WorldWideScience

Sample records for health days approach

  1. WORLD HEALTH DAY THEMES

    Directory of Open Access Journals (Sweden)

    S C Saxena

    2003-06-01

    Full Text Available 1970 - Early Detection of Cancer Saves Life. 1971- A Full Life Despite Diabetes. 1972 - Your Heart is Your Health. 1973 - Health Begins at Home. 1974- Better Food for a Healthier World. 1975 - Small Pox - Point of no Return. 1976 - Foresight Prevents Blindness. 1977 - Immunise and Protect Your Child. 1978 - Down With High Blood Pressure. 1979     - A Health Child-A Sure Future. 1980     - Smoking or Health - The Choice is Yours. 1981     - Health for all for by the Year 2000. 1982     - Add Years to Life. 1983     - Health for all by 2000 - The Count Down has Begun 1984     - Children’s Health: Tomorrows Wealth. 1985     - Health Youth : Our best Resource. 1986     - Health Living - Everyone a Winner. 1987     - Immunisation - A Chance for Every Child. 1988     - Health For All - All for Health. 1989-Let’s Talk Health. 1990    - Our Planet - Ourhealth; Think Globally, Act Locally. 1991    - Should Disaster Strike - Be Prepared. 1992    - Health Beat - The Rhythm of Life. 1993    - Handle Life with Care - Prevent Violence and Negligence. 1994    - Our Health for a Healthy Life. 1995    - Target - 2000 - A World Without Polio. 1996    - Healthy Cities for Better Life. 1997    - Emerging Infectious Diseases. 1998    - Safe Motherhood. 1999 - Active Ageing Makes the Difference. 2000 - Be a Life Saver, Be a Blood Doner; Blood Saves Life. 2001- Stop Exclusion, Dare to Care. 2002 - Move for Health. - Shape the Future of Life, Healthy Environments for Children

  2. WORLD HEALTH DAY THEMES

    Directory of Open Access Journals (Sweden)

    S C Saxena

    2003-06-01

    Full Text Available 1970     - Early Detection of Cancer Saves Life.1971     - A Full Life Despite Diabetes.1972     - Your Heart is Your Health.1973     - Health Begins at Home.1974     - Better Food for a Healthier World.1975     - Small Pox - Point of no Return.1976     - Foresight Prevents Blindness.1977     - Immunise and Protect Your Child.1978     - Down With High Blood Pressure.1979     - A Health Child-A Sure Future.1980     - Smoking or Health - The Choice is Yours.1981     - Health for all for by the Year 2000.1982     - Add Years to Life.1983     - Health for all by 2000 - The Count Down has Begun1984     - Children’s Health: Tomorrows Wealth.1985     - Health Youth : Our best Resource.1986     - Health Living - Everyone a Winner.1987     - Immunisation - A Chance for Every Child.1988     - Health For All - All for Health.1989-Let’s Talk Health.1990    - Our Planet - Ourhealth; Think Globally, Act Locally.1991    - Should Disaster Strike - Be Prepared.1992    - Health Beat - The Rhythm of Life.1993    - Handle Life with Care - Prevent Violence and Negligence.1994    - Our Health for a Healthy Life.1995    - Target - 2000 - A World Without Polio.1996    - Healthy Cities for Better Life.1997    - Emerging Infectious Diseases.1998    - Safe Motherhood.1999    - Active Ageing Makes the Difference.2000     - Be a Life Saver, Be a Blood Doner; Blood Saves Life.2001     - Stop Exclusion, Dare to Care.2002     - Move for Health.- Shape the Future of Life, Healthy Environments for Children

  3. 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.

  4. Health status of Seventh-Day Adventists.

    Science.gov (United States)

    Webster, I W; Rawson, G K

    1979-05-19

    A comparison of health status between 779 Seventh-day Adventists, who have a strong commitment to heal-related life styles, and two other groups of people--8363 persons referred by general practitioners and 9825 volunteers--was made. The Seventh-day Adventists showed less impairment of systolic and diastolic blood pressures, of plasma cholesterol and plasma urate concentrations, and of lung ventilatory capacity; and less obesity at most specific ages. With increasing age, the level of breathlessness, reported heart disease, hypertension, and hypertensive and diuretic therapy in this sample approached that of the comparative groups, possibly because of natural attrition of high-risk persons in the latter. Depression, sleeplessness, use of sedatives and tranquillizers were lower in the Seventh-day Adventists; although, once again, a drawing together of the three groups in older age categories was evident. It is concluded that the life style of Seventh-day Adventists is conducive to lessened morbidity, delayed mortality, and decreased call on health services in comparison with the general population.

  5. 'Disaster day': global health simulation teaching.

    Science.gov (United States)

    Mohamed-Ahmed, Rayan; Daniels, Alex; Goodall, Jack; O'Kelly, Emily; Fisher, James

    2016-02-01

    As society diversifies and globalisation quickens, the importance of teaching global health to medical undergraduates increases. For undergraduates, the majority of exposure to 'hands-on' teaching on global health occurs during optional elective periods. This article describes an innovative student-led initiative, 'Disaster Day', which used simulation to teach global health to undergraduates. The teaching day began with an introduction outlining the work of Médecins Sans Frontières and the basic principles of resuscitation. Students then undertook four interactive simulation scenarios: Infectious Diseases in a Refugee Camp, Natural Disaster and Crush Injury, Obstetric Emergency in a Low-Income Country, and Warzone Gunshot Wound. Sessions were facilitated by experienced doctors and fourth-year students who had been trained in the delivery of the scenarios. Students completed pre- and post-session evaluation forms that included the self-rating of confidence in eight learning domains (using a five-point Likert scale). Twenty-seven students voluntarily attended the session, and all provided written feedback. Analysis of the pre- and post-session evaluations demonstrated statistically significant improvements in confidence across all but one domains (Wilcoxon signed rank test). Free-text feedback was overwhelmingly positive, with students appreciating the practical aspect of the scenarios. For undergraduates, the majority of exposure to 'hands-on' teaching on global health occurs during optional elective periods Simulation-based teaching can provide students with 'hands-on' exposure to global health in a controlled, reproducible fashion and appears to help develop their confidence in a variety of learning domains. The more widespread use of such teaching methods is encouraged: helping tomorrow's doctors develop insight into global health challenges may produce more rounded clinicians capable of caring for more culturally diverse populations. © 2015 John Wiley & Sons

  6. [Towards safe motherhood. World Health Day].

    Science.gov (United States)

    Plata, M I

    1998-06-01

    The objective of the 'safe motherhood' initiative is to reduce maternal mortality by 50% by the year 2000. A strong policy is needed to permit development of national and international programs. The lifetime risk of death from causes related to complications of pregnancy is estimated at 1/16 in Africa, 1/65 in Asia, 1/130 in Latin America and the Caribbean, 1/1400 in Europe, and 1/3700 in North America. A minimum of 585,000 women die of maternal causes each year, with nearly 90% of the deaths occurring in Asia and Africa. Approximately 50 million women suffer from illnesses related to childbearing. A principal cause of maternal mortality is lack of medical care during labor, delivery, and the postpartum period. Motherhood will become safe if governments, multilateral and bilateral funding agencies, and nongovernmental organizations give it the high priority it requires. Women also die because they lack rights. Their reduced decision-making power and inequitable access to family and social resources prevents them from overcoming barriers to health care. Women die when they begin childbearing at a very young age, yet an estimated 11% of births throughout the world each year are to adolescents. Adolescents have very limited access to family planning, either through legal restrictions or obstacles created by family planning workers. Maternal deaths would be avoided if all births were attended by trained health workers; an estimated 60 million births annually are not. Prevention of unwanted pregnancy and, thus, of the 50 million abortions estimated to take place each year would avoid over 200 maternal deaths each day. Unsafe abortions account for 13% of maternal deaths. The evidence demonstrates that rates of unsafe abortion and abortion mortality are higher where laws are more restrictive.

  7. D-day for mental health.

    Science.gov (United States)

    2005-02-16

    THERE COULD be no better time for a review of mental health nursing. It is 11 years since the last one, which in itself suggests change must be overdue if professional practice is to keep pace with health service reforms. As the largest professional group in mental health care, nurses will be relied on to deliver the reforms outlined in the Mental Health Bill, as well as the measures to improve race equality in the service. Nurses will also be promoting good mental health as outlined in last autumn's public health white paper. All these initiatives can only benefit from the chance to take stock.

  8. Celebrating UNAM-Oshakati Campus health day/world health day: a community service: professional and personal life experiences

    OpenAIRE

    Lusia N. Ndahambelela Pinehas; NN. Shifiona; KKI. Shikongo

    2013-01-01

    Background: The University of Namibia-Oshakati Campus has a tradition to celebrate UNAM Health Day which coincided with the World Health Day annually. The day had always been celebrated within the Oshakati Campus premises. Nurse lecturers from the School of Nursing and Public Health always decide on the activities of the day and they volunteered themselves to take part in the event. The activities conducted were such as blood pressure monitoring, taking of weigh and giving general health edu...

  9. 76 FR 62295 - Child Health Day, 2011

    Science.gov (United States)

    2011-10-07

    ... based on pre-existing conditions. Getting children off to a healthy start at home and at school is vital... Challenge, thousands of child care providers are adopting healthier practices, and 1.7 million Americans... health professionals, faith-based and community organizations, and all levels of government to help...

  10. 77 FR 60617 - Child Health Day, 2012

    Science.gov (United States)

    2012-10-04

    ... healthy communities, we are working to reduce contaminants in our drinking water by updating standards and better protecting our water sources from pollution. We are also building on the successes of the Clean..., child health professionals, faith-based and community organizations, and all levels of government to...

  11. Feeling old today? Daily health, stressors, and affect explain day-to-day variability in subjective age.

    Science.gov (United States)

    Kotter-Grühn, Dana; Neupert, Shevaun D; Stephan, Yannick

    2015-01-01

    Subjective age is an important correlate of health, well-being, and longevity. So far, little is known about short-term variability in subjective age and the circumstances under which individuals feel younger/older in daily life. This study examined whether (a) older adults' felt age fluctuates on a day-to-day basis, (b) daily changes in health, stressors, and affect explain fluctuations in felt age, and (c) the daily associations between felt age and health, stressors, or affect are time-ordered. Using an eight-day daily diary approach, N = 43 adults (60-96 years, M = 74.65, SD = 8.19) filled out daily questionnaires assessing subjective age, health, daily stressors, and affect. Data were analysed using multilevel modelling. Subjective age, health, daily stressors, affect. Intra-individual variability in felt age was not explained by time but by short-term variability in other variables. Specifically, on days when participants experienced more than average health problems, stress, or negative affect they felt older than on days with average health, stress, or negative affect. No time-ordered effects were found. Bad health, many stressors, and negative affective experiences constitute circumstances under which older adults feel older than they typically do. Thus, daily measures of subjective age could be markers of health and well-being.

  12. Health: An Ecosystem Approach

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

    In the early days, the research supported was largely biomedical: vaccines, ... editor of Découvrir magazine in Montréal, who produced the first draft of the book, ...... Their transdisciplinary approach included gender-specific parameters. ..... Over time, some progress was made against malaria, but the war was far from won.

  13. Predicting 30-Day Pneumonia Readmissions Using Electronic Health Record Data.

    Science.gov (United States)

    Makam, Anil N; Nguyen, Oanh Kieu; Clark, Christopher; Zhang, Song; Xie, Bin; Weinreich, Mark; Mortensen, Eric M; Halm, Ethan A

    2017-04-01

    Readmissions after hospitalization for pneumonia are common, but the few risk-prediction models have poor to modest predictive ability. Data routinely collected in the electronic health record (EHR) may improve prediction. To develop pneumonia-specific readmission risk-prediction models using EHR data from the first day and from the entire hospital stay ("full stay"). Observational cohort study using stepwise-backward selection and cross-validation. Consecutive pneumonia hospitalizations from 6 diverse hospitals in north Texas from 2009-2010. All-cause nonelective 30-day readmissions, ascertained from 75 regional hospitals. Of 1463 patients, 13.6% were readmitted. The first-day pneumonia-specific model included sociodemographic factors, prior hospitalizations, thrombocytosis, and a modified pneumonia severity index; the full-stay model included disposition status, vital sign instabilities on discharge, and an updated pneumonia severity index calculated using values from the day of discharge as additional predictors. The full-stay pneumonia-specific model outperformed the first-day model (C statistic 0.731 vs 0.695; P = 0.02; net reclassification index = 0.08). Compared to a validated multi-condition readmission model, the Centers for Medicare and Medicaid Services pneumonia model, and 2 commonly used pneumonia severity of illness scores, the full-stay pneumonia-specific model had better discrimination (C statistic range 0.604-0.681; P pneumonia. This approach outperforms a first-day pneumonia-specific model, the Centers for Medicare and Medicaid Services pneumonia model, and 2 commonly used pneumonia severity of illness scores. Journal of Hospital Medicine 2017;12:209-216. © 2017 Society of Hospital Medicine

  14. Stennis Space Center observes 2009 Safety and Health Day

    Science.gov (United States)

    2009-01-01

    Sue Smith, a medical clinic employee at NASA's John C. Stennis Space Center, takes the temperature of colleague Karen Badon during 2009 Safety and Health Day activities Oct. 22. Safety Day activities included speakers, informational sessions and a number of displays on safety and health issues. Astronaut Dominic Gorie also visited the south Mississippi rocket engine testing facility during the day to address employees and present several Silver Snoopy awards for outstanding contributions to flight safety and mission success. The activities were part of an ongoing safety and health emphasis at Stennis.

  15. Day-to-day variations in health behaviors and daily functioning: two intensive longitudinal studies.

    Science.gov (United States)

    Flueckiger, Lavinia; Lieb, Roselind; Meyer, Andrea H; Witthauer, Cornelia; Mata, Jutta

    2017-04-01

    In two intensive longitudinal studies we examined the daily dynamics in health behaviors and their associations with two important indicators of young adults' daily functioning, namely, affect and academic performance. Over a period of 8 months, university students (Study 1: N = 292; Study 2: N = 304) reported sleep, physical activity, snacking, positive and negative affect, and learning goal achievement. A subsample wore an actigraph to provide an additional measurement of sleep and physical activity and participated in a controlled laboratory snacking situation. Multilevel structural equation models showed that better day-to-day sleep quality or more physical activity than usual, but not snacking, were associated with improved daily functioning, namely, affect and learning goal achievement. Importantly, self-report measurements of health behaviors correlated with behavioral measurements. These findings have the potential to inform health promotion programs aimed at supporting young adults in their daily functioning in good physical and mental health.

  16. Day-to-day inconsistency in parent knowledge: links with youth health and parents' stress.

    Science.gov (United States)

    Lippold, Melissa A; McHale, Susan M; Davis, Kelly D; Kossek, Ellen Ernst

    2015-03-01

    Considerable evidence documents the linkages between higher levels of parental knowledge about youth activities and positive youth outcomes. This study investigated how day-to-day inconsistency in parental knowledge of youth activities was linked to youth behavioral, psychological, and physical health and parents' stress. Participants were employees in the Information Technology Division of a Fortune 500 company and their children (N = 129, mean age of youth = 13.39 years, 55% female). Data were collected from parents and youth via separate workplace and in-home surveys as well as telephone diary surveys on eight consecutive evenings. We assessed day-to-day inconsistency in parental knowledge across these eight calls. Parents differed in their knowledge from day to day almost as much as their average knowledge scores differed from those of other parents. Controlling for mean levels of knowledge, youth whose parents exhibited more knowledge inconsistency reported more physical health symptoms (e.g., colds and flu). Knowledge inconsistency was also associated with more risky behavior for girls but greater psychological well-being for older adolescents. Parents who reported more stressors also had higher knowledge inconsistency. Assessing only average levels of parental knowledge does not fully capture how this parenting dimension is associated with youth health. Consistent knowledge may promote youth physical health and less risky behavior for girls. Yet knowledge inconsistency also may reflect normative increases in autonomy as it was positively associated with psychological well-being for older adolescents. Given the linkages between parental stress and knowledge inconsistency, parent interventions should include stress management components. Copyright © 2015 Society for Adolescent Health and Medicine. Published by Elsevier Inc. All rights reserved.

  17. Day-to-Day Inconsistency in Parent Knowledge: Links with Youth Health and Parents’ Stress

    Science.gov (United States)

    Lippold, Melissa A.; McHale, Susan M.; Davis, Kelly D.; Kossek, Ellen Ernst

    2015-01-01

    Purpose Considerable evidence documents the linkages between higher levels of parental knowledge about youth activities and positive youth outcomes. This study investigated how day-to-day inconsistency in parental knowledge of youth activities was linked to youth behavioral, psychological, and physical health as well as parents’ stress. Methods Participants were employees in the Information Technology division of a Fortune 500 company and their children (N =129, Mean age youth = 13.39 years, 55% female). Data were collected from parents and youth via separate workplace and in-home surveys as well as telephone diary surveys on 8 consecutive evenings. We assessed day-to-day inconsistency in parental knowledge across these eight calls. Results Parents differed in their knowledge from day to day almost as much as their average knowledge scores differed from those of other parents. Controlling for mean levels of knowledge, youth whose parents exhibited more knowledge inconsistency reported more physical health symptoms (e.g., colds, flu). Knowledge inconsistency was also associated with more risky behavior for girls but greater psychological well-being for older adolescents. Parents who reported more stressors also had higher knowledge inconsistency. Conclusions Assessing only average levels of parental knowledge does not fully capture how this parenting dimension is associated with youth health. Consistent knowledge may promote youth physical health and less risky behavior for girls. Yet knowledge inconsistency also may reflect normative increases in autonomy as it was positively associated with psychological well-being for older adolescents. Given the linkages between parental stress and knowledge inconsistency, parent interventions should include stress-management components. PMID:25703318

  18. [Work days lost due to health problems in industry].

