in the Peer Hero Training program to RAs who received training-as-usual. Participation in the Peer Hero Training program significantly increased RA first-aid efforts for residential students who may have had alcohol, other drug, mental health, or academic problems 6 months after baseline. Compared with those in the training-as-usual condition, RAs in the Peer Hero Training program made more than 10 times as many first-aid efforts for possible alcohol problems, almost 14 times the number of first-aid efforts for possible drug use, almost 3 times the number of first-aid efforts for possible mental health problems, and 3 times the number of first-aid efforts for academic problems. There was no evidence that measured RA attitudes mediated the effects of the intervention. Results of this preliminary evaluation trial suggest that online training using interactive video dramatizations is a viable approach to strengthening RAs' ability to provide alcohol, other drugs, and mental health first-aid to undergraduates.

  3. 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.

  4. 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

  5. Efforts made for health and medical care by International Atomic Energy Agency

    International Nuclear Information System (INIS)

    Watanabe, Naoyuki

    2016-01-01

    The author, being a former senior medical officer and currently a consultant of the Nuclear Medicine Section, the Division of Human Health, the Department of Nuclear Sciences and Applications, the International Atomic Energy Agency (IAEA) to standardize the isotope and radiation technologies for health and medical care and transfer them to the IAEA member states to address their health issues, participated in an international cooperation project to survey the current situation of the health and medical care in Viet Nam and exchange opinions with the World Health Organization Western Pacific Regional Office Viet Nam Office and the Viet Nam Health Department coordinated by the Japan Public Health Association from 10th to 15th January 2016 and perceived efforts made and action plans for the health and medical care in Viet Nam by the international organizations of the IAEA and the World Health Organization (WHO). IAEA has verified various isotopes and radiation technologies up to now in the international field of health and medical care and has being offered them to the member states under the sustainable frame work of technical co-operation. However, the activity in the health and medical care field of IAEA is hardly recognized by the public health professionals in Japan. In order to attain the objective to improve and maintain human health under the umbrella of the United Nations system, the peaceful use of nuclear technology has been promoted in the field of non-electric applications of nuclear energy including human health and medical care by the IAEA. There are several discrepancies seen with the field and tactics of health and medical care between the IAEA and the WHO. In terms of measures to fight NCDs which should be an urgent issue in most of the member states, a comprehensive approach is often needed beyond the capability of IAEA as isotopes and radiation technologies. The IAEA should strive to solve issues on human health and medical care maintaining much

  6. 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.

  7. 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.

  8. 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.

  9. 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.

  10. 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.

  11. Current knowledge of US metal and nonmetal miner health: Current and potential data sources for analysis of miner health status

    Science.gov (United States)

    Yeoman, K. M.; Halldin, C. N.; Wood, J.; Storey, E.; Johns, D.; Laney, A. S.

    2016-01-01

    ABSTRACT Little is known about the current health status of US metal and nonmetal (MNM) miners, in part because no health surveillance systems exist for this population. The National Institute for Occupational Safety and Health (NIOSH) is developing a program to characterize burden of disease among MNM miners. This report discusses current knowledge and potential data sources of MNM miner health. Recent national surveys were analyzed, and literature specific to MNM miner health status was reviewed. No robust estimates of disease prevalence were identified, and national surveys did not provide information specific to MNM miners. Because substantial gaps exist in the understanding of MNM miners' current health status, NIOSH plans to develop a health surveillance program for this population to guide intervention efforts to reduce occupational and personal risks for chronic illness. PMID:25658684

  12. 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...

  13. Implications of the 2015 World Health Organization isoniazid preventive therapy recommendations on tuberculosis prevention efforts in Namibia.

    Science.gov (United States)

    Oloo, Stella Anne

    2016-07-01

    The World Health Organization recently released guidelines recommending 36-month use of isoniazid preventive therapy in adults and adolescents living with HIV in resource-limited settings. Namibia continues to grapple with one of the highest incidences of tuberculosis (TB) worldwide. Implementation of these guidelines requires considerations of TB epidemiology, health infrastructure, programmatic priorities and patient adherence. This article explores the challenges Namibia currently faces in its fight against TB and the implications of the new guidelines on Namibian TB prevention efforts.

  14. 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…

  15. The Relationship Between the Effort-Reward Imbalance and Psychosocial Health in Nurses

    Directory of Open Access Journals (Sweden)

    Fariborz Roshangar

    2017-09-01

    Full Text Available The health of nurses as providers of health affects the quality of care provided by health care organizations to patients. The effort-reward imbalance is accompanied by repressive responses that can lead to physical and psychological diseases as well as stressful experiences in nurses’ activity. Regarding the existence of some discrimination in the system of health, the present study was conducted to determine the relationship between the effort-reward imbalance and psychosocial health in nurses. In this descriptive cross-sectional study, 270 nurses working in five medical-educational centers in Tabriz participated through random-quota sampling. The research tool included a demographic questionnaire, Siegrist effort- reward imbalance questionnaire and Copenhagen Psychosocial questionnaire. Data were analyzed by SPSS V18 and descriptive and inferential statistics. In the present study, 54.8% of the patients were suffering from effort- reward imbalance model (occupational stress. The relatively high prevalence of this can be attributed to the conditions of the hospital's working environment. The results of this study showed a significant relationship between psychosocial health and balance of reward and effort in nurses and also the findings of the research showed a positive and significant relationship between mental and social health and the score of effort-reward imbalance model (0.95 = R, and P <0.05. There was a significant relationship between effort and work commitment and job burnout. Considering the stressful nature of the profession among many reasons, the mental health of nurses is at a higher risk than that of other groups in the society. Because some factors related to the imbalance in the effort and reward (stress is inevitable, it is necessary in the profession of nursing for managers to review their employees' position and characteristics to find out their staff’s attitudes and behaviors and direct them in the right path.

  16. 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

  17. 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...

  18. 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...

  19. 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.

  20. 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

  1. 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.

  2. 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 ...

  3. 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.

  4. 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

  5. Current perspectives: the impact of cyberbullying on adolescent health

    Science.gov (United States)

    Nixon, Charisse L

    2014-01-01

    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. PMID:25177157

  6. Efforts to promote lifestyle change and better health: whither symbolic interactionism?

    Science.gov (United States)

    Pezza, P E

    1989-01-01

    Symbolic interactionism is a body of thought which attends to how the meaning of a message may be mutually defined in the process of social interaction. As interactionism and its qualitative methodologies have been increasingly recognized as useful and appropriate complements to other approaches, health education has been slow to respond. Proposed here is the application of an interactionist perspective to the study of contemporary efforts made to promote lifestyle change and better health. A specific case is made for examining the interaction which takes place when employers strive to promote employee health. Particular attention is paid to the following questions: 1. How may employer communication of corporate goals for employee lifestyle change best be studied?; 2. Are the messages transmitted by employers and those received by employees the same?; 3. What may be some unanticipated consequences of the health promotion effort and its messages?; and 4. Can the interactionist perspective be used to enlighten the planning process for health promotion programs?

  7. 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

  8. Measuring Sexual Orientation: A Review and Critique of U.S. Data Collection Efforts and Implications for Health Policy.

    Science.gov (United States)

    Wolff, Margaret; Wells, Brooke; Ventura-DiPersia, Christina; Renson, Audrey; Grov, Christian

    The U.S. Department of Health and Human Services' (HHS) Healthy People 2020 goals sought to improve health outcomes among sexual minorities; HHS acknowledged that a dearth of sexual orientation items in federal and state health surveys obscured a broad understanding of sexual minority-related health disparities. The HHS 2011 data progression plan aimed to advance sexual orientation data collection efforts at the national level. Sexual orientation is a complex, multidimensional construct often composed of sexual identity, sexual attraction, and sexual behavior, thus posing challenges to its quantitative and practical measurement and analysis. In this review, we (a) present existing sexual orientation constructs; (b) evaluate current HHS sexual orientation data collection efforts; (c) review post-2011 data progression plan research on sexual minority health disparities, drawing on HHS survey data; (d) highlight the importance of and (e) identify obstacles to multidimensional sexual orientation measurement and analysis; and (f) discuss methods for multidimensional sexual orientation analysis and propose a matrix for addressing discordance/branchedness within these analyses. Multidimensional sexual orientation data collection and analysis would elucidate sexual minority-related health disparities, guide related health policies, and enhance population-based estimates of sexual minority individuals to steer health care practices.

  9. 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.

  10. Closing the patient-oncologist communication gap: a review of historic and current efforts.

    Science.gov (United States)

    Pham, A Khoa; Bauer, Marianne T; Balan, Stefan

    2014-03-01

    Effective communication is essential in developing any relationship--this is particularly true between oncologists and their patients. The patient-oncologist relationship is one of the most delicate in medicine, and given the strong emotions associated with cancer, successful communication plays a paramount role in the wellbeing of patients and oncologists. Significant advances to close the communication gap have occurred over the past several decades, largely by addressing deficiencies in the various stages of an oncologist's lengthy training: undergraduate medical education, residency and fellowship, and continuing medical education. Stemming from several milestones achieved by highly motivated groups of individuals, including the creation of consensus statements and guidelines by communication education experts, progress has been made to improve patient-oncologist communication. This progress is marked by the development of evidence-based communication skills training programs, such as Oncotalk and Comskil, in addition to the creation of distant-learning modalities, such as the Studying Communication in Oncologist-Patient Encounters trial. This review article outlines the history of communication education during medical education and training, and brings to light more recent efforts to promote competent, communication-minded physicians necessary for effective cancer care.

  11. Current and potential technologies for the detection of radionuclide signatures of proliferation (R and D efforts)

    International Nuclear Information System (INIS)

    Perkins, R.W.; Wogman, N.A.

    1993-03-01

    A country with the goal of developing nuclear weapons could pursue their ambition in several ways. These could range from the purchase or theft of a weapon or of the principal weapons components to a basic development program which may independently produce all the materials and components which are necessary. If the latter approach were pursued, there would be many signatures of such an effort and the more definitive of these include the actual materials which would be produced in each phase of the fuel cycle/weapons production process. By identifying the more definitive signatures and employing appropriate environmental sampling and analysis techniques for their observation, including imaging procedures, it should be possible to detect nuclear proliferation processes. Possible proliferation processes include: uranium acquisition through fuel fabrication; uranium enrichment for weapons production; reactor operation for plutonium production; fuel reprocessing for plutonium extraction; weapons fabrication; and uranium 233 production. Each of these are briefly discussed. The technologies for the detection of proliferation signatures which are in concept or research and development phase are: whole air beta counter; radiokrypton/xenon separator/analyzer; I-129 detector; isotope analyzer; deuterium/tritium analysis by IR/Raman spectroscopy and scintillation counting; noble gas daughter analysis; and airborne radionuclide collector/analyzer

  12. 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.

  13. 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.

  14. 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)

  15. 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.

  16. Prevalence and correlates of metabolic syndrome in pre-crisis Syria: call for current relief efforts.

    Science.gov (United States)

    Ramadan, H; Naja, F; Fouad, F M; Antoun, E; Jaffa, M; Chaaban, R; Haidar, M; Sibai, A M

    2016-12-12

    This study aimed to assess the prevalence, components and correlates of metabolic syndrome (MetS) in adults in pre-crisis Aleppo, Syrian Arab Republic. We used a population-based, 2-stage cluster sampling method in a population of 557 men and 611 women, randomly selected from 83 residential neighbourhoods including many rural settlers. Sociodemographic and lifestyle characteristics, comorbidity, anthropometry and biochemical indices were measured. Prevalence of MetS was estimated at 39.6%, with comparable rates in men and women. Hypertension was the most prevalent component (56.6%), followed by central obesity (51.4%). Among women, education (12 years) was inversely associated with risk of MetS, while family history of obesity and diabetes was associated with an increased risk. The high prevalence of MetS and its components emphasizes the burden of cardiovascular diseases among adults in pre-crisis Aleppo. A system of surveillance and management for cardiovascular diseases needs to be incorporated into the current humanitarian response.

  17. African medicinal plants and their derivatives: Current efforts towards potential anti-cancer drugs.

    Science.gov (United States)

    Mbele, Mzwandile; Hull, Rodney; Dlamini, Zodwa

    2017-10-01

    Cancer is a leading cause of mortality and morbidity worldwide and second only to cardiovascular diseases. Cancer is a challenge in African countries because generally there is limited funding available to deal with the cancer epidemic and awareness and this should be prioritised and all possible resources should be utilized to prevent and treat cancer. The current review reports on the role of African medicinal plants in the treatment of cancer, and also outlines methodologies that can also be used to achieve better outcomes for cancer treatment. This review outlines African medicinal plants, isolated compounds and technologies that can be used to advance cancer research. Chemical structures of isolated compounds have an important role in anti-cancer treatments; new technologies and methods may assist to identify more properties of African medicinal plants and the treatment of cancer. In conclusion, African medicinal plants have shown their potential as enormous resources for novel cytotoxicity compounds. Finally it has been noted that the cytotoxicity depends on the chemical structural arrangements of African medicinal plants compounds. Copyright © 2017 Elsevier Inc. All rights reserved.

  18. 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.

  19. 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

  20. 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.

  1. 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.

  2. Public health efforts to build a surveillance system for child maltreatment mortality: lessons learned for stakeholder engagement.

    Science.gov (United States)

    Smith, Lucia Rojas; Gibbs, Deborah; Wetterhall, Scott; Schnitzer, Patricia G; Farris, Tonya; Crosby, Alex E; Leeb, Rebecca T

    2011-01-01

    Reducing the number of largely preventable and tragic deaths due to child maltreatment (CM) requires an understanding of the magnitude of and risk factors for fatal CM and targeted research, policy, and prevention efforts. Public health surveillance offers an opportunity to improve our understanding of the problem of CM. In 2006, the Centers for Disease Control and Prevention (CDC) funded state public health agencies in California, Michigan, and Oregon to implement a model approach for routine and sustainable CM surveillance and evaluated the experience of those efforts. We describe the experiences of 3 state health agencies in building collaborations and partnerships with multiple stakeholders for CM surveillance. Qualitative, structured key informant interviews were carried out during site visits as part of an evaluation of a CDC-funded project to implement a model approach to CM surveillance. Key informants included system stakeholders from state health agencies, law enforcement, child protective services, the medical community, and child welfare advocacy groups in the 3 funded states. Factors that facilitated stakeholder engagement for CM surveillance included the following: streamlining and coordinating the work of Child Death Review Teams (CDRTs); demonstrating the value of surveillance to non-public health partners; codifying relationships with participating agencies; and securing the commitment of decision-makers. Legislative mandates were helpful in bringing key stakeholders together, but it was not sufficient to ensure sustained engagement. The engagement process yielded multiple benefits for the stakeholders including a deeper appreciation of the complexity of defining CM; a greater understanding of risk factors for CM; and enhanced guidance for prevention and control efforts. States considering or currently undertaking CM surveillance can glean useful insights from the experiences of these 3 states and apply them to their own efforts to engage

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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

  8. 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

  9. 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.

  10. 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

  11. 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.

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

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    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,

  13. 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.

  14. 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.

  15. 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

  16. 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.

  17. 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.

  18. 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.

  19. 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...

  20. 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.

  1. 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

  2. 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.

  3. 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 ,

  4. 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.

  5. 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.

  6. 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

  7. Effort-reward imbalance in the school setting: associations with somatic pain and self-rated health.

    Science.gov (United States)

    Låftman, Sara Brolin; Modin, Bitte; Östberg, Viveca; Hoven, Hanno; Plenty, Stephanie

    2015-03-01

    According to the workplace theory of effort-reward imbalance (ERI), individuals who perceive a lack of reciprocity between their effort spent at work and the rewards received in turn are at an increased risk of stress-related ill-health. It is also assumed that being overcommitted to work is linked to an increased risk of stress-related ill-health. This study applies the effort-reward imbalance model to the school setting. It aims to analyse the associations that effort-reward imbalance and overcommitment share with somatic pain and self-rated health among adolescents. Data are from the School Stress and Support Study (TriSSS), involving students in grades 8 and 9 (ages 14-16 years) in two schools in Stockholm, Sweden, during 2010 (n=403). Information on effort-reward imbalance and health outcomes was gathered from self-report questionnaires. An adjusted short version of ERI was used. Factor analysis showed that extrinsic effort, reward and overcommitment constitute three distinct dimensions. The designed measures demonstrated sound psychometric properties both for the full sample and for subgroups. Ordered logistic regressions were conducted. The analyses showed that low reward and higher overcommitment were associated with greater somatic pain and poorer self-rated health. Furthermore, effort-reward imbalance was linked with an elevated risk of somatic pain and poorer self-rated health. Students are more likely to experience stress-related ill-health when they perceive an imbalance between their effort and rewards. In addition, high overcommitment is associated with an increased risk of ill-health among students. © 2014 the Nordic Societies of Public Health.

  8. 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.

  9. 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.

  10. 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.

  11. 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.

  12. 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...

  13. Stakeholders Perception of Current Health Education Situation ...

    African Journals Online (AJOL)

    Health Education is one of the critical eight essential pillars of the primary health care (PHC) adopted world-wide by WHO member countries in 1978. After over two decades of health education to support PHC implementation, the epidemiological profile of Ghana continues to be dominated by communicable diseases, and ...

  14. 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

  15. Current approaches to the European Health Policy

    Directory of Open Access Journals (Sweden)

    Anda CURTA

    2010-06-01

    Full Text Available The purpose of this paper is to identify the key elements that define the new European health policy. We observed that the health policy actually appeared to be an enclave within the integration process. The development of health policy in the new Member States followed a common pattern. Therefore, the European health policy reflected a general desire on behalf of the members to have more clarity of the rules in this area, given the different interpretation of the rules by different Member States.The Lisbon Treaty does not bring substantive changes regarding the public health policy, therefore the Member States shall keep their competence in defining the organization and financing this domain. However, the EU2020 Strategy states that “Europe faces a moment of transformation”. Therefore, the “Europeanization” of health policy could lead to the positive developments that all EU citizens are expecting.

  16. 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…

  17. 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.

  18. 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.

  19. 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. .

  20. 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

  1. 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

  2. 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

  3. 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.

  4. 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 ...

  5. Lipidomics in vascular health: current perspectives.

    Science.gov (United States)

    Kolovou, Genovefa; Kolovou, Vana; Mavrogeni, Sophie

    2015-01-01

    Identifying the mechanisms that convert a healthy vascular wall to an atherosclerotic wall is of major importance since the consequences may lead to a shortened lifespan. Classical risk factors (age, smoking, obesity, diabetes mellitus, hypertension, and dyslipidemia) may result in the progression of atherosclerotic lesions by processes including inflammation and lipid accumulation. Thus, the evaluation of blood lipids and the full lipid complement produced by cells, organisms, or tissues (lipidomics) is an issue of importance. In this review, we shall describe the recent progress in vascular health research using lipidomic advances. We will begin with an overview of vascular wall biology and lipids, followed by a short analysis of lipidomics. Finally, we shall focus on the clinical implications of lipidomics and studies that have examined lipidomic approaches and vascular health.

  6. Are current health behavioral change models helpful in guiding prevention of weight gain efforts?

    Science.gov (United States)

    Baranowski, Tom; Cullen, Karen W; Nicklas, Theresa; Thompson, Deborah; Baranowski, Janice

    2003-10-01

    Effective procedures are needed to prevent the substantial increases in adiposity that have been occurring among children and adults. Behavioral change may occur as a result of changes in variables that mediate interventions. These mediating variables have typically come from the theories or models used to understand behavior. Seven categories of theories and models are reviewed to define the concepts and to identify the motivational mechanism(s), the resources that a person needs for change, the processes by which behavioral change is likely to occur, and the procedures necessary to promote change. Although each model has something to offer obesity prevention, the early promise can be achieved only with substantial additional research in which these models are applied to diet and physical activity in regard to obesity. The most promising avenues for such research seem to be using the latest variants of the Theory of Planned Behavior and Social Ecology. Synergy may be achieved by taking the most promising concepts from each model and integrating them for use with specific populations. Biology-based steps in an eating or physical activity event are identified, and research issues are suggested to integrate behavioral and biological approaches to understanding eating and physical activity behaviors. Social marketing procedures have much to offer in terms of organizing and strategizing behavioral change programs to incorporate these theoretical ideas. More research is needed to assess the true potential for these models to contribute to our understanding of obesity-related diet and physical activity practices, and in turn, to obesity prevention.

  7. 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.

  8. 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.

  9. 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.

  10. Public health services and systems research: current state of finance research.

    Science.gov (United States)

    Ingram, Richard C; Bernet, Patrick M; Costich, Julia F

    2012-11-01

    There is a growing recognition that the US public health system should strive for efficiency-that it should determine the optimal ways to utilize limited resources to improve and protect public health. The field of public health finance research is a critical part of efforts to understand the most efficient ways to use resources. This article discusses the current state of public health finance research through a review of public health finance literature, chronicles important lessons learned from public health finance research to date, discusses the challenges faced by those seeking to conduct financial research on the public health system, and discusses the role of public health finance research in relation to the broader endeavor of Public Health Services and Systems Research.

  11. 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

  12. 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

  13. 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.

  14. Joint efforts and shared responsibilities - Health information exchange in primary care for people with intellectual disabilities

    NARCIS (Netherlands)

    Mastebroek, M.

    2017-01-01

    People with intellectual disabilities (ID) have a considerably worse health than people without ID, for a great part related to the quality of healthcare provision and health communication. This research studied health information exchange (HIE) between people with ID, their support network, and

  15. Effortful control as modifier of the association between negative emotionality and adolescents' mental health problems

    NARCIS (Netherlands)

    Oldehinkel, Albertine J.; Hartman, Catharina A.; Ferdinand, Robert F.; Verhulst, Frank C.; Ormel, Johan

    2007-01-01

    This study examined the extent to which effortful control moderated the risk of internalizing or externalizing problems associated with high negative emotionality in a Dutch population sample of pre- and early adolescents (N = 1,922). Internalizing and externalizing problems were assessed with the

  16. 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

  17. 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.

  18. Nd:YAG Laser-Based Dual-Line Detection Rayleigh Scattering and Current Efforts on UV, Filtered Rayleigh Scattering

    Science.gov (United States)

    Otugen, M. Volkan; Popovic, Svetozar

    1996-01-01

    Ongoing research in Rayleigh scattering diagnostics for variable density low speed flow applications and for supersonic flow measurements are described. During the past several years, the focus has been on the development and use of a Nd:YAG-based Rayleigh scattering system with improved signal-to-noise characteristics and with applicability to complex, confined flows. This activity serves other research projects in the Aerodynamics Laboratory which require the non-contact, accurate, time-frozen measurement of gas density, pressure, and temperature (each separately), in a fairly wide dynamic range of each parameter. Recently, with the acquisition of a new seed-injected Nd:YAG laser, effort also has been directed to the development of a high-speed velocity probe based on a spectrally resolved Rayleigh scattering technique.

  19. Measuring Racial and Ethnic Disparities in Health Care: Efforts to Improve Data Collection.

    OpenAIRE

    Patricia Collins Higgins; Erin Fries Taylor

    2009-01-01

    Disparities in the quality of health care contribute to higher rates of disease, disability, and mortality in racial and ethnic minority groups. A new policy brief examines recent federal and state activities aimed at strengthening the collection of health-related data on race, ethnicity, and primary language. It highlights three states—California, Massachusetts, and New Jersey—that implemented laws or regulations guiding data collection activities by hospitals, health plans, and governme...

  20. 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...

  1. Turning point: the Robert Wood Johnson Foundation's effort to revitalize public health at the state level.

    Science.gov (United States)

    Hassmiller, Susan

    2002-01-01

    The Robert Wood Johnson (RWJ) Foundation initiated Turning Point in collaboration with the W.K. Kellogg Foundation (Kellogg) in 1997. The purpose of this major national initiative was to strengthen the public health infrastructure in the United States so that states, local communities, and their public health agencies might respond to the challenge to protect and improve the public's health in the 21st century. RWJ funded 21 states and Kellogg funded 43 communities to work together to create a new way of thinking about how health could be improved and who should be involved. Although the ultimate outcome was to improve health, both foundations expected diverse partnerships to work together to create strategic health improvement plans at both the community and state levels. The foundations funded a variety of strategies within those health improvement plans during an implementation phase. The premise in funding partnerships, as opposed to a single entity, was that effective public health systems would be developed best through a shared responsibility (including the private sector) for the health of a community.

  2. 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.

  3. 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.

  4. 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

  5. Community-based health efforts for the prevention of falls in the elderly.

    LENUS (Irish Health Repository)

    Hanley, Alan

    2012-01-31

    Falls are a major public health problem in the elderly population. The associated health care cost is great. It has therefore become an important public health matter to evaluate those interventions that might be effective in reducing the risk of falls. Risk factors that predict an increased risk of falling are described. We discuss interventions that can be employed in the community to reduce the risk of falls and associated injuries by discipline, including physiotherapy, occupational therapy, and physician-led interventions. We also discuss the cost-effectiveness of such interventions.

  6. Case Based Measles Surveillance in Pune: Evidence to Guide Current and Future Measles Control and Elimination Efforts in India

    Science.gov (United States)

    Bose, Anindya Sekhar; Jafari, Hamid; Sosler, Stephen; Narula, Arvinder Pal Singh; Kulkarni, V. M.; Ramamurty, Nalini; Oommen, John; Jadi, Ramesh S.; Banpel, R. V.; Henao-Restrepo, Ana Maria

    2014-01-01

    Background According to WHO estimates, 35% of global measles deaths in 2011 occurred in India. In 2013, India committed to a goal of measles elimination by 2020. Laboratory supported case based measles surveillance is an essential component of measles elimination strategies. Results from a case-based measles surveillance system in Pune district (November 2009 through December 2011) are reported here with wider implications for measles elimination efforts in India. Methods Standard protocols were followed for case identification, investigation and classification. Suspected measles cases were confirmed through serology (IgM) or epidemiological linkage or clinical presentation. Data regarding age, sex, vaccination status were collected and annualized incidence rates for measles and rubella cases calculated. Results Of the 1011 suspected measles cases reported to the surveillance system, 76% were confirmed measles, 6% were confirmed rubella, and 17% were non-measles, non-rubella cases. Of the confirmed measles cases, 95% were less than 15 years of age. Annual measles incidence rate was more than 250 per million persons and nearly half were associated with outbreaks. Thirty-nine per cent of the confirmed measles cases were vaccinated with one dose of measles vaccine (MCV1). Conclusion Surveillance demonstrated high measles incidence and frequent outbreaks in Pune where MCV1 coverage in infants was above 90%. Results indicate that even high coverage with a single dose of measles vaccine was insufficient to provide population protection and prevent measles outbreaks. An effective measles and rubella surveillance system provides essential information to plan, implement and evaluate measles immunization strategies and monitor progress towards measles elimination. PMID:25290339

  7. Community-based health efforts for the prevention of falls in the elderly

    Directory of Open Access Journals (Sweden)

    Alan Hanley

    2010-12-01

    Full Text Available Alan Hanley1, Carmel Silke2, John Murphy31Department of Medicine, Letterkenny General Hospital, Letterkenny, Co Donegal, Ireland; 2Department of Rheumatology, Our Lady's Hospital Manorhamilton, Manorhamilton, Co Leitrim, Ireland; 3Department of Medicine, Castlebar, Co Mayo, IrelandAbstract: Falls are a major public health problem in the elderly population. The associated health care cost is great. It has therefore become an important public health matter to evaluate those interventions that might be effective in reducing the risk of falls. Risk factors that predict an increased risk of falling are described. We discuss interventions that can be employed in the community to reduce the risk of falls and associated injuries by discipline, including physiotherapy, occupational therapy, and physician-led interventions. We also discuss the cost-effectiveness of such interventions.Keywords: fall, fracture, prevention, public health

  8. Data Mining Mining Data: MSHA Enforcement Efforts, Underground Coal Mine Safety, and New Health Policy Implications

    OpenAIRE

    Thomas J. Kniesner; John D. Leeth

    2003-01-01

    Studies of industrial safety regulations, Occupational Safety and Health Administration (OSHA) in particular, often find little effect on worker safety. Critics of the regulatory approach argue that safety standards have little to do with industrial injuries and defenders of the regulatory approach cite infrequent inspections and low fines for violating safety standards. We use recently assembled data from the Mine Safety and Health Administration (MSHA) concerning underground coal mine produ...

  9. 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.

  10. 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.

  11. 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

  12. Have geopolitics influenced decisions on American health foreign assistance efforts during the Obama presidency?

    Science.gov (United States)

    Gupta, Vin; Tsai, Alexander C; Mason-Sharma, Alexandre; Goosby, Eric P; Jha, Ashish K; Kerry, Vanessa B

    2018-06-01

    This study sought to characterize the possible relationship between US geopolitical priorities and annual decisions on health foreign assistance among recipient nations between 2009 and 2016. Data on total planned United States (US) foreign aid and health aid were collected for the 194 member nations of the World Health Organization (WHO) from publicly available databases. Trends in per-capita spending were examined between 2009 and 2016 across the six regions of the WHO (Africa, Americas, Eastern Mediterranean, Europe, Southeast Asia, and the Western Pacific). Data on US national security threats were obtained from the Council on Foreign Relations' annual Preventive Priorities Survey. Multivariable regression models were fitted specifying planned health aid as the dependent variable and threat level of a recipient aid nation as the primary independent variable. Across the aggregate 80 planned recipient countries of US health aid over the duration of the study period, cumulative planned per-capita spending was stable (US$ 0.65 in both 2009 and 2016). The number of annual planned recipients of this aid declined from 74 in 2009 to 56 in 2016 (24.3% decline), with planned allocations decreasing in the Americas, Eastern Mediterranean, and Europe; corresponding increases were observed in Africa, Southeast Asia, and the Western Pacific. Regression analyses demonstrated a dose-response, whereby higher levels of threat were associated with larger declines in planned spending (critical threat nations: b = -3.81; 95% confidence interval (CI) -5.84 to -1.78, P  ≤ 0.001) and one-year lagged (critical threat nations: b = -3.91; 95% CI, -5.94 to -1.88, P  ≤ 0.001) analyses. Higher threat levels are associated with less health aid. This is a novel finding, as prior studies have demonstrated a strong association between national security considerations and decisions on development aid.

  13. Harmonising the Efforts of School Nurses and Teachers in Health Promotion in Schools

    Science.gov (United States)

    Kwatubana, Siphokazi

    2018-01-01

    A vital facet that adds value to schools is the partnership between the departments of education and health at national level. At the heart of making this partnership effective in order to achieve its potential is the need for synchronisation of the roles of school nurses and teachers to mitigate sustainability risks. In order to investigate the…

  14. Co-ordinated Interdisciplinary Efforts on Research in Animal Production and Health

    Directory of Open Access Journals (Sweden)

    Houe Hans

    2003-03-01

    Full Text Available The objectives are to review results and experiences from interdisciplinary research projects in Research Centre for the Management of Animal Production and Health (CEPROS concerning scientific content, organisation, and collaboration. The Centre has been founded as a result of an agreement between four institutions: the Danish Institute of Agricultural Sciences (DIAS, the Danish Veterinary Laboratory (DVL, the Danish Veterinary Institute for Virus Research (DVIV and The Royal Veterinary and Agricultural University (KVL. CEPROS is a "research centre without walls" and is physically located as an integrated part of the four institutions named above. The Centre has close collaboration with the industry. The superior goals of the Centre are to co-ordinate fundamental and applied research and simultaneously integrate the veterinary and the production oriented livestock research within animal health and welfare, taking into consideration the production economics and reduced use of medication. The assignment of the Centre is to initiate and carry out research, aiming to investigate the influence of breeding and production systems on animal health and welfare as well as on production and product quality. The Centre has since 1997 established 16 interdisciplinary research projects dealing with cattle, pigs, poultry, or mink. The scientific content can be divided into three research clusters: A. Management of animal production and health in production systems, B: Pathogenesis of production diseases, and C. Animal health economics. In Cluster A, the physical environments of production systems have been investigated, broader definitions of the concept health have been established and used in identification of risk factors. Cluster B has investigated physiological, immunological and genetic mechanisms behind development of production diseases and how to apply this knowledge in disease prevention. The cluster in animal health economics has developed decision

  15. 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 ...