    Science.gov (United States)

    Yano, Sylvia Regina Trindade; Santana, Vilma Sousa

    2012-05-01

    This cross-sectional study estimated the prevalence of work days lost due to health problems and associated factors among industrial workers. The study population was a simple random cluster sample of 3,403 workers from 16 to 65 years of age in the city of Salvador, Bahia State, Brazil. Data were collected with individual home interviews. Among industrial workers, one-year prevalence of work days lost to health problems was 12.5%, of which 5.5% were directly work-related and 4.1% aggravated by work. There were no statistically significant differences when compared to other worker categories. Self-perceived workplace hazards, history of work-related injury, and poor self-rated health were associated with work days lost due to work-related injuries/diseases. The findings showed that work days lost are common among both industrial and non-industrial workers, thereby affecting productivity and requiring prevention programs.

  19. [Modern-day slavery as a public health issue].

    Science.gov (United States)

    Leão, Luís Henrique da Costa

    2016-12-01

    Modern-day slave labor is one of the most pernicious and persistent social problems in Brazil. In the light of the need to implement a national occupational health policy, this paper discusses slave labor as a public health concern, highlighting possibilities for broadening strategies for vigilance and comprehensive care for this specific working population. Exploratory qualitative research was carried out based on the "social construction of reality" proposed by Lenoir, Berger and Luckmann. The investigation consisted of a theoretical review of modern-day slave labor on the national and international scene within the scope of the human, social and public health sciences and an analysis of social and political practices to tackle modern-day slave labor was conducted in the State of Rio de Janeiro. Semi-structured individual and group interviews with workers and representatives of social movements and public institutions were organized. The results reveal the theoretical and practical dimensions of slave labor and its relations with the health field and highlight the role and potential of public health in the enhancing of vigilance practices and health care of workers subjected to these chronic social conditions.

  20. [Health agencies and the every day management of bioethics].

    Science.gov (United States)

    Byk, Christian

    2014-06-01

    Taking into account their acquired experience, would not health agencies become the place where biomedical practices will be managed on an every day basis? Would in a near future these agencies have the role to interprete the principles of the bioethics law to adapt them to concrete issues?

  1. Cancer and Complementary Health Approaches

    Science.gov (United States)

    ... According to the 2007 National Health Interview Survey (NHIS), which included a comprehensive survey on the use ... their use of complementary health approaches. In the NHIS, survey respondents who had been diagnosed with cancer ...

  2. World Day for Safety and Health at Work

    CERN Multimedia

    2012-01-01

    27 April is World Day for Safety and Health at Work.   CERN’s health and safety teams look forward to seeing you at their stands in each of the three restaurants. This year, we cast the spotlight on two topics: • ergonomics • electrical hazards. Come and get tips that will help you to ensure your safety and to stay healthy and, you never know, you might be lucky enough to win a nice prize. Don't forget, Friday, 27 April 2012 from 11:30 a.m. to 2:30 p.m. in your nearest restaurant!

  3. Human rights approach to health.

    Science.gov (United States)

    Haigh, Fiona

    2002-04-01

    Adopting human rights approach to health carries many benefits, because it emphasizes the equality of all persons and their inherent right to health as the foundation of the health care system. It also argues that promotion and protection of health are fundamentally important social goals, focuses particularly on the needs of the most disadvantaged and vulnerable communities, balances individual needs with the common good, and so forth. However, it also raises some practical issues, such as organization of interdisciplinary education and work, and different use of the language, which often goes unacknowledged. The relationship between human rights and health is a reciprocal one, and can be beneficial or harmful. For the relationship to be beneficial and successful, the differences between human rights and public health approach to health, centered around the perspective taking, attitudes, and abilities of health professionals, need to be acknowledged and reconciled, and the need for interdisciplinarity adequately fulfilled.

  4. Fibromyalgia and Complementary Health Approaches

    Science.gov (United States)

    ... Musculoskeletal and Skin Diseases Web site . What the Science Says About Complementary Health Approaches for Fibromyalgia Mind ... Complementary and alternative medical therapies in fibromyalgia . Current Pharmaceutical Design . 2006;12(1):47–57. Sherman KJ, ...

  5. Diabetes Dictating Policy: An Editorial Commemorating World Health Day 2016.

    Science.gov (United States)

    Takian, Amirhossein; Kazempour-Ardebili, Sara

    2016-06-18

    The 21st century is an era of great challenge for humankind; we are combating terrorism, climate change, poverty, human rights issues and last but not least non-communicable diseases (NCDs). The burden of the latter has become so large that it is being recognized by world leaders globally as an area that it is in need of much greater attention. In light of this concern, the World Health Organization (WHO) dedicated this year's World Health Day (held on April 7, 2016) to raising international awareness on diabetes, the fastest growing NCD in the world. This editorial is an account of the macro politics in place for fighting diabetes, both internationally and nationally. © 2016 by Kerman University of Medical Sciences.

  6. Diabetes Dictating Policy: An Editorial Commemorating World Health Day 2016

    Directory of Open Access Journals (Sweden)

    Amirhossein Takian

    2016-10-01

    Full Text Available The 21st century is an era of great challenge for humankind; we are combating terrorism, climate change, poverty, human rights issues and last but not least non-communicable diseases (NCDs. The burden of the latter has become so large that it is being recognized by world leaders globally as an area that it is in need of much greater attention. In light of this concern, the World Health Organization (WHO dedicated this year’s World Health Day (held on April 7, 2016 to raising international awareness on diabetes, the fastest growing NCD in the world. This editorial is an account of the macro politics in place for fighting diabetes, both internationally and nationally.

  7. Gravity wave control on ESF day-to-day variability: An empirical approach

    Science.gov (United States)

    Aswathy, R. P.; Manju, G.

    2017-06-01

    The gravity wave control on the daily variation in nighttime ionization irregularity occurrence is studied using ionosonde data for the period 2002-2007 at magnetic equatorial location Trivandrum. Recent studies during low solar activity period have revealed that the seed perturbations should have the threshold amplitude required to trigger equatorial spread F (ESF), at a particular altitude and that this threshold amplitude undergoes seasonal and solar cycle changes. In the present study, the altitude variation of the threshold seed perturbations is examined for autumnal equinox of different years. Thereafter, a unique empirical model, incorporating the electrodynamical effects and the gravity wave modulation, is developed. Using the model the threshold curve for autumnal equinox season of any year may be delineated if the solar flux index (F10.7) is known. The empirical model is validated using the data for high, moderate, and low solar epochs in 2001, 2004, and 1995, respectively. This model has the potential to be developed further, to forecast ESF incidence, if the base height of ionosphere is in the altitude region where electrodynamics controls the occurrence of ESF. ESF irregularities are harmful for communication and navigation systems, and therefore, research is ongoing globally to predict them. In this context, this study is crucial for evolving a methodology to predict communication as well as navigation outages.Plain Language SummaryThe manifestation of nocturnal ionospheric irregularities at magnetic equatorial regions poses a major hazard for communication and navigation systems. It is therefore essential to arrive at prediction methodologies for these irregularities. The present study puts forth a novel empirical model which, using only solar flux index, successfully differentiates between days with and without nocturnal ionization irregularity occurrence. The model-derived curve is obtained such that the days with and without occurrence of

  8. What you do every day matters: A new direction for health promotion.

    Science.gov (United States)

    Gewurtz, Rebecca E; Moll, Sandra E; Letts, Lori J; Larivière, Nadine; Levasseur, Mélanie; Krupa, Terry M

    2016-08-15

    Canadian health promotion campaigns directed towards healthy living have traditionally emphasized discrete behaviours that influence health and wellbeing, such as diet, physical activity and smoking. Although this traditional approach is important and supported by evidence, it does not account for broader determinants of health. The purpose of this commentary is to propose an innovative health promotion approach that expands the healthy living discourse through a focus on patterns of daily activity. We highlight four key public health messages derived from a synthesis of existing research evidence. The messages are based on the premise that what you do every day has an important impact on health and well-being. Rather than being prescriptive or outlining minimum requirements, this approach invites reflection on various experiences and activity patterns that shape the health and well-being of individuals and communities. This broader and more inclusive approach to healthy living reflects diverse needs and experiences, making it relevant and attainable for people of all ages and abilities. Future efforts directed at operationalizing the key messages for individuals and communities hold much promise for populations that may be at risk of activity patterns believed to contribute to poor health and well-being.

  9. 'Have a nice day': consumerism, compassion and health care.

    Science.gov (United States)

    Sturgeon, David

    Plans to implement a quality measurement framework that will rate nurses according to the level of care and compassion they demonstrate have been proposed and discussed in a number of Department of Health documents. From September 2010 degree-level nursing students in Wales will receive regular feedback on their communication skills and whether they are exhibiting sufficient levels of compassion. This article examines the reasons why there have been such moves by both politicians and health professionals to demonstrate, in quantifiable terms, that they are able to measure something that is frequently contextual and subject to individual interpretation. It explores how these moves have been influenced by the disclosure of unacceptable standards of care by the Patients Association report and the enquiry into Mid-Staffordshire NHS Foundation Trust. It also discusses how the adoption of targets to evaluate care and compassion seems to reflect a market-driven and bureaucratic approach to health care that has resulted in a system in which measurability and outcome are considered the most important indicator of quality.

  10. 'Mental health day' sickness absence amongst nurses and midwives: workplace, workforce, psychosocial and health characteristics.

    Science.gov (United States)

    Lamont, Scott; Brunero, Scott; Perry, Lin; Duffield, Christine; Sibbritt, David; Gallagher, Robyn; Nicholls, Rachel

    2017-05-01

    To examine the workforce, workplace, psychosocial and health characteristics of nurses and midwives in relation to their reported use of sickness absence described as 'mental health days'. The occupational stress associated with the nursing profession is increasingly recognized and nurse/midwifery absenteeism is a significant global problem. Taking a 'mental health day' as sickness absence is a common phenomenon in Australian health care. No previous studies have empirically explored the characteristics of nurses and midwives using such sickness absence. Online cross-sectional survey. Survey comprising validated tools and questions on workplace and health characteristics was distributed to nurses and midwives in New South Wales, Australia, between May 2014 - February 2015. Sample characteristics were reported using descriptive statistics. Factors independently predictive of 'mental health day' reportage were determined using logistic regression. Fifty-four percentage of the n = 5041 nurse and midwife respondents took 'mental health days'. Those affected were significantly more likely to be at younger ages, working shifts with less time sitting at work; to report workplace abuse and plans to leave; having been admitted to hospital in previous 12 months; to be current smokers; to report mental health problems, accomplishing less due to emotional problems and current psychotropic medication use. Specific characteristics of nurses and midwives who report taking 'mental health day' sickness absence offer healthcare administrators and managers opportunities for early identification and intervention with workplace measures and support frameworks to promote well-being, health promotion and safety. © 2016 The Authors. Journal of Advanced Nursing Published by John Wiley & Sons Ltd.

  11. Study The role of latent variables in lost working days by Structural Equation Modeling Approach

    Directory of Open Access Journals (Sweden)

    Meysam Heydari

    2016-12-01

    Full Text Available Background: Based on estimations, each year about 250 million work-related injuries and many temporary or permanent disabilities occur which most are preventable. Oil and Gas industries are among industries with high incidence of injuries in the world. The aim of this study has investigated  the role and effect of different risk management variables on lost working days (LWD in the seismic projects. Methods: This study was a retrospective, cross-sectional and systematic analysis, which was carried out on occupational accidents between 2008-2015(an 8 years period in different seismic projects for oilfield exploration at Dana Energy (Iranian Seismic Company. The preliminary sample size of the study were 487accidents. A systems analysis approach were applied by using root case analysis (RCA and structural equation modeling (SEM. Tools for the data analysis were included, SPSS23 and AMOS23  software. Results: The mean of lost working days (LWD, was calculated 49.57, the final model of structural equation modeling showed that latent variables of, safety and health training factor(-0.33, risk assessment factor(-0.55 and risk control factor (-0.61 as direct causes significantly affected of lost working days (LWD in the seismic industries (p< 0.05. Conclusion: The finding of present study revealed that combination of variables affected in lost working days (LWD. Therefore,the role of these variables in accidents should be investigated and suitable programs should be considered for them.

  12. Pediatric day case surgery: Experience from a tertiary health ...

    African Journals Online (AJOL)

    surgical service is in great demand in developing countries, and in-patient beds and surgical supplies are insufficient. Method: A ..... Day Case Surgery in Children in Ile-Ife, Nigeria-An Audit. ... as a clinical indicator for quality assurance.

  13. Management of severe childhood pneumonia by day care approach in developing countries

    Directory of Open Access Journals (Sweden)

    Yasmin Jahan

    2018-01-01

    Full Text Available Background: Background: Pneumonia is a major cause of child mortality among children under 5 years, worldwide. Pneumonia infection may be caused by bacteria, viruses, or fungi in single or in both lungs. According to recent criteria developed by the World Health Organization(WHO in September (2013, pneumonia can be classified into severe pneumonia, pneumonia and no pneumonia. Most of the deaths occur from severe pneumonia.Methods: Disease management of severe childhood pneumonia requires early identification,prompt referral and the availability of intensive quality care. Under 5 years old children with severe pneumonia should receive day care, with antibiotic treatment, feeding, and supportive care with similar 24-hour hospital treatment.Discussion: Considering that difficulties, International Centre for Diarrheal Disease Research,Bangladesh (ICDDR, B initiated Day Care Approach (DCA model, as an innovative, safe,effective and less expensive alternative to hospital management of severe childhood pneumonia.A 24 months old girl came to the health care center with severe breathing difficulty, cough,history of fever and head nodding. The management described below was continued daily until there was clinical improvement; no fever, no fast breathing, no lower chest wall in drawing, no danger signs, no rales on auscultation, and no hypoxemia. Conclusion: Considering the WHO case management protocol for severe pneumonia, DCA recommends that diagnosis of severe pneumonia should be based primarily on visible clinical parameters. On that basis, severe childhood pneumonia can be successfully managed at daycare clinics including for children with hypoxemia who is required prolong (4-6 hours oxygen therapy.

  14. Health Inequalities during the First 1000 days in EU and Nordic countries

    DEFF Research Database (Denmark)

    Robertson, Aileen

    2016-01-01

    -for-gestational age (LGA) newborns; furthermore, the prevalence of both breast-feeding rates and correct infant feeding practices is lower in mothers with low levels of education. Opportunities to reduce the social gradient in health inequalities in Nordic countries by intervening during the first 1000 days...... to breastfeed exclusively for 6 months. Moreover, it is key for parents to learn about “anticipatory feeding” methods and to know when, what and how much safe, nutritious foods to feed their infant. A more “joined up” health sector requires much better integration and communication between maternal and infant...... benefits. Central governments can initiate joined-up approaches through creating joint priorities and building social safety-nets for the most disadvantaged. This includes honouring pledges concerning the Convention of Rights of Child and other UN Resolutions, including the length of paid maternity leave...

  15. 78 FR 38996 - Proposed Collection; 60-Day Comment Request; Family Life, Activity, Sun, Health, and Eating...

    Science.gov (United States)

    2013-06-28

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health Proposed Collection; 60-Day Comment Request; Family Life, Activity, Sun, Health, and Eating (FLASHE) Study (NCI) Summary: In.... Proposed Collection: Family Life, Activity, Sun, Health, and Eating (FLASHE) Study 0925--NEW, National...

  16. Children and Complementary Health Approaches

    Science.gov (United States)

    ... review and meta-analysis. Annals of Allergy, Asthma & Immunology . 2014;112(6):503–510. Ethical Conduct of ... Print this page Health Topics A–Z Related Topics Complementary, Alternative, or Integrative Health: What’s In a ...

  17. Five fruit and vegetables and five praises a day: the case for a proactive approach.

    Science.gov (United States)

    Sutton, Carole; Herbert, Martin

    2008-04-01

    The government has adopted the five outcomes of Every Child Matters as guiding principles for all those caring for and working with children. One of the ways in which efforts are being made to help children achieve good physical health is to encourage them to eat 'five fruit and vegetables a day'. This article sets out the case that practitioners can help children achieve good mental health by encouraging parents and those who care for children to give them at least'five praises a day'. Babies are predisposed from birth to make close social and emotional attachments with their main caregivers, and typically receive generous and loving admiration and appreciation. However, we know that some parents may not understand how infants and toddlers continue to need active nurturing attention, praise and positive messages from those who care for them as they grow. The authors seek to develop their inter-professional campaign to extend the 'five fruit and vegetables a day' maxim to include'five praises a day' for children. Health visitors are uniquely placed to help parents, to explain and encourage the contribution that praise and positive feedback make toward children's general wellbeing and sound mental health.

  18. Day labor and occupational health: time to take a closer look.

    Science.gov (United States)

    Buchanan, Susan

    2004-01-01

    The term "day labor" refers to work performed by individuals who are hired on a temporary basis, often for one day at a time. This type of employment has increased in North America as informal work arrangements and immigration have increased. Research on the occupational health of day laborers is minimal. The objectives of this article are to review the current literature pertaining to occupational health in day laborers, and to characterize the issues that affect this population's access to occupational health services. Surveys of day laborers and other immigrant, low-wage workers show that they are at elevated risk for occupational injury and are often unable to access medical care when injured on the job. Reasons include workers' reluctance to complain about unsafe work conditions, inadequate safety training, and lack of incentive for employers to reduce workplace injuries. More research is needed to better characterize the occupational health of this population.

  19. Improving the efficiency of a chemotherapy day unit: Applying a business approach to oncology

    NARCIS (Netherlands)

    van Lent, W.A.M.; Goedbloed, N.; van Harten, Willem H.

    2009-01-01

    Aim: To improve the efficiency of a hospital-based chemotherapy day unit (CDU). - Methods: The CDU was benchmarked with two other CDUs to identify their attainable performance levels for efficiency, and causes for differences. Furthermore, an in-depth analysis using a business approach, called lean

  20. eHealth development: a holistic approach

    NARCIS (Netherlands)

    Lentferink, Aniek

    2016-01-01

    This presentation was held during the course 'eHealth development a holistic approach' at the University of Twente. The presentation included information about the project Quantified Self at Work and specifically the approach of co-creation during eHealth design with important stakeholders.