  16. 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

  17. 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

  18. Comparing global alcohol and tobacco control efforts: network formation and evolution in international health governance.

    Science.gov (United States)

    Gneiting, Uwe; Schmitz, Hans Peter

    2016-04-01

    Smoking and drinking constitute two risk factors contributing to the rising burden of non-communicable diseases in low- and middle-income countries. Both issues have gained increased international attention, but tobacco control has made more sustained progress in terms of international and domestic policy commitments, resources dedicated to reducing harm, and reduction of tobacco use in many high-income countries. The research presented here offers insights into why risk factors with comparable levels of harm experience different trajectories of global attention. The analysis focuses particular attention on the role of dedicated global health networks composed of individuals and organizations producing research and engaging in advocacy on a given health problem. Variation in issue characteristics and the policy environment shape the opportunities and challenges of global health networks focused on reducing the burden of disease. What sets the tobacco case apart was the ability of tobacco control advocates to create and maintain a consensus on policy solutions, expand their reach in low- and middle-income countries and combine evidence-based research with advocacy reaching beyond the public health-centered focus of the core network. In contrast, a similar network in the alcohol case struggled with expanding its reach and has yet to overcome divisions based on competing problem definitions and solutions to alcohol harm. The tobacco control network evolved from a group of dedicated individuals to a global coalition of membership-based organizations, whereas the alcohol control network remains at the stage of a collection of dedicated and like-minded individuals. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine © The Author 2016; all rights reserved.

  19. Data Mining Mining Data: MSHA Enforcement Efforts, Underground Coal Mine Safety, and New Health Implications

    OpenAIRE

    Kniesner, Thomas J.; Leeth, John D.

    2003-01-01

    Studies of industrial safety regulations, OSHA in particular, often find little effect on worker safety. Critics of the regulatory approach argue that safety standards have little to do with industrial injuries, and defenders of the regulatory approach cite infrequent inspections and low penalties for violating safety standards. We use recently assembled data from the Mine Safety and Health Administration (MSHA) concerning underground coal mine production, safety regulatory activities, and wo...

  20. Military exceptionalism or tobacco exceptionalism: How civilian health leaders' beliefs may impede military tobacco control efforts

    OpenAIRE

    Smith, EA; Malone, RE

    2013-01-01

    Smoking impairs the readiness and performance of military personnel, yet congressional opposition has thwarted military tobacco control initiatives. Involvement of civilian organizations might alter this political dynamic. We interviewed 13 leaders of national civilian public health and tobacco control organizations to explore their perspectives on military tobacco control, inductively analyzing data for themes. Leaders believed that military tobacco use was problematic but lacked specific kn...

  1. Modeling the Movement of Homicide by Type to Inform Public Health Prevention Efforts.

    Science.gov (United States)

    Zeoli, April M; Grady, Sue; Pizarro, Jesenia M; Melde, Chris

    2015-10-01

    We modeled the spatiotemporal movement of hotspot clusters of homicide by motive in Newark, New Jersey, to investigate whether different homicide types have different patterns of clustering and movement. We obtained homicide data from the Newark Police Department Homicide Unit's investigative files from 1997 through 2007 (n = 560). We geocoded the address at which each homicide victim was found and recorded the date of and the motive for the homicide. We used cluster detection software to model the spatiotemporal movement of statistically significant homicide clusters by motive, using census tract and month of occurrence as the spatial and temporal units of analysis. Gang-motivated homicides showed evidence of clustering and diffusion through Newark. Additionally, gang-motivated homicide clusters overlapped to a degree with revenge and drug-motivated homicide clusters. Escalating dispute and nonintimate familial homicides clustered; however, there was no evidence of diffusion. Intimate partner and robbery homicides did not cluster. By tracking how homicide types diffuse through communities and determining which places have ongoing or emerging homicide problems by type, we can better inform the deployment of prevention and intervention efforts.

  2. 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.

  3. Reproductive Toxic Chemicals at Work and Efforts to Protect Workers' Health: A Literature Review

    Directory of Open Access Journals (Sweden)

    Kyung-Taek Rim

    2017-06-01

    Full Text Available A huge number of chemicals are produced and used in the world, and some of them can have negative effects on the reproductive health of workers. To date, most chemicals and work environments have not been studied for their potential to have damaging effects on the workers' reproductive system. Because of the lack of information, many workers may not be aware that such problems can be related to occupational exposures. Newly industrialized countries such as Republic of Korea have rapidly amassed chemicals and other toxicants that pose health hazards, especially to the reproductive systems of workers. This literature review provides an overview of peer-reviewed literature regarding the teratogenic impact and need for safe handling of chemicals. Literature searches were performed using PubMed, Google Scholar, and ScienceDirect. Search strategies were narrowed based on author expertise and 100 articles were chosen for detailed analysis. A total of 47 articles met prespecified inclusion criteria. The majority of papers contained studies that were descriptive in nature with respect to the Medical Subject Headings (MeSH terms and keywords: “reproductive and heath or hazard and/or workplace or workers or occupations.” In the absence of complete information about the safe occupational handling of chemicals in Republic of Korea (other than a material safety data sheet, this review serves as a valuable reference for identifying and remedying potential gaps in relevant regulations. The review also proposes other public health actions including hazard surveillance and primary prevention activities such as reduction, substitution, ventilation, as well as protective equipment.

  4. Breckinridge Project, initial effort. Report VII, Volume 4. Safety and health plan

    Energy Technology Data Exchange (ETDEWEB)

    None

    1982-01-01

    The Safety and Health Plan recognizes the potential hazards associated with the Project and has been developed specifically to respond to these risks in a positive manner. Prevention, the primary objective of the Plan, starts with building safety controls into the process design and continues through engineering, construction, start-up, and operation of the Project facilities and equipment. Compliance with applicable federal, state, and local health and safety laws, regulations, and codes throughout all Project phases is required and assured. The Plan requires that each major Project phase be thoroughly reviewed and analyzed to determine that those provisions required to assure the safety and health of all employees and the public, and to prevent property and equipment losses, have been provided. The Plan requires followup on those items or situations where corrective action needs were identified to assure that the action was taken and is effective. Emphasis is placed on loss prevention. Exhibit 1 provides a breakdown of Ashland Synthetic Fuels, Inc.'s (ASFI's) Loss Prevention Program. The Plan recognizes that the varied nature of the work is such as to require the services of skilled, trained, and responsible personnel who are aware of the hazards and know that the work can be done safely, if done correctly. Good operating practice is likewise safe operating practice. Training is provided to familiarize personnel with good operational practice, the general sequence of activities, reporting requirements, and above all, the concept that each step in the operating procedures must be successfully concluded before the following step can be safely initiated. The Plan provides for periodic review and evaluation of all safety and loss prevention activities at the plant and departmental levels.

  5. Reproductive Toxic Chemicals at Work and Efforts to Protect Workers' Health: A Literature Review.

    Science.gov (United States)

    Rim, Kyung-Taek

    2017-06-01

    A huge number of chemicals are produced and used in the world, and some of them can have negative effects on the reproductive health of workers. To date, most chemicals and work environments have not been studied for their potential to have damaging effects on the workers' reproductive system. Because of the lack of information, many workers may not be aware that such problems can be related to occupational exposures. Newly industrialized countries such as Republic of Korea have rapidly amassed chemicals and other toxicants that pose health hazards, especially to the reproductive systems of workers. This literature review provides an overview of peer-reviewed literature regarding the teratogenic impact and need for safe handling of chemicals. Literature searches were performed using PubMed, Google Scholar, and ScienceDirect. Search strategies were narrowed based on author expertise and 100 articles were chosen for detailed analysis. A total of 47 articles met prespecified inclusion criteria. The majority of papers contained studies that were descriptive in nature with respect to the Medical Subject Headings (MeSH) terms and keywords: "reproductive and heath or hazard and/or workplace or workers or occupations." In the absence of complete information about the safe occupational handling of chemicals in Republic of Korea (other than a material safety data sheet), this review serves as a valuable reference for identifying and remedying potential gaps in relevant regulations. The review also proposes other public health actions including hazard surveillance and primary prevention activities such as reduction, substitution, ventilation, as well as protective equipment.

  6. A University-Wide Collaborative Effort to Designing a Makerspace at an Academic Health Sciences Library.

    Science.gov (United States)

    Herron, Jennifer; Kaneshiro, Kellie

    2017-01-01

    This article describes the planning and development of a 3D printing makerspace at an academic health sciences library. At the start of 2015, a new library Technology Team was formed consisting of a team leader, an emerging technologies librarian, and a library systems analyst. One of the critical steps in the development of the proposal and with the planning of this project was collaborating and partnering with different departments and units outside the library. These connections helped shape the design of the makerspace.

  7. Organised crime and the efforts to combat it: a concern for public health.

    Science.gov (United States)

    Reynolds, Lucy; McKee, Martin

    2010-11-15

    This paper considers the public health impacts of the income-generating activities of organised crime. These range from the traditional vice activities of running prostitution and supplying narcotics, to the newer growth areas of human trafficking in its various forms, from international supply of young people and children as sex workers through deceit, coercion or purchase from family, through to smuggling of migrants, forced labour and the theft of human tissues for transplant, and the sale of fake medications, foodstuffs and beverages, cigarettes and other counterfeit manufactures. It looks at the effect of globalisation on integrating supply chains from poorly-regulated and impoverished source regions through to their distant markets, often via disparate groups of organised criminals who have linked across their traditional territories for mutual benefit and enhanced profit, with both traditional and newly-created linkages between production, distribution and retail functions of cooperating criminal networks from different cultures. It discusses the interactions between criminals and the structures of the state which enable illegal and socially undesirable activities to proceed on a massive scale through corruption and subversion of regulatory mechanisms. It argues that conventional approaches to tackling organised crime often have deleterious consequences for public health, and calls for an evidence-based approach with a focus on outcomes rather than ideology.

  8. Organised crime and the efforts to combat it: a concern for public health

    Science.gov (United States)

    2010-01-01

    This paper considers the public health impacts of the income-generating activities of organised crime. These range from the traditional vice activities of running prostitution and supplying narcotics, to the newer growth areas of human trafficking in its various forms, from international supply of young people and children as sex workers through deceit, coercion or purchase from family, through to smuggling of migrants, forced labour and the theft of human tissues for transplant, and the sale of fake medications, foodstuffs and beverages, cigarettes and other counterfeit manufactures. It looks at the effect of globalisation on integrating supply chains from poorly-regulated and impoverished source regions through to their distant markets, often via disparate groups of organised criminals who have linked across their traditional territories for mutual benefit and enhanced profit, with both traditional and newly-created linkages between production, distribution and retail functions of cooperating criminal networks from different cultures. It discusses the interactions between criminals and the structures of the state which enable illegal and socially undesirable activities to proceed on a massive scale through corruption and subversion of regulatory mechanisms. It argues that conventional approaches to tackling organised crime often have deleterious consequences for public health, and calls for an evidence-based approach with a focus on outcomes rather than ideology. PMID:21078158

  9. Organised crime and the efforts to combat it: a concern for public health

    Directory of Open Access Journals (Sweden)

    McKee Martin

    2010-11-01

    Full Text Available Abstract This paper considers the public health impacts of the income-generating activities of organised crime. These range from the traditional vice activities of running prostitution and supplying narcotics, to the newer growth areas of human trafficking in its various forms, from international supply of young people and children as sex workers through deceit, coercion or purchase from family, through to smuggling of migrants, forced labour and the theft of human tissues for transplant, and the sale of fake medications, foodstuffs and beverages, cigarettes and other counterfeit manufactures. It looks at the effect of globalisation on integrating supply chains from poorly-regulated and impoverished source regions through to their distant markets, often via disparate groups of organised criminals who have linked across their traditional territories for mutual benefit and enhanced profit, with both traditional and newly-created linkages between production, distribution and retail functions of cooperating criminal networks from different cultures. It discusses the interactions between criminals and the structures of the state which enable illegal and socially undesirable activities to proceed on a massive scale through corruption and subversion of regulatory mechanisms. It argues that conventional approaches to tackling organised crime often have deleterious consequences for public health, and calls for an evidence-based approach with a focus on outcomes rather than ideology.

  10. 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.

  11. 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.

  12. 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.

  13. Defining the Role of Public Health in Disaster Recovery: An Evaluation of State Public Health Planning Efforts

    Science.gov (United States)

    2013-03-01

    Brahmbhatt , Jennifer L. Chan, Edbert B. Hsu,Hani Mowafi, Thomas D. Kirsch, Asma Quereshi P. Gregg Greenough, “Public Health Preparedness of Post-Katrina...L. Chan, Edbert B. Hsu,Hani Mowafi, Thomas D. Kirsch, Asma Quereshi P. Gregg Greenough. “Public Health Preparedness of Post- Katrina and Rita

  14. 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.

  15. 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.

  16. 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.

  17. 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

  18. 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.

  19. 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...

  20. 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.

  1. 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.

  2. 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.

  3. 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...

  4. 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

  5. [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.

  6. 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.

  7. [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.

  8. Cultural context in the effort to improve oral health among Alaska Native people: the dental health aide therapist model.

    Science.gov (United States)

    Wetterhall, Scott; Burrus, Barri; Shugars, Daniel; Bader, James

    2011-10-01

    The Alaska Native people in rural Alaska face serious challenges in obtaining dental care. Itinerant care models have failed to meet their needs for more than 50 years. The dental health aide therapist (DHAT) model, which entails training midlevel care providers to perform limited restorative, surgical, and preventive procedures, was adopted to address some of the limitations of the itinerant model. We used quantitative and qualitative methods to assess residents' satisfaction with the model and the role of DHATs in the cultural context in which they operate. Our findings suggest that the DHAT model can provide much-needed access to urgent care and is beneficial from a comprehensive cultural perspective.

  9. 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.

  10. 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...

  11. 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.

  12. [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.

  13. 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

  14. 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.

  15. 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.

  16. 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.

  17. 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.

  18. Collaborative research efforts and related activities of the Office of Rare Diseases Research at the USA National Institutes of Health

    Directory of Open Access Journals (Sweden)

    Stephen C. Groft

    2009-12-01

    Full Text Available

    Introduction: Rare diseases present unique challenges to meet the numerous and varied needs of the rare diseases community and it is required to identify and address these needs. Significant financial and personnel resources are required to address these needs identified. The Office of Rare Diseases Research (ORDR at the USA National Institutes of Health (NIH has attempted to meet many of these needs in collaborative efforts with the research Institutes and Centers of NIH and other partners in the private and public sectors in the USA and around the world. Several of the activities of the NIH and the ORDR are presented as possible collaborative efforts available to research investigators and include the Rare Diseases Clinical Research Network, the Bench-to-Bedside research program at NIH, the Genetic and Rare Diseases Information center, the genetic test development program, and the information on clinical research studies made available through Clinical trials.gov. The value of an appropriate family medical history is discussed as are the provisions of the Genetic Information Non-Discrimination Act of 2008 (GINA. Definitions of rare or orphan diseases vary from country to country and may cause some confusion to the rare diseases community.

    Conclusions: Rare diseases are not limited by geographical or historical boundaries and global partnerships of the rare diseases community are experiencing rapid expansion to assist in the development of orphan products for the prevention, diagnosis and treatment of rare diseases and conditions. The unmet needs of the rare diseases community require additional innovative research and educational programs to reach the extensive global populations affected by the thousands of different rare diseases including activities with the National Organization for Rare Disorders and the Genetic Alliance.

  19. 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.

  20. 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.

  1. 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.

  2. 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.

  3. 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

  4. 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.

  5. 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.

  6. 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.

  7. 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

  8. Current status of Plasmodium knowlesi vectors: a public health concern?

    Science.gov (United States)

    Vythilingam, I; Wong, M L; Wan-Yussof, W S

    2018-01-01

    Plasmodium knowlesi a simian malaria parasite is currently affecting humans in Southeast Asia. Malaysia has reported the most number of cases and P. knowlesi is the predominant species occurring in humans. The vectors of P. knowlesi belong to the Leucosphyrus group of Anopheles mosquitoes. These are generally described as forest-dwelling mosquitoes. With deforestation and changes in land-use, some species have become predominant in farms and villages. However, knowledge on the distribution of these vectors in the country is sparse. From a public health point of view it is important to know the vectors, so that risk factors towards knowlesi malaria can be identified and control measures instituted where possible. Here, we review what is known about the knowlesi malaria vectors and ascertain the gaps in knowledge, so that future studies could concentrate on this paucity of data in-order to address this zoonotic problem.

  9. 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.

  10. Infant Nutrition and Later Health: A Review of Current Evidence

    Directory of Open Access Journals (Sweden)

    Caroline Fall

    2012-07-01

    Full Text Available There is a growing recognition of the need for a lifecourse approach to understanding the aetiology of adult disease, and there is now significant evidence that links patterns of infant feeding to differences in health outcomes, both in the short and longer term. Breastfeeding is associated with lower rates of infection in infancy; in high-income populations, it is associated with reductions in blood pressure and total blood cholesterol, and lower risks of obesity and diabetes in adult life. Breastfeeding rates are suboptimal in many countries, and strategies to promote breastfeeding could therefore confer important benefits for health at a population level. However, there are particular challenges in defining nutritional exposures in infancy, including marked social gradients in initiation and duration of breastfeeding. In recent studies of low and middle-income populations of children and young adults, where the influences on infant feeding practice differ, beneficial effects of breastfeeding on blood pressure, BMI and risk of diabetes have not been confirmed, and further information is needed. Little is currently known about the long-term consequences of differences in the timing and nature of the weaning diet. Future progress will depend on new studies that provide detailed prospective data on duration and exclusivity of breastfeeding together with appropriate characterisation of the weaning diet.

  11. Traditional scientific data vs. uncoordinated citizen science effort: A review of the current status and comparison of data on avifauna in Southern Brazil.

    Science.gov (United States)

    Klemann-Junior, Louri; Villegas Vallejos, Marcelo Alejandro; Scherer-Neto, Pedro; Vitule, Jean Ricardo Simões

    2017-01-01

    Data generated by citizen science is particularly valuable in ecological research. If used discerningly with data from traditional scientific references, citizen science can directly contribute to biogeography knowledge and conservation policies by increasing the number of species records in large geographic areas. Considering the current level of knowledge on south Brazilian avifauna, the large volume of data produced by uncoordinated citizen science effort (CS), and the growing need for information on changes in abundance and species composition, we have compiled an updated, general list of bird species occurrence within the state of Paraná. We have listed extinct, invasive and recently-colonizing species as well as indicator species of the state's vegetation types. We further assess the degree of knowledge of different regions within the state based on data from traditional scientific references, and the effect of including CS data in the same analysis. We have compiled data on 766 bird species, based on 70,346 individual records from traditional scientific references, and 79,468 from CS. Extinct and invasive species were identified by comparing their occurrence and abundance over a series of three time periods. Indicator species analysis pointed to the existence of three areas with bird communities typically found within the state: the Semideciduous Tropical Forest, the Tropical Rainforest and the junction of Grassland and Araucaria Moist Forest. We used rarefaction to measure sampling sufficiency, and found that rarefaction curves reached stabilization for all vegetation types except in Savanna. We observed differences in the level of knowledge of bird biodiversity among the microregions of the state, but including CS data, these differences were mitigated. The same effect was observed in other exploratory analyzes conducted here, emphasizing the fundamental importance of including CS data in macroecological studies. Production of easily accessible data and

  12. Public health system - current status and world experience

    Directory of Open Access Journals (Sweden)

    Andreyeva І.А.

    2016-09-01

    Full Text Available In the review, the evolution of Public Health and global development tendencies of Public Health system have been discussed. Stages of formation of the updated concept, principles of Public Health organization and the role of various organizations have been shown in the connection with development of the global concept of "Health for All". A well-functioning public health system is primarily the result of multisectoral cooperation. The aim of modern Public Health is to provide conditions of access to appropriate and cost-effective health care for all population groups, including health promotion and disease prevention.

  13. 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

  14. 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...

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

    Science.gov (United States)

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

    2009-09-05

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

  16. [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.

  17. Aviation and Health: A Key Nexus for the US Air Force’s Regional Security-Building Efforts

    Science.gov (United States)

    2015-06-01

    improved governance, commercial utility and economic growth, increased currency and training for air- crews in multiuse aircraft (for internal defense...jp5_0.pdf. 16. Mexican Commission on Macroeconomics and Health, Investing in Health for Economic Develop- ment (Puebla, Mexico: Mexican Commission...on Macroeconomics and Health, 2004); and Research Analyst, “The Role of Health in Economic Development,” Development Strategy, Advisory, and

  18. Health disparities monitoring in the U.S.: lessons for monitoring efforts in Israel and other countries.

    Science.gov (United States)

    Abu-Saad, Kathleen; Avni, Shlomit; Kalter-Leibovici, Ofra

    2018-02-28

    Health disparities are a persistent problem in many high-income countries. Health policymakers recognize the need to develop systematic methods for documenting and tracking these disparities in order to reduce them. The experience of the U.S., which has a well-established health disparities monitoring infrastructure, provides useful insights for other countries. This article provides an in-depth review of health disparities monitoring in the U.S. Lessons of potential relevance for other countries include: 1) the integration of health disparities monitoring in population health surveillance, 2) the role of political commitment, 3) use of monitoring as a feedback loop to inform future directions, 4) use of monitoring to identify data gaps, 5) development of extensive cross-departmental cooperation, and 6) exploitation of digital tools for monitoring and reporting. Using Israel as a case in point, we provide a brief overview of the healthcare and health disparities landscape in Israel, and examine how the lessons from the U.S. experience might be applied in the Israeli context. The U.S. model of health disparities monitoring provides useful lessons for other countries with respect to documentation of health disparities and tracking of progress made towards their elimination. Given the persistence of health disparities both in the U.S. and Israel, there is a need for monitoring systems to expand beyond individual- and healthcare system-level factors, to incorporate social and environmental determinants of health as health indicators/outcomes.

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

    Science.gov (United States)

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

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

  20. Oral Health and Menopause: A Comprehensive Review on Current ...

    African Journals Online (AJOL)

    Annals of Medical and Health Sciences Research ... As we all begin to reach an older age, dental health and hygiene becomes a major concern. ... to establish more authentic clinical guidelines for successful management of such conditions.

  1. International collaboration in health promotion and disease management: implications of U.S. health promotion efforts on Japan's health care system.

    Science.gov (United States)

    Pelletier, Kenneth R

    2005-01-01

    For more than 25 years, health promotion and disease management interventions have been conducted by large employers in the United States. Today there are more than 100 studies of such multifactorial, comprehensive interventions that all demonstrate positive clinical outcomes. For those interventions that have also been evaluated for return on investment, all but one have demonstrated cost-effectiveness. This article is an evidence-based overview of the clinical and cost outcomes research to elaborate on the insights gained from this research in the areas of implementation and evaluation of such programs; integration of health promotion and disease management programs into conventional, occupational medicine; accessing difficult to reach populations, such as mobile workers, retirees, and/or dependents; areas of potential conflict of interest and privacy/confidentiality issues; health consequences of downsizing and job strain; and, finally, recommendations for improved integration and evaluation of such programs for both clinical and cost outcomes. With medical costs rapidly escalating again on a global scale, these interventions with evidence of both clinical and cost outcomes can provide the foundation to improve the health, performance, and productivity of both individuals and their corporations.

  2. The parameters of the current legal framework for health research ...

    African Journals Online (AJOL)

    2013-11-02

    Nov 2, 2013 ... Health research. Health research is defined very broadly in section 1 of the NHA, as ... national ethical guidelines issued by the Department of Health define research as a ... This definition suggests that section 71 only applies to studies ... nursing, rehabilitative, palliative, convalescent, preventative or other.

  3. Innovative remote monitoring of plant health for environmental applications: A joint effort between EPCOT{reg_sign} and the DOE

    Energy Technology Data Exchange (ETDEWEB)

    Robitaille, H. [Walt Disney World Resort, Lake Buena Vista, FL (United States); Capelle, G.; Di Benedetto, J. [Special Technologies Lab., Santa Barbara, CA (United States)] [and others

    1996-12-31

    In September of 1994, the US Department of Energy (DOE), Environmental Management, Office of Science and Technology for (OST) and Epcot{reg_sign} in the WALT DISNEY WORLD{reg_sign} Resort (Epcot) signed an agreement to cooperate on the research, development, and public communication and display of environmental technologies. Although Epcot and OST have distinctive missions, certain areas of their respective research and development efforts are common, including the integration of remote sensors with robotics platforms, airborne surveys for environmental characterization and monitoring, and ground based measurements of vegetation stress. The first area of cooperative R&D pursued under the agreement is the evaluation of laser-induced fluorescence imaging (LIFI), a technology developed by OST and proven effective for uranium detection. This paper describes the efforts being conducted under the Epcot-OST agreement and presents initial results. An appendix describing LIFI technology is also included.

  4. Building relationships with physicians. Internal marketing efforts help strengthen organizational bonds at a rural health care clinic.

    Science.gov (United States)

    Peltier, J W; Boyt, T; Westfall, J E

    1997-01-01

    Physician turnover is costly for health care organizations, especially for rural organizations. One approach management can take to reduce turnover is to promote physician loyalty by treating them as an important customer segment. The authors develop an information--oriented framework for generating physician loyalty and illustrate how this framework has helped to eliminate physician turnover at a rural health care clinic. Rural health care organizations must develop a more internal marketing orientation in their approach to establishing strong relationship bonds with physicians.

  5. An Approach to Coordinate Efforts to Reduce the Public Health Burden of Stroke: The Delta States Stroke Consortium

    OpenAIRE

    Virginia J. Howard; Joe Acker; Camilo R. Gomez; Ada H. Griffies; Wanda Magers; Max Michael III; Sean R. Orr; Martha Phillips; James M. Raczynski; John E. Searcy; Richard M. Zweifler; George Howard

    2004-01-01

    Stroke is the third leading cause of death and a leading cause of disability in the United States, with a particularly high burden on the residents of the southeastern states, a region dubbed the Stroke Belt. These five states Alabama, Arkansas, Louisiana, Mississippi, and Tennessee have formed the Delta States Stroke Consortium to direct efforts to reduce this burden. The consortium is proposing an approach to identify domains where interventions may be instituted and an array of activitie...

  6. Integrated health care delivery system conducts ad agency search as part of its brand-launching effort.

    Science.gov (United States)

    Lewicki, G

    1999-01-01

    PennState Geisinger Health System, Hershey, Pa., conducted an extensive ad agency search after its inception in 1997. The integrated health care delivery system needed to introduce its brand to an audience that was confused by the wide array of available health care options. BVK/McDonald, Milwaukee, the agency selected, has created a branding campaign that revolves around the tag-line "The power of health." PennState Geisinger will tabulate the results of BVK/McDonald's multi-million dollar campaign in 2000; at that time it will know whether its selection committee chose wisely.

  7. 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.

  8. Hookah and Cigarette Smoking among African American College Students: Implications for Campus Risk Reduction and Health Promotion Efforts

    Science.gov (United States)

    Jones, Brittni D.; Cunningham-Williams, Renee M.

    2016-01-01

    Objective: To identify individual and institutional risks and protections for hookah and cigarette smoking among African American (AA) college students. Participants: AA college students (N = 1,402; mean age = 20, range = 18-24 years; 75% female) who completed the Fall 2012 American College Health Association--National College Health Assessment…

  9. Mental Health Promotion Efforts for Children and Youth in Canada and Beyond: Evidence in Research, Policy and Practice

    Science.gov (United States)

    Whitley, Jessica; Gooderham, Suzanne

    2015-01-01

    Mental health issues continue to present barriers for Canadian children, in terms of both psychological and academic outcomes. Growing numbers of students are placed "at risk" as a result. A mental health promotion approach suggests that students can develop a number of skills and competencies, namely those related to social-emotional…

  10. 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.

  11. 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.

  12. 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

  13. Community mental health care worldwide: current status and further developments

    Science.gov (United States)

    Thornicroft, Graham; Deb, Tanya; Henderson, Claire

    2016-01-01

    This paper aims to give an overview of the key issues facing those who are in a position to influence the planning and provision of mental health systems, and who need to address questions of which staff, services and sectors to invest in, and for which patients. The paper considers in turn: a) definitions of community mental health care; b) a conceptual framework to use when evaluating the need for hospital and community mental health care; c) the potential for wider platforms, outside the health service, for mental health improvement, including schools and the workplace; d) data on how far community mental health services have been developed across different regions of the world; e) the need to develop in more detail models of community mental health services for low‐ and middle‐income countries which are directly based upon evidence for those countries; f) how to incorporate mental health practice within integrated models to identify and treat people with comorbid long‐term conditions; g) possible adverse effects of deinstitutionalization. We then present a series of ten recommendations for the future strengthening of health systems to support and treat people with mental illness. PMID:27717265

  14. 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.

  15. Current environmental health problems and initiatives in Malaysia

    International Nuclear Information System (INIS)

    Sugunan Pillay, M.; Debbie Siru

    1996-01-01

    This paper discusses the various environmental changes that have taken place and the change health status of the people in Malaysia. This includes water pollution, air pollution, noise pollution, solid waste pollution, urbanisation and initiatives in environmental health protection via water resources, air quality, solid and toxic and hazardous waste , and urban management

  16. Current environmental health problems and initiatives in Malaysia

    Energy Technology Data Exchange (ETDEWEB)

    Sugunan Pillay, M; Siru, Debbie [Ministry of Health Malaysia, Kuala Lumpur (Malaysia). Engineering Div.

    1997-12-31

    This paper discusses the various environmental changes that have taken place and the change health status of the people in Malaysia. This includes water pollution, air pollution, noise pollution, solid waste pollution, urbanisation and initiatives in environmental health protection via water resources, air quality, solid and toxic and hazardous waste , and urban management.

  17. Quantitative health impact assessment: current practice and future directions

    NARCIS (Netherlands)

    J.L. Veerman (Lennert); J.J.M. Barendregt (Jan); J.P. Mackenbach (Johan)

    2005-01-01

    textabstractSTUDY OBJECTIVE: To assess what methods are used in quantitative health impact assessment (HIA), and to identify areas for future research and development. DESIGN: HIA reports were assessed for (1) methods used to quantify effects of policy on determinants of health

  18. Growth of health maintenance organisations in Nigeria and the potential for a role in promoting universal coverage efforts.