  1. Analyzing public health policy: three approaches.

    Science.gov (United States)

    Coveney, John

    2010-07-01

    Policy is an important feature of public and private organizations. Within the field of health as a policy arena, public health has emerged in which policy is vital to decision making and the deployment of resources. Public health practitioners and students need to be able to analyze public health policy, yet many feel daunted by the subject's complexity. This article discusses three approaches that simplify policy analysis: Bacchi's "What's the problem?" approach examines the way that policy represents problems. Colebatch's governmentality approach provides a way of analyzing the implementation of policy. Bridgman and Davis's policy cycle allows for an appraisal of public policy development. Each approach provides an analytical framework from which to rigorously study policy. Practitioners and students of public health gain much in engaging with the politicized nature of policy, and a simple approach to policy analysis can greatly assist one's understanding and involvement in policy work.

  2. "Ultra-rapid" sequential treatment in cholecystocholedocholithiasis: alternative same-day approach to laparoendoscopic rendezvous.

    Science.gov (United States)

    Borreca, Dario; Bona, Alberto; Bellomo, Maria Paola; Borasi, Andrea; De Paolis, Paolo

    2015-12-01

    There is still no consensus about timing of laparoscopic cholecystectomy after endoscopic retrograde cholangiopancreatography in the treatment of cholecystocholedocholithiasis. The aim of our retrospective study is to analyze the optimal timing of surgical treatment in patients presenting concurrent choledocholithiasis, choosing to perform a sequential endoscopic plus surgical approach, introducing a same-day two-stage alternative. All cases of cholecystocholedocholithiasis occurred between January 2007 and December 2014 in "Gradenigo" Hospital (Turin-Italy) were reviewed. Patients were divided into three groups, based on the timing of cholecystectomy after endoscopic retrograde cholangiopancreatography, and compared. Out of 2233 cholecystectomies performed in the mentioned time interval, have been identified 93 patients that fulfill the selection criteria. 36 patients were treated with a same-day approach, while 29 within first 72 h and 28 with delayed surgery. The overall length of stay was significantly lower in patients that were treated with a same-day approach (4.7 days), compared with other groups (p = 0.001), while no significant differences were found in terms of length of surgical intervention, intraoperative complications and conversions to open procedure, postoperative stay, morbidity and mortality. Patients treated with delayed surgery had a 18 % recurrency rate of biliary events, with an odds ratio of 14.13 (p = 0.018). Same-day two-stage approach should be performed in suitable patients at the index admission, reducing overall risks, improving the patients' quality-of-life, preventing recurrency, leading to a significant cost abatement; furthermore, this approach allows same outcomes of laparoendoscopic rendezvous, avoiding technical and organizational troubles.

  3. Paying for Complementary Health Approaches

    Science.gov (United States)

    ... Data from the 2012 National Health Interview Survey (NHIS) show that 33 percent of adults and almost ... 2 billion per year, according to the 2012 NHIS. This includes: $14.7 billion out-of-pocket ...

  4. Approaches to health assessment related to housing

    NARCIS (Netherlands)

    Guerra Santin, O.

    2006-01-01

    This research had the purpose of providing more information about possible approaches and indicators to measure indoor health in relation to housing. In researches related with health and some Life Cycle Assessment (LCA) databases, the model used for health assessment is the Impact Pathway Analysis

  5. CQI proiect Every other day nocturnal HHD - An alternative approach to reduce burden.

    Science.gov (United States)

    2016-08-01

    More frequent dialysis, typically performed five to six times per week at home, has been associated with a num- ber of clinical, cardiovascular, and health-related quality of life (HRQOL) benefits. Daily therapy often results in a burden for patients and care partners. A continuous qual- ity improvement (CQI) initiative was conducted to evaluate if an alternate day, longer duration therapy (3.5 treatments with six to 10 hour treatments per week) would provide a viable alternative for home hemodialysis (HHD). This initia- tive demonstrated that every other day (EOD) nocturnal HD is a feasible alternative option to daily HHD and should be considered to individualize home dialysis therapy.

  6. Health literacy and 30-day hospital readmission after acute myocardial infarction

    Science.gov (United States)

    Bailey, Stacy Cooper; Fang, Gang; Annis, Izabela E; O'Conor, Rachel; Paasche-Orlow, Michael K; Wolf, Michael S

    2015-01-01

    Objective To assess the validity of a predictive model of health literacy, and to examine the relationship between derived health literacy estimates and 30-day hospital readmissions for acute myocardial infarction (AMI). Design Retrospective cohort study. Setting and participants A National Institute of Aging (NIA) study cohort of 696 adult, English-speaking primary care patients, aged 55–74 years, was used to assess the validity of derived health literacy estimates. Claims from 7733 Medicare beneficiaries hospitalised for AMI in 2008 in North Carolina and Illinois were used to investigate the association between health literacy estimates and 30-day hospital readmissions. Measures The NIA cohort was administered 3 common health literacy assessments (Newest Vital Sign, Test of Functional Health Literacy in Adults, and Rapid Estimate of Adult Literacy in Medicine). Health literacy estimates at the census block group level were derived via a predictive model. 30-day readmissions were measured from Medicare claims data using a validated algorithm. Results Fair agreement was found between derived estimates and in-person literacy assessments (Pearson Correlation coefficients: 0.38–0.51; κ scores: 0.38–0.40). Medicare enrollees with above basic literacy according to derived health literacy estimates had an 18% lower risk of a 30-day readmission (RR=0.82, 95% CI 0.73 to 0.92) and 21% lower incidence rate of 30-day readmission (IRR=0.79, 95% CI 0.68 to 0.87) than patients with basic or below basic literacy. After adjusting for demographic and clinical characteristics, the risk of 30-day readmission was 12% lower (p=0.03), and the incidence rate 16% lower (pliteracy. Conclusions Health literacy, as measured by a predictive model, was found to be a significant, independent predictor of 30-day readmissions. As a modifiable risk factor with evidence-based solutions, health literacy should be considered in readmission reduction efforts. PMID:26068508

  7. Approaches to canine health surveillance.

    Science.gov (United States)

    O'Neill, Dan G; Church, David B; McGreevy, Paul D; Thomson, Peter C; Brodbelt, Dave C

    2014-01-01

    Effective canine health surveillance systems can be used to monitor disease in the general population, prioritise disorders for strategic control and focus clinical research, and to evaluate the success of these measures. The key attributes for optimal data collection systems that support canine disease surveillance are representativeness of the general population, validity of disorder data and sustainability. Limitations in these areas present as selection bias, misclassification bias and discontinuation of the system respectively. Canine health data sources are reviewed to identify their strengths and weaknesses for supporting effective canine health surveillance. Insurance data benefit from large and well-defined denominator populations but are limited by selection bias relating to the clinical events claimed and animals covered. Veterinary referral clinical data offer good reliability for diagnoses but are limited by referral bias for the disorders and animals included. Primary-care practice data have the advantage of excellent representation of the general dog population and recording at the point of care by veterinary professionals but may encounter misclassification problems and technical difficulties related to management and analysis of large datasets. Questionnaire surveys offer speed and low cost but may suffer from low response rates, poor data validation, recall bias and ill-defined denominator population information. Canine health scheme data benefit from well-characterised disorder and animal data but reflect selection bias during the voluntary submissions process. Formal UK passive surveillance systems are limited by chronic under-reporting and selection bias. It is concluded that active collection systems using secondary health data provide the optimal resource for canine health surveillance.

  8. Limits on same-day billing in Medicaid hinders integration of behavioral health into the medical home model.

    Science.gov (United States)

    Roby, Dylan H; Jones, Erynne E

    2016-02-01

    The potential expansion of insurance coverage through the Patient Protection and Affordable Care Act of 2010 can facilitate the reduction of access barriers and improved quality for behavioral health care. More than 5 million of the newly insured are expected to have mental health and substance use disorders. In addition, state and federal efforts to integrate behavioral and medical health needs through patient-centered medical home models and innovations in payment strategies provide an unprecedented opportunity to use federal financial support to improve not only access to care, but also improve quality through active care coordination, use of interdisciplinary teams, colocating services, and engaging in warm hand-offs between providers in the same setting. These potential advances are hindered in 24 different states because of Medicaid payment policy, with 7 explicitly limiting the ability to reimburse for physical health and behavioral health services on the same day for all providers. Without the ability for providers to be reimbursed for different services on the same day to improve behavioral and medical health care coordination, these states could be limited in their ability to improve care via patient-centered approaches and interdisciplinary team-based care that would involve physicians, clinical psychologists, psychiatrists, and other mental health professionals. Limits on same-day billing in Medicaid programs could impact up to 36.7 million people in 24 states, which is approximately 52.6% of all Medicaid enrollees. (c) 2016 APA, all rights reserved).

  9. Heating and cooling building energy demand evaluation; a simplified model and a modified degree days approach

    International Nuclear Information System (INIS)

    De Rosa, Mattia; Bianco, Vincenzo; Scarpa, Federico; Tagliafico, Luca A.

    2014-01-01

    Highlights: • A dynamic model to estimate the energy performance of buildings is presented. • The model is validated against leading software packages, TRNSYS and Energy Plus. • Modified degree days are introduced to account for solar irradiation effects. - Abstract: Degree days represent a versatile climatic indicator which is commonly used in building energy performance analysis. In this context, the present paper proposes a simple dynamic model to simulate heating/cooling energy consumption in buildings. The model consists of several transient energy balance equations for external walls and internal air according to a lumped-capacitance approach and it has been implemented utilizing the Matlab/Simulink® platform. Results are validated by comparison to the outcomes of leading software packages, TRNSYS and Energy Plus. By using the above mentioned model, energy consumption for heating/cooling is analyzed in different locations, showing that for low degree days the inertia effect assumes a paramount importance, affecting the common linear behavior of the building consumption against the standard degree days, especially for cooling energy demand. Cooling energy demand at low cooling degree days (CDDs) is deeply analyzed, highlighting that in this situation other factors, such as solar irradiation, have an important role. To take into account these effects, a correction to CDD is proposed, demonstrating that by considering all the contributions the linear relationship between energy consumption and degree days is maintained

  10. Keynote speaker Col. Fitch talks to employee audience at Super Safety and Health Day at KSC.

    Science.gov (United States)

    1999-01-01

    Capt. Dennis E. Fitch, a consultant and former pilot instructor with United Airlines, addresses an audience of KSC employees to kick off Super Safety and Health Day at KSC. Fitch related his tale of the catastrophic engine failure in UAL flight 232, which crash landed in Iowa in 1989, and the teamwork that contributed to his survival and the lives of 183 other passengers. For the second time Kennedy Space Center dedicated an entire day to safety and health. Most normal work activities were suspended to allow personnel to attend Super Safety and Health Day activities. The theme, 'Safety and Health Go Hand in Hand,' emphasized KSC's commitment to place the safety and health of the public, astronauts, employees and space-related resources first and foremost. Events also included a panel session about related issues, vendor exhibits, and safety training in work groups. The keynote address and panel session were also broadcast internally over NASA television.

  11. Machine learning-based Landsat-MODIS data fusion approach for 8-day 30m evapotranspiration monitoring

    Science.gov (United States)

    Im, J.; Ke, Y.; Park, S.

    2016-12-01

    Continuous monitoring of evapotranspiration (ET) is important for understanding of hydrological cycles and energy flux dynamics. At regional and local scales, routine ET estimation is a critical for efficient water management, drought impact assessment and ecosystem health monitoring, etc. Remote sensing has long been recognized to be able to provide ET monitoring over large areas. However, no single satellite could provide temporally continuous ET at relatively high spatial resolution due to the trade-off between the spatial and temporal resolution of current satellite sensors. Landsat-series satellites provide optical and thermal imagery at 30-100m resolution, whereas the 16-day revisit cycle hinders the observation of ET dynamics; MODIS provides sources of ET estimation at daily basis, but the 500-1000m ground sampling distance is too coarse for field level applications. In this study, we present a machine learning and STARFM based method for Landsat/MODIS ET fusion. The approach first downscales MODIS 8-day 1km ET (MOD16A2) to 30m based on eleven Landsat-derived indicators such as NDVI, EVI, NDWI etc on the cloud-free Landsat-available days using Random Forest approach. For the days when Landsat data are not available, downscaled ET is synthesized by MODIS and Landsat data fusion with STARFM and STI-FM approaches. The models are evaluated using in situ flux tower measurements at US-ARM and US-Twt AmeriFlux sites the United States. Results show that the downscaled 30m ET have good agreement with MODIS ET (RMSE=0.42-3.4mm/8days, rRMSE=3.2%-26%) and the downscaled ET have higher accuracy than MODIS ET when compared to in-situ measurements.

  12. Gestalt therapy approaches with aggressive children in a day care setting

    OpenAIRE

    Maxey, Win

    1987-01-01

    This research study was designed to evaluate whether or not Gestalt therapy approaches could be used effectively when intervening with aggressive acts in a day care setting. Five focus children were observed at timed intervals as to whether or not they were aggressive, how the caretaker intervened, and how the children responded to the caretaker intervention. After a baseline of aggressive acts was established, caretakers were trained to use Gestalt therapy interventio...

  13. The population health approach in historical perspective.

    Science.gov (United States)

    Szreter, Simon

    2003-03-01

    The origin of the population health approach is an historic debate over the relationship between economic growth and human health. In Britain and France, the Industrial Revolution disrupted population health and stimulated pioneering epidemiological studies, informing the early preventive public health movement. A century-long process of political adjustment between the forces of liberal democracy and propertied interests ensued. The 20th-century welfare states resulted as complex political mechanisms for converting economic growth into enhanced population health. However, the rise of a "neoliberal" agenda, denigrating the role of government, has once again brought to the fore the importance of prevention and a population health approach to map and publicize the health impacts of this new phase of "global" economic growth.

  14. A community approach to health.

    Science.gov (United States)

    Hagland, M

    1997-01-01

    Improving the health and well-being of a community may seem like a daunting task-particularly when you consider the vast number of factors that can influence the quality of life of a neighborhood or a region. It's not impossible, however, as six widely different communities across the U.S. are discovering. The Accelerating Community Transformation (ACT) project--now underway by The Healthcare Forum through a five-year, $5 million grant from pharmaceutical joint venture Astra Merck Inc.--is an innovative attempt to create real-life learning laboratories in communities as diverse as an inner-city neighborhood on the west side of Chicago; the small southern town of Aiken, S.C.: the semi-desert city of San Bernardino, Calif.; a corner of America's heartland where Missouri, Kansas. Nebraska and Iowa meet; the new town of Celebration, Fla.; and St. Louis, Mo. The goals: to evaluate and accelerate community-wide efforts that result in healthier, more desirable places for people to live, work and play; to build community capacity; and to achieve measurable improved health and quality of life outcomes.

  15. Health Trajectories of Family Caregivers: Associations With Care Transitions and Adult Day Service Use

    Science.gov (United States)

    Liu, Yin; Kim, Kyungmin; Zarit, Steven H.

    2017-01-01

    Objective The study examines family caregivers’ health changes over 1 year on four health dimensions and explores the association of differential health trajectories with adult day service (ADS) use and caregiving transitions. Method The participants were 153 primary caregivers of individuals with dementia (IWDs) who provided information on care situations and their own health at baseline, 6-month, and 12-month interviews. Results Caregivers showed increasing functional limitations and decreasing bodily pain over time, whereas role limitation and general health perception remained stable. Furthermore, caregivers’ trajectories of functional limitation were associated with their extent of ADS use at baseline and their relatives’ placement. Discussion Health is multidimensional; all dimensions of caregiver health do not change in a uniform manner. The findings underscore the importance of the association of caregiving transitions and caregiver health and the potential health benefits of ADS use for family caregivers. PMID:25348275

  16. Health Services Approach to the Communication Audit

    OpenAIRE

    Tereza Balcarová

    2014-01-01

    This paper deals with the use of a communication audit as a tool for evaluating the effectiveness of public relations within health services. The research was conducted within healthcare institutions operating in the Czech Republic. Areas of research questions were focused on these aspects of health services: The approach to the implementation of a communication audit: Is the communication audit tied to the level of public relations effectiveness evaluation? Is the approach influenced by publ...

  17. World health day - 7th april, 2004 "road safety is no accident"

    Directory of Open Access Journals (Sweden)

    S C Saxena

    2004-06-01

    Full Text Available In 1948, the First World Health Assembly called for the creation of a "World Health Day". Since 1950, World Health Day has been celebrated on the 7th of April of each year. The objective of World Health Day is to raise global awareness of a specific health theme to highlight a priority area of concern for the World Health Organization (WHO. The Day serves as a launch for a long-term advocacy program for which activities will be undertaken and resources provided well beyond 7th April. To Celebrate the theme of this year "Road Safety is No accident", on 7th April 2004 around the globle, hundreds of organizations hosted events to help raise awareness about road traffic injuries, their grave consequences and enormous casts to society. They also contributed to spreading the message that such injuries can be prevented. In 1948, the First World Health Assembly called for the creation of a "World Health Day". Since 1950, World Health Day has been celebrated on the 7th of April of each year. The objective of World Health Day is to raise global awareness of a specific health theme to highlight a priority area of concern for the World Health Organization (WHO. The Day serves as a launch for a long-term advocacy program for which activities will be undertaken and resources provided well beyond 7th April. To Celebrate the theme of this year "Road Safety is No accident", on 7th April 2004 around the globle, hundreds of organizations hosted events to help raise awareness about road traffic injuries, their grave consequences and enormous casts to society. They also contributed to spreading the message that such injuries can be prevented. The accident is defined as unexpected, unplanned event envolving injury, disability or death. The accidents occur in almost all countries. The most alarming fact is that accidents kill more young trained adults between 15-24 years of age group of males, mainly among two wheelers. All sorts of accidents kill more than 5 million

  18. World health day - 7th april, 2004 "road safety is no accident"

    Directory of Open Access Journals (Sweden)

    S C Saxena

    2006-06-01

    Full Text Available In 1948, the First World Health Assembly called for the creation of a "World Health Day". Since 1950, World Health Day has been celebrated on the 7th of April of each year. The objective of World Health Day is to raise global awareness of a specific health theme to highlight a priority area of concern for the World Health Organization (WHO. The Day serves as a launch for a long-term advocacy program for which activities will be undertaken and resources provided well beyond 7th April.To Celebrate the theme of this year "Road Safety is No accident", on 7th April 2004 around the globle, hundreds of organizations hosted events to help raise awareness about road traffic injuries, their grave consequences and enormous casts to society. They alsocontributed to spreading the message that such injuries can be prevented.In 1948, the First World Health Assembly called for the creation of a "World Health Day". Since 1950, World Health Day has been celebrated on the 7th of April of each year. The objective of World Health Day is to raise global awareness of a specific health theme to highlight a priority area of concern for the World Health Organization (WHO. The Day serves as a launch for a long-term advocacy program for which activities will be undertaken and resources provided well beyond 7th April.To Celebrate the theme of this year "Road Safety is No accident", on 7th April 2004 around the globle, hundreds of organizations hosted events to help raise awareness about road traffic injuries, their grave consequences and enormous casts to society. They alsocontributed to spreading the message that such injuries can be prevented.t '            ■The accident is defined as unexpected, unplanned event envolving injury, disability or death. The accidents occur in almost all countries. The most alarming fact is that accidents kill more young trained adults between 15-24 years of age group of males, mainly among two wheelers. All sorts of accidents

  19. A Mathematical Modelling Approach to One-Day Cricket Batting Orders

    Science.gov (United States)

    Bukiet, Bruce; Ovens, Matthews

    2006-01-01

    While scoring strategies and player performance in cricket have been studied, there has been little published work about the influence of batting order with respect to One-Day cricket. We apply a mathematical modelling approach to compute efficiently the expected performance (runs distribution) of a cricket batting order in an innings. Among other applications, our method enables one to solve for the probability of one team beating another or to find the optimal batting order for a set of 11 players. The influence of defence and bowling ability can be taken into account in a straightforward manner. In this presentation, we outline how we develop our Markov Chain approach to studying the progress of runs for a batting order of non- identical players along the lines of work in baseball modelling by Bukiet et al., 1997. We describe the issues that arise in applying such methods to cricket, discuss ideas for addressing these difficulties and note limitations on modelling batting order for One-Day cricket. By performing our analysis on a selected subset of the possible batting orders, we apply the model to quantify the influence of batting order in a game of One Day cricket using available real-world data for current players. Key Points Batting order does effect the expected runs distribution in one-day cricket. One-day cricket has fewer data points than baseball, thus extreme values have greater effect on estimated probabilities. Dismissals rare and probabilities very small by comparison to baseball. Probability distribution for lower order batsmen is potentially skewed due to increased risk taking. Full enumeration of all possible line-ups is impractical using a single average computer. PMID:24357943

  20. Process evaluation of child health services at outreach sites during health and nutrition day (Mamta Day) in urban slums of Western India.