    Science.gov (United States)

    Onoka, Chima A; Hanson, Kara; Mills, Anne

    2016-08-01

    There has been growing interest in the potential for private health insurance (PHI) and private organisations to contribute to universal health coverage (UHC). Yet evidence from low and middle income countries remains very thin. This paper examines the evolution of health maintenance organisations (HMOs) in Nigeria, the nature of the PHI plans and social health insurance (SHI) programmes and their performance, and the implications of their business practices for providing PHI and UHC-related SHI programmes. An embedded case study design was used with multiple subunits of analysis (individual HMOs and the HMO industry) and mixed (qualitative and quantitative) methods, and the study was guided by the structure-conduct-performance paradigm that has its roots in the neo-classical theory of the firm. Quantitative data collection and 35 in-depth interviews were carried out between October 2012 to July 2013. Although HMOs first emerged in Nigeria to supply PHI, their expansion was driven by their role as purchasers in the government's national health insurance scheme that finances SHI programmes, and facilitated by a weak accreditation system. HMOs' characteristics distinguish the market they operate in as monopolistically competitive, and HMOs as multiproduct firms operating multiple risk pools through parallel administrative systems. The considerable product differentiation and consequent risk selection by private insurers promote inefficiencies. Where HMOs and similar private organisations play roles in health financing systems, effective regulatory institutions and mandates must be established to guide their behaviours towards attainment of public health goals and to identify and control undesirable business practices. Lessons are drawn for policy makers and programme implementers especially in those low and middle-income countries considering the use of private organisations in their health financing systems. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Current issues in the impacts of transport on health.

    Science.gov (United States)

    van Schalkwyk, M C I; Mindell, J S

    2018-03-01

    Transport affects health in many ways. Benefits include access to education, employment, goods, services and leisure, and opportunities for incorporating physical activity into daily living. There are major inequalities: benefits generally accrue to wealthier people and harms to the more deprived, nationally and globally. Health on the Move 2; Journal of Transport and Health. Benefits of travel for access and physical activity. Harms include health impacts of air and noise pollution; injuries and fatalities from falls or collisions; sedentary behaviour with motorized transport; community severance (barrier effect of busy roads and transport infrastructure); global climate change; impacts on inequalities; transport's role in facilitating spread of communicable diseases. Biofuels; cycle safety; driving by older people. Effects of default 20 mph speed limits; impacts of autonomous vehicles on health and inequalities.

  20. 'It's interesting how few people die from smoking': tobacco industry efforts to minimize risk and discredit health promotion.

    Science.gov (United States)

    Smith, Elizabeth A

    2007-04-01

    It is well known that the tobacco industry has placed articles in scientific literature to maintain controversy over the dangers of tobacco use, while claiming that smokers are well-informed about risk. This study illuminates an industry attempt to directly undermine popular understanding of the hazards of smoking using an industry-created organization called Associates for Research in the Science of Enjoyment (ARISE). Searches of tobacco industry documents contained in the Legacy Tobacco Documents Library, British American Tobacco Documents Library, and British Columbia's Tobacco Industry documents were performed as well as searches of the LexisNexis database for news articles on ARISE published between 1989 and 2005. Qualitative analysis focused on industry motives, media strategies, and rhetorical tactics; quantitative content analysis focused on media coverage. Between 1989 and 2005, at least 846 articles appeared in the European, Australian, and US press mentioning ARISE, its members, or its activities. Many of these articles presented two themes: smoking was a healthful 'pleasure', and health promotion practices, including cessation, were stressful and unhealthy. Few articles included responses from health advocates, questioned ARISE's claims, or mentioned its funding. ARISE successfully planted stories in the press, designed to allay the health concerns of smokers and to discredit health promotion information and practices. ARISE's later interest in food suggests that counterfactual 'health' messages on almost any topic could be promoted similarly, regardless of their implausibility.

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

    Directory of Open Access Journals (Sweden)

    Georg F. Bauer

    2007-12-01

    Full Text Available

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

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

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

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

  2. 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...

  3. Assess Current and Potential Salmonid Production in Rattlesnake Creek in Association with Restoration Efforts, US Geological Survey Report, 2004-2005 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Allen, M. Brady; Connolly, Patrick J.; Jezorek, Ian G. (US Geological Survey, Western Fisheries Research Center, Columbia River Research Laboratory, Cook, WA)

    2006-06-01

    This project was designed to document existing habitat conditions and fish populations within the Rattlesnake Creek watershed (White Salmon River subbasin, Washington) before major habitat restoration activities are implemented and prior to the reintroduction of salmon and steelhead above Condit Dam. Returning adult salmon Oncorhynchus spp. and steelhead O. mykiss have not had access to Rattlesnake Creek since 1913. An assessment of resident trout populations should serve as a good surrogate for evaluation of factors that would limit salmon and steelhead production in the watershed. Personnel from United States Geological Survey's Columbia River Research Laboratory (USGS-CRRL) attended to three main objectives of the Rattlesnake Creek project. The first objective was to characterize stream and riparian habitat conditions. This effort included measures of water quality, water quantity, stream habitat, and riparian conditions. The second objective was to determine the status of fish populations in the Rattlesnake Creek drainage. To accomplish this, we derived estimates of salmonid population abundance, determined fish species composition, assessed distribution and life history attributes, obtained tissue samples for genetic analysis, and assessed fish diseases in the watershed. The third objective was to use the collected habitat and fisheries information to help identify and prioritize areas in need of restoration. As this report covers the fourth year of a five-year study, it is largely restricted to describing our efforts and findings for the first two objectives.

  4. Assess Current and Potential Salmonid Production in Rattlesnake Creek Associated with Restoration Efforts; US Geological Survey Reports, 2002-2003 Annual Report.

    Energy Technology Data Exchange (ETDEWEB)

    Connolly, Patrick J. (US Geological Survey, Columbia River Research Laboratory, Western Fisheries Research Center, Cook, WA)

    2003-12-01

    This project was designed to document existing habitat conditions and fish populations within the Rattlesnake Creek watershed (White Salmon River subbasin, Washington) before major habitat restoration activities are implemented and prior to the reintroduction of salmon and steelhead above Condit Dam. Returning adult salmon Oncorhynchus spp. and steelhead O. mykiss have not had access to Rattlesnake Creek since 1913. An assessment of resident trout populations should serve as a good surrogate for evaluation of factors that would limit salmon and steelhead production in the watershed. Personnel from United States Geological Survey's Columbia River Research Laboratory (USGS-CRRL) attend to three main objectives of the Rattlesnake Creek project. The first is to characterize stream and riparian habitat conditions. This effort includes measures of water quality, water quantity, stream habitat, and riparian conditions. The second objective is to determine the status of fish populations in the Rattlesnake Creek drainage. To accomplish this, we derived estimates of salmonid population abundance, determined fish species composition, assessed distribution and life history attributes, obtained tissue samples for genetic analysis, and assessed fish diseases in the watershed. The third objective is to use the collected habitat and fisheries information to help identify and prioritize areas in need of restoration. As this report covers the second year of at least a three-year study, it is largely restricted to describing our efforts and findings for the first two objectives.

  5. 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

  6. Divorce and health: current trends and future directions.

    Science.gov (United States)

    Sbarra, David A

    2015-04-01

    Social relationships play a vital role in health and well-being, and it follows that loss experiences can be highly stressful for some people. This article reviews what is known about the association between marital separation, divorce, and health outcomes. Key findings in the area of divorce and health are discussed, and the review outlines a series of specific questions for future research. In particular, the article integrates research in social epidemiology with research in social psychophysiology. The former approach provides a broad-based estimate of the association between marital status and health outcomes, whereas the latter approach studies mechanisms of action and individual differences associated with increased risk for poor outcomes. The experience of separation or divorce confers risk for poor health outcomes, including a 23% higher mortality rate. However, most people cope well and are resilient after their marriage or long-term relationship ends. Despite the fact that resilience is the most common response, a small percentage of people (approximately 10%-15%) struggle quite substantially, and it seems that the overall elevated adverse health risks are driven by the poor functioning of this group. Several candidate mechanisms and novel (ambulatory) assessment techniques that may elucidate the poor outcomes among people who adapt poorly to separation are discussed. To increase knowledge on the association between divorce and health, three primary areas require more research: a) genetic and third variable explanations for divorce-related health outcomes, (b) better studies of objective social behavior after separation, and (c) increased attention to interventions targeting high-risk adults.

  7. Mental health of adolescents with currently and formerly incarcerated parents

    OpenAIRE

    Davis, Laurel; Shlafer, Rebecca J.

    2016-01-01

    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 compar...

  8. 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...

  9. The parameters of the current legal framework for health research ...

    African Journals Online (AJOL)

    South African Journal of Bioethics and Law. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 6, No 2 (2013) >. Log in or Register to get access to full text downloads.

  10. 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...

  11. The Perceived Role of Direct Support Professionals in the Health Promotion Efforts of Adults with Developmental Disabilities Receiving Support Services

    Science.gov (United States)

    Leser, Kendall A.; Pirie, Phyllis L.; Ferketich, Amy K.; Havercamp, Susan M.; Wewers, Mary Ellen

    2018-01-01

    Direct support professionals (DSPs) play a large social role in the lives of people with developmental disabilities (DD) and have the potential to influence their health behaviors. Six qualitative focus groups (n = 48) were conducted with DD community agency administrators, DSPs, family members and adults with DD to better understand the perceived…

  12. Keep Kids in School: A Collaborative Community Effort to Increase Compliance with State-Mandated Health Requirements

    Science.gov (United States)

    Rogers, Valerie; Salzeider, Christine; Holzum, Laura; Milbrandt, Tracy; Zahnd, Whitney; Puczynski, Mark

    2016-01-01

    Background: It is important that collaborative relationships exist in a community to improve access to needed services for children. Such partnerships foster preventive services, such as immunizations, and other services that protect the health and well-being of all children. Methods: A collaborative relationship in Illinois involving an academic…

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

    NARCIS (Netherlands)

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

    2015-01-01

    Background 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

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

    Science.gov (United States)

    Safaei, Jalil

    2015-01-01

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

  15. Shift Work and Health: Current Problems and Preventive Actions

    Directory of Open Access Journals (Sweden)

    Giovanni Costa

    2010-12-01

    Full Text Available The paper gives an overview of the problems to be tackled nowadays by occupational health with regards to shift work as well as the main guidelines at organizational and medical levels on how to protect workers’ health and well-being. Working time organization is becoming a key factor on account of new technologies, market globalization, economic competition, and extension of social services to general populations, all of which involve more and more people in continuous assistance and control of work processes over the 24 hours in a day. The large increase of epidemiological and clinical studies on this issue document the severity of this risk factor on human health and well being, at both social and psychophysical levels, starting from a disruption of biological circadian rhythms and sleep/wake cycle and ending in several psychosomatic troubles and disorders, likely also including cancer, and extending to impairment of performance efficiency as well as family and social life. Appropriate interventions on the organization of shift schedules according to ergonomic criteria and careful health surveillance and social support for shift workers are important preventive and corrective measures that allow people to keep working without significant health impairment.

  16. 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.

  17. 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.

  18. Asbestos case and its current implications for global health

    Directory of Open Access Journals (Sweden)

    Daniela Marsili

    2013-09-01

    Full Text Available Notwithstanding a major body of evidence on the carcinogenicity of all asbestos fibres and a general consensus of the scientific community on the health impact of this agent, asbestos is still produced and used in a large number of countries, thus determining further harm for future generations. Prevention of asbestos-related disease requires international cooperation, transfer of know-how and dissemination of successful procedures in order to contrast asbestos exposure in the frame of a global environmental health approach.

  19. [The Rockefeller Foundation and its efforts toward a reorientation of German medicine and public health in the 1950s].

    Science.gov (United States)

    Schleiermacher, Sabine

    2010-01-01

    The Rockefeller Foundation invested substantial funds into promoting the development of public health as a discipline and a re-orientation of medical training in West Germany to support the democratization of German society. Not limiting itself to the simple provision of literature, the Foundation pursued a two-pronged strategy. Firstly, the Foundation organized a program for German university physicians and public health officers to visit various universities and teaching hospitals in the USA and Canada. A second aim was to establish training institutes for postgraduate physicians. However, rather than simply imposing the US model, the Foundation intended to adapt it to the German context, in the form of a postgraduate course for physicians that integrated practical experience with a university setting. My research to date shows that the Foundation's activities did not meet with much enthusiasm from German medical professionals. Intellectual, cultural, cognitive and political differences impaired constructive collaboration between the Foundation's staff and local practitioners and academics.

  20. Mass drug administration and the sustainable control of schistosomiasis: Community health workers are vital for global elimination efforts.

    Science.gov (United States)

    Inobaya, Marianette T; Chau, Thao N; Ng, Shu-Kay; MacDougall, Colin; Olveda, Remigio M; Tallo, Veronica L; Landicho, Jhoys M; Malacad, Carol M; Aligato, Mila F; Guevarra, Jerric R; Ross, Allen G

    2018-01-01

    Schistosomiasis control is centred on preventive chemotherapy through mass drug administration (MDA). However, endemic countries continue to struggle to attain target coverage rates and patient compliance. In the Philippines, barangay health workers (BHWs) play a vital role in the coordination of MDA, acting as advocates, implementers, and educators. The aim of this study was to determine whether BHW knowledge and attitudes towards schistosomiasis and MDA is sufficient and correlated with resident knowledge and drug compliance. A cross-sectional survey was conducted in 2015 among 2186 residents and 224 BHWs in the province of Northern Samar, the Philippines using a structured survey questionnaire. BHWs showed good familiarity on how schistosomiasis is acquired and diagnosed. Nevertheless, both BHWs and residents had poor awareness of the signs and symptoms of schistosomiasis, disease prevention, and treatment options. There was no correlation between the knowledge scores of the BHWs and the residents (r=0.080, p=0.722). Kruskal-Wallis analysis revealed significant differences in BHW knowledge scores between the low (3.29, 95% confidence interval 3.16-3.36), moderate (3.61, 95% confidence interval 3.49-3.69), and high (4.05, 95% confidence interval 3.77-4.13) compliance village groups (p=0.002), with the high compliance areas having the highest mean knowledge scores. This study highlights the importance of community health workers in obtaining the World Health Organization drug coverage rate of 75% and improving compliance with MDA in the community. Investing in the education of community health workers with appropriate disease-specific training is crucial if disease elimination is ultimately to be achieved. Copyright © 2017 The Author(s). Published by Elsevier Ltd.. All rights reserved.

  1. Do current sports nutrition guidelines conflict with good oral health?

    Science.gov (United States)

    Broad, Elizabeth M; Rye, Leslie A

    2015-01-01

    For optimal athletic performance, an athlete requires good oral health to reduce the risk of oral pain, inflammation, and infection and thereby minimize the use of analgesics and antimicrobial agents. Increased intake, frequency, and dental contact time of carbohydrate-rich foods, sports nutrition products, and acidic carbohydrate-containing sports and energy drinks may contribute to risks of dental erosion, caries, and inflammatory periodontal conditions in the athlete, especially when he or she also exhibits dehydration and poor oral hygiene habits. Examining the athlete before he or she begins participating in a sport allows the dental care provider to determine the patient's existing oral health, hygiene, and susceptibility to risk factors for erosion, caries, and inflammatory periodontal disease. This oral profile, in conjunction with the individual athlete's dietary needs, can be used to establish a treatment and preventive program, including oral health education. Good oral hygiene practices and application of topical fluoride, especially via fluoridated toothpastes and topical fluoride varnishes, must be available to the athlete. Rinsing with water or a neutral beverage after exposure to carbohydrates or acidic sports nutrition products may reduce carbohydrate contact time and bring oral pH levels back to neutral more quickly, reducing the risk of caries and erosion. Finally, the dentist should encourage the athlete to consult with an experienced sports dietitian to ensure that principles of sports nutrition are being appropriately applied for the type, frequency, and duration of exercise in consideration of the individual's oral health needs.

  2. Mental and psychosocial health among current and former professional footballers

    NARCIS (Netherlands)

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

    2015-01-01

    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

  3. Infectious Diseases: Current Issues in School and Community Health.

    Science.gov (United States)

    Bower, Wilma; And Others

    1986-01-01

    Some children in American schools have known and unknown communicable diseases, including herpes, cytomegalovirus, AIDS, mononucleosis, pinworms, and hepatitis. This article examines major public health issues, school responsibility, preventative measures (like basic hygiene), and the need for more effective community education programs. A disease…

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

    Directory of Open Access Journals (Sweden)

    Safaei J

    2015-12-01

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

  5. 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.

  6. 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.

  7. Credentialing Public Health Nurses: Current Issues and Next Steps Forward.

    Science.gov (United States)

    Vandenhouten, Christine L; DeVance-Wilson, Crystal L; Little, Barbara Battin

    2015-01-01

    The purpose of this descriptive, cross-sectional study was to identify Public Health Nurses' (PHN) perceived motivators and barriers to seeking PHN board certification. In collaboration with the Quad Council of Public Health Nursing Organizations, PHNs from across the United States were invited to complete the PHN Certification Survey, a 14-item online questionnaire. A total of 912 surveys were completed. PHNs were motivated to seek PHN board certification by three overarching categories: professional competence, personal satisfaction, and financial incentives. Frequently cited barriers to certification were lack of knowledge of certification opportunities, being unaware of eligibility criteria, cost, perceived lack of value/reward by employer, and preparation time. Demonstrating a highly educated, competent, and reliable PHN workforce can only be achieved through ongoing professional development and credentialing. PH stakeholders (i.e., PHN organizations, employers, PHNs, etc.) need a strategic approach to address the main barriers to certification identified in this study (a) awareness of certification and eligibility criteria, and (b) recognition of the credential by employers. In addition, research on the relationship between PHN credentialing and population health outcomes is essential. © 2015 Wiley Periodicals, Inc.

  8. Zika virus: Global health challenge, threat and current situation.

    Science.gov (United States)

    Aziz, Hafsa; Zia, Aadarash; Anwer, Amania; Aziz, Muneeba; Fatima, Shazia; Faheem, Muhammad

    2017-06-01

    ZIKV has emerged as grave global health issue in the past few years. ZIKV was firstly isolated in 1947 from a rhesus sentinel monkey in the Zika forest in Uganda. It is usually transmitted by the bite of infected mosquitoes and infects skin fibroblasts, skin keratinocytes, etc. ZIKV until now was under reported because of its clinical similarity with the dengue and chikungunya. It is usually spread through the course of the sylvatic cycle. In this cycle, the virus or pathogen lifespan is spent between the wild animal and vectors. The intrinsic incubation period is not yet fully known but it is observed that the very first symptoms of ZIKV infection can appear or develop within 3-12 days of time period and usually subside within 7 days of time. There is a strong relationship between prenatal Zika virus infection and microcephaly; other serious brain anomalies to the infant or newborn are Guillain-Barré syndrome. To date no vaccines are available for ZIKV prevention hence only symptomatic treatment is recommended in infected patients. Usually ZIKV is detected by serologic (IgM ELISA), plaque reduction neutralization test (PRNT) along with in-house" molecular techniques (RT-PCR). ZIKV infection being imminent global health issue warrants strong protective measures to prevent it from becoming an epidemic. Early detection and prevention is the key to tackle this grave potential health hazard. J. Med. Virol. 89:943-951, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  9. [The current perspectives regarding the burden on mental health caregivers].

    Science.gov (United States)

    Cardoso, Lucilene; Vieira, Mariana Verderoce; Ricci, Maira Aparecida Malagutti; Mazza, Rafael Severio

    2012-04-01

    A systematic literature review was performed regarding the burden on mental health caregivers. The studies were selected from the Virtual Health Library - Biblioteca Virtual de Saúde (BVS), using the keyword caregiver burden. The main criteria for this study were: full-text articles published between 2000 and 2010, in Portuguese, English or Spanish; indexed on the BVS databases; which investigated the burden of mental health caregivers, and had caregivers as the main subject. The analysis was performed considering the following: title, year of publication, objectives, methodological approach, instruments and main results. The analysis of 114 full-text articles showed the predominant objectives were the burden on informal caregivers and the validation of psychometric scales, particularly the Zarit Scale. Some studies showed an association between high levels of burden, feelings of guilt and depressive symptoms. On the other hand, psycho-educational interventions were indicated as having a positive impact. This theme has a growing scientific interest and there is a need for deeper studies addressing formal caregivers.

  10. 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.

  11. Enhancing atmospheric mercury research in China to improve the current understanding of the global mercury cycle: the need for urgent and closely coordinated efforts.

    Science.gov (United States)

    Ci, Zhijia; Zhang, Xiaoshan; Wang, Zhangwei

    2012-06-05

    The current understanding of the global mercury (Hg) cycle remains uncertain because Hg behavior in the environment is very complicated. The special property of Hg causes the atmosphere to be the most important medium for worldwide dispersion and transformation. The source and fate of atmospheric Hg and its interaction with the surface environment are the essential topics in the global Hg cycle. Recent declining measurement trends of Hg in the atmosphere are in apparent conflict with the increasing trends in global anthropogenic Hg emissions. As the single largest country contributor of anthropogenic Hg emission, China's role in the global Hg cycle will become more and more important in the context of the decreasing man-made Hg emission from developed regions. However, much less Hg information in China is available. As a global pollutant which undergoes long-range transport and is persistence in the environment, increasing Hg knowledge in China could not only promote the Hg regulation in this country but also improve the understanding of the fundamental of the global Hg cycle and further push the abatement of this toxin on a global scale. Then the atmospheric Hg research in China may be a breakthrough for improving the current understanding of the global Hg cycle. However, due to the complex behavior of Hg in the atmosphere, a deeper understanding of the atmospheric Hg cycle in China needs greater cooperation across fields.

  12. Surveillance efforts after mass drug administration to validate elimination of lymphatic filariasis as a public health problem in Vanuatu.

    Science.gov (United States)

    Taleo, Fasihah; Taleo, George; Graves, Patricia M; Wood, Peter; Kim, Sung Hye; Ozaki, Masayo; Joseph, Hayley; Chu, Brian; Pavluck, Alex; Yajima, Aya; Melrose, Wayne; Ichimori, Kazuyo; Capuano, Corinne

    2017-01-01

    Vanuatu was formerly highly endemic for lymphatic filariasis (LF), caused by Wuchereria bancrofti and transmitted by Anopheles mosquitoes. After a baseline survey showing 4.8% antigen prevalence in 1998, the country conducted nationwide (in one implementation unit) annual mass drug administration (MDA) with albendazole and diethylcarbamazine citrate from 2000 to 2004 and achieved prevalence of 0.2% by 2006 in a representative nationwide cluster survey among all age groups. Post MDA surveillance was conducted from 2006 to 2012. After MDA, the country was divided for surveillance into three evaluation units (EUs) formed by grouping provinces according to baseline prevalence: EU1: Torba, Sanma and Malampa; EU2: Penama; EU3: Shefa and Tafea. The study compiled all past data and information on surveys in Vanuatu from the country programme. This paper reviews the surveillance activities done after stopping MDA to validate the interruption of transmission and elimination of LF as a public health problem. Post-MDA surveillance consisting of at least three transmission assessment surveys (TAS) in each of the three EUs was conducted between 2006 and 2012. Sentinel and spot check surveys identified a few villages with persistent high prevalence; all antigen positive cases in these sites were treated and additional targeted MDA conducted for 3 years in 13 villages in one area of concern. All three EUs passed all TAS in 2007, 2010 and 2012 respectively, with no positives found except in EU2 (Penama province) in 2012 when 2 children tested positive for circulating filariasis antigen. Assessment of the burden of chronic filariasis morbidity found 95 cases in 2003 and 32 remaining cases in 2007, all aged over 60 years. Vanuatu has achieved validation of elimination of LF as a public health problem. Post-validation surveillance is still recommended especially in formerly highly endemic areas.

  13. IFMIF, the European–Japanese efforts under the Broader Approach agreement towards a Li(d,xn neutron source: Current status and future options

    Directory of Open Access Journals (Sweden)

    J. Knaster

    2016-12-01

    Full Text Available The necessity of a neutron source for fusion materials research was identified already in the 70s. Though neutrons induced degradation present similarities on a mechanistic approach, thresholds energies for crucial transmutations are typically above fission neutrons spectrum. The generation of He via 56Fe (n,α 53Cr in future fusion reactors with around 12 appm/dpa will lead to swelling and structural materials embrittlement. Existing neutron sources, namely fission reactors or spallation sources lead to different degradation, attempts for extrapolation are unsuccessful given the absence of experimental observations in the operational ranges of a fusion reactor. Neutrons with a broad peak at 14MeV can be generated with Li(d,xn reactions; the technological efforts that started with FMIT in the early 80s have finally matured with the success of IFMIF/EVEDA under the Broader Approach Agreement. The status today of five technological challenges, perceived in the past as most critical, are addressed. These are: 1. the feasibility of IFMIF accelerators, 2. the long term stability of lithium flow at IFMIF nominal conditions, 3. the potential instabilities in the lithium screen induced by the 2×5 MW impacting deuteron beam, 4. the uniformity of temperature in the specimens during irradiation, and 5. the validity of data provided with small specimens. Other ideas for fusion material testing have been considered, but they possibly are either not technologically feasible if fixed targets are considered or would require the results of a Li(d,xn facility to be reliably designed. In addition, today we know beyond reasonable doubt that the cost of IFMIF, consistently estimated throughout decades, is marginal compared with the cost of a fusion reactor. The less ambitious DEMO reactor performance being considered correlates with a lower need of fusion neutrons flux; thus IFMIF with its two accelerators is possibly not needed since with only one accelerator as

  14. Assessment of the current status of playground safety in the midwestern region of Turkey: an effort to provide a safe environment for children.

    Science.gov (United States)

    Uskun, Ersin; Kişioğlu, Ahmet Nesimi; Altay, Tülin; Cikinlar, Rengül; Kocakaya, Asuman

    2008-01-01

    This study aimed to identify and evaluate the degree of conformity to the playground standards and the level of compliance with current safety specifications of the playgrounds in the midwestern region of Turkey. An observational technique was used at a total of 57 public playgrounds. A playground safety control form was prepared based on the United States National Program for Playground Safety and the Consumer Product Safety Commission security standards, since there is no national law covering playground equipment and safety in Turkey. The study evaluated the surroundings of the playground, arrangement of equipment in the playground, and characteristics of the equipment. The percentage of playgrounds surveyed with inadequate or hard surfacing was 80.7%. Fifty-two percent of the equipment was found to be inappropriate. Equipment was higher than the recommended heights. The results of our study unfortunately point out that playgrounds for children do not meet many of the safety criteria.

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

    Science.gov (United States)

    Spiker, Douglas A; Hammer, Joseph H

    2018-02-13

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

  16. 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...

  17. Health physics instruments: what are the current needs

    International Nuclear Information System (INIS)

    Armantrout, G.A.

    1982-01-01

    Health Physics instruments are used to measure the risk which may be incurred by an individual exposed to a given radiation field. The response of the instrument sensors will differ markedly from actual human risk factors for a variety of reasons, and this requires the use of instrument modifications and conversion factors. The values of these conversion factors continue to be updated and will likely change in the future. To accommodate the effects of different types of radiation and new conversion and usage factors, new instruments should be able to determine the type, energy distribution, and direction of incoming radiation and then apply the proper weighting factors to determine relative human risk. Such instrumentation will need to utilize modern sensor elements and microprocessor electronics

  18. 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

  19. Mapping and Mitigating the International Rip Current Health Hazard

    Science.gov (United States)

    Trimble, S. M.; Houser, C.

    2016-12-01

    Rip currents are concentrated seaward flows of water originating in the surf zones of beaches. Rips cause hundreds of international drownings each year. Calculating exact numbers is barred by logistical difficulties in obtaining accurate incident reports, but annual rip current fatalities are estimated at 100, 53 and 21 in the United States (US), Costa Rica, and Australia respectively. Notably, Australia's lifeguards rescue 17,600 swimmers from rips each year. This project addresses the geophysical, social, and systematic causes of fatalities in hopes of decreasing the global number of rip-related deaths. We demonstrate a novel method for mapping bathymetry in the surf zone (20m deep or less), specifically within rip channels (topographic low spots in the nearshore that result from feedback amongst waves, substrate, and antecedent bathymetry). We calculate bathymetry using 8-band multispectral imagery from the Digital Globe WorldView2 (WV2) satellite and field measurements of depth, generating maps of the changing nearshore at two embayed, rip-prone beaches: Playa Cocles, Costa Rica, and Bondi Beach, Australia. WV2 has a 1.1 day pass-over rate with 1.84m ground pixel resolution of 8 bands, including `yellow' (585-625 nm) and `coastal blue' (400-450 nm). Methods are tested for consistency amongst dates and locations. Previous research shows drownings result from a combination of the physical environment with personal and group behaviors; for this reason we build on rip-detection by evaluating tourists' and locals' knowledge and understanding of their beach's rip behavior. By combining the geomorphologic maps developed from WV2 with interview data, we evaluate how the physical environment dictates the exposure of certain swimmers. Controls include rip channel location, beach access points, and environmental factors favored by swimmers. The project serves as an evaluation of the landscape's creation of a physical feature that becomes a hazard when vulnerable humans

  20. 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.

  1. 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.

  2. 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

  3. 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.

  4. Music therapy in cardiac health care: current issues in research.

    Science.gov (United States)

    Hanser, Suzanne B

    2014-01-01

    Music therapy is a service that has become more prevalent as an adjunct to medical practice-as its evidence base expands and music therapists begin to join the cardiology team in every phase of care, from the most serious cases to those maintaining good heart health. Although applications of music medicine, primarily listening to short segments of music, are capable of stabilizing vital signs and managing symptoms in the short-term, music therapy interventions by a qualified practitioner are showing promise in establishing deeper and more lasting impact. On the basis of mind-body approaches, stress/coping models, the neuromatrix theory of pain, and entrainment, music therapy capitalizes on the ability of music to affect the autonomic nervous system. Although only a limited number of randomized controlled trials pinpoint the efficacy of specific music therapy interventions, qualitative research reveals some profound outcomes in certain individuals. A depth of understanding related to the experience of living with a cardiovascular disease can be gained through music therapy approaches such as nonverbal music psychotherapy and guided imagery and music. The multifaceted nature of musical responsiveness contributes to strong individual variability and must be taken into account in the development of research protocols for future music therapy and music medicine interventions. The extant research provides a foundation for exploring the many potential psychosocial, physiological, and spiritual outcomes of a music therapy service for cardiology patients.

  5. Current status of yoga in mental health services.

    Science.gov (United States)

    Varambally, Shivarama; Gangadhar, B N

    2016-06-01

    Yoga (derived from 'yuj' which means to yoke together or unite) has been used for millennia as a tool for self-improvement, with the ultimate goal of uniting the individual consciousness with the universal. The physical elements of yoga, although seen as necessary in the path to achieve the goal, they were not considered as the endpoint for a practitioner. Sage Patanjali, who codified the practices into an eight-limbed model (Ashtanga yoga) in the Patanjali Yoga Sutras, makes it clear that the target of yoga is primarily the mind. However, in the modern world, yoga practices have become immensely popular as aids to improve health. Yoga-based practices are being extensively used as therapeutic ingredients, alone or as adjuncts to other therapies in a variety of disorders, both physical and mental. There is now strong evidence to suggest that yoga-based interventions are beneficial in several lifestyle disorders. Recent research has also shown significant benefits in mental disorders such as depression, anxiety, and psychosis. This paper discusses the place of yoga as one of the therapeutic strategies in the holistic approach to mental disorders, and the challenges inherent to research in this area.

  6. Current Understanding of the Health Effects of Electromagnetic Fields.

    Science.gov (United States)

    Miah, Tayaba; Kamat, Deepak

    2017-04-01

    There has been an exponential increase in the use of electronic devices over the past few decades. This has led to increased exposure to electromagnetic fields (EMF). Electric fields result from differences in voltage, whereas magnetic fields result from the flow of electric current. Higher-frequency waves of EMF have more energy than lower-frequency waves, and thus generally tend to be more harmful. An EMF activates cellular stress response and also causes breaks in DNA strands. There are many methodological barriers to effectively measuring the associations of EMF and childhood cancers. The consensus from multiple studies is that there is no causal role of extremely low-frequency EMFs in childhood cancers, including brain cancer. A recent study showed a link between EMF radiation and the development of malignant tumors in rats. In light of that study, the American Academy of Pediatrics set out new recommendations to decrease the adverse effects of cellphone exposure on children. [Pediatr Ann. 2017;46(4):e172-e174.]. Copyright 2017, SLACK Incorporated.

  7. 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

  8. 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.

  9. 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.

  10. 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

  11. 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.

  12. 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

  13. 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.

  14. Influence of Cancer Worry on Four Cancer Related Health Protective Behaviors among a Nationally Representative Sample: Implications for Health Promotion Efforts.

    Science.gov (United States)

    Amuta, Ann O; Mkuu, Rahma S; Jacobs, Wura; Ejembi, Agbenu Z

    2017-03-01

    The aims of this study were to assess what sociodemographic characteristics are associated with cancer worry and what the influence of cancer worry is on four cancer-related protective health behaviors. Data from the Health Information National Trends Survey (HINTS) (4th cycle of the 4th iteration) were used. Multiple regression models were used for all analyses. Behaviors analyzed were as follows: physical activity, diets, smoking, and routine medical screening. Demographics controls included participant age, income, body mass index (BMI), race/ethnicity, and education. N = 2630, Older participants (OR = .99, p health behavior and may be short-lived, the influence of worry on health-related decision making is likely to be lasting even when the emotions are no longer present.

  15. Current research efforts with Bacillus thuringiensis

    Science.gov (United States)

    Normand R. Dubois

    1991-01-01

    The bioassay of 260 strains of Bacillus thuringiensis (Bt) and 70 commercial preparations show that regression coefficient estimates may be as critical as LC5O estimates when evaluating them for future consideration.

  16. 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.

  17. Using the CDC Worksite Health ScoreCard to Assess Employer Health Promotion Efforts: A Case Study at Johns Hopkins Medicine.

    Science.gov (United States)

    Safeer, Richard; Bowen, Wendy; Maung, Zaw; Lucik, Meg

    2018-02-01

    The aim of this study was to determine whether the Centers for Disease Control and Prevention Worksite Health ScoreCard (ScoreCard) is an effective vehicle for measuring workplace health promotion programs and causing change in a large employer with multiple entities defined by different physical environments and types of workers. Johns Hopkins Medicine (JHM) representatives completed a baseline ScoreCard for each of their entities. In the subsequent year, improvement of the ScoreCard was tied to leadership performance evaluation. JHM year over year scores were analyzed, along with comparisons to national benchmarks. Eleven of the 12 JHM entities improved their overall score from year one to year two and the JHM enterprise surpassed national benchmarks in year two. Organizations can use the ScoreCard as an effective measurement tool and as a method to improve the number of evidenced-based health promotion strategies provided to their employees.

  18. 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

  19. 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.

  20. 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.

  1. Current State of Child Health in Rural America: How Context Shapes Children's Health.

    Science.gov (United States)

    Probst, Janice C; Barker, Judith C; Enders, Alexandra; Gardiner, Paula

    2018-02-01

    Children's health is influenced by the context in which they live. We provide a descriptive essay on the status of children in rural America to highlight features of the rural environment that may affect health. We compiled information concerning components of the rural environment that may contribute to health outcomes. Areas addressed include the economic characteristics, provider availability, uniquely rural health risks, health services use, and health outcomes among rural children. Nearly 12 million children live in the rural United States. Rural counties are economically disadvantaged, leading to higher rates of poverty among rural versus urban children. Rural and urban children are approximately equally likely to be insured, but Medicaid insures a higher proportion of children in rural areas. While generally similar in health, rural children are more likely to be overweight or obese than urban children. Rural parents are less likely to report that their children received preventive medical or oral health visits than urban parents. Rural children are more likely to die than their urban peers, largely due to unintentional injury. Improving rural children's health will require both increased public health surveillance and research that creates solutions appropriate for rural environments, where health care professionals may be in short supply. Most importantly, solutions must be multisectoral, engaging education, economic development, and other community perspectives as well as health care. © 2016 National Rural Health Association.

  2. 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...

  3. 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...

  4. 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

  5. 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.

  6. Creating supportive nutrition environments for population health impact and health equity: an overview of the Nutrition and Obesity Policy Research and Evaluation Network's efforts.

    Science.gov (United States)

    Blanck, Heidi M; Kim, Sonia A

    2012-09-01

    Childhood obesity is a major threat to individual health and society overall. Policies that support healthier food and beverage choices have been endorsed by many decision makers. These policies may reach a large proportion of the population or in some circumstances aim to reduce nutrition disparities to ensure health equity. The Nutrition and Obesity Policy Research and Evaluation Network (NOPREN) evaluates policy as a tool to improve food and beverage environments where Americans live, work, play, and learn. The network aspires to address research and evaluation gaps related to relevant policies, create standardized research tools, and help build the evidence base of effective policy solutions for childhood obesity prevention with a focus on reach, equity, cost effectiveness, and sustainability. Published by Elsevier Inc.

  7. 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.

  8. 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

  9. 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…

  10. Training of Community Health Agents in health hearing children: current perspectives.

    Science.gov (United States)

    Castro, Taís Teixeira de Oliveira; Zucki, Fernanda

    2015-01-01

    To characterize the training of Community Health Workers in the field of child hearing health. A systematic literature review on Biblioteca Virtual em Saúde (BVS) and Biblioteca Digital de Teses e Dissertações of USP databases was performed. The search strategy was oriented by the specific question: "How have the Community Health Workers been trained to work in the field of child hearing health?" The study selection criteria involved consistency with the proposed theme, belonging to the category of scientific papers, dissertation or thesis, and publication in Brazilian Portuguese. A total of 2,687 studies were found. After analyzing the title and abstract, eight studies were chosen for full reading, however, only four of them met the proposed criteria and were included in the review. The studies indicated live and virtual classes with the use of video conferencing or CD-ROM as training strategies for Community Health Workers. Trainings were effective. Only one questionnaire about hearing and language monitoring was described. Different possibilities for the activities of Community Health Workers were identified. Different learning methodologies have been used for training the Community Health Worker in the field of child hearing health, and all of have proven effective for knowledge acquisition. Community Health Workers play an important role in promoting and monitoring child hearing health.

  11. 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.

  12. Comparative Study of Children's Current Health Conditions and Health Education in New Zealand and Japan

    Science.gov (United States)

    Watanabe, Kanae; Dickinson, Annette

    2015-01-01

    In New Zealand (NZ) and Japan, despite comprehensive national health and physical education (HPE) curriculums in schools, there continues to be significant health issues for children. A qualitative interpretative descriptive research method was used to compare how primary school teachers taught HPE in both countries. In NZ, there is some freedom…

  13. 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.

  14. Current trends in Canadian health care: myths and misconceptions in health economics.

    Science.gov (United States)

    Coyte, P C

    1990-01-01

    This paper is concerned with the economic aspects of the trends in Canadian health care. Various myths and misconceptions abound regarding the applicability of economics to behaviour in the health care industry as well as to the interpretation of recent trends. Both issues are examined in this paper. While most discussions regarding health care trends begin with the share of health expenditures in Gross National Product, I propose an alternative share that adjusts for cyclical variations in both unemployment and labour force participation. Using this measure, I show that the "real" growth of resources devoted to the health care industry is much larger than that obtained with conventional measures, and that the difference in growth rates between Canada and the U.S. is narrowed considerably. The paper outlines and disputes the validity of three public health policy propositions. First, it is not empirically valid to say that the introduction of universal medical insurance in Canada successfully contained the growth in the share of society's resources devoted to the health care industry. Second, it is not correct to argue that the change in the federal funding for hospital and medical care in 1977 was a "fiscal non-event". And finally, the proposed "equity" funding formula for Ontario hospitals is unlikely to contain costs and will potentially skew hospitals towards the provision of complex forms of care instead of cost-effective community-based alternatives.

  15. 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

  16. 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.

  17. 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

  18. Fiscal 1998 research report. Survey on the current trend of private R and D efforts; 1998 nendo chosa hokokusho. Minkan no kenkyu kaihatsu doko no jittai ni kansuru chosa

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1999-03-01

    For promotion of the R and D system of technologies creating new industries, this survey collected the basic data and information on the trend of private R and D efforts and industries, and arranged every data and information obtained. The data on United States, Germany, France and U.K. in addition to Japan were collected. Survey was made first on the administrative support system for private R and D efforts. The R and D-related budget, R and D support program and private R and D-related fund of Japan, United States and U.K. are mainly outlined. Survey was made next on private R and D activities. The R and D-related fund, researcher and patent of main countries are outlined in international comparison. Survey was also made on the current state of various industries. The industry scale and structure of every Japanese manufacturing industry are outlined. Finally, the industrial statistics are given concerning Japanese 'chemical industry,' 'communication-electronics-electric measuring instrument industry' and 'automobile industry' with a high rate of R and D-related expenditures. (NEDO)

  19. Current Challenge in Consumer Health Informatics: Bridging the Gap between Access to Information and Information Understanding

    Directory of Open Access Journals (Sweden)

    Laurence Alpay

    2009-01-01

    Full Text Available The number of health-related websites has proliferated over the past few years. Health information consumers confront a myriad of health related resources on the internet that have varying levels of quality and are not always easy to comprehend. There is thus a need to help health information consumers to bridge the gap between access to information and information understanding—i.e. to help consumers understand health related web-based resources so that they can act upon it. At the same time health information consumers are becoming not only more involved in their own health care but also more information technology minded. One way to address this issue is to provide consumers with tailored information that is contextualized and personalized e.g. directly relevant and easily comprehensible to the person’s own health situation. This paper presents a current trend in Consumer Health Informatics which focuses on theory-based design and development of contextualized and personalized tools to allow the evolving consumer with varying backgrounds and interests to use online health information efficiently. The proposed approach uses a theoretical framework of communication in order to support the consumer’s capacity to understand health-related web-based resources.

  20. 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.

  1. [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.

  2. 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.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. Lot quality assurance sampling techniques in health surveys in developing countries: advantages and current constraints.

    Science.gov (United States)

    Lanata, C F; Black, R E

    1991-01-01

    Traditional survey methods, which are generally costly and time-consuming, usually provide information at the regional or national level only. The utilization of lot quality assurance sampling (LQAS) methodology, developed in industry for quality control, makes it possible to use small sample sizes when conducting surveys in small geographical or population-based areas (lots). This article describes the practical use of LQAS for conducting health surveys to monitor health programmes in developing countries. Following a brief description of the method, the article explains how to build a sample frame and conduct the sampling to apply LQAS under field conditions. A detailed description of the procedure for selecting a sampling unit to monitor the health programme and a sample size is given. The sampling schemes utilizing LQAS applicable to health surveys, such as simple- and double-sampling schemes, are discussed. The interpretation of the survey results and the planning of subsequent rounds of LQAS surveys are also discussed. When describing the applicability of LQAS in health surveys in developing countries, the article considers current limitations for its use by health planners in charge of health programmes, and suggests ways to overcome these limitations through future research. It is hoped that with increasing attention being given to industrial sampling plans in general, and LQAS in particular, their utilization to monitor health programmes will provide health planners in developing countries with powerful techniques to help them achieve their health programme targets.

  8. 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

  9. 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.

  10. 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

  11. 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.

  12. Current patient and healthcare worker attitudes to eHealth and the personally controlled electronic health record in major hospitals.

    Science.gov (United States)

    Armani, R; Mitchell, L E; Allen-Graham, J; Heriot, N R; Kotsimbos, T; Wilson, J W

    2016-06-01

    The current health system in Australia is comprised of both electronic- and paper-based medical records. The Federal Government has approved funding for the development of an individual health identifier and a universally adopted online health repository. To determine attitudes and beliefs of patients and healthcare workers regarding the use of stored medical information and the personally controlled electronic health record (PCEHR) in selected major hospitals in Victoria. Qualitative survey of patients and healthcare workers (n = 600 each group) conducted during 2014 across five major hospitals in Melbourne to measure the awareness, attitudes and barriers to electronic health and the PCEHR. Of the patients, 93.3% support the concept of a shared electronic healthcare record, 33.7% were aware of the PCEHR and only 11% had registered. The majority of healthcare workers believed that the presence of a shared health record would result in an increased appropriateness of care and patient safety by reducing adverse drug events and improving the timeliness of care provided. However, only 46% of healthcare workers were aware of the PCEHR. This study provides a baseline evaluation of perceptions surrounding eHealth and PCHER in acute health services in five metropolitan centres. While there appears to be a readiness for adoption of these strategies for healthcare documentation, patients require motivation to register for the PCEHR, and healthcare workers require more information on the potential benefits to them to achieve more timely and efficient care. © 2016 Royal Australasian College of Physicians.

  13. 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

  14. 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.

  15. 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.

  16. 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.

  17. 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).

  18. Addressing unmet mental health and substance abuse needs: a partnered planning effort between grassroots community agencies, faith-based organizations, service providers, and academic institutions.

    Science.gov (United States)

    Wong, Eunice C; Chung, Bowen; Stover, Gabriel; Stockdale, Susan; Jones, Felica; Litt, Paula; Klap, Ruth S; Patel, Kavita; Wells, Kenneth B

    2011-01-01

    To conduct a process evaluation of the Restoration Center Los Angeles, a community-academic partnered planning effort aimed at holistically addressing the unmet mental health and substance abuse needs of the Los Angeles African American community. Semi-structured interviews with open-ended questions on key domains of partnership effectiveness were conducted with a random stratified sample of participants varying by level of involvement. Eleven partners representing grassroots community agencies, faith-based organizations, service providers, and academic institutions. Common themes identified by an evaluation consultant and partners relating to partnership effectiveness, perceived benefits and costs, and future expectations. Findings underscore the importance of considering the potential issues that may arise with the increasing diversity of partners and perspectives. Many of the challenges and facilitating factors that arise within academic-community partnerships were similarly experienced between the diverse set of community partners. Challenges that affected partnership development between community-to-community partners included differences in expectations regarding the final goal of the project, trust-building, and the distribution of funds. Despite such challenges, partners were able to jointly develop a final set of recommendations for the creation of restoration centers, which was viewed as a major accomplishment. Limited guidance exists on how to navigate differences that arise between community members who have shared identities on some dimensions (eg, African American ethnicity, Los Angeles residence) but divergent identities on other dimensions (eg, formal church affiliation). With increasing diversity of community representation, careful attention needs to be dedicated to not only the development of academic-community partnerships but also community-community partnerships.

  19. 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…

  20. Current Levels of Perceived Stress among Mental Health Social Workers Who Work with Suicidal Clients

    Science.gov (United States)

    Ting, Laura; Jacobson, Jodi M.; Sanders, Sara

    2011-01-01

    Mental health social workers are at increased risk of being confronted with fatal and nonfatal client suicidal behavior (CSB). Research has documented personal and professional reactions to CSB; however, empirical evidence describing the potential long-term effects is scarce. This study examined current reactions of perceived stress and continual…

  1. 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

  2. [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.

  3. DOE ORDER 435.1, IMPLEMENTATION AND COMPLIANCE DECLARATION AT THE SAVANNAH RIVER SITE AND ACROSS THE DOE COMPLEX IN CONTRAST TO CURRENT PUSHBACK EFFORTS FROM THE ''TOP-TO-BOTTOM'' REVIEW

    International Nuclear Information System (INIS)

    GOLDSTON, WELFORD T.; SMITH, WINCHESTER IV.

    2003-01-01

    DOE issued Order 435.1, ''Radioactive Waste Management,'' on July 9, 1999 for immediate implementation. The requirements for Low Level Mixed, Transuranic, and High Level Waste have been completely rewritten. The entire DOE complex has been struggling with how to implement these new requirements within the one year required timeframe. This paper will chronicle the implementation strategy and actual results of the work to carry out that strategy at the Savannah River Site. DOE-SR and the site contractors worked closely together to implement each of the new requirements across the SRS, crossing many barriers and providing innovative solutions to the many problems that surfaced throughout the year. The results are that SRS declared compliance with all of the requirements of the Order within the prescribed timeframe. The challenge included all waste types in SRS facilities and programs that handle LLW, MLLW, TRU, and HLW. This paper will describe the implementation details for development of Radioactive Waste Management Basis for each facility, Identification of Wastes with No Path to Disposal, Waste Incidental to Reprocessing Determinations, Low Level Waste 90-Day Staging and One Year Limits for Storage Programs, to name a few of the requirements that were addressed by the SRS 435.1 Implementation Team. This paper will trace the implementation, problems (both technical and administrative), and the current pushback efforts associated with the DOE ''Top-to-Bottom'' review

  4. [The current and future organisational structure of the OIE (World Organisation for Animal Health)].

    Science.gov (United States)

    Crespo León, F; Ruiz Mercader, J; Sabater Sánchez, R; Rodríguez Ferri, E F; Crespo Azofra, L

    2003-12-01

    The authors analyse the organisational structure of the OIE (World organisation for animal health), highlighting the roles of the Central Bureau, the Specialist Commissions, Regional Commissions, working groups and ad hoc groups, Regional Representations, Reference Laboratories and Collaborating Centres. The paper also includes some suggestions as to how the OIE could work more closely with its 'customers', that is, the Member Countries. These suggestions are based on current theories of organisational flexibility, and take into account not only the current organisational structure of the OIE, but also the Strategic Plan and the Working Plan, which were adopted at the 69th General Session of the OIE International Committee in 2001.

  5. 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.

  6. Predicting Motivation: Computational Models of PFC Can Explain Neural Coding of Motivation and Effort-based Decision-making in Health and Disease.

    Science.gov (United States)

    Vassena, Eliana; Deraeve, James; Alexander, William H

    2017-10-01

    Human behavior is strongly driven by the pursuit of rewards. In daily life, however, benefits mostly come at a cost, often requiring that effort be exerted to obtain potential benefits. Medial PFC (MPFC) and dorsolateral PFC (DLPFC) are frequently implicated in the expectation of effortful control, showing increased activity as a function of predicted task difficulty. Such activity partially overlaps with expectation of reward and has been observed both during decision-making and during task preparation. Recently, novel computational frameworks have been developed to explain activity in these regions during cognitive control, based on the principle of prediction and prediction error (predicted response-outcome [PRO] model [Alexander, W. H., & Brown, J. W. Medial prefrontal cortex as an action-outcome predictor. Nature Neuroscience, 14, 1338-1344, 2011], hierarchical error representation [HER] model [Alexander, W. H., & Brown, J. W. Hierarchical error representation: A computational model of anterior cingulate and dorsolateral prefrontal cortex. Neural Computation, 27, 2354-2410, 2015]). Despite the broad explanatory power of these models, it is not clear whether they can also accommodate effects related to the expectation of effort observed in MPFC and DLPFC. Here, we propose a translation of these computational frameworks to the domain of effort-based behavior. First, we discuss how the PRO model, based on prediction error, can explain effort-related activity in MPFC, by reframing effort-based behavior in a predictive context. We propose that MPFC activity reflects monitoring of motivationally relevant variables (such as effort and reward), by coding expectations and discrepancies from such expectations. Moreover, we derive behavioral and neural model-based predictions for healthy controls and clinical populations with impairments of motivation. Second, we illustrate the possible translation to effort-based behavior of the HER model, an extended version of PRO

  7. [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.

  8. 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

  9. Viral Diseases of Public Health Importance in India: Current Priorities with Special Emphasis on Prevention

    Directory of Open Access Journals (Sweden)

    Mageshbabu Ramamurthy

    2017-10-01

    Full Text Available India faces problems with both communicable and non communicable diseases. The major non communicable diseases are cancer, cardiovascular disease and diabetes mellitus. This article focuses on communicable diseases (infectious diseases especially viral infections of public health importance. The infections include bacterial, parasitic and viruses. It could be said that fungal infections by the nature of the spread are not of public health concern. The viral infections are transmitted by the respiratory route, water and food borne route, vectors and blood and blood products, sexual route and are of major concern. Efforts are aimed at early detection, prevention by use of vaccines and sentinel surveillance. For the success of public health programmes sentinel surveillance of diseases is mandatory. India has got several programme initiatives addressing the problem. The programs include IDSP, VBDCP and NACO. The approximate cumulative annual prevalence of infectious disease in India ranges from 100 to 200 million individuals affected in one year. India should aim to improve case detection by strengthening laboratory services with manpower training and nationwide quality control scheme, sentinel surveillance activity and prevention by improving the efficiency and scope of UIP. Also, creation of a single portal of infectious disease data handling hub to collect information from different sources will help avoid overlap and duplication of reporting.

  10. 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...

  11. 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.

  12. Right to health in Russian Federation: identification of its current stage of constitutional and legal recognition

    Directory of Open Access Journals (Sweden)

    TARASENKO, Elena

    2013-11-01

    Full Text Available Russian Federation has made a strong legal commitment to the human right to health through the ratification of several key international human rights laws. Current public health care policies also demonstrate that Russian Federation has committed itself to provide the human right to health protection of people residing with its jurisdiction. All residents of Russia are eligible for medical care free of charge. Medical services are provided directly to patients by government health care providers. This includes general and specialist medical care, hospitalization, diagnostic laboratory services, dental care, maternity care and transportation, free drugs for disabled, medical rehabilitation, etc. The legal basis for the human right to health at the federal level is provided by a variety of legislative acts (codes, federal laws, presidential decrees, decisions and proposals of the government of the Russian Federation, and orders of the government and of the Ministry of Health and other ministries. The legal bas is at the regional level is provided by legislative instruments enacted by the governments of the Subjects of Russian Federation.

  13. 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.

  14. 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

  15. 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.

  16. 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.

  17. The response of 1578 school leavers to a campaign combining commercial, Health Boards' and GDPs' sponsorship in an effort to improve dental attendance

    DEFF Research Database (Denmark)

    Craven, R; Blinkhorn, A S; Schou, L

    1993-01-01

    A dental health promotion campaign was developed by Forth Valley Health Board in conjunction with the Scottish Health Education Group and the Department of Marketing at Strathclyde University. The aim was to encourage dental attendance among early school leavers. The emphasis was on the contribut...

  18. 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.

  19. 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

  20. 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.

  1. [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.

  2. [Current status of costs and utilizations of hospital based home health nursing care in Korea].

    Science.gov (United States)

    Ryu, Hosihn

    2006-12-01

    The purpose of this study was to describe the current status of utilization and costs of home health nursing care by the levels of medical institutes in Korea. A secondary analysis of existing data was used from the national electronic data information(EDI) of 148 home health agencies for 6 months from May to Oct 2005 in total. The 148 agencies had multiple services in cerebral infaction, essential hypertension, sequela of cerebrovascular disease, type 2 diabetes mellitus, etc.. The highest 10 rankings of 76 categories of home health nursing services were composed of 96.4% of the total services, such as simple treatment, inflammatory treatment, urethra & bladder irrigation, inserting indwelling catheter etc., in that order. The highest 20 rankings of 226 categories of home examination services were composed of 77.0% of the total home examination services. In addition, the average cost of home health care per visit was 46,088 Won ( approximately 48 $, 1 $=960 Won). The costs ranged from 74,523 Won ( approximately 78 $, loss of chronic kidney function, N18) to 32,270 Won ( approximately 34 $, other cerebrovascular diseases, I67). Results suggest that client characteristics of hospital based HHNC are not different from community based HHNC or visiting nursing services for elderly. The national results will contribute to baseline data used to establish a policy for the home health nursing care system and education.

  3. Utilization of formal health services for children aged 1-5 in Aceh after the 2004 tsunami: Which children did not receive the health care they needed? Implications for other natural disaster relief efforts.

    Science.gov (United States)

    Rassekh, Bahie Mary; Santosham, Mathuram

    2014-01-01

    Aceh, Indonesia, was the hardest-hit area in the December 26, 2004 Indian Ocean earthquake and tsunami, with more than 500,000 people displaced, 120,000 people dead, and total damages and losses estimated at $4.5 billion. The relief effort following the tsunami was also immense, with billions of dollars of aid pledged to this province alone. Since then, there have been several natural disasters, including Typhoon Haiyan, which have caused great loss of life and displacement and for which these results are applicable. This study aimed to determine and assess utilization patterns of health services for children under the age of five with diarrhea, cough and difficulty breathing, fever, or skin disease and to identify determinants of formal and non-formal healthcare usage. A household survey of 1439 households was administered to caretakers of children aged 1-5 years. A sample of clusters within Banda Aceh and Aceh Besar were selected and those caretakers within the cluster who fit the inclusion criteria were interviewed. In the two weeks prior to the survey, 78.3% of respondents utilized formal health services as the first line of care for their child's illness episode. Factors significantly associated with decreased formal healthcare usage for the sick children were if the children were living in a displaced household, if the children's mother or father were not living, and if the children's caretaker was not the mother. Although utilization of formal health services for children was quite high after the tsunami, there were certain children who received significantly less care, including those who were displaced, those who were being cared for by someone other than their mother, and those for whom one or both parents had died. Among the recommendations are suggestions to target these children to ensure that they receive the health care they need.

  4. Electronic health records and online medical records: an asset or a liability under current conditions?

    Science.gov (United States)

    Allen-Graham, Judith; Mitchell, Lauren; Heriot, Natalie; Armani, Roksana; Langton, David; Levinson, Michele; Young, Alan; Smith, Julian A; Kotsimbos, Tom; Wilson, John W

    2018-02-01

    Objective The aim of the present study was to audit the current use of medical records to determine completeness and concordance with other sources of medical information. Methods Medical records for 40 patients from each of five Melbourne major metropolitan hospitals were randomly selected (n=200). A quantitative audit was performed for detailed patient information and medical record keeping, as well as data collection, storage and utilisation. Using each hospital's current online clinical database, scanned files and paperwork available for each patient audited, the reviewers sourced as much relevant information as possible within a 30-min time allocation from both the record and the discharge summary. Results Of all medical records audited, 82% contained medical and surgical history, allergy information and patient demographics. All audited discharge summaries lacked at least one of the following: demographics, medication allergies, medical and surgical history, medications and adverse drug event information. Only 49% of records audited showed evidence the discharge summary was sent outside the institution. Conclusions The quality of medical data captured and information management is variable across hospitals. It is recommended that medical history documentation guidelines and standardised discharge summaries be implemented in Australian healthcare services. What is known about this topic? Australia has a complex health system, the government has approved funding to develop a universal online electronic medical record system and is currently trialling this in an opt-out style in the Napean Blue Mountains (NSW) and in Northern Queensland. The system was originally named the personally controlled electronic health record but has since been changed to MyHealth Record (2016). In Victoria, there exists a wide range of electronic health records used to varying degrees, with some hospitals still relying on paper-based records and many using scanned medical records

  5. Using genetic algorithms to optimise current and future health planning - the example of ambulance locations

    Directory of Open Access Journals (Sweden)

    Suzuki Hiroshi

    2010-01-01

    Full Text Available Abstract Background Ambulance response time is a crucial factor in patient survival. The number of emergency cases (EMS cases requiring an ambulance is increasing due to changes in population demographics. This is decreasing ambulance response times to the emergency scene. This paper predicts EMS cases for 5-year intervals from 2020, to 2050 by correlating current EMS cases with demographic factors at the level of the census area and predicted population changes. It then applies a modified grouping genetic algorithm to compare current and future optimal locations and numbers of ambulances. Sets of potential locations were evaluated in terms of the (current and predicted EMS case distances to those locations. Results Future EMS demands were predicted to increase by 2030 using the model (R2 = 0.71. The optimal locations of ambulances based on future EMS cases were compared with current locations and with optimal locations modelled on current EMS case data. Optimising the location of ambulance stations locations reduced the average response times by 57 seconds. Current and predicted future EMS demand at modelled locations were calculated and compared. Conclusions The reallocation of ambulances to optimal locations improved response times and could contribute to higher survival rates from life-threatening medical events. Modelling EMS case 'demand' over census areas allows the data to be correlated to population characteristics and optimal 'supply' locations to be identified. Comparing current and future optimal scenarios allows more nuanced planning decisions to be made. This is a generic methodology that could be used to provide evidence in support of public health planning and decision making.

  6. 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.

  7. Forensic mental health services: Current service provision and planning for a prison mental health service in the Eastern Cape

    Directory of Open Access Journals (Sweden)

    Kiran Sukeri

    2016-05-01

    Full Text Available Objectives: No research data exists on forensic psychiatric service provision in the Eastern Cape, Republic of South Africa. The objective of this research was to assess current forensic psychiatric service provision and utilisation rates at Fort England Hospital. This is important in improving and strengthening the service. A related objective was to develop a model for a provincial prison mental health service. Methodology: This study is a situational analysis of an existing forensic psychiatric service in the Eastern Cape. The design of the study was cross sectional. An audit questionnaire was utilised to collate quantitative data, which was submitted to Fort England Hospital, Grahamstown. A proposed prison mental health service was developed utilising prevalence rates of mental illness among prisoners to calculate bed and staff requirements for an ambulatory and in-patient service. Results: During the study period a total of 403 remand detainees were admitted to the forensic psychiatry division of Fort England Hospital. The average length of stay was 494 days and the bed utilisation rate was determined at 203.54%. We estimate that to provide a provincial prison mental health service to treat psychotic illnesses and major depression the province requires a 52 bedded facility and a total staff complement of approximately 31. Conclusions: Forensic psychiatric services include the assessment, management and treatment of mentally disordered persons in conflict with the law and prisoners requiring psychiatric assessments. The Eastern Cape Province does not have plans or policies to assess and manage mentally ill offenders, resulting in an increased load on available services. We recommend that an inter-departmental task team, which includes Health, Justice and Constitutional Development and Correctional Services, should be established in the province, to develop a strategy to assist in the development of an effective and efficient forensic

  8. 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.