    Science.gov (United States)

    Mehta, Kedar; Pandya, Chandresh; Chavda, Paragkumar; Solanki, Dipak

    2017-01-01

    Health indicators of rural and urban India show a wide variation. Rural areas have received large focus in child health services, but on the flip side, urban areas have been the last to receive such attention. A cross-sectional study was conducted to include one randomly selected outreach session from all the 19 urban primary health centers of Vadodara city from April 2013 to May 2014. Nineteen session sites were observed for the process evaluation of three components of child health care, namely, "planning of Health and Nutrition Day," "availability of vaccines/logistics," and "direct observation of actual immunization process" at the site using a structured checklist. Most of the vaccines and logistics were present at all 19 sites visited, but adverse events following immunization kit were observed at ten sites (52%) only. Open vial policy, no-touch technique, and immediate cutting of syringe with hub cutter were implemented at all sites; however, completely filled Mamta Card was observed at 9 (47%) sites only. All four key messages were given at 5 (26%) sites only. Immunization services such as proper vaccine administration with no-touch technique and open vial policy were mainly focused; however, other services such as biomedical waste management, record keeping, and delivery of all four key messages need to be strengthened during Mamta Divas. Strengthening of other child health care services such as growth monitoring, Integrated Management of Neonatal and Childhood Illnesses, and referral services is required in urban areas.

  1. Day-to-day discrimination and health among Asian Indians: a population-based study of Gujarati men and women in Metropolitan Detroit.

    Science.gov (United States)

    Yoshihama, Mieko; Bybee, Deborah; Blazevski, Juliane

    2012-10-01

    This study examined the relationship between experiences of day-to-day discrimination and two measures of health among Gujaratis, one of the largest ethnic groups of Asian Indians in the U.S. Data were collected via computer-assisted telephone interviews with a random sample of Gujarati men and women aged 18-64 in Metropolitan Detroit (N = 423). Using structural equation modeling, we tested two gender-moderated models of the relationship between day-to-day discrimination and health, one using the single-item general health status and the other using the 4-item emotional wellbeing measure. For both women and men, controlling for socio-demographic and other relevant characteristics, the experience of day-to-day discrimination was associated with worse emotional wellbeing. However, day-to-day discrimination was associated with the single-item self-rated general health status only for men. This study identified not only gender differences in discrimination-health associations but also the importance of using multiple questions in assessing perceived health status.

  2. Global energy supply the day before yesterday, the day after tomorrow, today, tomorrow - a qualitative modeling approach

    International Nuclear Information System (INIS)

    Herrmann, D.

    2004-01-01

    Current developments, and peak world market price levels, of oil, which add to the prices also of natural gas and other energy resources, give rise to the question whether there is any reason to expect fundamental changes and trend reversals in energy prices and on energy markets on a medium to long term basis. Attempts to find answers to such questions about the future can be helped by looking back into the more than three hundred years of global history of the development of modern industrial-sale power supply. Over that period of time, there have always been changes of boundary conditions and reversals of trends, respectively; step by step, by trial and error, a structural change has evolved from the use mainly of renewable energy resources to the primary use of fossil fuels supplemented by nuclear power. A model is presented which is able not only to describe and explain in a consistent and plausible way the global qualitative development of industrial-scale energy supply over the three different development periods, as far as contents go, between 1700 and 2100, but also allows higher resolution to be achieved in terms both of contents and time. The modeling approach is applied to the entire era of energy supply on an industrial scale, and should be seen as a representation of the specific perspective in this approach for further discussion. (orig.)

  3. A MATHEMATICAL MODELLING APPROACH TO ONE-DAY CRICKET BATTING ORDERS

    Directory of Open Access Journals (Sweden)

    Matthews Ovens1

    2006-12-01

    Full Text Available While scoring strategies and player performance in cricket have been studied, there has been little published work about the influence of batting order with respect to One-Day cricket. We apply a mathematical modelling approach to compute efficiently the expected performance (runs distribution of a cricket batting order in an innings. Among other applications, our method enables one to solve for the probability of one team beating another or to find the optimal batting order for a set of 11 players. The influence of defence and bowling ability can be taken into account in a straightforward manner. In this presentation, we outline how we develop our Markov Chain approach to studying the progress of runs for a batting order of non- identical players along the lines of work in baseball modelling by Bukiet et al., 1997. We describe the issues that arise in applying such methods to cricket, discuss ideas for addressing these difficulties and note limitations on modelling batting order for One-Day cricket. By performing our analysis on a selected subset of the possible batting orders, we apply the model to quantify the influence of batting order in a game of One Day cricket using available real-world data for current players

  4. Brush Day & Night Phase III to Phase IV: ensuring that good oral health habits are sustainable.

    Science.gov (United States)

    Melo, Paulo; Fine, Charlotte; Malone, Sinead; Horn, Virginie

    2018-05-01

    Over the past 10 years, the FDI-Unilever Brush Day & Night partnership has significantly influenced the life of children worldwide through the implementation of school programmes for oral health education and prevention. This article reports the key facts and outcomes of Phase III of the partnership, and announces the launch of Phase IV. During Phase III, the expert advisors of the Brush Day & Night partnership conducted a longitudinal study to evaluate the impact of the '21 Day' programme in almost 8,000 children in 10 countries. Analysis revealed the effectiveness of the 21 Day programme in sustainably educating children to brush their teeth twice a day, with the greatest impact observed in children aged 7-9 years. With the launch of Phase IV, the Brush Day & Night partnership will continue to deliver its oral health school programme for 7-9 year-old children with a strengthened methodology, including randomized sampling and control groups. The scope of the evaluation will be broadened to include oral health-related quality of life indicators, and monitoring of the oral health knowledge of children's parents/carers. © 2018 FDI World Dental Federation.

  5. Political Action Day: A Student-Led Initiative to Increase Health Advocacy Training Among Medical Students

    Directory of Open Access Journals (Sweden)

    Harbir Gill

    2010-07-01

    Full Text Available Background: Health advocacy is a critical aspect of the competent physician's role. It is identified as a core competency by several national physician regulatory organizations, yet few formal training programs exist. We developed an initiative to teach medical students health advocacy skills. Methods: At Political Action Day, students from Alberta medical schools lobbied the provincial government. A day of training seminars preceded Political Action Day that focused on teaching health advocacy and communication strategies. The following day, medical students met with elected representatives at the Legislative Assembly. An entry and exit survey was administered to students. Results: On October 26-27th, 2008, 40 students met with 38/83 (46% elected representatives including the Minister of Health and Wellness. Feedback from students and politicians suggests the event was effective in teaching advocacy skills. This initiative inspired students to be politically active in the future. Conclusions: Political Action Day helps fulfill the health advocacy competency objectives, and requires minimal curriculum time and resources for integration. It is an effective tool to begin teaching advocacy, and should be further expanded and replicated at other Canadian medical schools.

  6. Facing Immigration Fears: A Constructive Local Approach to Day Labor, Community, and Integration

    Directory of Open Access Journals (Sweden)

    Sandra Lazo de la Vega

    2013-07-01

    Full Text Available As one of the most visible and vulnerable manifestations of the presence of Latino immigrants in “new destination” communities across the United States, day laborers have become a locus of conflict  over the past fifteen years for local policy makers, advocacy organizations, and neighborhood residents. Communities have dealt with day labor in drastically different ways. Some have passed harsh anti-immigrant ordinances, hoping that a hostile environment will encourage immigrants to leave. Restrictionist state and local legislation, however, has proven costly to enforce, has been challenged in court, and has hindered immigrant integration. Other communities have gone against the restrictionist tide. This paper argues that organized day labor centers, such as the El Sol Resource Center in Jupiter, Florida address many of the fundamental fears that polarize local policymaking and the national immigration reform debate. In Jupiter, El Sol has not only eliminated a controversial open-air labor market by bringing the process into a formal and organized structure, it has also provided access to English and civics classes, preventive health screenings and legal services in cases of wage theft. Furthermore, through El Sol the Town of Jupiter has opened a two-way process of immigrant integration. Jupiter’s day laborers are no longer “hiding in the shadows”, but rather are engaging in active citizenship and working with native-born community volunteers to run the center.

  7. A QC approach to the determination of day-to-day reproducibility and robustness of LC-MS methods for global metabolite profiling in metabonomics/metabolomics.

    Science.gov (United States)

    Gika, Helen G; Theodoridis, Georgios A; Earll, Mark; Wilson, Ian D

    2012-09-01

    An approach to the determination of day-to-day analytical robustness of LC-MS-based methods for global metabolic profiling using a pooled QC sample is presented for the evaluation of metabonomic/metabolomic data. A set of 60 urine samples were repeatedly analyzed on five different days and the day-to-day reproducibility of the data obtained was determined. Multivariate statistical analysis was performed with the aim of evaluating variability and selected peaks were assessed and validated in terms of retention time stability, mass accuracy and intensity. The methodology enables the repeatability/reproducibility of extended analytical runs in large-scale studies to be determined, allowing the elimination of analytical (as opposed to biological) variability, in order to discover true patterns and correlations within the data. The day-to-day variability of the data revealed by this process suggested that, for this particular system, 3 days continuous operation was possible without the need for maintenance and cleaning. Variation was generally based on signal intensity changes over the 7-day period of the study, and was mainly a result of source contamination.

  8. Does Johnson's Prescriptive Approach Still Have a Role to Play in Modern-Day Dictionaries?

    Directory of Open Access Journals (Sweden)

    Rufus H. Gouws

    2011-10-01

    Full Text Available

    ABSTRACT: Samuel Johnson's dictionary (1755 confirmed both the status of dictionaries as authoritative sources of (linguistic knowledge and the prescriptive approach in lexicography. This approach prevailed for a long time. During the last decades the descriptive approach came to the fore, aptly supported by the increased reliance on lexicographic corpora. Modern-day lexicography has also witnessed the introduction of a third approach, i.e. the proscriptive approach, which includes features of both the prescriptive and the descriptive approach. This article investigates the occurrence of the prescriptive, descriptive and proscriptive approaches in modern-day dictionaries. A distinction is made between dictionaries focusing on language for general purposes and dictionaries focusing on languages for special purposes. It is shown that users rely on dictionaries as prescriptive reference sources and expect lexicographers to provide them with an answer to the specific question that prompted the dictionary consultation process. It is argued that knowledgeable dictionary users must be able to achieve an unambiguous retrieval of information and must be able to rely on the dictionary to satisfy their specific cognitive or communicative needs. Here the proscriptive approach plays an important role.

    OPSOMMING: Het Johnson se preskriptiewe benadering nog 'n rol te speel in moderne woordeboeke? Samuel Johnson se woordeboek (1755 het die status van woordeboeke as gesaghebbende houers van (taalkundige kennis, maar eweneens die preskriptiewe benadering in leksikografie gevestig. Hierdie benadering het lank gegeld. Gedurende die onlangse dekades het die deskriptiewe benadering op die voorgrond getree, sterk ondersteun deur toenemende benutting van korpora. Moderne leksikografie het 'n derde benadering beleef, te wete die proskriptiewe benadering wat kenmerke van sowel die preskriptiewe as die deskriptiewe benadering bevat. Hierdie artikel ondersoek die

  9. Days of heroin use predict poor self-reported health in hospitalized heroin users

    Science.gov (United States)

    Meshesha, Lidia Z.; Tsui, Judith I.; Liebschutz, Jane M.; Crooks, Denise; Anderson, Bradley J.; Herman, Debra S.; Stein, Michael D.

    2013-01-01

    This study examined associations between substance use behaviors and self-reported health among hospitalized heroin users. Of the 112 participants, 53 (47%) reported good or better health. In multivariable logistic regression models, each day of heroin use in the last month was associated with an 8% lower odds of reporting health as good or better (OR=.92; 95%CI 0.87, 0.97, p < .05). Cocaine, cannabis, cigarettes, alcohol use, unintentional overdose, nor injection drug use were associated with health status. PMID:24045030

  10. Improving the efficiency of a chemotherapy day unit: applying a business approach to oncology.

    Science.gov (United States)

    van Lent, Wineke A M; Goedbloed, N; van Harten, W H

    2009-03-01

    To improve the efficiency of a hospital-based chemotherapy day unit (CDU). The CDU was benchmarked with two other CDUs to identify their attainable performance levels for efficiency, and causes for differences. Furthermore, an in-depth analysis using a business approach, called lean thinking, was performed. An integrated set of interventions was implemented, among them a new planning system. The results were evaluated using pre- and post-measurements. We observed 24% growth of treatments and bed utilisation, a 12% increase of staff member productivity and an 81% reduction of overtime. The used method improved process design and led to increased efficiency and a more timely delivery of care. Thus, the business approaches, which were adapted for healthcare, were successfully applied. The method may serve as an example for other oncology settings with problems concerning waiting times, patient flow or lack of beds.

  11. Process evaluation of child health services at outreach sites during health and nutrition day (Mamta Day in urban slums of Western India

    Directory of Open Access Journals (Sweden)

    Kedar Mehta

    2017-01-01

    Full Text Available Introduction: Health indicators of rural and urban India show a wide variation. Rural areas have received large focus in child health services, but on the flip side, urban areas have been the last to receive such attention. Materials and Methods: A cross-sectional study was conducted to include one randomly selected outreach session from all the 19 urban primary health centers of Vadodara city from April 2013 to May 2014. Nineteen session sites were observed for the process evaluation of three components of child health care, namely, “planning of Health and Nutrition Day,” “availability of vaccines/logistics,” and “direct observation of actual immunization process” at the site using a structured checklist. Results: Most of the vaccines and logistics were present at all 19 sites visited, but adverse events following immunization kit were observed at ten sites (52% only. Open vial policy, no-touch technique, and immediate cutting of syringe with hub cutter were implemented at all sites; however, completely filled Mamta Card was observed at 9 (47% sites only. All four key messages were given at 5 (26% sites only. Conclusion: Immunization services such as proper vaccine administration with no-touch technique and open vial policy were mainly focused; however, other services such as biomedical waste management, record keeping, and delivery of all four key messages need to be strengthened during Mamta Divas. Strengthening of other child health care services such as growth monitoring, Integrated Management of Neonatal and Childhood Illnesses, and referral services is required in urban areas.