  9. Global women's health: current clinical trials in low- and middle-income countries.

    Science.gov (United States)

    Merriel, A; Harb, H M; Williams, H; Lilford, R; Coomarasamy, A

    2015-01-01

    Clinical trials in low- and middle-income countries (LMICs) are necessary to develop evidence-based approaches to improve women's health. Understanding what research is currently being conducted will allow the identification of research gaps, avoidance of duplication, planning of future studies, collaboration amongst research groups, and geographical targeting for research investments. To provide an overview of active women's health trials in LMICs. The World Health Organization's International Clinical Trials Registry Platform was searched for trials registered between 1 April 2012 and 31 March 2014. Selected trials were randomised, conducted in LMICs, active, and with a women's health intervention or a significant outcome for the woman. Two reviewers extracted data. Analysis included geographical spread, speciality areas, pre-enrolment registration, study size, and funders. Of the 8966 records, 509 were eligible for inclusion. Gynaecology trials made up 57% of the research, whereas the remaining 43% of trials were in obstetrics. Research activity focused on fertility (17%), the antenatal period (15%), benign gynaecology (14%), intrapartum care (9%), and pre-invasive disease and cancers (8%). The majority of trials (84%) took place in middle-income countries (MICs). In low-income countries (LICs) 83% of research investigated obstetrics, and in MICs 60% of research investigated gynaecology. Most trials (80%) had a sample size of 500 or fewer participants. The median size of trials in LICs was 815 compared with 128 in MICs. Pre-enrolment registration occurred in 54% of trials. The majority (62%) of trials were funded locally. Many LMICs are active in women's health research. The majority of registered trials are located in MICs; however, the trials in LICs are often larger. The focus of research in MICs may be driven by local priorities and funding, with fertility being highly researched. In LICs, pregnancy is the focus, perhaps reflecting the international

  10. Fit for purpose? Validation of a conceptual framework for personal recovery with current mental health consumers.

    Science.gov (United States)

    Bird, Victoria; Leamy, Mary; Tew, Jerry; Le Boutillier, Clair; Williams, Julie; Slade, Mike

    2014-07-01

    Mental health services in the UK, Australia and other Anglophone countries have moved towards supporting personal recovery as a primary orientation. To provide an empirically grounded foundation to identify and evaluate recovery-oriented interventions, we previously published a conceptual framework of personal recovery based on a systematic review and narrative synthesis of existing models. Our objective was to test the validity and relevance of this framework for people currently using mental health services. Seven focus groups were conducted with 48 current mental health consumers in three NHS trusts across England, as part of the REFOCUS Trial. Consumers were asked about the meaning and their experience of personal recovery. Deductive and inductive thematic analysis applying a constant comparison approach was used to analyse the data. The analysis aimed to explore the validity of the categories within the conceptual framework, and to highlight any areas of difference between the conceptual framework and the themes generated from new data collected from the focus groups. Both the inductive and deductive analysis broadly validated the conceptual framework, with the super-ordinate categories Connectedness, Hope and optimism, Identity, Meaning and purpose, and Empowerment (CHIME) evident in the analysis. Three areas of difference were, however, apparent in the inductive analysis. These included practical support; a greater emphasis on issues around diagnosis and medication; and scepticism surrounding recovery. This study suggests that the conceptual framework of personal recovery provides a defensible theoretical base for clinical and research purposes which is valid for use with current consumers. However, the three areas of difference further stress the individual nature of recovery and the need for an understanding of the population and context under investigation. © The Royal Australian and New Zealand College of Psychiatrists 2014.

  11. 'Big data' in mental health research: current status and emerging possibilities.

    Science.gov (United States)

    Stewart, Robert; Davis, Katrina

    2016-08-01

    'Big data' are accumulating in a multitude of domains and offer novel opportunities for research. The role of these resources in mental health investigations remains relatively unexplored, although a number of datasets are in use and supporting a range of projects. We sought to review big data resources and their use in mental health research to characterise applications to date and consider directions for innovation in future. A narrative review. Clear disparities were evident in geographic regions covered and in the disorders and interventions receiving most attention. We discuss the strengths and weaknesses of the use of different types of data and the challenges of big data in general. Current research output from big data is still predominantly determined by the information and resources available and there is a need to reverse the situation so that big data platforms are more driven by the needs of clinical services and service users.

  12. The health care system for female workers and its current status in Japan.

    Science.gov (United States)

    Nohara, M; Kagawa, J

    2000-11-01

    In this paper we describe female workers' health care, the women's and maternal protection system within the Japanese legal system, the current status of female workers in Japan, and problems regarding methods of advancing health care and the women's or maternal protection system. Motherhood is respected in the workplace in Japan, and in order to provide an environment in which women can work and still bear and rear children with a sense of security, laws concerning maternal protection of female workers, and revisions in terms of the system have been made, and a new system has been in effect since the fiscal year of 1998. Nevertheless, gender discrimination against women and the disparagement of women, rooted in gender role stereotypes concerning the division of labor, remain firmly planted in the social environment and in long-established custom.

  13. Educating Medical Laboratory Technologists: Revisiting Our Assumptions in the Current Economic and Health-Care Environment

    Directory of Open Access Journals (Sweden)

    Regina Linder

    2012-08-01

    Full Text Available Health care occupies a distinct niche in an economy struggling to recover from recession. Professions related to the care of patients are thought to be relatively resistant to downturns, and thus become attractive to students typically drawn to more lucrative pursuits. Currently, a higher profile for clinical laboratory technology among college students and those considering career change results in larger and better prepared applicant pools. However, after decades of contraction marked by closing of programs, prospective students encounter an educational system without the capacity or vigor to meet their needs. Here discussed are some principles and proposals to allow universities, partnering with health-care providers, government agencies, and other stakeholders to develop new programs, or reenergize existing ones to serve our students and patients. Principles include academic rigor in biomedical and clinical science, multiple points of entry for students, flexibility in format, cost effectiveness, career ladders and robust partnerships.

  14. Basic priority rating model 2.0: current applications for priority setting in health promotion practice.

    Science.gov (United States)

    Neiger, Brad L; Thackeray, Rosemary; Fagen, Michael C

    2011-03-01

    Priority setting is an important component of systematic planning in health promotion and also factors into the development of a comprehensive evaluation plan. The basic priority rating (BPR) model was introduced more than 50 years ago and includes criteria that should be considered in any priority setting approach (i.e., use of predetermined criteria, standardized comparisons, and a rubric that controls bias). Although the BPR model has provided basic direction in priority setting, it does not represent the broad array of data currently available to decision makers. Elements in the model also give more weight to the impact of communicable diseases compared with chronic diseases. For these reasons, several modifications are recommended to improve the BPR model and to better assist health promotion practitioners in the priority setting process. The authors also suggest a new name, BPR 2.0, to represent this revised model.

  15. Current ethical and legal issues in health-related direct-to-consumer genetic testing.

    Science.gov (United States)

    Niemiec, Emilia; Kalokairinou, Louiza; Howard, Heidi Carmen

    2017-09-01

    A variety of health-related genetic testing is currently advertized directly to consumers. This article provides a timely overview of direct-to-consumer genetic testing (DTC GT) and salient ethical issues, as well as an analysis of the impact of the recently adopted regulation on in vitro diagnostic medical devices on DTC GT. DTC GT companies currently employ new testing approaches, report on a wide spectrum of conditions and target new groups of consumers. Such activities raise ethical issues including the questionable analytic and clinical validity of tests, the adequacy of informed consent, potentially misleading advertizing, testing in children, research uses and commercialization of genomic data. The recently adopted regulation on in vitro diagnostic medical devices may limit the offers of predisposition DTC GT in the EU market.

  16. Human factors and ergonomics in home care: Current concerns and future considerations for health information technology

    Science.gov (United States)

    Or, Calvin K.L.; Valdez, Rupa S.; Casper, Gail R.; Carayon, Pascale; Burke, Laura J.; Brennan, Patricia Flatley; Karsh, Ben-Tzion

    2010-01-01

    Sicker patients with greater care needs are being discharged to their homes to assume responsibility for their own care with fewer nurses available to aid them. This situation brings with it a host of human factors and ergonomic (HFE) concerns, both for the home care nurse and the home dwelling patient, that can affect quality of care and patient safety. Many of these concerns are related to the critical home care tasks of information access, communication, and patient self-monitoring and self-management. Currently, a variety of health information technologies (HITs) are being promoted as possible solutions to those problems, but those same technologies bring with them a new set of HFE concerns. This paper reviews the HFE considerations for information access, communication, and patients self-monitoring and self-management, discusses how HIT can potentially mitigate current problems, and explains how the design and implementation of HIT itself requires careful HFE attention. PMID:19713630

  17. Violence against children in Latin America and Caribbean countries: a comprehensive review of national health sector efforts in prevention and response

    Directory of Open Access Journals (Sweden)

    Andrea L. Wirtz

    2016-09-01

    Full Text Available Abstract Background Violence against children (VAC remains a global problem. The health sector has an opportunity and responsibility to be part of the multi-sector collaboration to prevent and respond to VAC. This review aimed to assess the health sector’s response to VAC among Latin American & Caribbean (LAC countries, particularly as it relates to physical violence, sexual violence, and neglect. Method National protocols for the identification and provision of health care to child survivors of violence, abuse and neglect were solicited in partnership with UNICEF and PAHO/WHO country offices within the LAC region. A parallel systematic review was undertaken in January 2015 to review studies published in the last 10 years that describe the regional health sector response to VAC. Results We obtained health sectors guidelines/protocols related to VAC from 22 of 43 (51 % countries and reviewed 97 published articles/reports that met the review inclusion criteria. Country protocols were presented in Spanish (n = 12, Portuguese (n = 1, and English (n = 9. Thematic areas of country protocols included: 1 identifying signs and symptoms of VAC, 2 providing patient-centered care to the victim, and 3 immediate treatment of injuries related to VAC. The systematic review revealed that health professionals are often unaware of national protocols and lack training, resources, and support to respond to cases of VAC. Further, there is limited coordination between health and social protection services. Conclusions VAC remains an international, public health priority. Health professionals are well-positioned to identify, treat and refer cases of VAC to appropriate institutions and community-based partners. However, poor protocol dissemination and training, limited infrastructure, and inadequate human resources challenge adherence to VAC guidelines.

  18. 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

  19. NOAA's efforts to map extent, health and condition of deep sea corals and sponges and their habitat on the banks and island slopes of Southern California

    Science.gov (United States)

    Etnoyer, P. J.; Salgado, E.; Stierhoff, K.; Wickes, L.; Nehasil, S.; Kracker, L.; Lauermann, A.; Rosen, D.; Caldow, C.

    2015-12-01

    Southern California's deep-sea corals are diverse and abundant, but subject to multiple stressors, including corallivory, ocean acidification, and commercial bottom fishing. NOAA has surveyed these habitats using a remotely operated vehicle (ROV) since 2003. The ROV was equipped with high-resolution cameras to document deep-water groundfish and their habitat in a series of research expeditions from 2003 - 2011. Recent surveys 2011-2015 focused on in-situ measures of aragonite saturation and habitat mapping in notable habitats identified in previous years. Surveys mapped abundance and diversity of fishes and corals, as well as commercial fisheries landings and frequency of fishing gear. A novel priority setting algorithm was developed to identify hotspots of diversity and fishing intensity, and to determine where future conservation efforts may be warranted. High density coral aggregations identified in these analyses were also used to guide recent multibeam mapping efforts. The maps suggest a large extent of unexplored and unprotected hard-bottom habitat in the mesophotic zone and deep-sea reaches of Channel Islands National Marine Sanctuary.

  20. The Uranium Recovery Industry and the Current Nuclear Renaissance — A Health Physicists Perspective

    Energy Technology Data Exchange (ETDEWEB)

    Brown, S.H., E-mail: sbrown@senes.ca [SENES, Englewood, CO (United States)

    2014-05-15

    Concurrent with the recognition that nuclear generated electricity must play an increasing role in worldwide energy supply and in consideration of the new nuclear power plants ordered or planned, the demand for uranium needed to fuel these reactors has already outpaced supplies. Accordingly, the price of uranium (typically expressed as US$ per pound U{sub 3}O{sub 8} equivalent) had increased significantly in recent years. As a result, numerous new and reconstituted uranium recovery projects are being developed in the United States and in other countries that possess considerable uranium ore reserves (e.g., Canada, Australia, Kazakhstan, Mongolia, Namibia, and others). It should be noted that in the United States, the current reactor fleet of 104 operating units, which generate 20 percent of the US’s base-load electricity, requires approximately 55 million pounds of U{sub 3}O{sub 8} per year, but only about 4–5 million pounds per year is produced domestically. That is, over 90 percent of current demand, ignoring anticipated increase in requirements in the near future as new plants come online, must come from foreign sources. Domestic uranium production over the last 10 years reached a low of about two million pounds in 2003 and has been increasing steadily since then. Uranium recovery as defined in this paper encompasses conventional uranium mining and milling as well as in situ recovery techniques and the recovery of uranium as a byproduct from other processes, such as phosphoric acid production. Following a brief history of uranium recovery in the US, the paper describes the basic methods and technologies associated with conventional uranium mining, conventional uranium milling and In Situ Recovery (ISR). The “health physicists perspective” is introduced into these discussions by providing summaries of the various radiological environmental monitoring and operational health physics programs that are required for these facilities. Applicable regulatory

  1. The dynamic system of parental work of care for children with special health care needs: A conceptual model to guide quality improvement efforts

    Directory of Open Access Journals (Sweden)

    Hexem Kari R

    2011-10-01

    Full Text Available Abstract Background The work of care for parents of children with complex special health care needs may be increasing, while excessive work demands may erode the quality of care. We sought to summarize knowledge and develop a general conceptual model of the work of care. Methods Systematic review of peer-reviewed journal articles that focused on parents of children with special health care needs and addressed factors related to the physical and emotional work of providing care for these children. From the large pool of eligible articles, we selected articles in a randomized sequence, using qualitative techniques to identify the conceptual components of the work of care and their relationship to the family system. Results The work of care for a child with special health care needs occurs within a dynamic system that comprises 5 core components: (1 performance of tasks such as monitoring symptoms or administering treatments, (2 the occurrence of various events and the pursuit of valued outcomes regarding the child's physical health, the parent's mental health, or other attributes of the child or family, (3 operating with available resources and within certain constraints (4 over the passage of time, (5 while mentally representing or depicting the ever-changing situation and detecting possible problems and opportunities. These components interact, some with simple cause-effect relationships and others with more complex interdependencies. Conclusions The work of care affecting the health of children with special health care needs and their families can best be understood, studied, and managed as a multilevel complex system.

  2. Current best practice for the health surveillance of enzyme workers in the soap and detergent industry.

    Science.gov (United States)

    Nicholson, P J; Newman Taylor, A J; Oliver, P; Cathcart, M

    2001-03-01

    This study defines current best practice for the health surveillance of workers who are potentially exposed to enzymes in the manufacture of enzymatic detergent products. It is recommended that health surveillance is performed 6-monthly for the first 2 years and annually thereafter. The health surveillance programme should include a respiratory questionnaire to detect symptoms, assessment of lung function to detect pre-symptomatic changes and an immunological test to detect specific immunoglobulin E (IgE) to enzymes. The International Union Against Tuberculosis and Lung Disease respiratory questionnaire should be used since it has been validated extensively for detecting asthma. Operators should observe the American Thoracic Society performance criteria for spirometers and standardized procedures for conducting spirometry. Since current airborne monitoring techniques for enzymes do not detect short-duration peak exposures, the incidence of employee sensitizations remains the most reliable measure of the integrity of environmental control. The Pepys skin prick test has been validated as a sensitive, specific and practical test for detecting specific IgE to many inhalant allergens including enzymes. For newly sensitized workers, a multi-cause investigation should be conducted to identify potential sources of exposure. Group results of immunological test results assist in the evaluation of workplace control measures, and should be used to monitor the effectiveness of hygiene and engineering programmes and to help prioritize areas for improvement. Positive responses to a questionnaire or abnormal spirometry should be assessed further. Occupational asthma should be excluded in any case of adult-onset asthma that starts or deteriorates during working life. This is particularly important because an accurate diagnosis of occupational asthma with early avoidance of exposure to its cause can result in remission of symptoms and restoration of lung function.

  3. Articulating current service development practices: a qualitative analysis of eleven mental health projects.

    Science.gov (United States)

    Jun, Gyuchan Thomas; Morrison, Cecily; Clarkson, P John

    2014-01-17

    The utilisation of good design practices in the development of complex health services is essential to improving quality. Healthcare organisations, however, are often seriously out of step with modern design thinking and practice. As a starting point to encourage the uptake of good design practices, it is important to understand the context of their intended use. This study aims to do that by articulating current health service development practices. Eleven service development projects carried out in a large mental health service were investigated through in-depth interviews with six operation managers. The critical decision method in conjunction with diagrammatic elicitation was used to capture descriptions of these projects. Stage-gate design models were then formed to visually articulate, classify and characterise different service development practices. Projects were grouped into three categories according to design process patterns: new service introduction and service integration; service improvement; service closure. Three common design stages: problem exploration, idea generation and solution evaluation - were then compared across the design process patterns. Consistent across projects were a top-down, policy-driven approach to exploration, underexploited idea generation and implementation-based evaluation. This study provides insight into where and how good design practices can contribute to the improvement of current service development practices. Specifically, the following suggestions for future service development practices are made: genuine user needs analysis for exploration; divergent thinking and innovative culture for idea generation; and fail-safe evaluation prior to implementation. Better training for managers through partnership working with design experts and researchers could be beneficial.

  4. Co-occurring Mental Disorders in Substance Abuse Treatment: the Current Health Care Situation in Germany.

    Science.gov (United States)

    Dauber, Hanna; Braun, Barbara; Pfeiffer-Gerschel, Tim; Kraus, Ludwig; Pogarell, Oliver

    2018-01-01

    Aim of this study was to investigate the current health care situation for patients with co-occurring mental disorders in addiction treatment. Therefore, data from the German Substance Abuse Treatment System ( N  = 194,406) was analysed with regard to the prevalence of comorbid mental disorders, treatment characteristics and outcomes of patients with comorbid psychiatric diagnosis. In outpatient setting, the prevalence of comorbid diagnoses was considerably lower (4.6%) than in inpatient setting (50.7%), but mood and anxiety disorders were the most prevalent additional diagnoses in both settings. In the treatment of patients with these comorbid disorders, we found higher rates of complementary internal and external (psychiatric) treatment, more co-operations and referrals after treatment, and positive treatment process outcomes. Findings indicate that the knowledge of an additional diagnosis influences the health care provision of affected patients and can therefore be seen as the essential precondition for providing adequate and comprehensive treatment. This highlights the importance of a sufficient consideration and diagnostic assessment of mental disorders in addiction treatment to further improve the health care situation of comorbid patients.

  5. Radiation in pediatric health care: current situation and challenges in the Philippines

    International Nuclear Information System (INIS)

    Cabrera, Maria Gladys R.

    2009-01-01

    Radiation exposure to human health has been the topic of much research to date, focusing particularly on children as they are especially vulnerable and have longer life span to develop log term health effects. Taking into account the higher vulnerability of children, prevention of unnecessary radiation exposure is critical in pediatric patients. Issues such as pediatric patient receive a higher dose than necessary has been identified because adult computed tomography (CT) settings are used for children. Assessment of population exposures resulting from medical use of radiation is mainly available in industrialized countries, while in developing countries such as the Philippines, data are scarce. This information is very much scarce in the field of pediatric medical exposures and appropriate national surveys including frequency of pediatric procedures and children doses are still lacking. A broader and more effective participation of the regulatory authorities in such surveys could contribute to children risk assessment. The presentation explains the current situation, approach and challenges in the Philippines in dealing with radiation in pediatric health care. (author)

  6. [The health food product Noni--does marketing harmonize with the current status of research?].

    Science.gov (United States)

    Johansen, Rolf

    2008-03-13

    Norwegian cancer patients frequently use Noni. The objective of this study was to find out whether the way noni is marketed in Norway and the health claims made about the product harmonize with current scientific knowledge of its benefits/adverse effects. An overview of medical research on noni was obtained from three databases. Web sites for private persons and for companies that sell noni in Norway were examined. Books, pamphlets etc. from a company specializing in selling information material about noni, were also examined. 48 scientific articles were included in the study, but none of these were clinical studies of humans. Several pharmacological effects of noni have been shown in vitro and in animal models (e.g., increased survival for animals with cancer). Information material describes noni as a health-promoting product that patients with most diseases will benefit from. Noni is to a great extent sold by multi-level marketing, but is also commonly sold by health food stores. There is no scientific basis for claiming that patients will benefit from using noni for any diseases. The way this product is sold has several worrying aspects.

  7. Comparing Self-Concept Among Youth Currently Receiving Inpatient Versus Outpatient Mental Health Services.

    Science.gov (United States)

    Choi, Chris; Ferro, Mark A

    2018-01-01

    This study compared levels of self-concept among youth who were currently receiving inpatient versus outpatient mental health services. Forty-seven youth were recruited from the Child & Youth Mental Health Program at McMaster Children's Hospital. Self-concept was measured using the Self-Perception Profile for Children and Adolescents. The mean age was 14.5 years and most participants were female (70.2%). ANOVAs comparing self-concept with population norms showed large significant effects (d = 0.77 to 1.93) indicating compromised self-concept among youth receiving mental health services. Regression analyses controlling for patient age, sex, family income, and diagnoses of major depressive disorder, generalized social phobia, and generalized anxiety showed that the inpatient setting was a significant predictor of lower global self-worth (β=-.26; p=.035). Compared to outpatients, inpatients generally reported lower self-concept, but differences were significant only for global self-worth. Future research replicating this finding and assessing its clinical significance is encouraged.

  8. The impact of managed care and current governmental policies on an urban academic health care center.

    Science.gov (United States)

    Rodriguez, J L; Peterson, D J; Muehlstedt, S G; Zera, R T; West, M A; Bubrick, M P

    2001-10-01

    Managed care and governmental policies have restructured hospital reimbursement. We examined reimbursement trends in trauma care to assess the impact of this market driven change on an urban academic health center. Patients injured between January 1997 and December 1999 were analyzed for Injury Severity Score (ISS), length of hospital stay, hospital cost, payer, and reimbursement. Between 1997 and 1999, the volume of patients with an ISS less than 9 increased and length of stay decreased. In addition, overall cost, payment, and profit margin increased. Commercially insured patients accounted for this margin increase, because the margins of managed care and government insured patients experienced double-digit decreases. Patients with ISS of 9 or greater also experienced a volume increase and a reduction in length of stay; however, costs within this group increased greater than payments, thereby reducing profit margin. Whereas commercially insured patients maintained their margin, managed care and government insured patients did not (double- and triple-digit decreases). Managed care and current governmental policies have a negative impact on urban academic health center reimbursement. Commercial insurers subsidize not only the uninsured but also the government insured and managed care patients as well. National awareness of this issue and policy action are paramount to urban academic health centers and may also benefit commercial insurers.

  9. Modelling efforts needed to advance herpes simplex virus (HSV) vaccine development: Key findings from the World Health Organization Consultation on HSV Vaccine Impact Modelling.

    Science.gov (United States)

    Gottlieb, Sami L; Giersing, Birgitte; Boily, Marie-Claude; Chesson, Harrell; Looker, Katharine J; Schiffer, Joshua; Spicknall, Ian; Hutubessy, Raymond; Broutet, Nathalie

    2017-06-21

    Development of a vaccine against herpes simplex virus (HSV) is an important goal for global sexual and reproductive health. In order to more precisely define the health and economic burden of HSV infection and the theoretical impact and cost-effectiveness of an HSV vaccine, in 2015 the World Health Organization convened an expert consultation meeting on HSV vaccine impact modelling. The experts reviewed existing model-based estimates and dynamic models of HSV infection to outline critical future modelling needs to inform development of a comprehensive business case and preferred product characteristics for an HSV vaccine. This article summarizes key findings and discussions from the meeting on modelling needs related to HSV burden, costs, and vaccine impact, essential data needs to carry out those models, and important model components and parameters. Copyright © 2017. Published by Elsevier Ltd.

  10. Rapid assessment of health needs in mass emergencies: review of current concepts and methods.

    Science.gov (United States)

    Guha-Sapir, D

    1991-01-01

    The increase in the number of natural disasters and their impact on population is of growing concern to countries at risk and agencies involved in health and humanitarian action. The numbers of persons killed or disabled as a result of earthquakes, cyclones, floods and famines have reached record levels in the last decade. Population density, rampant urbanization and climatic changes have brought about risk patterns that are exposing larger and larger sections of populations in developing countries to life-threatening natural disasters. Despite substantial spending on emergency relief, the approaches to relief remain largely ad hoc and amateurish, resulting generally in inappropriate and/or delayed action. In recent years, mass emergencies of the kind experienced in Bangladesh or the Sahelian countries have highlighted the importance of rapid assessment of health needs for better allocation of resources and relief management. As a result, the development of techniques for rapid assessment of health needs has been identified as a priority for effective emergency action. This article sketches the health context of disasters in terms of mortality and morbidity patterns; it describes initial assessment techniques currently used and their methodological biases and constraints; it also discusses assessment needs which vary between different types of disasters and the time frame within which assessments are undertaken. Earthquakes, cyclones, famines, epidemics or refugees all have specific risk profiles and emergency conditions which differ for each situation. Vulnerability to mortality changes according to age and occupation, for earthquakes and famines. These risk factors then have significant implications for the design of rapid assessment protocols and checklists. Experiences from the field in rapid survey techniques and estimation of death rates are discussed, with emphasis on the need for a reliable denominator even for the roughest assessment. Finally, the

  11. The effectiveness of current French health warnings displayed on alcohol advertisements and alcoholic beverages.

    Science.gov (United States)

    Dossou, Gloria; Gallopel-Morvan, Karine; Diouf, Jacques-François

    2017-08-01

    Many countries use health warnings in an attempt to regulate alcohol consumption. However, there is a lack of conclusive evidence in the research on alcohol warnings to support decision-making on effective health policies. This study explores the effectiveness of two mandatory warnings introduced in France in 1991 and 2007: the first (Alcohol abuse is harmful) is displayed on alcohol advertisements; the second (a pictogram) on bottles. Given that advertising content regulations have been implemented in some countries to reduce the attractiveness of alcohol marketing (e.g. the Evin law in France), this research also aims to explore whether such regulations can improve the effectiveness of warnings. In-depth interviews were conducted with 26 French people aged 15-29 years. The effectiveness of health warnings was assessed in terms of recall, noticeability, credibility, comprehension, responsiveness, and ability to encourage moderate drinking and abstinence during pregnancy. Participants were shown alcohol advertisements and bottles that either followed or challenged content regulations. The data were analyzed using double manual coding and NVivo software. While both warnings suffered from a lack of visibility and noticeability due to their size, location, and outdatedness and because of competition from marketing design elements, the warning on the advertisement that followed content regulations was most visible. Both warnings were considered to be informationally vague, lacking in credibility and ineffective in terms of making participants feel concerned and influencing consumption habits. Current French warnings are ineffective and require modification. Improvements are suggested regarding the design and content of warnings to help increase their effectiveness. © The Author 2017. Published by Oxford University Press on behalf of the European Public Health Association. All rights reserved.

  12. Global occupational health: current challenges and the need for urgent action.

    Science.gov (United States)

    Lucchini, Roberto G; London, Leslie

    2014-01-01

    Global occupational health and safety (OHS) is strictly linked to the dynamics of economic globalization. As the global market is increasing, the gap between developed and underdeveloped countries, occupational diseases, and injuries affect a vast number of workers worldwide. Global OHS issues also become local in developed countries due to many factors, including untrained migrant workers in the informal sector, construction, and agriculture. To identify the current status and challenges of global occupational health and safety and the needs for preventive action. Absence of OHS infrastructure amplifies the devastating consequences of infectious outbreaks like the Ebola pandemic and tuberculosis. Interventions in global OHS are urgently needed at various levels: 1. Increased governmental funding is needed for international organizations like the World Health Organization and the International Labor Organization to face the increasing demand for policies, guidance, and training. 2. Regulations to ban and control dangerous products are needed to avoid the transfer of hazardous production to developing countries. 3. The OHS community must address global OHS issues through advocacy, position papers, public statements, technical and ethical guidelines, and by encouraging access of OHS professionals from the developing countries to leadership positions in professional and academic societies. 4. Research, education, and training of OHS professionals, workers, unions and employers are needed to address global OHS issues and their local impact. 5. Consumers also can influence significantly the adoption of OHS practices by demanding the protection of workers who are producing he goods that are sold in the global market. Following the equation of maximized profits prompted by the inhibition of OHS is an old practice that has proven to cause significant costs to societies in the developed world. It is now an urgent priority to stop this process and promote a harmonized global

  13. Perceived Need Versus Current Spending: Gaps in Providing Foundational Public Health Services in Communities.

    Science.gov (United States)

    Bekemeier, Betty; Marlowe, Justin; Squires, Linda Sharee; Tebaldi, Jennifer; Park, Seungeun

    Our objective was to estimate the gap between the costs for local health jurisdictions (LHJs) to provide foundational public health services (FPHS) and actual spending on FPHS and to examine factors associated with that gap. We employed resource-based cost estimation methods for this observational study and conducted multivariate analyses with measures derived from secondary administrative data. We used primary data collected from LHJ leaders that depicted 2014 spending and perceived need. We also included secondary administrative data depicting annual 2000-2013 expenditures organized into categories containing key elements of FPHS areas. We included primary data from a representative sample of 10 LHJs in Washington State and secondary data for all 35 LHJs in Washington. Participants were public health practice leaders from each sample LHJ. Our main outcome of interest was the gap identified between current spending and the perceived spending needed to provide FPHS in a jurisdiction. Actual FPHS spending was approximately 65% of spending needed to provide overall FPHS for our sample LHJs, but the size of the gap varied substantially by program. Some gaps also varied widely by LHJ, with spending gaps widest among rural and high poverty communities. Percent poverty and the metropolitan nature of a jurisdiction were factors significantly related to FPHS spending in our multivariate analyses. Actual spending lags far behind local officials' estimates of spending needed to provide FPHS and is likely influenced by local conditions. Major apparent gaps between spending and need, particularly in areas such as costly Business Competencies, underscore the need for cross-cutting capabilities to support public health system responsiveness and for attention to be paid to local conditions.

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

    Science.gov (United States)

    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, concerns about usage and disposal are diverse and include accumulation of waste in landfills and in natural habitats, physical problems for wildlife resulting from ingestion or entanglement in plastic, the leaching of chemicals from plastic products and the potential for plastics to transfer chemicals to wildlife and humans. However, perhaps the most important overriding concern, which is implicit throughout this volume, is that our current usage is not sustainable. Around 4 per cent of world oil production is used as a feedstock to make plastics and a similar amount is used as energy in the process. Yet over a third of current production is used to make items of packaging, which are then rapidly discarded. Given our declining reserves of fossil fuels, and finite capacity for disposal of waste to landfill, this linear use of hydrocarbons, via packaging and other short-lived applications of plastic, is simply not sustainable. There are solutions, including material reduction, design for end-of-life recyclability, increased recycling capacity, development of bio-based feedstocks, strategies to reduce littering, the application of green chemistry life-cycle analyses and revised risk assessment approaches. Such measures will be most effective through the combined actions of the public, industry, scientists and policymakers. There is some urgency, as the quantity of plastics produced in the first 10 years of the current century is likely to approach the quantity produced in the

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

    Science.gov (United States)

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

    2009-07-27

    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, concerns about usage and disposal are diverse and include accumulation of waste in landfills and in natural habitats, physical problems for wildlife resulting from ingestion or entanglement in plastic, the leaching of chemicals from plastic products and the potential for plastics to transfer chemicals to wildlife and humans. However, perhaps the most important overriding concern, which is implicit throughout this volume, is that our current usage is not sustainable. Around 4 per cent of world oil production is used as a feedstock to make plastics and a similar amount is used as energy in the process. Yet over a third of current production is used to make items of packaging, which are then rapidly discarded. Given our declining reserves of fossil fuels, and finite capacity for disposal of waste to landfill, this linear use of hydrocarbons, via packaging and other short-lived applications of plastic, is simply not sustainable. There are solutions, including material reduction, design for end-of-life recyclability, increased recycling capacity, development of bio-based feedstocks, strategies to reduce littering, the application of green chemistry life-cycle analyses and revised risk assessment approaches. Such measures will be most effective through the combined actions of the public, industry, scientists and policymakers. There is some urgency, as the quantity of plastics produced in the first 10 years of the current century is likely to approach the quantity produced in the

  16. A Concentrated Effort

    Science.gov (United States)

    Lum, Lydia

    2010-01-01

    For years, New York health-care providers have treated Asian-Americans afflicted by serious, even life-threatening illnesses with ever-increasing frequency. Many doctors in the nation's largest city agreed that Asians seemed particularly at risk for specific health problems, but there was neither research nor statistics supporting physician…

  17. Health impact assessment in Latin American countries: Current practice and prospects

    International Nuclear Information System (INIS)

    Pereira, Carlos A.R.; Périssé, André R.S.; Knoblauch, Astrid M.; Utzinger, Jürg; Hacon, Sandra de Souza

    2017-01-01

    Background: With the objective to avoid and mitigate potential adverse health impacts of projects, programmes and policies, health impact assessment (HIA) offers an opportunity for disease prevention and health promotion. Although HIA has gained importance over the past two decades, it is unclear whether and to what extent HIA practice has been established and institutionalised in Latin America. To address this issue, the current practice and prospects of HIA in Latin America was assessed in the peer-reviewed literature and existing guidelines. Methodology: The peer-reviewed literature was systematically searched using five electronic databases until February 2016. Studies were included on a set of pre-defined criteria. The search was carried out in English, French, Portuguese and Spanish. Additionally, a search for HIA guidelines used in Latin American countries and territories was performed by means of a Google search and on websites of government departments and institutions that may promote HIA. Results: The search yielded 167 hits in the peer-reviewed literature of which 17 articles met inclusion criteria. Only four peer-reviewed articles described prospective HIAs and four featured a discussion of the HIA approach. The remaining nine articles presented health impact evaluations. Most studies were published only recently, after 2012 (88%). Seven HIA guideline documents were identified, two of which were country-specific (i.e. Brazil and Mexico) and the remaining five addressed HIA at the regional level. Conclusions: This study confirmed the paucity of literature pertaining to HIA implementation, as well as HIA guidelines in Latin America. Mexico, Brazil and Cuba have the longest track record in scientific literature and guidelines on HIA. In order to better understand current barriers and limitations to practice and institutionalisation of HIA in Latin American countries, a broad discussion among policy makers, academic institutions and HIA practitioners is

  18. 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.

  19. Associations between causal attributions and personal stigmatizing attitudes in untreated persons with current mental health problems.

    Science.gov (United States)

    Stolzenburg, Susanne; Freitag, Simone; Schmidt, Silke; Schomerus, Georg

    2018-02-01

    Past research has shown that among the general public, certain causal explanations like biomedical causes are associated with stronger desire for social distance from persons with mental illness. Aim of this study was to find out how different causal attributions of persons with untreated mental health problems regarding their own complaints are associated with stigmatizing attitudes, anticipated self-stigma when seeking help and perceived stigma-stress. Altogether, 207 untreated persons with a current depressive syndrome were interviewed. Biomedical causes, but also belief in childhood trauma or unhealthy behavior as a cause of the problem, were associated with stronger personal stigma and with more stigma-stress. Similarities and differences to findings among the general population and implications for future research are discussed. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. [Development and Current Status of the Health Education Curriculum of the German Pension Insurance].

    Science.gov (United States)

    Worringen, Ulrike; Meng, Karin; Bitzer, Eva-Maria; Brandes, Iris; Faller, Hermann

    2017-08-01

    The health education curriculum of the German pension insurance comprises 27 patient education programs that are mostly indication-based. The curriculum aims to support the implementation of patient-oriented patient education in German rehabilitation centers. The effectiveness of several of the educational programs was evaluated in controlled trials with heterogeneous results. Overall, the dissemination of the evaluated programs in rehabilitation practice can be recommended. They constitute an essential part of the overall treatment concept, but are often modified in clinical practice. In particular, the physician led modules are frequently conducted in larger group settings. It is currently considered how these routine working conditions might be reflected in the quality assurance system of the German pension insurance and a cross-organizational conceptual framework. © Georg Thieme Verlag KG Stuttgart · New York.

  1. Association between childhood health, socioeconomic and school-related factors and effort-reward imbalance at work: a 25-year follow-up study.

    Science.gov (United States)

    Wang, Shuo; Sanderson, Kristy; Venn, Alison; Dwyer, Terence; Gall, Seana

    2018-01-01

    Stress pathways can have origins in childhood, but few early predictors have been explored in relation to adult job stress. This study examined whether childhood school, health or socioeconomic factors were associated with adult job stress. Data came from the Childhood Determinants of Adult Health study that began in 1985 with children aged 7-15 years who reported effortreward imbalance (ERI) scales at ages 31-41 years. Linear regression assessed the association between childhood factors and adult ERI adjusted for age and socioeconomic position (SEP) in childhood and adulthood. There were between 999 and 1390 participants in each analysis. Lower adulthood ERI, indicating less job stress, was predicted by several school-related factors in men. For example, each higher category of learner self-concept was associated with a 19% (95% CI - 32% to 6%) reduction in adult ERI, and each unit increase in academic attainment was associated with a 15% (95% CI -28% to 3%) reduction in adult ERI. Childhood health was associated with adult ERI. For example, in women, overweight children had 14% (95% CI 5% to 22%) higher adult ERI scores compared with healthy weight children, and each unit of negative affect was associated with 2% (95% CI 1% to 4%) increase in adult ERI. Adult SEP had no effect on these associations for men but explained some of the effect in women. Childhood SEP had inconsistent associations with adult ERI. Our findings suggest that a range of childhood socioeconomic, school- and health-related factors might contribute to the development of job stress in adulthood. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. Psychological distress, health protection, and sexual practices among young men who have sex with men: Using social action theory to guide HIV prevention efforts.

    Directory of Open Access Journals (Sweden)

    Ian W Holloway

    Full Text Available The present study addresses gaps in the literature related to theory development for young men who have sex with men (YMSM sexual practices through the application and modification of Social Action Theory. Data come from the Healthy Young Men study (N = 526, which longitudinally tracked a diverse cohort of YMSM ages 18-24 to characterize risk and protective factors associated with drug use and sexual practices. Structural equation modeling examined the applicability of, and any necessary modifications to a YMSM-focused version of Social Action Theory. The final model displayed excellent fit (CFI = 0.955, TLI = 0.947, RMSEA = 0.037 and suggested concordance between social support and personal capacity for sexual health promotion. For YMSM, practicing health promotion and avoiding practices that may put them at risk for HIV was associated with both social isolation and psychological distress (β = -0.372, t = -4.601, p<0.001; psychological distress is an internalized response to environmental and cognitive factors and sexual practices are an externalized response. Results point to the utility of Social Action Theory as a useful model for understanding sexual practices among YMSM, the application of which shows health protective sexual practices are a function of sociocognitive factors that are influenced by environmental contexts. Social Action Theory can help prevention scientists better address the needs of this vulnerable population.

  3. Psychological distress, health protection, and sexual practices among young men who have sex with men: Using social action theory to guide HIV prevention efforts

    Science.gov (United States)

    Holloway, Ian W.; Traube, Dorian E.; Schrager, Sheree M.; Tan, Diane; Dunlap, Shannon; Kipke, Michele D.

    2017-01-01

    The present study addresses gaps in the literature related to theory development for young men who have sex with men (YMSM) sexual practices through the application and modification of Social Action Theory. Data come from the Healthy Young Men study (N = 526), which longitudinally tracked a diverse cohort of YMSM ages 18–24 to characterize risk and protective factors associated with drug use and sexual practices. Structural equation modeling examined the applicability of, and any necessary modifications to a YMSM-focused version of Social Action Theory. The final model displayed excellent fit (CFI = 0.955, TLI = 0.947, RMSEA = 0.037) and suggested concordance between social support and personal capacity for sexual health promotion. For YMSM, practicing health promotion and avoiding practices that may put them at risk for HIV was associated with both social isolation and psychological distress (β = -0.372, t = -4.601, pcognitive factors and sexual practices are an externalized response. Results point to the utility of Social Action Theory as a useful model for understanding sexual practices among YMSM, the application of which shows health protective sexual practices are a function of sociocognitive factors that are influenced by environmental contexts. Social Action Theory can help prevention scientists better address the needs of this vulnerable population. PMID:28886128

  4. Sugars and health: a review of current evidence and future policy.

    Science.gov (United States)

    Evans, Charlotte Elizabeth Louise

    2017-08-01

    The automation of the process of extracting sugars in the 1900s reduced cost and increased availability of sugars leading to a dramatic rise in consumption, which reached a peak in the 1970s. There are different definitions for sugars not naturally available in foods, and free sugars is the term used by WHO. The epidemiological evidence of the associations between sugars and obesity and type 2 diabetes mellitus is fairly strong and consistent, particularly for sugar sweetened drinks in adults. The Department of Health in the UK and many other countries have recently updated their recommendations for free sugars as a result of this scientific evidence. In the UK the recommended amount of free sugars is currently 5 % of energy (reduced from 10 %), which is difficult to meet and very different from current British dietary patterns. Reducing intakes of free sugars is a challenge and will necessitate a range of different actions and policies. Public Health England has put forward eight suggestions but the four most likely to improve dietary behaviour based on available evidence are social marketing, reduction of marketing of high sugar foods and drinks to children, reformulation and reductions in portion size and a sugar excise tax. Any action taken needs to be evaluated to check inequalities are not widened. The new childhood obesity strategy has incorporated some but not all of these strategies and may not go far enough. It is likely that government policies alone will not be sufficient and a change in the food culture is necessary to see real progress.

  5. Current Allergic Rhinitis Experiences Survey (CARES): Health-care practitioners' awareness, attitudes and practices.

    Science.gov (United States)

    Blaiss, Michael S; Fromer, Leonard M; Jacob-Nara, Juby A; Long, Randall M; Mannion, Karen M; Lauersen, Lori A

    2014-01-01

    Allergic rhinitis (AR) is a common health problem in the United States, with significant comorbidities and impairment of quality of life despite the availability of many prescription (Rx) and over-the-counter (OTC) medications. The health-care practitioners (HCPs) arm of the Current Allergic Rhinitis Experiences Survey (CARES) assessed HCPs' perceptions about the current management of AR. This U.S.-based national survey included 375 primary care physicians and 375 nurse practitioners/physician assistants. Participants were screened to ensure that they treat ≥15 AR sufferers per month during allergy season. The majority of HCPs (86%) agreed that AR patients can easily recognize allergy symptoms after diagnosis and that 57% of their patients come to them self-recognizing their symptoms. A total of 82% strongly agreed that AR sufferers are primarily diagnosed via history and physical and do not typically undergo diagnostic testing until after pharmacologic intervention. HCPs reported that 63-77% of AR sufferers can easily manage AR once treatment is established. According to surveyed HCPs, OTC medication should precede an Rx medication for AR management. A total of 82% HCPs considered intranasal steroids (INSs) to be the gold standard AR treatment and have minimal safety concerns about INS use. HCPs perceive that patients can easily recognize and self-manage their AR symptoms. Patient history/symptoms and physical examination are the primary methods of AR diagnosis. INSs are considered the gold standard for treatment of AR. However, most HCPs feel OTC medication should be tried before Rx medication for AR management.

  6. 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.

  7. 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.

  8. Achieving universal health care coverage: Current debates in Ghana on covering those outside the formal sector

    Directory of Open Access Journals (Sweden)

    Abiiro Gilbert

    2012-10-01

    Full Text Available Abstract Background Globally, extending financial protection and equitable access to health services to those outside the formal sector employment is a major challenge for achieving universal coverage. While some favour contributory schemes, others have embraced tax-funded health service cover for those outside the formal sector. This paper critically examines the issue of how to cover those outside the formal sector through the lens of stakeholder views on the proposed one-time premium payment (OTPP policy in Ghana. Discussion Ghana in 2004 implemented a National Health Insurance Scheme, based on a contributory model where service benefits are restricted to those who contribute (with some groups exempted from contributing, as the policy direction for moving towards universal coverage. In 2008, the OTPP system was proposed as an alternative way of ensuring coverage for those outside formal sector employment. There are divergent stakeholder views with regard to the meaning of the one-time premium and how it will be financed and sustained. Our stakeholder interviews indicate that the underlying issue being debated is whether the current contributory NHIS model for those outside the formal employment sector should be maintained or whether services for this group should be tax funded. However, the advantages and disadvantages of these alternatives are not being explored in an explicit or systematic way and are obscured by the considerable confusion about the likely design of the OTPP policy. We attempt to contribute to the broader debate about how best to fund coverage for those outside the formal sector by unpacking some of these issues and pointing to the empirical evidence needed to shed even further light on appropriate funding mechanisms for universal health systems. Summary The Ghanaian debate on OTPP is related to one of the most important challenges facing low- and middle-income countries seeking to achieve a universal health care system. It

  9. Advance Care Planning Documentation in Electronic Health Records: Current Challenges and Recommendations for Change.

    Science.gov (United States)

    Lamas, Daniela; Panariello, Natalie; Henrich, Natalie; Hammes, Bernard; Hanson, Laura C; Meier, Diane E; Guinn, Nancy; Corrigan, Janet; Hubber, Sean; Luetke-Stahlman, Hannah; Block, Susan

    2018-04-01

    To develop a set of clinically relevant recommendations to improve the state of advance care planning (ACP) documentation in the electronic health record (EHR). Advance care planning (ACP) is a key process that supports goal-concordant care. For preferences to be honored, clinicians must be able to reliably record, find, and use ACP documentation. However, there are no standards to guide ACP documentation in the electronic health record (EHR). We interviewed 21 key informants to understand the strengths and weaknesses of EHR documentation systems for ACP and identify best practices. We analyzed these interviews using a qualitative content analysis approach and subsequently developed a preliminary set of recommendations. These recommendations were vetted and refined in a second round of input from a national panel of content experts. Informants identified six themes regarding current inadequacies in documentation and accessibility of ACP information and opportunities for improvement. We offer a set of concise, clinically relevant recommendations, informed by expert opinion, to improve the state of ACP documentation in the EHR.

  10. Current status of environmental, health, and safety issues of lithium polymer electric vehicle batteries

    Energy Technology Data Exchange (ETDEWEB)

    Corbus, D; Hammel, C J

    1995-02-01

    Lithium solid polymer electrolyte (SPE) batteries are being investigated by researchers worldwide as a possible energy source for future electric vehicles (EVs). One of the main reasons for interest in lithium SPE battery systems is the potential safety features they offer as compared to lithium battery systems using inorganic and organic liquid electrolytes. However, the development of lithium SPE batteries is still in its infancy, and the technology is not envisioned to be ready for commercialization for several years. Because the research and development (R&D) of lithium SPE battery technology is of a highly competitive nature, with many companies both in the United States and abroad pursuing R&D efforts, much of the information concerning specific developments of lithium SPE battery technology is proprietary. This report is based on information available only through the open literature (i.e., information available through library searches). Furthermore, whereas R&D activities for lithium SPE cells have focused on a number of different chemistries, for both electrodes and electrolytes, this report examines the general environmental, health, and safety (EH&S) issues common to many lithium SPE chemistries. However, EH&S issues for specific lithium SPE cell chemistries are discussed when sufficient information exists. Although lithium batteries that do not have a SPE are also being considered for EV applications, this report focuses only on those lithium battery technologies that utilize the SPE technology. The lithium SPE battery technologies considered in this report may contain metallic lithium or nonmetallic lithium compounds (e.g., lithium intercalated carbons) in the negative electrode.

  11. Child obesity prevention in primary health care: investigating practice nurse roles, attitudes and current practices.

    Science.gov (United States)

    Robinson, Alison; Denney-Wilson, Elizabeth; Laws, Rachel; Harris, Mark

    2013-04-01

    Overweight and obesity affects approximately 20% of Australian pre-schoolers. The general practice nurse (PN) workforce has increased in recent years; however, little is known of PN capacity and potential to provide routine advice for the prevention of child obesity. This mixed methods pilot study aims to explore the current practices, attitudes, confidence and training needs of Australian PNs surrounding child obesity prevention in the general practice setting. PNs from three Divisions of General Practice in New South Wales were invited to complete a questionnaire investigating PN roles, attitudes and practices in preventive care with a focus on child obesity. A total of 59 questionnaires were returned (response rate 22%). Semi-structured qualitative interviews were also conducted with a subsample of PNs (n = 10). Questionnaire respondent demographics were similar to that of national PN data. PNs described preventive work as enjoyable despite some perceived barriers including lack of confidence. Number of years working in general practice did not appear to strongly influence nurses' perceived barriers. Seventy per cent of PNs were interested in being more involved in conducting child health checks in practice, and 85% expressed an interest in taking part in child obesity prevention training. Findings from this pilot study suggest that PNs are interested in prevention of child obesity despite barriers to practice and low confidence levels. More research is needed to determine the effect of training on PN confidence and behaviours in providing routine healthy life-style messages for the prevention of child obesity. © 2013 The Authors. Journal of Paediatrics and Child Health © 2013 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  12. Fried Food Consumption and Cardiovascular Health: A Review of Current Evidence

    Directory of Open Access Journals (Sweden)

    Taraka V. Gadiraju

    2015-10-01

    Full Text Available Fried food consumption and its effects on cardiovascular disease are still subjects of debate. The objective of this review was to summarize current evidence on the association between fried food consumption and cardiovascular disease, diabetes, hypertension and obesity and to recommend directions for future research. We used PubMed, Google Scholar and Medline searches to retrieve pertinent publications. Most available data were based on questionnaires as a tool to capture fried food intakes, and study design was limited to case-control and cohort studies. While few studies have reported a positive association between frequencies of fried food intake and risk of coronary artery disease, heart failure, diabetes or hypertension, other investigators have failed to confirm such an association. There is strong evidence suggesting a higher risk of developing chronic disease when fried foods are consumed more frequently (i.e., four or more times per week. Major gaps in the current literature include a lack of detailed information on the type of oils used for frying foods, stratification of the different types of fried food, frying procedure (deep and pan frying, temperature and duration of frying, how often oils were reused and a lack of consideration of overall dietary patterns. Besides addressing these gaps, future research should also develop tools to better define fried food consumption at home versus away from home and to assess their effects on chronic diseases. In summary, the current review provides enough evidence to suggest adverse health effects with higher frequency of fried food consumption. While awaiting confirmation from future studies, it may be advisable to the public to consume fried foods in moderation while emphasizing an overall healthy diet.

  13. Current and future climate- and air pollution-mediated impacts on human health.

    Science.gov (United States)

    Doherty, Ruth M; Heal, Mathew R; Wilkinson, Paul; Pattenden, Sam; Vieno, Massimo; Armstrong, Ben; Atkinson, Richard; Chalabi, Zaid; Kovats, Sari; Milojevic, Ai; Stevenson, David S

    2009-12-21

    We describe a project to quantify the burden of heat and ozone on mortality in the UK, both for the present-day and under future emission scenarios. Mortality burdens attributable to heat and ozone exposure are estimated by combination of climate-chemistry modelling and epidemiological risk assessment. Weather forecasting models (WRF) are used to simulate the driving meteorology for the EMEP4UK chemistry transport model at 5 km by 5 km horizontal resolution across the UK; the coupled WRF-EMEP4UK model is used to simulate daily surface temperature and ozone concentrations for the years 2003, 2005 and 2006, and for future emission scenarios. The outputs of these models are combined with evidence on the ozone-mortality and heat-mortality relationships derived from epidemiological analyses (time series regressions) of daily mortality in 15 UK conurbations, 1993-2003, to quantify present-day health burdens. During the August 2003 heatwave period, elevated ozone concentrations > 200 microg m-3 were measured at sites in London and elsewhere. This and other ozone photochemical episodes cause breaches of the UK air quality objective for ozone. Simulations performed with WRF-EMEP4UK reproduce the August 2003 heatwave temperatures and ozone concentrations. There remains day-to-day variability in the high ozone concentrations during the heatwave period, which on some days may be explained by ozone import from the European continent.Preliminary calculations using extended time series of spatially-resolved WRF-EMEP4UK model output suggest that in the summers (May to September) of 2003, 2005 & 2006 over 6000 deaths were attributable to ozone and around 5000 to heat in England and Wales. The regional variation in these deaths appears greater for heat-related than for ozone-related burdens.Changes in UK health burdens due to a range of future emission scenarios will be quantified. These future emissions scenarios span a range of possible futures from assuming current air quality

  14. 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.

  15. Current and emerging occupational safety and health (OSH) issues in the healthcare sector, including home and community care

    NARCIS (Netherlands)

    Jong, T. de; Bos, E.; Pawlowska-Cyprysiak, K.; Hildt-Ciupinska, K.; Malinska, M.; Nicolescu, G.; Trifu, A.

    2014-01-01

    This report gives an overview of the current and emerging OSH issues for health- and social care workers and how these affect their safety and health at work and influence the quality of care they provide. It combines a literature review and the responses received to a questionnaire sent to OSH

  16. 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.

  17. Income, Poverty, and Health Insurance Coverage in the United States: 2012. Current Population Reports P60-245

    Science.gov (United States)

    DeNavas-Walt, Carmen; Proctor, Bernadette D.; Smith, Jessica C.

    2013-01-01

    This report presents data on income, poverty, and health insurance coverage in the United States based on information collected in the 2013 and earlier Current Population Survey Annual Social and Economic Supplements (CPS ASEC) conducted by the U.S. Census Bureau. For most groups, the 2012 income, poverty, and health insurance estimates were not…

  18. The relevance of the early history of probability theory to current risk assessment practices in mental health care.

    Science.gov (United States)

    Large, Matthew

    2013-12-01

    Probability theory is at the base of modern concepts of risk assessment in mental health. The aim of the current paper is to review the key developments in the early history of probability theory in order to enrich our understanding of current risk assessment practices.

  19. Current and Projected Characteristics and Unique Health Care Needs of the Patient Population Served by the Department of Veterans Affairs

    OpenAIRE

    Eibner, Christine; Krull, Heather; Brown, Kristine M.; Cefalu, Matthew; Mulcahy, Andrew W.; Pollard, Michael; Shetty, Kanaka; Adamson, David M.; Amaral, Ernesto F. L.; Armour, Philip; Beleche, Trinidad; Bogdan, Olena; Hastings, Jaime; Kapinos, Kandice; Kress, Amii

    2016-01-01

    The Veterans Access, Choice, and Accountability Act of 2014 addressed the need for access to timely, high-quality health care for veterans. Section 201 of the legislation called for an independent assessment of various aspects of veterans' health care. The RAND Corporation was tasked with an assessment of the current and projected demographics and health care needs of patients served by the Department of Veterans Affairs (VA). The number of U.S. veterans will continue to decline over the next...

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

    Science.gov (United States)

    2013-01-01

    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. PMID:24025845

  1. 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.

  2. Literality and Cognitive Effort

    DEFF Research Database (Denmark)

    Lacruz, Isabel; Carl, Michael; Yamada, Masaru

    2018-01-01

    We introduce a notion of pause-word ratio computed using ranges of pause lengths rather than lower cutoffs for pause lengths. Standard pause-word ratios are indicators of cognitive effort during different translation modalities.The pause range version allows for the study of how different types...... remoteness. We use data from the CRITT TPR database, comparing translation and post-editing from English to Japanese and from English to Spanish, and study the interaction of pause-word ratio for short pauses ranging between 300 and 500ms with syntactic remoteness, measured by the CrossS feature, semantic...... remoteness, measured by HTra, and syntactic and semantic remoteness, measured by Literality....

  3. Breckinridge Project, initial effort

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    1982-09-01

    Report III, Volume 1 contains those specifications numbered A through J, as follows: General Specifications (A); Specifications for Pressure Vessels (C); Specifications for Tanks (D); Specifications for Exchangers (E); Specifications for Fired Heaters (F); Specifications for Pumps and Drivers (G); and Specifications for Instrumentation (J). The standard specifications of Bechtel Petroleum Incorporated have been amended as necessary to reflect the specific requirements of the Breckinridge Project, and the more stringent specifications of Ashland Synthetic Fuels, Inc. These standard specifications are available to the Initial Effort (Phase Zero) work performed by all contractors and subcontractors. Report III, Volume 1 also contains the unique specifications prepared for Plants 8, 15, and 27. These specifications will be substantially reviewed during Phase I of the project, and modified as necessary for use during the engineering, procurement, and construction of this project.

  4. Keep Kids Current on Vaccines (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    The Vaccines for Children program was created in response to a major measles epidemic. This podcast discusses the program’s efforts to provide vaccinations for children whose parents cannot afford them.

  5. Impact of current cough on health-related quality of life in patients with COPD

    Directory of Open Access Journals (Sweden)

    Deslee G

    2016-09-01

    [FEV1]: 57 [37–72] % predicted (median [Q1–Q3]. In univariate analyses, health-related quality of life (Saint George’s respiratory questionnaire total score was associated with each CASA-Q domain and with chronic bronchitis, exacerbations, dyspnea, FEV1, depression, and anxiety. All four domains introduced separately were independently associated with health-related quality of life. When introduced together in multivariate analyses, only the cough impact domain remained independently associated with health-related quality of life (R2=0.60. With chronic bronchitis (standard definition instead of the CASA-Q, the R2 was lower (R2=0.54.Conclusion: This study provides evidence that current cough in the previous 7 days is an important determinant of health-related quality of life impairment in stable COPD patients.Keywords: signs and symptoms, respiratory, sputum, questionnaires, dyspnea, multivariate analysis

  6. A Pilot Health Information Technology-Based Effort to Increase the Quality of Transitions From Skilled Nursing Facility to Home: Compelling Evidence of High Rate of Adverse Outcomes.

    Science.gov (United States)

    Donovan, Jennifer L; Kanaan, Abir O; Gurwitz, Jerry H; Tjia, Jennifer; Cutrona, Sarah L; Garber, Lawrence; Preusse, Peggy; Field, Terry S

    2016-04-01

    Older adults are often transferred from hospitals to skilled nursing facilities (SNFs) for post-acute care. Patients may be at risk for adverse outcomes after SNF discharges, but little research has focused on this period. Assessment of the feasibility of a transitional care intervention based on a combination of manual information transmission and health information technology to provide automated alert messages to primary care physicians and staff; pre-post analysis to assess potential impact. A multispecialty group practice. Adults aged 65 and older, discharged from SNFs to home; comparison group drawn from SNF discharges during the previous 1.5 years, matched on facility, patient age, and sex. For the pre-post analysis, we tracked rehospitalization within 30 days after discharge and adverse drug events within 45 days. The intervention was developed and implemented with manual transmission of information between 8 SNFs and the group practice followed by entry into the electronic health record. The process required a 5-day delay during which a large portion of the adverse events occurred. Over a 1-year period, automated alert messages were delivered to physicians and staff for the 313 eligible patients discharged from the 8 SNFs to home. We compared outcomes to those of individually matched discharges from the previous 1.5 years and found similar percentages with 30-day rehospitalizations (31% vs 30%, adjusted HR 1.06, 95% CI 0.80-1.4). Within the adverse drug event (ADE) study, 30% of the discharges during the intervention period and 30% of matched discharges had ADEs within 45 days. Older adults discharged from SNFs are at high risk of adverse outcomes immediately following discharge. Simply providing alerts to outpatient physicians, especially if delivered multiple days after discharge, is unlikely to have any impact on reducing these rates. Copyright © 2016 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All

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

    Science.gov (United States)

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

    2014-05-01

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

  8. Monitoring Exposure to Ebola and Health of U.S. Military Personnel Deployed in Support of Ebola Control Efforts - Liberia, October 25, 2014-February 27, 2015.

    Science.gov (United States)

    Cardile, Anthony P; Murray, Clinton K; Littell, Christopher T; Shah, Neel J; Fandre, Matthew N; Drinkwater, Dennis C; Markelz, Brian P; Vento, Todd J

    2015-07-03

    In response to the unprecedented Ebola virus disease (Ebola) outbreak in West Africa, the U.S. government deployed approximately 2,500 military personnel to support the government of Liberia. Their primary missions were to construct Ebola treatment units (ETUs), train health care workers to staff ETUs, and provide laboratory testing capacity for Ebola. Service members were explicitly prohibited from engaging in activities that could result in close contact with an Ebola-infected patient or coming in contact with the remains of persons who had died from unknown causes. Military units performed twice-daily monitoring of temperature and review of exposures and symptoms ("unit monitoring") on all persons throughout deployment, exit screening at the time of departure from Liberia, and post-deployment monitoring for 21 days at segregated, controlled monitoring areas on U.S. military installations. A total of 32 persons developed a fever during deployment from October 25, 2014, through February 27, 2015; none had a known Ebola exposure or developed Ebola infection. Monitoring of all deployed service members revealed no Ebola exposures or infections. Given their activity restrictions and comprehensive monitoring while deployed to Liberia, U.S. military personnel constitute a unique population with a lower risk for Ebola exposure compared with those working in the country without such measures.

  9. Growing health partnerships in rural and remote communities: what drives the joint efforts of primary schools and universities in maintaining service learning partnerships?

    Science.gov (United States)

    Kirby, Sue; Held, Fabian P; Jones, Debra; Lyle, David

    2018-01-10

    Aim This study explored the partnership between universities and local primary schools to deliver a classroom-based paediatric communication impairment service provided by undergraduate speech pathology students. It aimed to understand how partnerships work to facilitate programme replication. The partners included universities sending students on rural clinical placement, local host academic units and primary schools who worked together to provide paediatric speech and language services in primary schools in three sites in Australia. Rural and remote communities experience poorer health outcomes because of chronic workforce shortages, social disadvantage and high Aboriginality, poor access to services and underfunding. The study was in twofold: qualitative analysis of data from interviews/focus group with the partners in the university and education sectors, and quantitative social network analysis of data from an electronic survey of the partners. Findings Factors supporting partnerships were long-term, work and social relationships, commitment to community, trust and an appetite for risk-taking. We postulate that these characteristics are more likely to exist in rural communities.

  10. Current and cumulative night shift work and subclinical atherosclerosis: results of the Gutenberg Health Study.

    Science.gov (United States)

    Jankowiak, S; Backé, E; Liebers, F; Schulz, A; Hegewald, J; Garthus-Niegel, S; Nübling, M; Blankenberg, S; Pfeiffer, N; Lackner, K J; Beutel, M; Blettner, M; Münzel, T; Wild, P S; Seidler, A; Letzel, S; Latza, U

    2016-11-01

    The study examines the association between exposure to current and cumulative night shift work and subclinical parameters of atherosclerosis. Participants of a population-based cohort study (the Gutenberg Health Study, N = 15,010) aged 35-64 years were examined at baseline (2007-2012). Investigations included measurements of arterial stiffness, vascular function [reactive hyperaemia (RH) index], and intima media thickness (IMT). Also, a complete job history (including up to 15 periods), occupational exposures, a variety of lifestyle, and dispositional variables were enquired. Night shift work was performed by 1071 out of 8065 currently employed individuals. The strongest association after adjustment for age, sex, job complexity level, being a manager, overtime work, and noise appeared for more than 660 night shifts within the last 10 years and a significantly increased arterial stiffness of 0.33 m/s. This reflects a 4 % flow velocity increase for individuals with more than 660 night shifts compared to non-night workers. Regarding the entire professional life, night shift workers showed a significantly decreased vascular function by -0.054 RH index points by using the same adjustment. IMT values did not differ statistically from non-night workers. Lifestyle and dispositional factors showed an influence on all used subclinical atherosclerosis parameters. The cross-sectional results demonstrate an association between night work and detrimental changes in the atherosclerotic process. The association is more pronounced with more years in night shift and is partly explained by lifestyle and dispositional factors. Longitudinal analyses are necessary to confirm the results.

  11. [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.

  12. [Overwork and its health effects--current status and future approach regarding Karoshi].