  12. Increased 30-Day Emergency Department Revisits Among Homeless Patients with Mental Health Conditions

    Directory of Open Access Journals (Sweden)

    Chun Nok Lam

    2016-09-01

    Full Text Available Introduction: Patients with mental health conditions frequently use emergency medical services. Many suffer from substance use and homelessness. If they use the emergency department (ED as their primary source of care, potentially preventable frequent ED revisits and hospital readmissions can worsen an already crowded healthcare system. However, the magnitude to which homelessness affects health service utilization among patients with mental health conditions remains unclear in the medical community. This study assessed the impact of homelessness on 30-day ED revisits and hospital readmissions among patients presenting with mental health conditions in an urban, safety-net hospital. Methods: We conducted a secondary analysis of administrative data on all adult ED visits in 2012 in an urban safety-net hospital. Patient demographics, mental health status, homelessness, insurance coverage, level of acuity, and ED disposition per ED visit were analyzed using multilevel modeling to control for multiple visits nested within patients. We performed multivariate logistic regressions to evaluate if homelessness moderated the likelihood of mental health patients’ 30-day ED revisits and hospital readmissions. Results: Study included 139,414 adult ED visits from 92,307 unique patients (43.5±15.1 years, 51.3% male, 68.2% Hispanic/Latino. Nearly 8% of patients presented with mental health conditions, while 4.6% were homeless at any time during the study period. Among patients with mental health conditions, being homeless contributed to an additional 28.0% increase in likelihood (4.28 to 5.48 odds of 30-day ED revisits and 38.2% increase in likelihood (2.04 to 2.82 odds of hospital readmission, compared to non-homeless, non-mental health (NHNM patients as the base category. Adjusted predicted probabilities showed that homeless patients presenting with mental health conditions have a 31.1% chance of returning to the ED within 30-day post discharge and a 3

  13. A Comparison of Three Holistic Approaches to Health: One Health, EcoHealth, and Planetary Health

    Directory of Open Access Journals (Sweden)

    Henrik Lerner

    2017-09-01

    Full Text Available Several holistic and interdisciplinary approaches exist to safeguard health. Three of the most influential concepts at the moment, One Health, EcoHealth, and Planetary Health, are analyzed in this paper, revealing similarities and differences at the theoretical conceptual level. These approaches may appear synonymous, as they all promote the underlying assumption of humans and other animals sharing the same planet and the same environmental challenges, infections and infectious agents as well as other aspects of physical—and possibly mental—health. However, we would like to illuminate the differences between these three concepts or approaches, and how the choice of terms may, deliberately or involuntary, signal the focus, and underlying values of the approaches. In this paper, we have chosen some proposed and well-known suggestions of definitions. In our theoretical analysis, we will focus on at least two areas. These are (1 the value of the potential scientific areas which could be included and (2 core values present within the approach. In the first area, our main concern is whether the approaches are interdisciplinary and whether the core scientific areas are assigned equal importance. For the second area, which is rather wide, we analyze core values such as biodiversity, health, and how one values humans, animals, and ecosystems. One Health has been described as either a narrow approach combining public health and veterinary medicine or as a wide approach as in the wide-spread “umbrella” depiction including both scientific fields, core concepts, and interdisciplinary research areas. In both cases, however, safeguarding the health of vertebrates is usually in focus although ecosystems are also included in the model. The EcoHealth approach seems to have more of a biodiversity focus, with an emphasis on all living creatures, implying that parasites, unicellular organisms, and possibly also viruses have a value and should be protected

  14. A Comparison of Three Holistic Approaches to Health: One Health, EcoHealth, and Planetary Health.

    Science.gov (United States)

    Lerner, Henrik; Berg, Charlotte

    2017-01-01

    Several holistic and interdisciplinary approaches exist to safeguard health. Three of the most influential concepts at the moment, One Health, EcoHealth, and Planetary Health, are analyzed in this paper, revealing similarities and differences at the theoretical conceptual level. These approaches may appear synonymous, as they all promote the underlying assumption of humans and other animals sharing the same planet and the same environmental challenges, infections and infectious agents as well as other aspects of physical-and possibly mental-health. However, we would like to illuminate the differences between these three concepts or approaches, and how the choice of terms may, deliberately or involuntary, signal the focus, and underlying values of the approaches. In this paper, we have chosen some proposed and well-known suggestions of definitions. In our theoretical analysis, we will focus on at least two areas. These are (1) the value of the potential scientific areas which could be included and (2) core values present within the approach. In the first area, our main concern is whether the approaches are interdisciplinary and whether the core scientific areas are assigned equal importance. For the second area, which is rather wide, we analyze core values such as biodiversity, health, and how one values humans, animals, and ecosystems. One Health has been described as either a narrow approach combining public health and veterinary medicine or as a wide approach as in the wide-spread "umbrella" depiction including both scientific fields, core concepts, and interdisciplinary research areas. In both cases, however, safeguarding the health of vertebrates is usually in focus although ecosystems are also included in the model. The EcoHealth approach seems to have more of a biodiversity focus, with an emphasis on all living creatures, implying that parasites, unicellular organisms, and possibly also viruses have a value and should be protected. Planetary Health, on the

  15. Rainy Day: A Remote Sensing-Driven Extreme Rainfall Simulation Approach for Hazard Assessment

    Science.gov (United States)

    Wright, Daniel; Yatheendradas, Soni; Peters-Lidard, Christa; Kirschbaum, Dalia; Ayalew, Tibebu; Mantilla, Ricardo; Krajewski, Witold

    2015-04-01

    Progress on the assessment of rainfall-driven hazards such as floods and landslides has been hampered by the challenge of characterizing the frequency, intensity, and structure of extreme rainfall at the watershed or hillslope scale. Conventional approaches rely on simplifying assumptions and are strongly dependent on the location, the availability of long-term rain gage measurements, and the subjectivity of the analyst. Regional and global-scale rainfall remote sensing products provide an alternative, but are limited by relatively short (~15-year) observational records. To overcome this, we have coupled these remote sensing products with a space-time resampling framework known as stochastic storm transposition (SST). SST "lengthens" the rainfall record by resampling from a catalog of observed storms from a user-defined region, effectively recreating the regional extreme rainfall hydroclimate. This coupling has been codified in Rainy Day, a Python-based platform for quickly generating large numbers of probabilistic extreme rainfall "scenarios" at any point on the globe. Rainy Day is readily compatible with any gridded rainfall dataset. The user can optionally incorporate regional rain gage or weather radar measurements for bias correction using the Precipitation Uncertainties for Satellite Hydrology (PUSH) framework. Results from Rainy Day using the CMORPH satellite precipitation product are compared with local observations in two examples. The first example is peak discharge estimation in a medium-sized (~4000 square km) watershed in the central United States performed using CUENCAS, a parsimonious physically-based distributed hydrologic model. The second example is rainfall frequency analysis for Saint Lucia, a small volcanic island in the eastern Caribbean that is prone to landslides and flash floods. The distinct rainfall hydroclimates of the two example sites illustrate the flexibility of the approach and its usefulness for hazard analysis in data-poor regions.

  16. Sociology, environment and health: a materialist approach.

    Science.gov (United States)

    Fox, N J; Alldred, P

    2016-12-01

    This paper reviews the sociology of environment and health and makes the case for a postanthropocentric approach based on new materialist theory. This perspective fully incorporates humans and their health into 'the environment', and in place of human-centred concerns considers the forces that constrain or enhance environmental capacities. This is not an empirical study. The paper uses a hypothetical vignette concerning child health and air pollution to explore the new materialist model advocated in the paper. This paper used sociological analysis. A new materialist and postanthropocentric sociology of environment and health are possible. This radically reconfigures both sociological theory and its application to research and associated policies on health and the environment. Theoretically, human health is rethought as one among a number of capacities emerging from humans interactions with the social and natural world. Practically, the focus of intervention and policy shifts towards fostering social and natural interactions that enhance environmental (and in the process, human) potentiality. This approach to research and policy development has relevance for public health practice and policy. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  17. Heroes or Health Victims?: Exploring How the Elite Media Frames Veterans on Veterans Day.

    Science.gov (United States)

    Rhidenour, Kayla B; Barrett, Ashley K; Blackburn, Kate G

    2017-11-27

    We examine the frames the elite news media uses to portray veterans on and surrounding Veterans Day 2012, 2013, 2014, and 2015. We use mental health illness and media framing literature to explore how, why, and to what extent Veterans Day news coverage uses different media frames across the four consecutive years. We compiled a Media Coverage Corpora for each year, which contains the quotes and paraphrased remarks used in all veterans news stories for that year. In our primary study, we applied the meaning extraction method (MEM) to extract emergent media frames for Veterans Day 2014 and compiled a word frequency list, which captures the words most commonly used within the corpora. In post hoc analyses, we collected news stories and compiled word frequency lists for Veterans Day 2012, 2013, and 2015. Our findings reveal dissenting frames across 2012, 2013, and 2014 Veterans Day media coverage. Word frequency results suggest the 2012 and 2013 media frames largely celebrate Veterans as heroes, but the 2014 coverage depicts veterans as victimized by their wartime experiences. Furthermore, our results demonstrate how the prevailing 2015 media frames could be a reaction to 2014 frames that portrayed veterans as health victims. We consider the ramifications of this binary portrayal of veterans as either health victims or heroes and discuss the implications of these dueling frames for veterans' access to healthcare resources.

  18. Advancing Care Within an Adult Mental Health Day Hospital: Program Re-Design and Evaluation.

    Science.gov (United States)

    Taube-Schiff, Marlene; Mehak, Adrienne; Marangos, Sandy; Kalim, Anastasia; Ungar, Thomas

    2017-11-13

    Day hospital mental health programs provide alternate care to individuals of high acuity that do not require an inpatient psychiatric stay. Ensuring provision of best practice within these programs is essential for patient stabilization and recovery. However, there is scant literature to review when creating such a program. This paper provides an overview of the steps an acute care hospital took when designing and implementing new programming within a day hospital program. Qualitative data was collected following initial program rollout. This data helped to inform the ongoing modification of groups offered, group scheduling and content, as well as ensuring patient satisfaction and adequate skill delivery during the rollout period and beyond. The goal of this paper is to inform health service delivery for other programs when attempting to build or re-design a day hospital program.

  19. A Danish nursing home for all nationalities - an every day life approach

    DEFF Research Database (Denmark)

    Blaakilde, Anne Leonora; Algreen-Petersen, Eva; Swane, Christine E.

    on everyday life of particularly inhabitants but also of family caregivers and staff. The methodological approach is phenomenological through ethnographic fieldwork and qualitative interviews. The aim is to follow the discourses and practices related to concepts of diversity as they may change during...... ethnic origin and their family members. Anne Leonora Blaakilde, MA, PhD, research consultant at EGV Foundation (Social inclusion of older persons) al@blaakildes.net Eva Algreen-Petersen, MA, PhD, Consultant in the Municipality of Copenhagen, Department of Health and Elderly Care. fl70@suf.kk.dk Christine...

  20. New approaches in human health risk assessment.

    Science.gov (United States)

    Abass, Khaled; Carlsen, Anders; Rautio, Arja

    2016-01-01

    Studies on the precise impact of environmental pollutants on human health are difficult to undertake and interpret, because many genetic and environmental factors influence health at the same time and to varying degrees. Our chapter in the AMAP report was based on new approaches to describe risks and future needs. In this paper, we will introduce the issues associated with risk assessment of single chemicals, and present suggestions for future studies as well as a summary of lessons learned during the health-related parts of the European Union-funded FP7 project ArcRisk (Arctic Health Risks: Impacts on health in the Arctic and Europe owing to climate-induced changes in contaminant cycling, 2009-2014; www.arcrisk.eu).

  1. New approaches in human health risk assessment

    Directory of Open Access Journals (Sweden)

    Khaled Abass

    2016-12-01

    Full Text Available Studies on the precise impact of environmental pollutants on human health are difficult to undertake and interpret, because many genetic and environmental factors influence health at the same time and to varying degrees. Our chapter in the AMAP report was based on new approaches to describe risks and future needs. In this paper, we will introduce the issues associated with risk assessment of single chemicals, and present suggestions for future studies as well as a summary of lessons learned during the health-related parts of the European Union-funded FP7 project ArcRisk (Arctic Health Risks: Impacts on health in the Arctic and Europe owing to climate-induced changes in contaminant cycling, 2009–2014; www.arcrisk.eu.

  2. Interest in health promotion among Korean American Seventh-day Adventists attending a religious retreat.

    Science.gov (United States)

    Jo, Angela M; Maxwell, Annette E; Choi, Sunhye; Bastani, Roshan

    2012-01-01

    Little is known about interest in faith-based health promotion programs among Asian American populations. Among the Christian denominations, the Seventh-day Adventist (SDA) church is known to place a strong doctrinal emphasis on health. To understand appropriate ways to develop and implement health promotion programs and to conduct research among Korean American SDAs. We collaborated with the North American Division of Korean SDA Churches which sponsors annual week-long religious retreats for their church members. We developed and administered a 10-page questionnaire at their 2009 retreat in order to assess socio-demographic and church characteristics, religiosity, perceived relationship between health and religion, and interest and preferences for church-based health promotion programs. Overall, 223 participants completed our survey (123 in Korean and 100 in English). The sample consisted of regular churchgoers who were involved in a variety of helping activities, and many holding leadership positions in their home churches. The vast majority was interested in receiving health information at church (80%) in the form of seminars, cooking classes and workshops (50-60%). Fewer respondents were interested in support groups (27%). Some interests and preferences differed between English and Korean language groups. Korean American SDA church retreat participants from a large geographic area are very interested in receiving health information and promoting health at their churches and can potentially serve as "agents of influence" in their respective communities.

  3. Preliminary Analyses Showed Short-Term Mental Health Improvements after a Single-Day Manager Training.

    Science.gov (United States)

    Boysen, Elena; Schiller, Birgitta; Mörtl, Kathrin; Gündel, Harald; Hölzer, Michael

    2018-01-10

    Psychosocial working conditions attract more and more attention when it comes to mental health in the workplace. Trying to support managers to deal with their own as well as their employees' psychological risk factors, we conducted a specific manager training. Within this investigation, we wanted to learn about the training's effects and acceptance. A single-day manager training was provided in a large industrial company in Germany. The participants were asked to fill out questionnaires regarding their own physical and mental health condition as well as their working situation. Questionnaires were distributed at baseline, 3-month, and 12-month follow-up. At this point of time the investigation is still ongoing. The current article focuses on short-term preliminary effects. Analyses only included participants that already completed baseline and three months follow-up. Preliminary results from three-month follow-up survey ( n = 33, nmale = 30, Mage = 47.5) indicated positive changes in the manager's mental health condition measured by the Patient Health Questionnaire for depression (PHQ-9: Mt1 = 3.82, Mt2 = 3.15). Training managers about common mental disorders and risk factors at the workplace within a single-day workshop seems to promote positive effects on their own mental health. Especially working with the managers on their own early stress symptoms might have been an important element.

  4. Circadian-Time Sickness: Time-of-Day Cue-Conflicts Directly Affect Health.

    Science.gov (United States)

    van Ee, Raymond; Van de Cruys, Sander; Schlangen, Luc J M; Vlaskamp, Björn N S

    2016-11-01

    A daily rhythm that is not in synchrony with the environmental light-dark cycle (as in jetlag and shift work) is known to affect mood and health through an as yet unresolved neural mechanism. Here, we combine Bayesian probabilistic 'cue-conflict' theory with known physiology of the biological clock of the brain, entailing the insight that, for a functional pacemaker, it is sufficient to have two interacting units (reflecting environmental and internal time-of-day cues), without the need for an extra homuncular directing unit. Unnatural light-dark cycles cause a time-of-day cue-conflict that is reflected by a desynchronization between the ventral (environmental) and dorsal (internal) pacemaking signals of the pacemaker. We argue that this desynchronization, in-and-of-itself, produces health issues that we designate as 'circadian-time sickness', analogous to 'motion sickness'. Copyright © 2016 Elsevier Ltd. All rights reserved.

  5. Day hospital and psychosocial care center: Expanding the discussion of partial hospitalization in mental health

    Directory of Open Access Journals (Sweden)

    César Augusto Trinta Weber

    Full Text Available Summary Introduction: Since the second half of the twentieth century the discussions about mental patient care reveal ongoing debate between two health care paradigms: the biomedical/biopsychosocial paradigm and the psychosocial paradigm. The struggle for hegemony over the forms of care, on how to deal optimally with the experience of becoming ill is underpinned by an intentionality of reorganizing knowledge about the health/disease dichotomy, which is reflected in the models proposed for the implementation of actions and services for the promotion, prevention, care and rehabilitation of human health. Objective: To discuss the guidelines of care in mental health day hospitals (MHDH in contrast to type III psychosocial care centers (CAPS III. Method: Review of mental health legislation from 1990 to 2014. Results: A definition of therapeutic project could not be found, as well as which activities and techniques should be employed by these health services. Conclusion: The MHDH and PCC III are services that replace psychiatric hospital admission and are characterized by their complementarity in the care to the mentally ill. Due to their varied and distinctive intervention methods, which operate synergistically, the contributions from both models of care are optimized. Discussions on the best mental health care model reveal polarization between the biomedical/biopsychosocial and psychosocial paradigms. This reflects the supremacy of the latter over the former in the political-ideological discourse that circumscribes the reform of psychiatric care, which may hinder a better clinical outcome for patients and their families.

  6. Latino immigrant day laborer perceptions of occupational safety and health information preferences.

    Science.gov (United States)

    Díaz Fuentes, Claudia M; Martinez Pantoja, Leonardo; Tarver, Meshawn; Geschwind, Sandy A; Lara, Marielena

    2016-06-01

    We address immigrant day laborers' experiences with occupational safety in the construction industry in New Orleans, and opinions about content and method of communication for educational interventions to reduce occupational risks. In 2011, we conducted seven focus groups with 48 Spanish-speaking day laborers (8 women, 40 men, 35 years on average). Focus group results are based on thematic analysis. Most employers did not provide safety equipment, threatened to dismiss workers who asked for it, and did not provide health insurance. Attitudes toward accepting unsafe work conditions varied. Women faced lower pay and hiring difficulties than men. Day laborers preferred audio format over written, and content about consequences from and equipment for different jobs/exposures. Day laborers have common occupational experiences, but differences existed by gender, literacy and sense of control over safety. Day laborer information preferences and use of media needs further studying. Am. J. Ind. Med. 59:476-485, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  7. Predicting number of hospitalization days based on health insurance claims data using bagged regression trees.

    Science.gov (United States)

    Xie, Yang; Schreier, Günter; Chang, David C W; Neubauer, Sandra; Redmond, Stephen J; Lovell, Nigel H

    2014-01-01

    Healthcare administrators worldwide are striving to both lower the cost of care whilst improving the quality of care given. Therefore, better clinical and administrative decision making is needed to improve these issues. Anticipating outcomes such as number of hospitalization days could contribute to addressing this problem. In this paper, a method was developed, using large-scale health insurance claims data, to predict the number of hospitalization days in a population. We utilized a regression decision tree algorithm, along with insurance claim data from 300,000 individuals over three years, to provide predictions of number of days in hospital in the third year, based on medical admissions and claims data from the first two years. Our method performs well in the general population. For the population aged 65 years and over, the predictive model significantly improves predictions over a baseline method (predicting a constant number of days for each patient), and achieved a specificity of 70.20% and sensitivity of 75.69% in classifying these subjects into two categories of 'no hospitalization' and 'at least one day in hospital'.

  8. Systems approach to monitoring and evaluation guides scale up of the Standard Days Method of family planning in Rwanda

    Science.gov (United States)

    Igras, Susan; Sinai, Irit; Mukabatsinda, Marie; Ngabo, Fidele; Jennings, Victoria; Lundgren, Rebecka

    2014-01-01

    There is no guarantee that a successful pilot program introducing a reproductive health innovation can also be expanded successfully to the national or regional level, because the scaling-up process is complex and multilayered. This article describes how a successful pilot program to integrate the Standard Days Method (SDM) of family planning into existing Ministry of Health services was scaled up nationally in Rwanda. Much of the success of the scale-up effort was due to systematic use of monitoring and evaluation (M&E) data from several sources to make midcourse corrections. Four lessons learned illustrate this crucially important approach. First, ongoing M&E data showed that provider training protocols and client materials that worked in the pilot phase did not work at scale; therefore, we simplified these materials to support integration into the national program. Second, triangulation of ongoing monitoring data with national health facility and population-based surveys revealed serious problems in supply chain mechanisms that affected SDM (and the accompanying CycleBeads client tool) availability and use; new procedures for ordering supplies and monitoring stockouts were instituted at the facility level. Third, supervision reports and special studies revealed that providers were imposing unnecessary medical barriers to SDM use; refresher training and revised supervision protocols improved provider practices. Finally, informal environmental scans, stakeholder interviews, and key events timelines identified shifting political and health policy environments that influenced scale-up outcomes; ongoing advocacy efforts are addressing these issues. The SDM scale-up experience in Rwanda confirms the importance of monitoring and evaluating programmatic efforts continuously, using a variety of data sources, to improve program outcomes. PMID:25276581

  9. Social representations: a theoretical approach in health

    Directory of Open Access Journals (Sweden)

    Isaiane Santos Bittencourt

    2011-03-01

    Full Text Available Objective: To present the theory of social representations, placing its epistemology and knowing the basic concepts of its approach as a structural unit of knowledge for health studies. Justification: The use of this theory comes from the need to understand social eventsunder the lens of the meanings constructed by the community. Data Synthesis: This was a descriptive study of literature review, which used as a source of data collection the classical authors of social representations supported by articles from electronic search at Virtual Health Library (VHL. The definition and discussion of collected data enabled to introduce two themes, versed on the history and epistemology of representations and on the structuralapproach of representations in health studies. Conclusion: This review allowed highlight the importance of locating the objects of study with regard to contextual issues of individual and collective histories, valuing the plurality of relations, to come closer to reality that is represented by the subjects.

  10. Evaluating interventions in health: a reconciliatory approach.

    Science.gov (United States)

    Wolff, Jonathan; Edwards, Sarah; Richmond, Sarah; Orr, Shepley; Rees, Geraint

    2012-11-01

    Health-related Quality of Life measures have recently been attacked from two directions, both of which criticize the preference-based method of evaluating health states they typically incorporate. One attack, based on work by Daniel Kahneman and others, argues that 'experience' is a better basis for evaluation. The other, inspired by Amartya Sen, argues that 'capability' should be the guiding concept. In addition, opinion differs as to whether health evaluation measures are best derived from consultations with the general public, with patients, or with health professionals. And there is disagreement about whether these opinions should be solicited individually and aggregated, or derived instead from a process of collective deliberation. These distinctions yield a wide variety of possible approaches, with potentially differing policy implications. We consider some areas of disagreement between some of these approaches. We show that many of the perspectives seem to capture something important, such that it may be a mistake to reject any of them. Instead we suggest that some of the existing 'instruments' designed to measure HR QoLs may in fact successfully already combine these attributes, and with further refinement such instruments may be able to provide a reasonable reconciliation between the perspectives. © 2011 Blackwell Publishing Ltd.

  11. Megaloblastic anemia - A clinical spectrum and a hematological profile: The day-to-day public health problem

    Directory of Open Access Journals (Sweden)

    S Srikanth

    2016-01-01

    Full Text Available Aims and Objectives: To know the various parameters and diagnostic approach of megaloblastic anemia. To know the age incidence and sex ratio. Materials and Methods: A hospital-based retrospective and prospective study was done for a period of 1-year. Totally, 21 cases were analyzed, and we correlated signs, symptoms, and hematological investigations. Results: Totally, 21 children with megaloblastic anemia in the above said period were studied. The patients age group was ranged from 2 months to 15 years. Megaloblastic anemia was observed in all the cases. Conclusion: Megaloblastic anemia is one of the common causes of undiagnosed anemia, and the treatment is simple and easily affordable. If left untreated, it can lead to morbidity both because of anemia and attendant neurological involvement.

  12. Marginalisation, discrimination and the health of Latino immigrant day labourers in a central North Carolina community.

    Science.gov (United States)

    Fleming, Paul J; Villa-Torres, Laura; Taboada, Arianna; Richards, Chelly; Barrington, Clare

    2017-03-01

    The morbidity and mortality of Latino immigrants in the United States (US) stem from a complex mix of policy, culture, discrimination and economics. Immigrants working as day labourers may be particularly vulnerable to the negative influences of these social factors due to limited access to social, financial and legal resources. We aimed to understand how the health of male Latino day labourers in North Carolina, US is influenced by their experiences interacting with their community and perceptions of their social environment. To respond to our research questions, we conducted three focus groups (n = 9, n = 10, n = 10) and a photovoice project (n = 5) with Latino male immigrants between October 2013 and March 2014. We conducted a thematic analysis of transcripts from the discussions in the focus groups and the group discussions with Photovoice participants. We found that men's health and well-being were primarily shaped by their experiences and feelings of discrimination and marginalisation. We identified three main links between discrimination/marginalisation and poor health: (i) dangerous work resulted in workplace injuries or illnesses; (ii) unsteady employment caused stress, anxiety and insufficient funds for healthcare; and (iii) exclusionary policies and treatment resulted in limited healthcare accessibility. Health promotion with Latino immigrant men in new settlement areas could benefit from community-building activities, addressing discrimination, augmenting the reach of formal healthcare and building upon the informal mechanisms that immigrants rely on to meet their health needs. Reforms to immigration and labour policies are also essential to addressing these structural barriers to health for these men. © 2016 John Wiley & Sons Ltd.

  13. [Medicine on mission: The international health reform of Seventh-Day Adventists and their health care facilities in Sweden].

    Science.gov (United States)

    Eklöf, Motzi

    2008-01-01

    The international non-conformist denomination, Seventh-day Adventists, have since their foundation in 1863, had a distinctive health care model for their members. The life-style has included vegetarian diet, abstinence from alcohol, tobacco and other drugs and the observance of a day of rest once a week. The health policy has striven to care for God's creation in the hope of resurrection at the Day of Judgment and to reform the conventional medical practice. The Adventists have pursued an extensive international health care system--from the start based on dietary and physical treatment methods, such as hydrotherapy, massage and physiotherapy--in line with the Christian mission. Health care establishments have been inaugurated around the world as a vehicle for enabling the Christian health care message to reach the upper classes. With Adventist and Doctor, John Harvey Kellogg's Battle Creek Sanatorium in Michigan as both inspirational source and educational institution, the health care mission--including a vegetarian health food industry, following in the footsteps of cornflakes--spread to the Nordic countries by the turn of the century, 1900. Skodsborgs Badesanatorium near Copenhagen became the model institution for several health care establishments in Sweden during the 1900's, such as Hultafors Sanatorium. The American-Nordic link has manifested itself through co-publication of papers, exchange of health care personnel and reporting to the central Adventist church. The American non-conformist domain as well as a private sphere of activity, aiming mainly from the outset at society's upper classes, has encountered certain difficulties in maintaining this distinction in Sweden's officially increasing secularised society, and in relation to a state health insurance and a publicly financed health care system. With the passing of time, the socioeconomic composition of patients at Hultafors became more heterogeneous, and conventional medical procedures were increasingly

  14. Applying discursive approaches to health psychology.

    Science.gov (United States)

    Seymour-Smith, Sarah

    2015-04-01

    The aim of this paper is to outline the contribution of two strands of discursive research, glossed as 'macro' and 'micro,' to the field of health psychology. A further goal is to highlight some contemporary debates in methodology associated with the use of interview data versus more naturalistic data in qualitative health research. Discursive approaches provide a way of analyzing talk as a social practice that considers how descriptions are put together and what actions they achieve. A selection of recent examples of discursive research from one applied area of health psychology, studies of diet and obesity, are drawn upon in order to illustrate the specifics of both strands. 'Macro' discourse work in psychology incorporates a Foucauldian focus on the way that discourses regulate subjectivities, whereas the concept of interpretative repertoires affords more agency to the individual: both are useful for identifying the cultural context of talk. Both 'macro' and 'micro' strands focus on accountability to varying degrees. 'Micro' Discursive Psychology, however, pays closer attention to the sequential organization of constructions and focuses on naturalistic settings that allow for the inclusion of an analysis of the health professional. Diets are typically depicted as an individual responsibility in mainstream health psychology, but discursive research highlights how discourses are collectively produced and bound up with social practices. (c) 2015 APA, all rights reserved).

  15. Bioaccessibility and human health risk assessment of lead in soil from Daye City

    Science.gov (United States)

    Li, Q.; Li, F.; Xiao, M. S.; Cai, Y.; Xiong, L.; Huang, J. B.; Fu, J. T.

    2018-01-01

    Lead (Pb) in soil from 4 sampling sites of Daye City was studied. Bioaccessibilities of Pb in soil were determined by the method of simplified bioaccessible extraction test (SBET). Since traditional health risk assessment was built on the basis of metal total content, the risk may be overestimated. Modified human health risk assessment model considering bioaccessibility was built in this study. Health risk of adults and children exposure to Pb based on total contents and bioaccessible contents were evaluated. The results showed that bioaccessible content of Pb in soil was much lower than its total content, and the average bioaccessible factor (BF) was only 25.37%. The hazard indexes (HIs) for adults and children calculated by two methods were all lower than 1. It indicated that there were no no-carcinogenic risks of Pb for human in Daye. By comparing with the results, the average bioaccessible HIs for adults and children were lower than the total one, which was due to the lower hazard quotient (HQ). Proportions of non-carcinogenic risk exposure to Pb via different pathways have also changed. Particularly, the most main risk exposure pathway for adults turned from the oral ingestion to the inhalation.

  16. 77 FR 52748 - 60-Day Proposed Information Collection: Indian Health Service (IHS) Sharing What Works-Best...

    Science.gov (United States)

    2012-08-30

    ... DEPARTMENT OF HEALTH AND HUMAN SERVICES Indian Health Service 60-Day Proposed Information Collection: Indian Health Service (IHS) Sharing What Works--Best Practice, Promising Practice, and Local Effort (BPPPLE) Form; Request For Public Comment AGENCY: Indian Health Service, HHS. ACTION: Notice...

  17. Health information exchange: national and international approaches.

    Science.gov (United States)

    Vest, Joshua R

    2012-01-01

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

  18. Outcomes of a Freedom of Choice Reform in Community Mental Health Day Center Services.

    Science.gov (United States)

    Eklund, Mona; Markström, Urban

    2015-11-01

    A freedom-of-choice reform within mental health day center services was evaluated. The reform aimed to (1) facilitate users' change between units and (2) increase the availability of service providers. Seventy-eight users responded to questionnaires about the reform, empowerment, social network, engagement and satisfaction and were followed-up after 15 months. Fifty-four percent knew about the reform. A majority stated the reform meant nothing to them; ~25 % had a negative and ~20 % a positive opinion. Satisfaction with the services had decreased after 15 months. Empowerment decreased for a more intensively followed subgroup. No positive consequences of the reform could thus be discerned.

  19. A reasoned action approach to health promotion.

    Science.gov (United States)

    Fishbein, Martin

    2008-01-01

    This article describes the integrative model of behavioral prediction (IM), the latest formulation of a reasoned action approach. The IM attempts to identify a limited set of variables that can account for a considerable proportion of the variance in any given behavior. More specifically, consistent with the original theory of reasoned action, the IM assumes that intentions are the immediate antecedents of behavior, but in addition, the IM recognizes that environmental factors and skills and abilities can moderate the intention-behavior relationship. Similar to the theory of planned behavior, the IM also assumes that intentions are a function of attitudes, perceived normative pressure and self-efficacy, but it views perceived normative pressure as a function of descriptive as well as of injunctive (i.e., subjective) norms. After describing the theory and addressing some of the criticisms directed at a reasoned action approach, the paper illustrates how the theory can be applied to understanding and changing health related behaviors.

  20. Days out of role due to common physical and mental conditions : results from the WHO World Mental Health surveys

    NARCIS (Netherlands)

    Alonso, J.; Petukhova, M.; Vilagut, G.; Chatterji, S.; Heeringa, S.; Uestuen, T. B.; Alhamzawi, A. O.; Viana, M. C.; Angermeyer, M.; Bromet, E.; Bruffaerts, R.; de Girolamo, G.; Florescu, S.; Gureje, O.; Haro, J. M.; Hinkov, H.; Hu, C-y; Karam, E. G.; Kovess, V.; Levinson, D.; Medina-Mora, M. E.; Nakamura, Y.; Ormel, J.; Posada-Villa, J.; Sagar, R.; Scott, K. M.; Tsang, A.; Williams, D. R.; Kessler, R. C.; Ustun, T.B.; de, Girolamo G.

    2011-01-01

    Days out of role because of health problems are a major source of lost human capital. We examined the relative importance of commonly occurring physical and mental disorders in accounting for days out of role in 24 countries that participated in the World Health Organization (WHO) World Mental

  1. 25 CFR 36.82 - May behavioral health professional(s) provide services during the academic school day?

    Science.gov (United States)

    2010-04-01

    ...) provide services during the academic school day? Behavioral health professional(s) must average at least... 25 Indians 1 2010-04-01 2010-04-01 false May behavioral health professional(s) provide services during the academic school day? 36.82 Section 36.82 Indians BUREAU OF INDIAN AFFAIRS, DEPARTMENT OF THE...

  2. Environment and Health in Children Day Care Centres (ENVIRH) - Study rationale and protocol.

    Science.gov (United States)

    Araújo-Martins, J; Carreiro Martins, P; Viegas, J; Aelenei, D; Cano, M M; Teixeira, J P; Paixão, P; Papoila, A L; Leiria-Pinto, P; Pedro, C; Rosado-Pinto, J; Annesi-Maesano, I; Neuparth, N

    2014-01-01

    Indoor air quality (IAQ) is considered an important determinant of human health. The association between exposure to volatile organic compounds, particulate matter, house dust mite, molds and bacteria in day care centers (DCC) is not completely clear. The aim of this project was to study these effects. This study comprised two phases. Phase I included an evaluation of 45 DCCs (25 from Lisbon and 20 from Oporto, targeting 5161 children). In this phase, building characteristics, indoor CO2 and air temperature/relative humidity, were assessed. A children's respiratory health questionnaire derived from the ISAAC (International Study on Asthma and Allergies in Children) was also distributed. Phase II encompassed two evaluations and included 20 DCCs selected from phase I after a cluster analysis (11 from Lisbon and 9 from Oporto, targeting 2287 children). In this phase, data on ventilation, IAQ, thermal comfort parameters, respiratory and allergic health, airway inflammation biomarkers, respiratory virus infection patterns and parental and child stress were collected. In Phase I, building characteristics, occupant behavior and ventilation surrogates were collected from all DCCs. The response rate of the questionnaire was 61.7% (3186 children). Phase II included 1221 children. Association results between DCC characteristics, IAQ and health outcomes will be provided in order to support recommendations on IAQ and children's health. A building ventilation model will also be developed. This paper outlines methods that might be implemented by other investigators conducting studies on the association between respiratory health and indoor air quality at DCC. Copyright © 2013 Sociedade Portuguesa de Pneumologia. Published by Elsevier España. All rights reserved.

  3. Health benefits achieved through the Seventh-Day Adventist Wellness Challenge program.

    Science.gov (United States)

    Kamieneski, R; Brown, C M; Mitchell, C; Perrin, K M; Dindial, K

    2000-11-01

    The Wellness Challenge program introduces the philosophy of the healing power of God and stresses the importance of developing a sense of spirituality in conjunction with the promotion of good health. To employ scientific rigor to the outcome measures of the Seventh-Day Adventist Wellness Challenge program. A 2-tailed, paired sample t test. East Pasco Medical Center in Zephyrhills, Fla. 165 participants. Presurvey, 21-day outpatient wellness intervention; postsurvey, 6 weeks after completion of the program. Changes in behaviors related to cigarette smoking, alcohol use, eating patterns, exercise, water consumption, rest, relaxation, and time spent outdoors, as well as demographic data. Statistically significant differences were found between the pre- and postprogram clinical and laboratory test results for the participants' blood pressure, weight, glucose levels, and cholesterol at .05 alpha. Furthermore, self-health improvements measured by a pre- and postsurvey response confirmed statistically significant improvement in participants' willingness to improve their lifestyle behaviors for a potentially greater quality of life. The Wellness Challenge program offers ways to reduce risk factors related to chronic disease while improving the quality of life within an adult population by allowing people to slowly incorporate newly acquired tools into their everyday life.

  4. Nutrition in the first 1000 days and respiratory health: A descriptive review of the last five years' literature.

    Science.gov (United States)

    Verduci, E; Martelli, A; Miniello, V L; Landi, M; Mariani, B; Brambilla, M; Diaferio, L; Peroni, D G

    The aim of this paper is to discuss the current evidence regarding short and long-term health respiratory effects of nutrients and dietary patterns during the first 1000 days from conception. Population of interest included children from birth to two years and their mothers (during pregnancy and lactation). Studies were searched on MEDLINE® and Cochrane database, inserting individually and using the Boolean ANDs and ORs, 'nutrients', 'micronutrients', 'LC-PUFA', 'Mediterranean Diet', 'human milk', 'complementary food', 'pregnancy', 'respiratory disease', 'pulmonary disease', 'asthma', 'epigenetics', 'first 1000 days', 'maternal diet' and 'respiratory health'. All sources were retrieved between 01-09-2015 and 07-12-2016. While unhealthy maternal dietary patterns (high fat intake) during pregnancy can result in alteration of foetal lung development, with increased risk of respiratory disorders, Mediterranean diet has been associated with a lower risk of allergic sensitisation and allergic rhinitis. Breastfeeding has beneficial effects on respiratory infections while evidences about its protective effect on allergic disorders are unclear. During complementary feeding there is no evidence to avoid or encourage exposition to 'highly allergenic' foods to have modification of tolerance development. In children from birth to two years of age, Mediterranean diet has been associated with a lower risk of atopy, wheezing and asthma. Micronutrients, antioxidant and LCPUFA supplementation is not recommended and a whole food approach should be preferred, except for Vitamin D. Copyright © 2017 SEICAP. Published by Elsevier España, S.L.U. All rights reserved.