    Science.gov (United States)

    Hoshuyama, Tsutomu

    2003-09-01

    The word karoshi, i.e. death due to overwork, is not defined for medical diagnosis, but in Japan it means cases of compensation awarded by reason of fatal occupational diseases, particularly ischemic heart diseases and cerebrovascular diseases which are recognized as caused by a heavy workload. Current studies have shown that 1) almost definitely there is evidence of an association between overwork and cardiovascular diseases and the risk factors were found, 2) no reports have been published on evidence of a causal relationship between overwork and fatal effects even though the possibility remains, and 3) the adverse health effects can vary according to workers' characteristics such as gender, age, stress coping and perception. Recently there has been an increase in the proportion of compensated cases versus claims from 3.1% in the 1988 fiscal year to 20.7% in the 2001 fiscal year. This may be related to the deregulation of criteria for compensation, or nintei-kijun. The period of determination of overwork for victims has been extended to a maximum of six months in the newest criteria set in 2001, up from only one week in the criteria set in 1987. According to sociological analysis, long working hours in Japan are related not only to the structure of the working-time system but also the sociocultural background of labor. In 2002, the Japanese government provided the first countermeasures for the prevention of karoshi for all employees stating that they should not work more than 45 h overtime per month and that government intervention in the form of administrative guidance to employees and their employers should be conducted if overtime exceeds 100 h per month. It is a population strategy targeting all workers equally, not just a high-risk strategy targeting only those with some risk factors, and is expected to provide more fruitful results with flexibility, i.e. differentially reinforced management for older workers and those working under highly stressful

  13. Feeling angry about current health status: using a population survey to determine the association with demographic, health and social factors

    Directory of Open Access Journals (Sweden)

    Tiffany K. Gill

    2016-07-01

    Full Text Available Abstract Background Feeling angry about their health status may influence disease progression in individuals, creating a greater burden on the health care system. Identifying associations between different variables and feeling angry about health status may assist health professionals to improve health outcomes. This study used path analysis to explore findings from a population-based survey, informed by qualitative descriptions obtained from focus groups, to determine the prevalence of health-related anger within the community and variables associated with reporting health-related anger. Methods A population-based Computer Assisted Telephone Interview (CATI survey of 3003 randomly selected adults Australia-wide was conducted to examine the prevalence of health-related anger. A wide range of other covariates were included in the survey. Multivariable logistic regression and path analysis were undertaken to identify the relationships between different variables associated with feeling angry about the health status of people, to explore the direction of these associations and as a consequence of the results, consider implications for health service use and delivery. Results Overall, 18.5 % of the population reported feeling angry about their health “some of the time”, “most of the time” or “all of the time”. People who felt angry about their health were more likely to have a severe health condition, at least one chronic condition, high psychological distress, fair to poor health status, and needed to adjust their daily lives because of a health condition. Having a tertiary level education was protective. Receiving some form of social support, usually from a support group, and not always doing as advised by a doctor, were also associated with a higher likelihood of being angry about their health. Conclusions People living with significant health problems are more likely to feel angry about their health. The path between illness and

  14. Effort to Enhance Early Detection for Vulnerable Pregnancy by Midwives Through Complete Fulfillment of Maternal and Child Health (MCH Bookin Bangkalan East Java Year 2013

    Directory of Open Access Journals (Sweden)

    Ristrini Ristrini

    2015-03-01

    Kesehatan Kabupaten Bangkalan agar memberikan penghargaan bagi bidan yang berprestasi.Kata kunci:Kelengkapan Pengisian Buku KIA, Deteksi Dini Risiko Tinggi, Ibu Hamil ABSTRACTBackground:MCH book is a tool for early detection for vulnerable gravida. Meanwhile, the utilization of MCH book was still low. The target achieved for early detection was 12% out of 20% from 2011 to 2012. Based on SDKI 2012 duka, the average maternal mortality rate reached 359 per 100.000 live births, increased significantly from the data of SDKI 2007 which reached 228 per 100.000 live births. Methods:This study was observational with cross sectional design. Both quantitative and qualitative data were collected. Secondary data were collected by the availability of MCH book, midwives training, supervisions, and complete fulfillment of MCH book. Populations in Puskesmas Kedundung and Puskesmas Geger Bangkalan District. The samples were midwives with more than one year working and graduated from DIII (diploma. The complete fulfillment of MCH book was identified from family identity, delivery preparation, gravida medical record, antenatal medical record, postnatal medical record, KMS (Booklet to Infant Nutritional Status Detection, Neonatus medical record, infant medical record, vitamin A supplementary. Result: The complete fulfillments were in Puskesmas Geger 0.66 (category: good 0.51–1.00 and Puskesmas Kedundung 0.35 (category: low 0.00–0.50. Midwives’ Motivations were low (50.0% and midwives workload were high (66.7% at Puskesmas Geger. Midwives were highly motivated (66.7% and their workloads are fair. Recomendation: make group of work and allocate the job description properly to assist midwives workload. In addition, health office of Bangkalan should give reward to those who do the work excellently.Key words:complete fulfilment of MCH book, early detection of highrisk pregnancy, pregnant women

  15. Swedish nuclear waste efforts

    International Nuclear Information System (INIS)

    Rydberg, J.

    1981-09-01

    After the introduction of a law prohibiting the start-up of any new nuclear power plant until the utility had shown that the waste produced by the plant could be taken care of in an absolutely safe way, the Swedish nuclear utilities in December 1976 embarked on the Nuclear Fuel Safety Project, which in November 1977 presented a first report, Handling of Spent Nuclear Fuel and Final Storage of Vitrified Waste (KBS-I), and in November 1978 a second report, Handling and Final Storage of Unreprocessed Spent Nuclear Fuel (KBS II). These summary reports were supported by 120 technical reports prepared by 450 experts. The project engaged 70 private and governmental institutions at a total cost of US $15 million. The KBS-I and KBS-II reports are summarized in this document, as are also continued waste research efforts carried out by KBS, SKBF, PRAV, ASEA and other Swedish organizations. The KBS reports describe all steps (except reprocessing) in handling chain from removal from a reactor of spent fuel elements until their radioactive waste products are finally disposed of, in canisters, in an underground granite depository. The KBS concept relies on engineered multibarrier systems in combination with final storage in thoroughly investigated stable geologic formations. This report also briefly describes other activities carried out by the nuclear industry, namely, the construction of a central storage facility for spent fuel elements (to be in operation by 1985), a repository for reactor waste (to be in operation by 1988), and an intermediate storage facility for vitrified high-level waste (to be in operation by 1990). The R and D activities are updated to September 1981

  16. Role of government in public health: Current scenario in India and future scope

    Directory of Open Access Journals (Sweden)

    Subitha Lakshminarayanan

    2011-01-01

    Full Text Available The new agenda for Public Health in India includes the epidemiological transition, demographical transition, environmental changes and social determinants of health. Based on the principles outlined at Alma-Ata in 1978, there is an urgent call for revitalizing primary health care in order to meet these challenges. The role of the government in influencing population health is not limited within the health sector but also by various sectors outside the health systems. This article is a literature review of the existing government machinery for public health needs in India, its success, limitations and future scope. Health system strengthening, human resource development and capacity building and regulation in public health are important areas within the health sector. Contribution to health of a population also derives from social determinants of health like living conditions, nutrition, safe drinking water, sanitation, education, early child development and social security measures. Population stabilization, gender mainstreaming and empowerment, reducing the impact of climate change and disasters on health, improving community participation and governance issues are other important areas for action. Making public health a shared value across the various sectors is a politically challenging strategy, but such collective action is crucial.

  17. The effectiveness of health appraisal processes currently in addressing health and wellbeing during spatial plan appraisal: a systematic review.

    Science.gov (United States)

    Gray, Selena; Carmichael, Laurence; Barton, Hugh; Mytton, Julie; Lease, Helen; Joynt, Jennifer

    2011-11-24

    Spatial planning affects the built environment, which in turn has the potential to have a significant impact on health, for good or ill. One way of ensuring that spatial plans take due account of health is through the inclusion of health considerations in the statutory and non statutory appraisal processes linked to plan-making processes. A systematic review to identify evaluation studies of appraisals or assessments of plans where health issues were considered from 1987 to 2010. A total of 6161 citations were identified: 6069 from electronic databases, 57 fromwebsite searches, with a further 35 citations from grey literature, of which 20 met the inclusion criteria. These 20 citations reported on a total of 135 different case studies: 11 UK HIA; 11 non UK high income countries HIA, 5 UK SEA or other integrated appraisal; 108 non UK high income SEA or other integrated appraisal. All studies were in English. No relevant studies were identified reporting on low or middle income countries.The studies were limited by potential bias (no independent evaluation, with those undertaking the appraisal also responsible for reporting outcomes), lack of detail and a lack of triangulation of results. Health impact assessments generally covered the four specified health domains (physical activity, mental health and wellbeing, environmental health issues such as pollution and noise, injury) more comprehensively than SEA or other integrated appraisals, although mental health and wellbeing was an underdeveloped area. There was no evidence available on the incorporation of health in Sustainability Appraisal, limited evidence that the recommendations from any type of appraisal were implemented, and almost no evidence that the recommendations had led to the anticipated outcomes or improvements in health postulated. Research is needed to assess (i) the degree to which statutory plan appraisal processes (SA in the UK) incorporate health; (ii) whether recommendations arising from health

  18. The effectiveness of health appraisal processes currently in addressing health and wellbeing during spatial plan appraisal: a systematic review

    Directory of Open Access Journals (Sweden)

    Gray Selena

    2011-11-01

    Full Text Available Abstract Background Spatial planning affects the built environment, which in turn has the potential to have a significant impact on health, for good or ill. One way of ensuring that spatial plans take due account of health is through the inclusion of health considerations in the statutory and non statutory appraisal processes linked to plan-making processes. Methods A systematic review to identify evaluation studies of appraisals or assessments of plans where health issues were considered from 1987 to 2010. Results A total of 6161 citations were identified: 6069 from electronic databases, 57 fromwebsite searches, with a further 35 citations from grey literature, of which 20 met the inclusion criteria. These 20 citations reported on a total of 135 different case studies: 11 UK HIA; 11 non UK high income countries HIA, 5 UK SEA or other integrated appraisal; 108 non UK high income SEA or other integrated appraisal. All studies were in English. No relevant studies were identified reporting on low or middle income countries. The studies were limited by potential bias (no independent evaluation, with those undertaking the appraisal also responsible for reporting outcomes, lack of detail and a lack of triangulation of results. Health impact assessments generally covered the four specified health domains (physical activity, mental health and wellbeing, environmental health issues such as pollution and noise, injury more comprehensively than SEA or other integrated appraisals, although mental health and wellbeing was an underdeveloped area. There was no evidence available on the incorporation of health in Sustainability Appraisal, limited evidence that the recommendations from any type of appraisal were implemented, and almost no evidence that the recommendations had led to the anticipated outcomes or improvements in health postulated. Conclusion Research is needed to assess (i the degree to which statutory plan appraisal processes (SA in the UK

  19. Games for Health for Children-Current Status and Needed Research

    NARCIS (Netherlands)

    Baranowski, Tom; Blumberg, Fran; Buday, Richard; DeSmet, Ann; Fiellin, Lynn E; Green, C Shawn; Kato, Pamela M; Lu, Amy Shirong; Maloney, Ann E; Mellecker, Robin; Morrill, Brooke A; Peng, Wei; Shegog, Ross; Simons, Monique; Staiano, Amanda E; Thompson, Debbe; Young, Kimberly

    2015-01-01

    Videogames for health (G4H) offer exciting, innovative, potentially highly effective methods for increasing knowledge, delivering persuasive messages, changing behaviors, and influencing health outcomes. Although early outcome results are promising, additional research is needed to determine the

  20. Games for health for children—Current status and needed research

    Science.gov (United States)

    Videogames for health (G4H) offer exciting, innovative, potentially highly effective methods for increasing knowledge, delivering persuasive messages, changing behaviors, and influencing health outcomes. Although early outcome results are promising, additional research is needed to determine the gam...

  1. Women's occupational health: a critical review and discussion of current issues.

    Science.gov (United States)

    Messing, K

    1997-01-01

    Action to improve women's occupational health has been slowed by a notion that women's jobs are safe and that any health problems identified among women workers can be attributed to unfitness for the job or unnecessary complaining. With increasing numbers of women in the labor force, the effects of work on women's health have recently started to interest health care providers, health and safety representatives and researchers. We begin our summary of their discoveries with a discussion of women's place in the workplace and its implications for occupational health, followed by a brief review of some gender-insensitive data-gathering techniques. We have then chosen to concentrate on the following four areas: methods and data collection; directing attention to women's occupational health problems; musculoskeletal disease; mental and emotional stress. We conclude by pointing out some neglected occupational groups and health issues.

  2. [Current status and trends in the health of the Moscow population].

    Science.gov (United States)

    Tishuk, E A; Plavunov, N F; Soboleva, N P

    1997-01-01

    Based on vast comprehensive medical statistical database, the authors analyze the health status of the population and the efficacy of public health service in Moscow. The pre-crisis tendencies and the modern status of public health under modern socioeconomic conditions are noted.

  3. Designing serious video games for health behavior change: Current status and future directions

    Science.gov (United States)

    Serious video games for health are designed to entertain while changing a specific health behavior. This article identifies behavioral principles that can guide the development of serious video games focused on changing a variety of health behaviors, including those attempting to decrease risk of o...

  4. Current mHealth technologies for physical activity assessment and promotion.

    Science.gov (United States)

    O'Reilly, Gillian A; Spruijt-Metz, Donna

    2013-10-01

    Novel mobile assessment and intervention capabilities are changing the face of physical activity (PA) research. A comprehensive systematic review of how mobile technology has been used for measuring PA and promoting PA behavior change is needed. Article collection was conducted using six databases from February to June 2012 with search terms related to mobile technology and PA. Articles that described the use of mobile technologies for PA assessment, sedentary behavior assessment, and/or interventions for PA behavior change were included. Articles were screened for inclusion and study information was extracted. Analyses were conducted from June to September 2012. Mobile phone-based journals and questionnaires, short message service (SMS) prompts, and on-body PA sensing systems were the mobile technologies most utilized. Results indicate that mobile journals and questionnaires are effective PA self-report measurement tools. Intervention studies that reported successful promotion of PA behavior change employed SMS communication, mobile journaling, or both SMS and mobile journaling. mHealth technologies are increasingly being employed to assess and intervene on PA in clinical, epidemiologic, and intervention research. The wide variations in technologies used and outcomes measured limit comparability across studies, and hamper identification of the most promising technologies. Further, the pace of technologic advancement currently outstrips that of scientific inquiry. New adaptive, sequential research designs that take advantage of ongoing technology development are needed. At the same time, scientific norms must shift to accept "smart," adaptive, iterative, evidence-based assessment and intervention technologies that will, by nature, improve during implementation. © 2013 American Journal of Preventive Medicine.

  5. Keep Kids Current on Vaccines (A Minute of Health with CDC)

    Centers for Disease Control (CDC) Podcasts

    2014-03-24

    The Vaccines for Children program was created in response to a major measles epidemic. This podcast discusses the program’s efforts to provide vaccinations for children whose parents cannot afford them.  Created: 3/24/2014 by MMWR.   Date Released: 3/24/2014.

  6. 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.

  7. Reproductive health policy affecting low-income women: historical precedents and current need for social work action.

    Science.gov (United States)

    Averitt Taylor, Jessica

    2014-01-01

    This article provides an overview of the historical arguments surrounding reproductive health policy and current policy initiatives. Because reproductive policy itself is a vast subject matter with sometimes blurry boundaries, the struggle concerning the advent of birth control is used to illustrate the historic complexities of policy affecting such a wide array of individuals. The battle over introduction of the birth control pill is pertinent because the very same arguments are used today in debates over reproductive health policy.

  8. Current and Projected Characteristics and Unique Health Care Needs of the Patient Population Served by the Department of Veterans Affairs.

    Science.gov (United States)

    Eibner, Christine; Krull, Heather; Brown, Kristine M; Cefalu, Matthew; Mulcahy, Andrew W; Pollard, Michael; Shetty, Kanaka; Adamson, David M; Amaral, Ernesto F L; Armour, Philip; Beleche, Trinidad; Bogdan, Olena; Hastings, Jaime; Kapinos, Kandice; Kress, Amii; Mendelsohn, Joshua; Ross, Rachel; Rutter, Carolyn M; Weinick, Robin M; Woods, Dulani; Hosek, Susan D; Farmer, Carrie M

    2016-05-09

    The Veterans Access, Choice, and Accountability Act of 2014 addressed the need for access to timely, high-quality health care for veterans. Section 201 of the legislation called for an independent assessment of various aspects of veterans' health care. The RAND Corporation was tasked with an assessment of the current and projected demographics and health care needs of patients served by the Department of Veterans Affairs (VA). The number of U.S. veterans will continue to decline over the next decade, and the demographic mix and geographic locations of these veterans will change. While the number of veterans using VA health care has increased over time, demand will level off in the coming years. Veterans have more favorable economic circumstances than non-veterans, but they are also older and more likely to be diagnosed with many health conditions. Not all veterans are eligible for or use VA health care. Whether and to what extent an eligible veteran uses VA health care depends on a number of factors, including access to other sources of health care. Veterans who rely on VA health care are older and less healthy than veterans who do not, and the prevalence of costly conditions in this population is projected to increase. Potential changes to VA policy and the context for VA health care, including effects of the Affordable Care Act, could affect demand. Analysis of a range of data sources provided insight into how the veteran population is likely to change in the next decade.

  9. Opening up mental health service delivery to cultural diversity: current situation, development and examples from three northern European countries.

    Science.gov (United States)

    Bäärnhielm, Sofie; Jávo, Cecilie; Mösko, Mike-Oliver

    2013-01-01

    There are inequalities in health among migrants and local populations in Europe. Due to migration, Germany, Norway and Sweden have become ethnic culturally diverse nations. There are barriers to mental health care access for refugees, migrants and minorities, and problems with quality of culturally sensitive care in the three countries. This is despite tax-funded health care systems based on equity in service provision. There is a need to develop culturally sensitive mental health services that respond to the increasing diversity of the populations. In this chapter, we will take a closer look at cultural diversity in the countries in question, discuss challenges and give examples of current work to open up mental health services to cultural diversity. The German example will focus on the movement of Interkulturelle Öffnung (cross-cultural opening of the health care system) and work on creating national guidelines and quality standards. From Norway, the work of the National Centre for Mental Health for the indigenous Sámi population will be presented. The Swedish example will focus on the work carried out by the Transcultural Centre. The latter is a competence centre supporting development of culturally sensitive care as an integrated part of the regional health and mental health care system in Stockholm. Finally, the relevance of mental health care for a culturally diverse population, as a part of the larger social project of building tolerant multicultural societies, will be discussed. Copyright © 2013 S. Karger AG, Basel.

  10. Current and Projected Characteristics and Unique Health Care Needs of the Patient Population Served by the Department of Veterans Affairs

    Science.gov (United States)

    Eibner, Christine; Krull, Heather; Brown, Kristine M.; Cefalu, Matthew; Mulcahy, Andrew W.; Pollard, Michael; Shetty, Kanaka; Adamson, David M.; Amaral, Ernesto F. L.; Armour, Philip; Beleche, Trinidad; Bogdan, Olena; Hastings, Jaime; Kapinos, Kandice; Kress, Amii; Mendelsohn, Joshua; Ross, Rachel; Rutter, Carolyn M.; Weinick, Robin M.; Woods, Dulani; Hosek, Susan D.; Farmer, Carrie M.

    2016-01-01

    Abstract The Veterans Access, Choice, and Accountability Act of 2014 addressed the need for access to timely, high-quality health care for veterans. Section 201 of the legislation called for an independent assessment of various aspects of veterans' health care. The RAND Corporation was tasked with an assessment of the current and projected demographics and health care needs of patients served by the Department of Veterans Affairs (VA). The number of U.S. veterans will continue to decline over the next decade, and the demographic mix and geographic locations of these veterans will change. While the number of veterans using VA health care has increased over time, demand will level off in the coming years. Veterans have more favorable economic circumstances than non-veterans, but they are also older and more likely to be diagnosed with many health conditions. Not all veterans are eligible for or use VA health care. Whether and to what extent an eligible veteran uses VA health care depends on a number of factors, including access to other sources of health care. Veterans who rely on VA health care are older and less healthy than veterans who do not, and the prevalence of costly conditions in this population is projected to increase. Potential changes to VA policy and the context for VA health care, including effects of the Affordable Care Act, could affect demand. Analysis of a range of data sources provided insight into how the veteran population is likely to change in the next decade. PMID:28083423

  11. 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.

  12. 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.

  13. 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.

  14. CURRENT ECONOMIC AND MEDICAL REFORMS IN THE ROMANIAN HEALTH CARE SYSTEM

    Directory of Open Access Journals (Sweden)

    Dragoi Mihaela Cristina

    2011-12-01

    Full Text Available The issue of health has always been, both in social reality and in academia and research, a sensitive topic considering the relationship each individual has with his own health and the health care system as a public policy. At public opinion levels and not only, health care is the most important sector demanding the outmost attention, considering that individual health is the fundamental prerequisite for well-being, happiness and a satisfying life. The ever present research and practical question is on the optimal financing of the health care system. Any answer to this question is also a political decision, reflecting the social-economic value of health for a particular country. The size of the resource pool and the criteria and methods for resource allocation are the central economic problems for any health system. This paper takes into consideration the limited resources of the national health care system (the rationalization of health services, the common methods of health financing, the specificity of health services market (the health market being highly asymmetric, with health professionals knowing most if not all of the relevant information, such as diagnosis, treatment options and costs and consumers fully dependent on the information provided in each case and the performance of all hospitals in Romania, in order to assess the latest strategic decisions (introduction of co-payment and merging and reconversion of hospitals taken within the Romanian health care system and their social and economic implications. The main finding show that, even though the intention of reforming and transforming the Romanian health care system into a more efficient one is obvious, the lack of economic and demographic analysis may results into greater discrepancies nationwide. This paper is aimed to renew the necessity of joint collaboration between the economic and medical field, since the relationship between health and economic development runs both ways

  15. Designing Serious Video Games for Health Behavior Change: Current Status and Future Directions

    OpenAIRE

    Thompson, Debbe

    2012-01-01

    Serious video games for health are designed to entertain while changing a specific health behavior. This article identifies behavioral principles that can guide the development of serious video games focused on changing a variety of health behaviors, including those attempting to decrease risk of obesity and type 2 diabetes. Guidelines discussed include how to develop video games that provide a solid foundation for behavior change by enhancing a player’s knowledge and skill, ways in which per...

  16. [Individual rights vs public health in the fight against contagious diseases: proposals to improve the current legal framework].

    Science.gov (United States)

    Salamero Teixidó, Laura

    2016-11-01

    The public health protection constitutional mandate requires public powers to protect the population from contagious diseases. This requires a legal framework that both protects public health effectively and respects individual rights and freedoms that could be undermined by the public administrations. This article analyses, from a legal perspective, the current legal framework regulating the adoption of health measures to protect public health against contagious diseases. It argues that current regulations generate legal uncertainty on the basis of the wide range of discretionary powers they give to the public administration and the lack of provisions for limiting these powers. As a result, the guarantee mechanisms (primarily judicial consent) only weakly protect the rights and freedoms of the citizens affected by health measures. To conclude, the article proposes several amendments to improve public health regulations related to contagious diseases. The purpose is to render a legal framework that offers more legal certainty, in which it is possible to protect individual rights and freedoms when measures are adopted, without sacrificing the effective protection of public health. Copyright © 2016 SESPAS. Publicado por Elsevier España, S.L.U. All rights reserved.

  17. Dietary fibre in Europe: current state of knowledge on definitions, sources, recommendations, intakes and relationships to health.

    Science.gov (United States)

    Stephen, Alison M; Champ, Martine M-J; Cloran, Susan J; Fleith, Mathilde; van Lieshout, Lilou; Mejborn, Heddie; Burley, Victoria J

    2017-12-01

    Research into the analysis, physical properties and health effects of dietary fibre has continued steadily over the last 40-50 years. From the knowledge gained, countries have developed guidelines for their populations on the optimal amount of fibre to be consumed each day. Food composition tables from many countries now contain values for the dietary fibre content of foods, and, from these, combined with dietary surveys, population intakes have been determined. The present review assessed the uniformity of the analytical methods used, health claims permitted, recommendations and intakes, particularly from national surveys across Europe and around the world. It also assessed current knowledge on health effects of dietary fibre and related the impact of different fibre types on health. The overall intent was to be able to provide more detailed guidance on the types of fibre which should be consumed for good health, rather than simply a total intake figure, the current situation. Analysis of data indicated a fair degree of uniformity in the definition of dietary fibre, the method used for analysis, the recommended amount to be consumed and a growing literature on effects on digestive health and disease risk. However, national dietary survey data showed that intakes do not reach recommendations and very few countries provide guidance on the types of fibre that are preferable to achieve recommended intakes. Research gaps were identified and ideas suggested to provide information for more detailed advice to the public about specific food sources that should be consumed to achieve health benefits.

  18. The connection between art, healing, and public health: a review of current literature.

    Science.gov (United States)

    Stuckey, Heather L; Nobel, Jeremy

    2010-02-01

    This review explores the relationship between engagement with the creative arts and health outcomes, specifically the health effects of music engagement, visual arts therapy, movement-based creative expression, and expressive writing. Although there is evidence that art-based interventions are effective in reducing adverse physiological and psychological outcomes, the extent to which these interventions enhance health status is largely unknown. Our hope is to establish a foundation for continued investigation into this subject and to generate further interest in researching the complexities of engagement with the arts and health.

  19. Social Media, Big Data, and Mental Health: Current Advances and Ethical Implications.

    Science.gov (United States)

    Conway, Mike; O'Connor, Daniel

    2016-06-01

    Mental health (including substance abuse) is the fifth greatest contributor to the global burden of disease, with an economic cost estimated to be US $2.5 trillion in 2010, and expected to double by 2030. Developing information systems to support and strengthen population-level mental health monitoring forms a core part of the World Health Organization's Comprehensive Action Plan 2013-2020. In this paper, we review recent work that utilizes social media "big data" in conjunction with associated technologies like natural language processing and machine learning to address pressing problems in population-level mental health surveillance and research, focusing both on technological advances and core ethical challenges.

  20. The current status of mHealth for diabetes: will it be the next big thing?

    Science.gov (United States)

    Klonoff, David C

    2013-05-01

    mHealth is an emerging concept in health care and uses mobile communications devices for health services and information. Mobile phones, patient monitoring devices, tablets, personal digital assistants, and other wireless devices can be part of mHealth systems. With mHealth systems, glucose data can now be automatically collected, transmitted, aggregated with other physiologic data, analyzed, stored, and presented as actionable information. mHealth systems use mobile decision support software applications (or apps) to assist or direct health care professionals to make decisions, or they can assist or direct patients to make decisions without waiting for input from a clinician. With real-time decision support for patients, appropriate actions can be taken in real time without waiting to see a clinician. Decisions can be personalized if individual treatment goals and personal preferences for treatment are inputted into an app. Few mHealth apps for diabetes have been rigorously tested. Outcome studies of the use of mHealth for diabetes from the literature have shown the potential for benefits, but higher-quality studies are needed. Regulatory approval of mHealth products will require demonstration of safety and effectiveness, especially where information and trends are not just presented to patients, but used to make treatment recommendations. Three additional hurdles must be overcome to facilitate widespread adoption of this technology, including demonstration of the following: (1) privacy to satisfy regulators, (2) clinical benefit to satisfy clinicians, and (3) economic benefit to satisfy payers. mHealth for diabetes is making rapid strides and is expected to be a transforming technology that will be the next big thing. © 2013 Diabetes Technology Society.

  1. VA Pipeline for Future Nurse Leaders: an Exploration of Current Nurse Leadership Development in the Veteran’s Health Administration

    Science.gov (United States)

    2016-06-10

    Democratic Society White House Leadership Development Program (WHLD) Harvard Kennedy School (HKS)–Senior Executive Fellows Program George......Nurse Leaders: An Exploration of Current Nurse Leadership Development in the Veterans Health Administration 5a. CONTRACT NUMBER 5b. GRANT NUMBER

  2. Current status of Australian Radioisotopes, the National Medicine Cyclotron and the Biomedicine and Health Program at Ansto

    International Nuclear Information System (INIS)

    Garnett, H.

    1995-01-01

    An overview is provided of the current roles of Australian Radioisotopes, the National Medicine Cyclotron, and the Biomedicine and Health Program in the light of the recommendations of the recent Bain/Battelle review of ANSTO which was commissioned by the ANSTO's Board in 1994

  3. Longitudinal research on subjective aging, health, and longevity : Current evidence and new directions for research

    NARCIS (Netherlands)

    Westerhof, Gerben J.; Wurm, Susanne

    2015-01-01

    In this chapter, we carry out a narrative review of the longitudinal impact of subjective aging on health and survival. We have a specifi c focus on the different pathways which can explain the relation of subjective aging to health and survival. We focus on the three most common conceptualizations

  4. Mobile health in adults with congenital heart disease: Current use and future needs

    NARCIS (Netherlands)

    Schuuring, M.J.; A. Backx (Ad); Zwart, R.; Veelenturf, A.H.; D. Robbers-Visser (Daniëlle); M. Groenink (Maarten); A. Abu-Hanna (Ameen); N. Bruining (Nico); M.P. Schijven; B.J.M. Mulder (Barbara); B.J. Bouma (Berto)

    2016-01-01

    textabstractObjective Many adults with congenital heart disease (CHD) are affected lifelong by cardiac events, particularly arrhythmias and heart failure. Despite the care provided, the cardiac event rate remains high. Mobile health (mHealth) brings opportunities to enhance daily monitoring and

  5. Female non-regular workers in Japan: their current status and health.

    Science.gov (United States)

    Inoue, Mariko; Nishikitani, Mariko; Tsurugano, Shinobu

    2016-12-07

    The participation of women in the Japanese labor force is characterized by its M-shaped curve, which reflects decreased employment rates during child-rearing years. Although, this M-shaped curve is now improving, the majority of women in employment are likely to fall into the category of non-regular workers. Based on a review of the previous Japanese studies of the health of non-regular workers, we found that non-regular female workers experienced greater psychological distress, poorer self-rated health, a higher smoking rate, and less access to preventive medicine than regular workers did. However, despite the large number of non-regular workers, there are limited researches regarding their health. In contrast, several studies in Japan concluded that regular workers also had worse health conditions due to the additional responsibility and longer work hours associated with the job, housekeeping, and child rearing. The health of non-regular workers might be threatened by the effects of precarious employment status, lower income, a lower safety net, outdated social norm regarding non-regular workers, and difficulty in achieving a work-life balance. A sector wide social approach to consider life course aspect is needed to protect the health and well-being of female workers' health; promotion of an occupational health program alone is insufficient.