  5. Navigation Study of Lower Lock Approach, John Day Lock and Dam, Columbia River, Oregon

    National Research Council Canada - National Science Library

    Wilson, Donald

    2001-01-01

    Representatives of the Columbia River Towing Association reported recent structural and/or operational changes at John Day Lock and Dam have created difficult navigation conditions for tows entering...

  6. Effects of Adult Day Care on Daily Stress of Caregivers: A Within-Person Approach

    Science.gov (United States)

    Kim, Kyungmin; Femia, Elia E.; Almeida, David M.; Savla, Jyoti; Molenaar, Peter C. M.

    2011-01-01

    Objectives. This article examined exposure to and appraisal of care-related stressors associated with use of adult day services (ADS) by family caregivers of individuals with dementia. Methods. Using a within-person withdrawal design (A-B-A-B), we compared caregivers’ exposure to and appraisal of behavior problems on days their relative attended and did not attend ADS. Participants were 121 family caregivers enrolling a relative with dementia in an ADS program. Daily assessments were obtained prior to the person's attending ADS for the first time and after 1 and 2 months of attendance on days the person attended and did not attend ADS. Results. Total exposure to stressors and stress appraisals decreased significantly over time on ADS days compared with non-ADS days. Most of this difference was accounted by the time the person with dementia was away from the caregiver, but there were also significant reductions in behavioral problems during the evening and improved sleep immediately following ADS use. Discussion. ADS use lowered caregivers’ exposure to stressors and may improve behavior and sleep for people with dementia on days they have ADS. The study highlights how a within-person design can identify the effects of an intermittent intervention, such as ADS. PMID:21642593

  7. Religious involvement and health-related behaviors among Black Seventh-Day Adventists in Canada.

    Science.gov (United States)

    McKenzie, Monica M; Modeste, Naomi N; Marshak, Helen Hopp; Wilson, Colwick

    2015-03-01

    Most studies that involve Black Seventh-Day Adventists (SDAs) have been conducted in the United States. We sought to examine the association between religious involvement and lifestyle practices among Black SDAs in Canada. A convenience sample of 509 Black SDA church members 18 years and older completed a self-administered questionnaire, assessing religious involvement and seven lifestyle practices promoted by the SDA church: diet, physical activity, water intake, exposure to sunlight, alcohol use, caffeine and tobacco use, and rest. Compliance with lifestyle practices ranged from a low of 10% meeting fitness guidelines to a high of 99% abstaining from tobacco products. Religious involvement and lifestyle were positively related (rs = .11, p < .05). Multivariate analyses indicated that private religious practice (β = .16, p =.003), importance of the health principles (β = .17, p = .003), and acceptance of health principles (β = .65, p = .00001) significantly predicted the number of behaviors practiced. Greater religious involvement is associated with positive lifestyle practices but is not an independent predictor of lifestyle practices for Black Canadian SDAs. © 2014 Society for Public Health Education.

  8. An Effective Approach to Improving Day-Case Rates following Laparoscopic Cholecystectomy

    Directory of Open Access Journals (Sweden)

    M. G. Clarke

    2011-01-01

    Full Text Available Background. Day-case laparoscopic cholecystectomy (LC is a safe and cost-effective treatment for gallstones. In 2006, our institution recorded an 86% laparoscopic, 10% day-case, and 5% readmission rate. A gallbladder pathway was therefore introduced in 2007 with the aim of increasing daycase rates. Methods. Patients with symptomatic gallstones, proven on ultrasound, were referred to a specialist-led clinic. Those suitable for surgery were consented, preassessed, and provided with a choice of dates. All defaulted to day case unless deemed unsuitable due to comorbidity or social factors. Results. The number of cholecystectomies increased from 464 in 2006 to 578 in 2008. Day-case rates in 2006, 2007, 2008, and June 2009 were 10%, 20%, 30%, and 61%, respectively. Laparoscopic and readmission rates remained unchanged. Conversion rates for elective cholecystectomy fell from 6% in 2006 to 3% in 2009. Conclusions. Development of a gallbladder pathway increased day-case rates sixfold without an associated increase in conversion or readmission rates.

  9. A Latter-day Saint Approach to Addiction: Aetiology, Consequences and Treatment in a Theological Context

    Directory of Open Access Journals (Sweden)

    James D. Holt

    2014-12-01

    Full Text Available This article explores the theological underpinning of the nature, aetiology and treatment of addictions within The Church of Jesus Christ of Latter-day Saints. The first section outlines the “plan of salvation” and how this provides the theological framework for the source and solution to addictions. The final section explores addiction against this background in terms of its aetiology, types, consequences and treatment in a Latter-day Saint context. In so doing it builds on the recognition by the Church in recent years that addiction is a problem in the lives of some of its members and that treatment programs coherent with its teachings and beliefs are necessary. The article concludes by suggesting that while addiction may be more openly discussed within a Latter-day Saint context there is a need to keep this dialogue moving forward. This article does not examine Latter-day Saint teaching within the wider context of psychotherapy and other definitions of addiction; rather it explores the place of addiction as understood within the theological and ecclesiological context of Mormonism.

  10. Formalizing the First Day in an Organic Chemistry Laboratory Using a Studio-Based Approach

    Science.gov (United States)

    Collison, Christina G.; Cody, Jeremy; Smith, Darren; Swartzenberg, Jennifer

    2015-01-01

    A novel studio-based lab module that incorporates student-centered activities was designed and implemented to introduce second-year undergraduate students to the first-semester organic chemistry laboratory. The "First Day" studio module incorporates learning objectives for the course, lab safety, and keeping a professional lab notebook.

  11. World Sight Day 2013 Memorandum - Farabi Statement on the Prevention of Blindness and Eye Health

    Directory of Open Access Journals (Sweden)

    S-Farzad Mohammadi

    2013-12-01

    Full Text Available The World Sight Day (WSD is held on the 2nd Thursday of October to emphasize the importance of sight and impact of vision impairment. This observance is a joint initiative of the International Agency for the Prevention of Blindness (IAPB, the World Health Organization (WHO and other international non-governmental organizations.1 The celebration resonates with Vision 2020 initiative for the control of avoidable blindness by the year 2020. It can promote professional as well as public awareness about sight and vision impairment. This is wise as we know that most cases of visual impairment are preventable or treatable; nonetheless there are more than 280 million people, including 19 million children, who live with visual impairment.2 This is much more a priority for the developing countries because they inhabit 90% of the visually impaired.3 Epidemiological transition has already commenced in the developing world4-7 but they are not ready to take care of the age-related blinding conditions. Non-governmental and community organizations would probably be the ideal entities to organize and celebrate WSD on a national level. But participation from a wide range of state and humanitarian bodies and even leading figures and celebrities is conceivable and welcomed. This should culminate in community initiatives for wanting resources and fund raising, and should influence policy-makers to develop and implement blindness prevention programs. The WHO Action Plan 2013 on the prevention of avoidable blindness and visual impairment has suggested the theme ‘Universal Eye Health’ for WSD 2013. The plan seeks “integration of comprehensive eye care (from promotion to rehabilitation services into health systems”, and expects to address equity challenge. The theme is so ambitious and encompassing that might continue as a consistent one in the next years, focusing on a different aspect of the theme each year. The call to action in 2013 was ‘Get your Eyes

  12. A novel surveillance approach for disaster mental health.

    Directory of Open Access Journals (Sweden)

    Oliver Gruebner

    Full Text Available Disasters have substantial consequences for population mental health. Social media data present an opportunity for mental health surveillance after disasters to help identify areas of mental health needs. We aimed to 1 identify specific basic emotions from Twitter for the greater New York City area during Hurricane Sandy, which made landfall on October 29, 2012, and to 2 detect and map spatial temporal clusters representing excess risk of these emotions.We applied an advanced sentiment analysis on 344,957 Twitter tweets in the study area over eleven days, from October 22 to November 1, 2012, to extract basic emotions, a space-time scan statistic (SaTScan and a geographic information system (QGIS to detect and map excess risk of these emotions.Sadness and disgust were among the most prominent emotions identified. Furthermore, we noted 24 spatial clusters of excess risk of basic emotions over time: Four for anger, one for confusion, three for disgust, five for fear, five for sadness, and six for surprise. Of these, anger, confusion, disgust and fear clusters appeared pre disaster, a cluster of surprise was found peri disaster, and a cluster of sadness emerged post disaster.We proposed a novel syndromic surveillance approach for mental health based on social media data that may support conventional approaches by providing useful additional information in the context of disaster. We showed that excess risk of multiple basic emotions could be mapped in space and time as a step towards anticipating acute stress in the population and identifying community mental health need rapidly and efficiently in the aftermath of disaster. More studies are needed to better control for bias, identify associations with reliable and valid instruments measuring mental health, and to explore computational methods for continued model-fitting, causal relationships, and ongoing evaluation. Our study may be a starting point also for more fully elaborated models that can

  13. Cultural/Favorite Recipe Day: Strengthening Approaches to Increase Culturally Diverse Foods Served in Head Start Meals

    Science.gov (United States)

    Hoffman, Jessica A.; Agrawal, Tara; Carter, Sonia; Grinder, AnnMarie; Castaneda-Sceppa, Carmen

    2012-01-01

    One approach to halting the childhood obesity epidemic has been the modification of foods available to children during the school day. In recent years there has been an increased focus on obesity prevention efforts among children ages birth to 5 and the role of child care settings in prevention efforts. Head Start serves as an important venue for…

  14. International convention on World Homoeopathy Day: Integrating Homoeopathy in health care delivery

    Directory of Open Access Journals (Sweden)

    Anil Khurana

    2016-01-01

    Full Text Available An International Convention on World Homoeopathy Day was held to commemorate the 261 st birth anniversary of Dr. Samuel Hahnemann on 9 th -10 th April 2016, at Vigyan Bhawan, New Delhi, India. The theme of the Convention was "Integrating Homoeopathy in Healthcare" for achieving Universal Health Coverage (UHC as advocated by the World Health Organization (WHO. The Convention made for an ideal platform for extensive deliberations on the existing global scenario of Homoeopathy, with particular reference to India, strategy building and formulation of national policies for worldwide promotion, safety, quality, and effectiveness of medicines, evolving standards of education, international cooperation, and evidence-based practice of Homoeopathy. Organized jointly by Central Council for Research in Homoeopathy (CCRH, an autonomous research organization of Ministry of AYUSH, Government of India, and Liga Medicorum Homoeopathica Internationalis (LMHI, the Convention witnessed presentations of more than 100 papers during 21 technical sessions held in parallel in four halls, each named after homoeopathic stalwarts, viz., Hahnemann, Boenninghansen, Hering, and Kent.

  15. Family environment, coping, and mental health in adolescents attending therapeutic day schools.

    Science.gov (United States)

    Rodriguez, Erin M; Donenberg, Geri R; Emerson, Erin; Wilson, Helen W; Brown, Larry K; Houck, Christopher

    2014-10-01

    This study examined associations among family environment, coping, and emotional and conduct problems in adolescents attending therapeutic day schools due to mental health problems. Adolescents (N = 417; 30.2% female) ages 13-20 (M = 15.25) reported on their family environment (affective involvement and functioning), coping (emotion-focused support-seeking, cognitive restructuring, avoidant actions), and emotional and conduct problems. Poorer family environment was associated with less emotion-focused support-seeking and cognitive restructuring, and more emotional and conduct problems. Emotional problems were negatively associated with cognitive restructuring, and conduct problems were negatively associated with all coping strategies. Cognitive restructuring accounted for the relationship between family environment and emotional problems. Cognitive restructuring and emotion-focused support-seeking each partially accounted for the relationship between family functioning and conduct problems, but not the relationship between family affective involvement and conduct problems. Findings implicate the role of coping in the relationship between family environment and adolescent mental health. Copyright © 2014 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.

  16. A regime-switching copula approach to modeling day-ahead prices in coupled electricity markets

    DEFF Research Database (Denmark)

    Pircalabu, Anca; Benth, Fred Espen

    2017-01-01

    significant evidence of tail dependence in all pairs of interconnected areas we consider. As a first application of the proposed model, we consider the pricing of financial transmission rights, and highlight how the choice of marginal distributions and copula impacts prices. As a second application we......The recent price coupling of many European electricity markets has triggered a fundamental change in the interaction of day-ahead prices, challenging additionally the modeling of the joint behavior of prices in interconnected markets. In this paper we propose a regime-switching AR–GARCH copula...... to model pairs of day-ahead electricity prices in coupled European markets. While capturing key stylized facts empirically substantiated in the literature, this model easily allows us to 1) deviate from the assumption of normal margins and 2) include a more detailed description of the dependence between...

  17. Exploring Organized and Visionary Approaches to Designing an Advent Fun Day in an Educational Setting

    Science.gov (United States)

    Francis, Leslie J.; Smith, Greg

    2015-01-01

    This study draws on one of the four components of psychological type theory (the distinction between judging and perceiving attitudes toward the outside world) to examine the implications of these two contrasting psychological perspectives for shaping approaches to Christian ministry within an educational setting. Qualitative data were generated…

  18. Economic evaluation of a Child Health Days strategy to deliver multiple maternal and child health interventions in Somalia.

    Science.gov (United States)

    Vijayaraghavan, Maya; Wallace, Aaron; Mirza, Imran Raza; Kamadjeu, Raoul; Nandy, Robin; Durry, Elias; Everard, Marthe

    2012-03-01

    Child Health Days (CHDs) are increasingly used by countries to periodically deliver multiple maternal and child health interventions as time-limited events, particularly to populations not reached by routine health services. In countries with a weak health infrastructure, this strategy could be used to reach many underserved populations with an integrated package of services. In this study, we estimate the incremental costs, impact, cost-effectiveness, and return on investment of 2 rounds of CHDs that were conducted in Somalia in 2009 and 2010. We use program costs and population estimates reported by the World Health Organization and United Nations Children's Fund to estimate the average cost per beneficiary for each of 9 interventions delivered during 2 rounds of CHDs implemented during the periods of December 2008 to May 2009 and August 2009 to April 2010. Because unstable areas were unreachable, we calculated costs for targeted and accessible beneficiaries. We model the impact of the CHDs on child mortality using the Lives Saved Tool, convert these estimates of mortality reduction to life years saved, and derive the cost-effectiveness ratio and the return on investment. The estimated average incremental cost per intervention for each targeted beneficiary was $0.63, with the cost increasing to $0.77 per accessible beneficiary. The CHDs were estimated to save the lives of at least 10,000, or 500,000 life years for both rounds combined. The CHDs were cost-effective at $34.00/life year saved. For every $1 million invested in the strategy, an estimated 615 children's lives, or 29,500 life years, were saved. If the pentavalent vaccine had been delivered during the CHDs instead of diphtheria-pertussis-tetanus vaccine, an additional 5000 children's lives could have been saved. Despite high operational costs, CHDs are a very cost-effective service delivery strategy for addressing the leading causes of child mortality in a conflict setting like Somalia and compare

  19. Ensemble ANNs-PSO-GA Approach for Day-ahead Stock E-exchange Prices Forecasting

    Directory of Open Access Journals (Sweden)

    Yi Xiao

    2013-02-01

    Full Text Available Stock e-exchange prices forecasting is an important financial problem that is receiving increasing attention. This study proposes a novel three-stage nonlinear ensemble model. In the proposed model, three different types of neural-network based models, i.e. Elman network, generalized regression neural network (GRNN and wavelet neural network (WNN are constructed by three non-overlapping training sets and are further optimized by improved particle swarm optimization (IPSO. Finally, a neural-network-based nonlinear meta-model is generated by learning three neural-network based models through support vector machines (SVM neural network. The superiority of the proposed approach lies in its flexibility to account for potentially complex nonlinear relationships. Three daily stock indices time series are used for validating the forecasting model. Empirical results suggest the ensemble ANNs-PSO-GA approach can significantly improve the prediction performance over other individual models and linear combination models listed in this study.

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

    Science.gov (United States)

    Davidson, H. Clint, Jr.

    2004-01-01

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

  1. Similarity-based multi-model ensemble approach for 1-15-day advance prediction of monsoon rainfall over India

    Science.gov (United States)

    Jaiswal, Neeru; Kishtawal, C. M.; Bhomia, Swati

    2018-04-01

    The southwest (SW) monsoon season (June, July, August and September) is the major period of rainfall over the Indian region. The present study focuses on the development of a new multi-model ensemble approach based on the similarity criterion (SMME) for the prediction of SW monsoon rainfall in the extended range. This approach is based on the assumption that training with the similar type of conditions may provide the better forecasts in spite of the sequential training which is being used in the conventional MME approaches. In this approach, the training dataset has been selected by matching the present day condition to the archived dataset and days with the most similar conditions were identified and used for training the model. The coefficients thus generated were used for the rainfall prediction. The precipitation forecasts from four general circulation models (GCMs), viz. European Centre for Medium-Range Weather Forecasts (ECMWF), United Kingdom Meteorological Office (UKMO), National Centre for Environment Prediction (NCEP) and China Meteorological Administration (CMA) have been used for developing the SMME forecasts. The forecasts of 1-5, 6-10 and 11-15 days were generated using the newly developed approach for each pentad of June-September during the years 2008-2013 and the skill of the model was analysed using verification scores, viz. equitable skill score (ETS), mean absolute error (MAE), Pearson's correlation coefficient and Nash-Sutcliffe model efficiency index. Statistical analysis of SMME forecasts shows superior forecast skill compared to the conventional MME and the individual models for all the pentads, viz. 1-5, 6-10 and 11-15 days.

  2. The Effects of Adult Day Services on Family Caregivers’ Daily Stress, Affect, and Health: Outcomes From the Daily Stress and Health (DaSH) Study

    OpenAIRE

    Zarit, Steven H.; Kim, Kyungmin; Femia, Elia E.; Almeida, David M.; Klein, Laura C.