  6. Female non-regular workers in Japan: their current status and health

    Science.gov (United States)

    INOUE, Mariko; NISHIKITANI, Mariko; TSURUGANO, Shinobu

    2016-01-01

    The participation of women in the Japanese labor force is characterized by its M-shaped curve, which reflects decreased employment rates during child-rearing years. Although, this M-shaped curve is now improving, the majority of women in employment are likely to fall into the category of non-regular workers. Based on a review of the previous Japanese studies of the health of non-regular workers, we found that non-regular female workers experienced greater psychological distress, poorer self-rated health, a higher smoking rate, and less access to preventive medicine than regular workers did. However, despite the large number of non-regular workers, there are limited researches regarding their health. In contrast, several studies in Japan concluded that regular workers also had worse health conditions due to the additional responsibility and longer work hours associated with the job, housekeeping, and child rearing. The health of non-regular workers might be threatened by the effects of precarious employment status, lower income, a lower safety net, outdated social norm regarding non-regular workers, and difficulty in achieving a work-life balance. A sector wide social approach to consider life course aspect is needed to protect the health and well-being of female workers’ health; promotion of an occupational health program alone is insufficient. PMID:27818453

  7. 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...

  8. Rethinking the relationship between socioeconomic status and health: Challenging how socioeconomic status is currently used in health inequality research.

    Science.gov (United States)

    Gagné, Thierry; Ghenadenik, Adrian E

    2018-02-01

    The Scandinavian Journal of Public Health recently reiterated the importance of addressing social justice and health inequalities in its new editorial policy announcement. One of the related challenges highlighted in that issue was the limited use of sociological theories able to inform the complexity linking the resources and mechanisms captured by the concept of socioeconomic status. This debate article argues that part of the problem lies in the often unchallenged reliance on a generic conceptualization and operationalization of socioeconomic status. These practices hinder researchers' capacity to examine in finer detail how resources and circumstances promote the unequal distribution of health through distinct yet intertwined pathways. As a potential way forward, this commentary explores how research practices can be challenged through concrete publication policies and guidelines. To this end, we propose a set of recommendations as a tool to strengthen the study of socioeconomic status and, ultimately, the quality of health inequality research. Authors, reviewers, and editors can become champions of change toward the implementation of sociological theory by holding higher standards regarding the conceptualization, operationalization, analysis, and interpretation of results in health inequality research.

  9. Lay perceptions of current and future health, the causes of illness, and the nature of recovery: explaining health and illness in Malaysia.

    Science.gov (United States)

    Swami, Viren; Arteche, Adriane; Chamorro-Premuzic, Tomas; Maakip, Ismail; Stanistreet, Debbi; Furnham, Adrian

    2009-09-01

    This study examined beliefs about the causes and determinants of health, illness, and recovery in an opportunistic sample from Malaysia. In all, 371 women and 350 men completed the Health and Illness Scale, a 124-item scale that examined beliefs about current and future health, and beliefs about the causes of illness and recovery. Each of the four subscales of the Health Illness Scale were factor analysed to reveal the underlying structure. Results showed the emergence of a number of distinct factors in the case of each subscale, of which environmental, life-style, psychological, religious, and fate-related factors were fairly stable across subscales. Results also showed a number of differences in beliefs between religious groups, and that religiosity and sex were the strongest predictors of beliefs across the four subscales. The results are discussed in terms of the available cross-cultural literature on lay beliefs about health.

  10. HIV/AIDS prevention, faith, and spirituality among black/African American and Latino communities in the United States: strengthening scientific faith-based efforts to shift the course of the epidemic and reduce HIV-related health disparities.

    Science.gov (United States)

    Sutton, Madeline Y; Parks, Carolyn P

    2013-06-01

    Black/African American and Latino communities are disproportionately affected by the domestic HIV/AIDS epidemic. Blacks/African Americans and Latinos are also more likely to report a formal, religious, or faith affiliation when compared with non-Hispanic whites. As such, faith leaders and their institutions have been identified in the National HIV/AIDS Strategy as having a vital role to serve in reducing: (1) HIV-related health disparities and (2) the number of new HIV infections by promoting non-judgmental support for persons living with and at risk for HIV/AIDS and by serving as trusted information resources for their congregants and communities. We describe faith doctrines and faith-science partnerships that are increasing in support of faith-based HIV prevention and service delivery activities and discuss the vital role of these faith-based efforts in highly affected black/African American and Latino communities.

  11. Health and human rights education in U.S. schools of medicine and public health: current status and future challenges.

    Science.gov (United States)

    Cotter, L Emily; Chevrier, Jonathan; El-Nachef, Wael Noor; Radhakrishna, Rohan; Rahangdale, Lisa; Weiser, Sheri D; Iacopino, Vincent

    2009-01-01

    Despite increasing recognition of the importance of human rights in the protection and promotion of health, formal human rights education has been lacking in schools of medicine and public health. Our objectives were: 1) to determine the nature and extent of health and human rights (HHR) education among schools of medicine (SOMs) and public health (SPHs); 2) to identify perceived barriers to implementing HHR curricula; 3) to learn about deans' interests and attitudes toward HHR education, and; 4) to identify factors associated with offering HHR education. We conducted a cross-sectional survey among deans of all accredited allopathic SOMs and SPHs in the United States and Puerto Rico. Seventy-one percent of U.S. SOMs and SPHs responded. Thirty-seven percent of respondents indicated that their schools offered some form of HHR education. Main barriers to offering HHR education included competition for time, lack of qualified instructors and lack of funding. Among schools not offering HHR education, 35% of deans were interested in offering HHR education. Seventy-six percent of all deans believed that it was very important or important to offer HHR education. Multiple regression analysis revealed that deans' attitudes were the most important factor associated with offering any HHR education. Findings indicate that though a majority of deans of SOMs and SPHs believe that knowledge about human rights is important in health practice and support the inclusion of HHR studies in their schools, HHR education is lacking at most of their institutions. These results and the growing recognition of the critical interdependence between health and human rights indicate a need for SOMs and SPHs to work towards formal inclusion of HHR studies in their curricula, and that HHR competency requirements be considered to overcome barriers to its inclusion.

  12. Getting sports injury prevention on to public health agendas - addressing the shortfalls in current information sources.

    Science.gov (United States)

    Finch, Caroline F

    2012-01-01

    Public health policy is a successful population-level strategy for injury prevention but it is yet to be widely applied to the sports sector. Such policy is generally coordinated by government health departments concerned with the allocation of limited resources to health service delivery and preventive programs for addressing large community health issues. Prioritisation of sports injury prevention (SIP) requires high-quality evidence about the size of the problem and its public health burden; identification of at-risk vulnerable groups; confirmed effective prevention solutions; evidence of intervention cost-effectiveness; and quantification of both financial and policy implications of inaction. This paper argues that the major reason for a lack of sports injury policy by government departments for health or sport to date is a lack of relevant information available for policy makers to make their decisions. Key information gaps evident in Australia are used to highlight this problem. SIP policy does not yet rank highly because, relative to other health/injury issues, there is very little hard evidence to support: claims for its priority ranking, the existence of solutions that can be implemented and which will work, and potential cost-savings to government agencies. Moreover, policy action needs to be integrated across government portfolios, including sport, health and others. Until sports medicine research generates high-quality population-level information of direct relevance and importance to policy makers, especially intervention costing and implementation cost-benefit estimates, and fully engage in policy-informing partnerships, SIP will continue to be left off the public health agenda.

  13. Current costing models: are they suitable for allocating health resources? The example of fall injury prevention in Australia.

    Science.gov (United States)

    Moller, Jerry

    2005-01-01

    The example of fall injury among older people is used to define and illustrate how current Australian systems for allocation of health resources perform for funding emerging public health issues. While the examples are Australian, the allocation and priority setting methods are common in the health sector in all developed western nations. With an ageing population the number of falls injuries in Australia and the cost of treatment will rise dramatically over the next 20-50 years. Current methods of allocating funds within the health system are not well suited to meeting this coming epidemic. The information requirements for cost-benefit and cost-effectiveness measures cannot be met. Marginal approaches to health funding are likely to continue to fund already well-funded treatment or politically driven prevention processes and to miss the opportunity for new prevention initiatives in areas that do not have a high political profile. Fall injury is one of many emerging areas that struggle to make claims for funding because the critical mass of intervention and evidence of its impact is not available. The beneficiaries of allocation failure may be those who treat the disease burden that could have been easily prevented. Changes to allocation mechanisms, data systems and new initiative funding practices are required to ensure that preventative strategies are able to compete on an equal footing with treatment approaches for mainstream health funding.

  14. Social Media, Big Data, and Mental Health: Current Advances and Ethical Implications

    OpenAIRE

    Conway, Mike; O���Connor, Daniel

    2016-01-01

    Mental health (including substance abuse) is the fifth greatest contributor to the global burden of disease, with an economic cost estimated to be US $2.5 trillion in 2010, and expected to double by 2030. Developing information systems to support and strengthen population-level mental health monitoring forms a core part of the World Health Organization���s Comprehensive Action Plan 2013���2020. In this paper, we review recent work that utilizes social media ���big data��� in...

  15. Providing health information to the general public: a survey of current practices in academic health sciences libraries.

    Science.gov (United States)

    Hollander, S M

    2000-01-01

    A questionnaire was mailed to 148 publicly and privately supported academic health sciences libraries affiliated with Association of American Medical Colleges (AAMC-accredited medical schools in the United States and Canada to determine level of access and services provided to the general public. For purposes of this study, "general public" was defined as nonaffiliated students or health care professionals, attorneys and other nonhealth-related professionals, patients from affiliated or other hospitals or clinics, and general consumers. One hundred five (71%) libraries responded. Results showed 98% of publicly supported libraries and 88% of privately supported libraries provided access to some or all of the general public. Publicly supported libraries saw greater numbers of public patrons, often provided more services, and were more likely to circulate materials from their collections than were privately supported libraries. A significant number of academic health sciences libraries housed a collection of consumer-oriented materials and many provided some level of document delivery service, usually for a fee. Most allowed the public to use some or all library computers. Results of this study indicated that academic health sciences libraries played a significant role in serving the information-seeking public and suggested a need to develop written policies or guidelines covering the services that will be provided to minimize the impact of this service on primary clientele.

  16. Providing health information to the general public: a survey of current practices in academic health sciences libraries*

    Science.gov (United States)

    Hollander, Sue M.

    2000-01-01

    A questionnaire was mailed to 148 publicly and privately supported academic health sciences libraries affiliated with Association of American Medical Colleges (AAMC)–accredited medical schools in the United States and Canada to determine level of access and services provided to the general public. For purposes of this study, “general public” was defined as nonaffiliated students or health care professionals, attorneys and other nonhealth-related professionals, patients from affiliated or other hospitals or clinics, and general consumers. One hundred five (71%) libraries responded. Results showed 98% of publicly supported libraries and 88% of privately supported libraries provided access to some or all of the general public. Publicly supported libraries saw greater numbers of public patrons, often provided more services, and were more likely to circulate materials from their collections than were privately supported libraries. A significant number of academic health sciences libraries housed a collection of consumer-oriented materials and many provided some level of document delivery service, usually for a fee. Most allowed the public to use some or all library computers. Results of this study indicated that academic health sciences libraries played a significant role in serving the information-seeking public and suggested a need to develop written policies or guidelines covering the services that will be provided to minimize the impact of this service on primary clientele. PMID:10658965

  17. Genetic discrimination in health insurance: current legal protections and industry practices.

    Science.gov (United States)

    Pollitz, Karen; Peshkin, Beth N; Bangit, Eliza; Lucia, Kevin

    2007-01-01

    Most states have enacted genetic nondiscrimination laws in health insurance, and federal legislation is pending in Congress. Scientists worry fear of discrimination discourages some patients from participating in clinical trials and hampers important medical research. This paper describes a study of medical underwriting practices in the individual health insurance market related to genetic information. Underwriters from 23 companies participated in a survey that asked them to underwrite four pairs of hypothetical applicants for health insurance. One person in each pair had received a positive genetic test result indicating increased risk of a future health condition--breast cancer, hemochromatosis, or heart disease--for a total of 92 underwriting decisions on applications involving genetic information. In seven of these 92 applications, underwriters said they would deny coverage, place a surcharge on premiums,or limit covered benefits based on an applicant's genetic information.

  18. Competition in health insurance markets: limitations of current measures for policy analysis.

    Science.gov (United States)

    Scanlon, Dennis P; Chernew, Michael; Swaminathan, Shailender; Lee, Woolton

    2006-12-01

    Health care reform proposals often rely on increased competition in health insurance markets to drive improved performance in health care costs, access, and quality. We examine a range of data issues related to the measures of health insurance competition used in empirical studies published from 1994-2004. The literature relies exclusively on market structure and penetration variables to measure competition. While these measures are correlated, the degree of correlation is modest, suggesting that choice of measure could influence empirical results. Moreover, certain measurement issues such as the lack of data on PPO enrollment, the treatment of small firms, and omitted market characteristics also could affect the conclusions in empirical studies. Importantly, other types of measures related to competition (e.g., the availability of information on price and outcomes, degree of entry barriers, etc.) are important from both a theoretical and policy perspective, but their impact on market outcomes has not been widely studied.

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

    DEFF Research Database (Denmark)

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

    2007-01-01

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

  20. Current and future health care professionals attitudes toward and knowledge of statistics: How confidence influences learning.

    Science.gov (United States)

    Baghi, Heibatollah; Kornides, Melanie L

    2013-01-01

    Health care professionals require some understanding of statistics to successfully implement evidence based practice. Developing competency in statistical reasoning is necessary for students training in health care administration, research, and clinical care. Recently, the interest in healthcare professional's attitudes toward statistics has increased substantially due to evidence that these attitudes can hinder professionalism developing an understanding of statistical concepts. In this study, we analyzed pre- and post-instruction attitudes towards and knowledge of statistics obtained from health science graduate students, including nurses and nurse practitioners, enrolled in an introductory graduate course in statistics (n = 165). Results show that the students already held generally positive attitudes toward statistics at the beginning of course. However, these attitudes-along with the students' statistical proficiency-improved after 10 weeks of instruction. The results have implications for curriculum design and delivery methods as well as for health professionals' effective use of statistics in critically evaluating and utilizing research in their practices.

  1. Current issues in the design of academic health sciences libraries: findings from three recent facility projects.

    Science.gov (United States)

    Nelson, Patricia P

    2003-07-01

    Planning a new health sciences library at the beginning of the twenty-first century is a tremendous challenge. Technology has radically changed the way libraries function in an academic environment and the services they provide. Some individuals question whether the library as place will continue to exist as information becomes increasingly available electronically. To understand how libraries resolve programming and building design issues, visits were made to three academic health sciences libraries that have had significant renovation or completed new construction. The information gathered will be valuable for planning a new library for the University of Colorado Health Sciences Center and may assist other health sciences librarians as they plan future library buildings.

  2. Journal abstracts from current research in the field of child and adolescent mental health.

    Science.gov (United States)

    Idemudia, Erhabor S

    2011-06-01

    Gonzales NA, Coxe S, Roosa MW, White RMB, Knight GP, Zeiders KH and Saenz D (2011) Economic hardship, neighborhood context, and parenting: Prospective effects on Mexican-American adolescent's mental health. American Journal of Community Psychology 47(1-2): 98-113 O'Kane D (2011) A phenomenological study of child and adolescent mental health consultation in primary care. Journal of Psychiatric and Mental Health Nursing 18(2): 185-188 Sentse M, Ormel J, Veenstra R, Verhulst FC and Oldehinkel AJ (2011) Child temperament moderates the impact of parental separation on adolescent mental health: The trails study. Journal of Family Psychology 25(1): 97-106 Leo RJ, Srinivasan SP and Parekh S (2011) The role of the mental health practitioner in the assessment and treatment of child and adolescent chronic pain. Child and Adolescent Mental Health 16(1): 2-8 James AC, Winmill L, Anderson C and Alfoadari K (2011) A preliminary study of an extension of a community dialectic behaviour therapy (DBT) programme to adolescents in the looked after care system. Child and Adolescent Mental Health 16(1): 9-13 Flouri E, Hickey J, Mavroveli S and Hurry J (2011) Adversity, emotional arousal, and problem behaviour in adolescence: The role of non-verbal cognitive ability as a resilience promoting factor. Child and Adolescent Mental Health 16(1): 22-29 Paradis AD, Giaconia RM, Reinherz HZ, Beardslee WR, Ward KE and Fitzmaurice GM (2011) Adolescent family factors promoting healthy adult functioning: A longitudinal community study. Child and Adolescent Mental Health 16(1): 30-37 Webster-Stratton C, Rinaldi J and Reid JM (2011) Long-term outcomes of Incredible Years parenting program: Predictors of adolescent adjustment. Child and Adolescent Mental Health 16(1): 38-46 Baruch G, Vrouva I and Wells C (2011) Outcome findings from a parent training programme for young people with conduct problems. Child and Adolescent Mental Health 16(1): 47-54 Davis Kenaley BL and Williams NJ (2011) A preliminary

  3. Serious Games and Gamification for Mental Health: Current Status and Promising Directions

    OpenAIRE

    Fleming, Theresa M.; Bavin, Lynda; Stasiak, Karolina; Hermansson-Webb, Eve; Merry, Sally N.; Cheek, Colleen; Lucassen, Mathijs; Lau, Ho Ming; Pollmuller, Britta; Hetrick, Sarah

    2017-01-01

    Computer games are ubiquitous and can be utilized for serious purposes such as health and education. ?Applied games? including serious games (in brief, computerized games for serious purposes) and gamification (gaming elements used outside of games) have the potential to increase the impact of mental health internet interventions via three processes. First, by extending the reach of online programs to those who might not otherwise use them. Second, by improving engagement through both game-ba...

  4. Current and future funding sources for specialty mental health and substance abuse treatment providers.

    Science.gov (United States)

    Levit, Katharine R; Stranges, Elizabeth; Coffey, Rosanna M; Kassed, Cheryl; Mark, Tami L; Buck, Jeffrey A; Vandivort-Warren, Rita

    2013-06-01

    Goals were to describe funding for specialty behavioral health providers in 1986 and 2005 and examine how the recession, parity law, and Affordable Care Act (ACA) may affect future funding. Numerous public data sets and actuarial methods were used to estimate spending for services from specialty behavioral health providers (general hospital specialty units; specialty hospitals; psychiatrists; other behavioral health professionals; and specialty mental health and substance abuse treatment centers). Between 1986 and 2005, hospitals-which had received the largest share of behavioral health spending-declined in importance, and spending shares trended away from specialty hospitals that were largely funded by state and local governments. Hospitals' share of funding from private insurance decreased from 25% in 1986 to 12% in 2005, and the Medicaid share increased from 11% to 23%. Office-based specialty providers continued to be largely dependent on private insurance and out-of-pocket payments, with psychiatrists receiving increased Medicaid funding. Specialty centers received increased funding shares from Medicaid (from 11% to 29%), and shares from other state and local government sources fell (from 64% to 46%). With ACA's full implementation, spending on behavioral health will likely increase under private insurance and Medicaid. Parity in private plans will also push a larger share of payments for office-based professionals from out-of-pocket payments to private insurance. As ACA provides insurance for formerly uninsured individuals, funding by state behavioral health authorities of center-based treatment will likely refocus on recovery and support services. Federal Medicaid rules will increase in importance as more people needing behavioral health treatment become covered.

  5. 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.

  6. 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)

  7. Relationships between work-related factors and musculoskeletal health with current and future work ability among male workers.

    Science.gov (United States)

    Boschman, J S; Noor, A; Lundström, R; Nilsson, T; Sluiter, J K; Hagberg, M

    2017-08-01

    The purpose was to increase job-specific knowledge about individual and work-related factors and their relationship with current and future work ability (WA). We studied cross-sectional relationships between mental demands, physical exertion during work, grip strength, musculoskeletal pain in the upper extremities and WA and the relationships between these variables and WA 11 years later. We used a dataset of a prospective cohort study (1997-2008) among employees of an engineering plant (n = 157). The cohort was surveyed by means of tests and written questions on work demands, musculoskeletal health, WA score (WAS; 0-10), and mental and physical WA. Spearman correlation coefficients and logistic regression analysis were used. Among manual workers, we found weak correlations between grip strength and current and future physical WA. We did not find predictors for future poor WA among the manual workers. Among the office workers, we found that musculoskeletal pain was moderately and negatively related to current WAS and physical WA. More handgrip strength related to better future WAS and physical WA. Musculoskeletal pain (OR 1.67 p health and work ability depending on occupation. However, the present implies that predicting work ability in the far future based on health surveillance data is rather difficult. Testing the musculoskeletal system (grip strength) and asking workers' about their musculoskeletal health seems relevant when monitoring work ability.

  8. Health care justice and its implications for current policy of a mandatory waiting period for elective tubal sterilization.

    Science.gov (United States)

    Moaddab, Amirhossein; McCullough, Laurence B; Chervenak, Frank A; Fox, Karin A; Aagaard, Kjersti Marie; Salmanian, Bahram; Raine, Susan P; Shamshirsaz, Alireza A

    2015-06-01

    Tubal sterilization during the immediate postpartum period is 1 of the most common forms of contraception in the United States. This time of the procedure has the advantage of 1-time hospitalization, which results in ease and convenience for the woman. The US Collaborative Review of Sterilization Study indicates the high efficacy and effectiveness of postpartum tubal sterilization. Oral and written informed consent is the ethical and legal standard for the performance of elective tubal sterilization for permanent contraception for all patients, regardless of source of payment. Current health care policy and practice regarding elective tubal sterilization for Medicaid beneficiaries places a unique requirement on these patients and their obstetricians: a mandatory waiting period. This requirement originates in decades-old legislation, which we briefly describe. We then introduce the concept of health care justice in professional obstetric ethics and explain how it originates in the ethical concepts of medicine as a profession and of being a patient and its deontologic and consequentialist dimensions. We next identify the implications of health care justice for the current policy of a mandatory 30-day waiting period. We conclude that Medicaid policy allocates access to elective tubal sterilization differently, based on source of payment and gender, which violates health care justice in both its deontologic and consequentialist dimensions. Obstetricians should invoke health care justice in women's health care as the basis for advocacy for needed change in law and health policy, to eliminate health care injustice in women's access to elective tubal sterilization. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Current understandings and perspectives on non-cancer health effects of benzene: A global concern

    Energy Technology Data Exchange (ETDEWEB)

    Bahadar, Haji [International Campus, Tehran University of Medical Sciences (Iran, Islamic Republic of); Pharmaceutical Sciences Research Center and Faculty of Pharmacy, Tehran University of Medical Sciences (Iran, Islamic Republic of); Mostafalou, Sara [Pharmaceutical Sciences Research Center and Faculty of Pharmacy, Tehran University of Medical Sciences (Iran, Islamic Republic of); Abdollahi, Mohammad, E-mail: Mohammad.Abdollahi@UToronto.Ca [Pharmaceutical Sciences Research Center and Faculty of Pharmacy, Tehran University of Medical Sciences (Iran, Islamic Republic of)

    2014-04-15

    Objective: Benzene, as a volatile organic compound, is known as one of the main air pollutants in the environment. The aim of this review is to summarize all available evidences on non-cancerous health effects of benzene providing an overview of possible association of exposure to benzene with human chronic diseases, specially, in those regions of the world where benzene concentration is being poorly monitored. Methodology: A bibliographic search of scientific databases including PubMed, Google Scholar, and Scirus was conducted with key words of “benzene toxic health effects”, “environmental volatile organic compounds”, “diabetes mellitus and environmental pollutants”, “breast cancer and environmental pollution”, “prevalence of lung cancer”, and “diabetes prevalence”. More than 300 peer reviewed papers were examined. Experimental and epidemiologic studies reporting health effects of benzene and volatile organic compounds were included in the study. Results: Epidemiologic and experimental studies suggest that benzene exposure can lead to numerous non-cancerous health effects associated with functional aberration of vital systems in the body like reproductive, immune, nervous, endocrine, cardiovascular, and respiratory. Conclusion: Chronic diseases have become a health burden of global dimension with special emphasis in regions with poor monitoring over contents of benzene in petrochemicals. Benzene is a well known carcinogen of blood and its components, but the concern of benzene exposure is more than carcinogenicity of blood components and should be evaluated in both epidemiologic and experimental studies. Aspect of interactions and mechanism of toxicity in relation to human general health problems especially endocrine disturbances with particular reference to diabetes, breast and lung cancers should be followed up. - Highlights: • Benzene is a volatile organic compound and established blood carcinogen. • Exposure to benzene needs to be

  10. Examples of Holistic Good Practices in Promoting and Protecting Mental Health in the Workplace: Current and Future Challenges.

    Science.gov (United States)

    Sivris, Kelly C; Leka, Stavroula

    2015-12-01

    While attention has been paid to physical risks in the work environment and the promotion of individual employee health, mental health protection and promotion have received much less focus. Psychosocial risk management has not yet been fully incorporated in such efforts. This paper presents good practices in promoting mental health in the workplace in line with World Health Organization (WHO) guidance by identifying barriers, opportunities, and the way forward in this area. Semistructured interviews were conducted with 17 experts who were selected on the basis of their knowledge and expertise in relation to good practice identified tools. Interviewees were asked to evaluate the approaches on the basis of the WHO model for healthy workplaces. The examples of good practice for Workplace Mental Health Promotion (WMHP) are in line with the principles and the five keys of the WHO model. They support the third objective of the WHO comprehensive mental health action plan 2013-2020 for multisectoral implementation of WMHP strategies. Examples of good practice include the engagement of all stakeholders and representatives, science-driven practice, dissemination of good practice, continual improvement, and evaluation. Actions to inform policies/legislation, promote education on psychosocial risks, and provide better evidence were suggested for higher WMHP success. The study identified commonalities in good practice approaches in different countries and stressed the importance of a strong policy and enforcement framework as well as organizational responsibility for WMHP. For progress to be achieved in this area, a holistic and multidisciplinary approach was unanimously suggested as a way to successful implementation.

  11. Discounting of qualitatively different delayed health outcomes in current and never smokers

    Science.gov (United States)

    Friedel, Jonathan E.; DeHart, William B.; Frye, Charles C. J.; Rung, Jillian M.; Odum, Amy L.

    2016-01-01

    In delay discounting, temporally remote outcomes have less value. Cigarette smoking is associated with steeper discounting of money and consumable outcomes. It is presently unclear whether smokers discount health outcomes more than non-smokers. We sought to establish the generality of steep discounting for different types of health outcomes in cigarette smokers. Seventy participants (38 smokers and 32 non-smokers) completed four hypothetical outcome delay-discounting tasks: a gain of $500, a loss of $500, a temporary boost in health, and temporary cure from a debilitating disease. Participants reported the duration of each health outcome that would be equivalent to $500; these durations were then used in the respective discounting tasks. Delays ranged from 1 week to 25 years. Smokers’ indifference points for monetary gains, boosts in health, and temporary cures were lower than indifference points from non-smokers. Indifference points of one outcome were correlated with indifference points of other outcomes. Smokers demonstrate steeper discounting across a range of delayed outcomes. How a person discounts one outcome predicts how they will discount other outcomes. These two findings support our assertion that delay discounting is in part a trait. PMID:26691848

  12. Current trends in the health of children and young people in learning environments

    Directory of Open Access Journals (Sweden)

    S.V. Garkusha

    2013-10-01

    Full Text Available Determined by the dynamics in the health of students and medical teams consisting of physical training in secondary schools. Analyzed the records in-depth inspection of magazines and leaflets health of 32484 schoolchildren of Chernigov for the period 2008-2012. Established a steady trend to a significant deterioration in the health of schoolchildren. A decline in the number of healthy children with the increase in the period of study from 1 to 11. Revealed negative trend decline in the health of children in the main medical group. Shows a tendency to increase the number of children belonging to the preparatory and special medical groups. It is recommended to use a recreational form of physical education and health educational use of technology. It is recommended to include in the training sessions: gymnastics, gymnastic minutes during lessons, exercise, and outdoor games on the elongated recess and daily physical education classes in the extended day, independent study after school, sports and mass work in the community.

  13. Global health training and international clinical rotations during residency: current status, needs, and opportunities.

    Science.gov (United States)

    Drain, Paul K; Holmes, King K; Skeff, Kelley M; Hall, Thomas L; Gardner, Pierce

    2009-03-01

    Increasing international travel and migration have contributed to globalization of diseases. Physicians today must understand the global burden and epidemiology of diseases, the disparities and inequities in global health systems, and the importance of cross-cultural sensitivity. To meet these needs, resident physicians across all specialties have expressed growing interest in global health training and international clinical rotations. More residents are acquiring international experience, despite inadequate guidance and support from most accreditation organizations and residency programs. Surveys of global health training, including international clinical rotations, highlight the benefits of global health training as well as the need for a more coordinated approach. In particular, international rotations broaden a resident's medical knowledge, reinforce physical examination skills, and encourage practicing medicine among underserved and multicultural populations. As residents recognize these personal and professional benefits, a strong majority of them seek to gain international clinical experience. In conclusion, with feasible and appropriate administrative steps, all residents can receive global health training and be afforded the accreditation and programmatic support to participate in safe international rotations. The next steps should address accreditation for international rotations and allowance for training away from continuity clinics by residency accreditation bodies, and stipend and travel support for six or more weeks of call-free elective time from residency programs.

  14. Current evidence on physiological activity and expected health effects of kombucha fermented beverage.

    Science.gov (United States)

    Vīna, Ilmāra; Semjonovs, Pāvels; Linde, Raimonds; Deniņa, Ilze

    2014-02-01

    Consumption of kombucha fermented tea (KT) has always been associated with different health benefits. Many personal experiences and testimonials of KT drinkers are available throughout the world on the ability of KT to protect against a vast number of metabolic and infectious diseases, but very little scientific evidence is available that validates the beneficial effects of KT. The aim of this review is to give an overview of the recent studies in search of experimental confirmation of the numerous KT health-promoting aspects cited previously. Analysis of the literature data is carried out in correspondence to the recent concepts of health protection's requirements. Attention is given to the active compounds in KT, responsible for the particular effect, and to the mechanisms of their actions. It is shown that KT can efficiently act in health prophylaxis and recovery due to four main properties: detoxification, antioxidation, energizing potencies, and promotion of depressed immunity. The recent experimental studies on the consumption of KT suggest that it is suitable for prevention against broad-spectrum metabolic and infective disorders. This makes KT attractive as a fermented functional beverage for health prophylaxis.

  15. [Is it possible to improve the preventive usefulness of workers' health surveillance in the current regulatory framework?

    Science.gov (United States)

    Rodríguez Jareño, Mari Cruz; De Montserrat I Nonó, Jaume

    In Spain, the limited preventive usefulness of health surveillance is determined by the indiscriminate use of nonspecific "generic" health examinations aimed at producing a "fitness for work list", presumably allowing companies to comply with health and safety regulations. This study aimed to produce a technical interpretation of the Spanish Prevention of Risks at Work Act and propose a new conceptual framework to favour greater preventive usefulness of health surveillance within the current regulatory framework. Using qualitative techniques of content analysis, the text of the Law was studied, the key concepts that impeded the fulfilment of the preventive objectives of health surveillance were identified, and a technical interpretation adjusted to regulations was made in order to propose a new conceptual framework RESULTS: This conceptual framework would include: clearly differentiating health surveillance from health examinations (one of its instruments) and from fitness for work evaluations (an independent concept in itself); restricting mandatory health surveillance to situations in which it is "imperative" to carry it out because of the existence of a substantial risk to workers or third parties, including potentially vulnerable workers; and communicating the results of health surveillance through preventive recommendations to the company, reserving fitness for duty certificates -always based on clear, pre-established and justified criteria in relation to risk- for mandatory surveillance. The proposed new conceptual framework falls within the scope of the Spanish Prevention of Risks at Work Act, and its implementation could contribute to improving the preventive usefulness of health surveillance without the need to reform the legislation. Copyright belongs to the Societat Catalana de Salut Laboral.

  16. 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 tracti