    2013-01-01

    Purpose: We examine the effects of use of adult day service (ADS) by caregivers of individuals with dementia (IWD) on daily stressors, affect, and health symptoms. Participants were interviewed for 8 consecutive days. On some days, the IWD attended an ADS program and on the other days caregivers provide most or all of the care at home. Methods: Participants were 173 family caregivers of IWDs using an ADS program. Daily telephone interviews assessed care-related stressors, noncare stressors, p...

  3. Challenges in the management of nutritional disorders and communicable diseases in child day care centers: a quantitative and qualitative approach.

    Science.gov (United States)

    Konstantyner, Tulio; Konstantyner, Thais Cláudia Roma de Oliveira; Toloni, Maysa Helena Aguiar; Longo-Silva, Giovana; Taddei, José Augusto de Aguiar Carrazedo

    2017-03-01

    In Brazil, although many children from low income families attend day care centers with appropriate hygiene practices and food programs, they have nutritional disorders and communicable diseases. This quantitative and qualitative cross-sectional study identified staff challenges in child day care centers and suggested alternative activity management to prevent nutritional disorders and communicable diseases. The study included 71 nursery teachers and 270 children from public and philanthropic day care centers (teacher to child ratios of 1:2.57 and 1:6.40, respectively). Interviews and focus groups were conducted with teachers and parents, and anthropometry and blood samples were drawn from the children by digital puncture. Children in philanthropic child day care centers were more likely to be hospitalized due to communicable diseases. Teachers from philanthropic child day care centers had lower age, income and education and higher work responsibilities based on the number of children and working time. The focus groups characterized institutions with organized routines, standard food practices, difficulties with caretaking, and lack of training to provide healthcare to children. Strategies to improve children's health in day care settings should focus on training of teachers about healthcare and nutrition.

  4. Games and playthings in a child day care center: a bioecological approach

    Directory of Open Access Journals (Sweden)

    Rute Estanislava Tolocka

    2010-02-01

    Full Text Available Social changes have contributed to decreased opportunities for children to perform physical activities. Children have been introduced in preschools where the opportunities of playing are insufficient, thus being deprived of the benefits of such activity. The aim of this study was to analyze the relationship between ludic physical activities and child development. A descriptive study was conducted on 68 children of both genders, aged 4 to 6 years, from a public child day care center. A physical education program was offered twice per week and an event involving other children was carried out. Activities, social roles, interpersonal relations, emotions, and personal characteristics were analyzed. Improvement was observed in interpersonal relations and social relationships, as well as in emotional control. Basic emotions and different child characteristics were expressed. Thus, the introduction of games and playthings at school may contribute to child development and to the engagement of children in physical activities.

  5. Diet quality on meatless days: National Health and Nutrition Examination Survey (NHANES), 2007-2012.

    Science.gov (United States)

    Conrad, Zach; Karlsen, Micaela; Chui, Kenneth; Jahns, Lisa

    2017-06-01

    To compare diet quality scores between adult non-meat eaters and meat eaters, and to compare the consumption of diet components across quintiles of diet quality. Cross-sectional analysis. The Healthy Eating Index-2010 (HEI-2010) and Alternative Healthy Eating Index-2010 (AHEI-2010) were used to assess mean diet quality. Differences in consumption of diet components between quintiles of diet quality were tested using post hoc Wald tests and z tests. The National Health and Nutrition Examination Survey (NHANES), 2007-2012. The sample consisted of 16810 respondents aged≥18 years, including 280 individuals who reported not consuming meat, poultry, game birds or seafood on two non-consecutive days of dietary recall. Dietary data were obtained from one dietary recall per individual. Non-meat eaters had substantially greater HEI-2010 and AHEI-2010 scores than meat eaters (Pempty calories and unsaturated:saturated fatty acids. Mean consumption across AHEI-2010 quintiles demonstrated different (Pempty calories, and increased consumption of nuts and legumes, PUFA and vegetables, as a way to improve overall dietary quality.

  6. 78 FR 56901 - Submission for OMB Review; 30-day Comment Request: Family Life, Activity, Sun, Health, and Eating...

    Science.gov (United States)

    2013-09-16

    ...; 30-day Comment Request: Family Life, Activity, Sun, Health, and Eating (FLASHE) Study (NCI) SUMMARY... Collection: Family Life, Activity, Sun, Health, and Eating (FLASHE) Study (NCI), 0925-NEW, Expiration Date xx... behaviors (but also examining other behaviors such as sleep, sun-safety, and tobacco) in new ways not...

  7. Effects of health insurance on non-working married women's medical care use and bed days at home.

    Science.gov (United States)

    Lee, Changwoo; Shin, Euichul

    2013-07-01

    This study examines whether bed days are alternative methods to medical care use for treating a particular illness. If bed days at home are considered as an alternative to medical treatment, then medical care use and bed days at home should be influenced by an individual's health insurance status. This study uses data from the 2003 Medical Expenditure Panel Survey (MEPS) on medical care use and bed days at home for each contracted illness of non-working married women. The results suggest that the health insurance status of non-working married women has considerable influence on their choice between medical care use and bed days at home. In addition, those with health insurance are more likely to use medical care and less likely to use bed days at home, but they tend to avoid the simultaneous use of medical care and bed days at home. In contrast to previous studies' findings indicating that absences from work and medical care use among working males may be complements, this study's results for non-working married women without health insurance suggest that they use rest and medical treatment as substitutes, not complements.

  8. Effects of health insurance on non-working married women’s medical care use and bed days at home

    Science.gov (United States)

    2013-01-01

    Background This study examines whether bed days are alternative methods to medical care use for treating a particular illness. If bed days at home are considered as an alternative to medical treatment, then medical care use and bed days at home should be influenced by an individual’s health insurance status. Method This study uses data from the 2003 Medical Expenditure Panel Survey (MEPS) on medical care use and bed days at home for each contracted illness of non-working married women. Results The results suggest that the health insurance status of non-working married women has considerable influence on their choice between medical care use and bed days at home. In addition, those with health insurance are more likely to use medical care and less likely to use bed days at home, but they tend to avoid the simultaneous use of medical care and bed days at home. Conclusions In contrast to previous studies’ findings indicating that absences from work and medical care use among working males may be complements, this study’s results for non-working married women without health insurance suggest that they use rest and medical treatment as substitutes, not complements. PMID:23816313

  9. Ecosystem Approaches to Human Health Graduate Training Awards ...

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

    IDRC's Ecosystem Approaches to Human Health (Ecohealth) program initiative ... Each grant will consist of CA $15 000 for field research and up to CA $4 000 for ... Nutrition, health policy, and ethics in the age of public-private partnerships.

  10. Mobile Health Approaches to Non-Communicable Diseases in ...

    African Journals Online (AJOL)

    Mobile Health Approaches to Non-Communicable Diseases in Rwanda ... child health, it would be cost-effective to leverage this infrastructure and adapt it for the NCD domain. .... gram currently exists in Rwanda that simultaneously ad-.

  11. A Data-driven Approach for Forecasting Next-day River Discharge

    Science.gov (United States)

    Sharif, H. O.; Billah, K. S.

    2017-12-01

    This study focuses on evaluating the performance of the Soil and Water Assessment Tool (SWAT) eco-hydrological model, a simple Auto-Regressive with eXogenous input (ARX) model, and a Gene expression programming (GEP)-based model in one-day-ahead forecasting of discharge of a subtropical basin (the upper Kentucky River Basin). The three models were calibrated with daily flow at the US Geological Survey (USGS) stream gauging station not affected by flow regulation for the period of 2002-2005. The calibrated models were then validated at the same gauging station as well as another USGS gauge 88 km downstream for the period of 2008-2010. The results suggest that simple models outperform a sophisticated hydrological model with GEP having the advantage of being able to generate functional relationships that allow scientific investigation of the complex nonlinear interrelationships among input variables. Unlike SWAT, GEP, and to some extent, ARX are less sensitive to the length of the calibration time series and do not require a spin-up period.

  12. 75 FR 3906 - Request for Public Comment: 30-Day Proposed Information Collection: Indian Health Service...

    Science.gov (United States)

    2010-01-25

    ... Proposed Information Collection: Indian Health Service Customer Satisfaction Survey AGENCY: Indian Health...: 0917-NEW, ``Indian Health Service Customer Satisfaction Survey.'' Type of Information Collection... facilities programs will make improvements that will result in improved quality of services. Voluntary...

  13. Health-promoting schools: evidence for a holistic approach to promoting health and improving health literacy.

    Science.gov (United States)

    Lee, Albert

    2009-01-01

    Chronic diseases are now the major causes of death and disability worldwide, and non-communicable diseases (NCD) account for the majority of the global health burden. About half of premature deaths are related to health-risking behaviours that are often established during youth and extend to adulthood. While these diseases might not be curable, they are preventable. Prevention is possible when sustained actions are directed at individuals and families, as well as at the broader social, economic and cultural determinants of NCD. A 'life-course' approach to promoting healthy behaviour should begin early in life. The aim of this article is to discuss the impact of the 'health-promoting school' (HPS) on improvements in youth health. HPS can be described as a holistic, whole-school approach in which a broad health education curriculum is supported by the environment and ethos of the school. HPS moves beyond individual behavioural change to consider organizational and policy change such as improving the physical and social environment of the school, as well as its curricula and teaching and learning methods. A positive culture for health would facilitate higher levels of health literacy by helping individuals tackle the determinants of health better as they build the personal, cognitive and social skills for maintaining good health. There is reasonable evidence to demonstrate that the whole-school approach using the HPS framework is effective in improving health, ranging from physical activities and healthy eating to emotional health. Schools adopting the HPS framework have demonstrated changes in culture and organizational practice to become more conducive to health improvement. These schools were reported to have better school health policies, higher degrees of community participation, and a more hygienic environment than non-HPS schools, and students in these schools had a more positive health behaviour profile. Health promotion and disease prevention is essential to

  14. Scientific days on electromagnetic fields: from dosimetry to human health - Conference proceedings

    International Nuclear Information System (INIS)

    Wiart, J.; Ghanmi, A.; Picon, O.; Conil, E.; Varsier, N.; Hadjem, A.; Sudret, B.; Magne, I.; Souques, M.; Gaudaire, F.; De Seze, R.; Jawad, O.; Lautru, D.; Dricot, J.M.; Horlin, F.; De Doncker, P.; Drissaoui, A.; Musy, F.; Nicolas, L.; Perrussel, R.; Scorretti, R.; Voyer, D.; Jala, M.; Moulines, E.; Levy-Leduc, C.; Mahfouz, Z.; Gati, A.; Fouad Hanna, V.; Leveque, P.; Arnaud-Cormos, D.; Zhadobov, M.; Jarrige, P.; Gaborit, G.; Kohler, S.; Ticaud, N.; Duvillaret, L.; Guelilia, Z.; Loison, R.; Gillard, R.; Laisne, A.; Favet, D.; Benadhira, R.; Mir, L.; Nadi, M.; Kourtiche, D.; Gazeau, F.; Wilhelm, C.; Delemotte, L.; Breton, M.; Tarek, M.; Marc-Vergnes, J.P.; Yardin, C.; Perrin, A.; Le Drean, Y.; Sauleau, R.; Lambrozo, J.; Selmaoui, B.; Ghosn, R.; Thuroczy, G.; Villegier, A.S.; Loos, N.; Brenet-Dufour, V.; Liabeuf, S.; Bach, V.; Moretti, D.; Lewis, N.; Garenne, A.; Poulletier De Gannes, F.; Haro, E.; Lagroye, I.; Bornat, Y.; Boutaib, Y.; Saighi, S.; Renaud, S.; Veyre, B.; Schuz, J.; Deltour, I.; Van Deventer, E.; Vecchia, P.; Merckel, O.; Bellaouel, A.; Demaret, P.; Donati, P.; Jovanovic, D.; Chauvin, S.; Desreumaux, J.P.; Fouquet, L.; Picard, D.; Massardier-Pilonchery, A.; Hours, M.; Bergeret, A.; Person, C.; Toutain, Y.; Butet, R.; Berrahma, K.; Balderelli, I.; Stelmaszyk, V.; Cretallaz, C.; Lamproglou, I.; Amourette, C.; Diserbo, M.; Fauquette, W.; Martigne, P.; Collin, A.; Lagroye, I.; Ait Aissa, S.; Hurtier, A.; Taxile, M.; Le Montagner, L.; Athane, A.; Duleu, S.; Percherancier, Y.; Geffard, M.; Ruffie, G.; Billaudel, B.; Veyret, B.; Pelletier, A.; Delanaud, S.; Libert, J.P.; Schunck, T.; Bieth, F.; Soubere Mahamoud, Y.; Le Quement, C.; Ferrand, G.; Le Guevel, R.; Carton, P.H.; Luong, M.; Tanvir, S.; Selmaoui, B.; Silva Pires-Antonietti, V.; Sonnet, P.; Pulvin, S.; Kuster, O.; Tetelin, C.

    2012-04-01

    This document brings together the available presentations (articles and slides) given at the URSI scientific days on electromagnetic fields: dosimetry, peoples' exposure, biological and health risks, risk management, and medical uses. 48 presentations are compiled in this document and deal with: 1 - Stochastic dosimetry: variability challenge; 2 - How to estimate the exposure to 50/60 Hz magnetic field in an epidemiological study?; 3 - Joint analysis of population exposure and radio coverage of GSM and UMTS mobile phone networks; 4 - Study of the specific energy absorption rate (SAR) sensitiveness to phone positions near the head for 2 GSM mobile phones; 5 - Statistical Study of SAR under Wireless Channel - Exposure in Indoor Environment; 6 - Uncertainty propagation in numerical dosimetry: how to reduce calculation costs?; 7 - Use of a simplified pregnant woman model for foetus exposure analysis; 8 - SAR estimation using multi-exposure with a mobile phone; 9 - State-of-the-art in experimental dosimetry (RF and pulses); 10 - Mm-waves dosimetry: issues, stakes and actual solutions; 11 - Use of DG-FDTD for a dosimetry calculation in a strongly multi-scale problem: determination of the eye-SAR near a HF/VHF vehicle-borne source; 12 - Dosimetric measurements with a fiber-type electro-optical sensor; 13 - Partial experimental evaluation of basic restrictions in the HF/VHF range; 14 - Repetitive trans-cranial magnetic stimulation Stimulation (rTMS) in psychiatry: present day situation and perspectives; 15 - Medical applications of electric fields; 16 - Measurements for life: new perspectives? 17 - Nano-particles and magnetic stimuli for medical imaging and therapy; 18 - Molecular Insights into electroporation and siRNA electro-transfer through model cell membranes; 19 - State of knowledge on electromagnetic fields hypersensitivity (HS-CEM); 20 - Experimentation methodology: from results to interpretation; 22 - Mm waves - update on biological effects at 40-60 GHz; 23

  15. Mental health recovery on care farms and day centres: a qualitative comparative study of users' perspectives.

    Science.gov (United States)

    Iancu, Sorana C; Zweekhorst, Marjolein B M; Veltman, Dick J; van Balkom, Anton J L M; Bunders, Joske F G

    2014-01-01

    Mental health services increasingly incorporate the vision of recovery. This qualitative study analysed and compared experiences of recovery on prevocational services, in order to assess if users make progress towards recovery, relative to a staged recovery model. Data were collected through semi-structured interviews with participants on care farms (n = 14), work (n = 7) and creative projects (n = 5). The transition from past to current lives was described as a progressive, non-linear process, with different stages guided by different goals. Participants on creative projects lacked clear goals, presented less interest in peers and high need for emotional support. Participants on work projects aimed for occupational rehabilitation, but struggled with the patient culture of the peer community. Participants on care farms aimed for daytime occupations and closer contact with society. They experienced care farms as open, real-life work settings where they could exercise responsibility and connect with people. Participants progressed towards recovery, as care farms, work- and creative projects empowered them to leave behind inactive, isolated or disorganized living. In day centres, users focused on self-reflection and personal development (creative projects) or on occupational performance (work projects), whereas on care farms, users fulfilled worker roles in a real-life, open community environment. Organized as open communities in real-life settings, care farms facilitate the reflection on personal and social responsibility, and therefore have the potential to help users internalize worker identities and improve their motivation to progress towards recovery. Supervisors on care farms are regarded by users as close contacts within the social networks they develop on the service, a position that allows supervisors to actively engage and promote users' progress towards recovery. Elements of the farm environment (such as the "normal life", presence of family

  16. A Social Work Approach to Policy: Implications for Population Health.

    Science.gov (United States)

    Miller, Daniel P; Bazzi, Angela R; Allen, Heidi L; Martinson, Melissa L; Salas-Wright, Christopher P; Jantz, Kathryn; Crevi, Katherine; Rosenbloom, David L

    2017-12-01

    The substantial disparities in health and poorer outcomes in the United States relative to peer nations suggest the need to refocus health policy. Through direct contact with the most vulnerable segments of the population, social workers have developed an approach to policy that recognizes the importance of the social environment, the value of social relationships, and the significance of value-driven policymaking. This approach could be used to reorient health, health care, and social policies. Accordingly, social workers can be allies to public health professionals in efforts to eliminate disparities and improve population health.

  17. A Social Work Approach to Policy: Implications for Population Health

    Science.gov (United States)

    Bazzi, Angela R.; Allen, Heidi L.; Martinson, Melissa L.; Salas-Wright, Christopher P.; Jantz, Kathryn; Crevi, Katherine; Rosenbloom, David L.

    2017-01-01

    The substantial disparities in health and poorer outcomes in the United States relative to peer nations suggest the need to refocus health policy. Through direct contact with the most vulnerable segments of the population, social workers have developed an approach to policy that recognizes the importance of the social environment, the value of social relationships, and the significance of value-driven policymaking. This approach could be used to reorient health, health care, and social policies. Accordingly, social workers can be allies to public health professionals in efforts to eliminate disparities and improve population health. PMID:29236535

  18. 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.

  19. Re-assessing Present Day Global Mass Transport and Glacial Isostatic Adjustment From a Data Driven Approach

    Science.gov (United States)

    Wu, X.; Jiang, Y.; Simonsen, S.; van den Broeke, M. R.; Ligtenberg, S.; Kuipers Munneke, P.; van der Wal, W.; Vermeersen, B. L. A.

    2017-12-01

    Determining present-day mass transport (PDMT) is complicated by the fact that most observations contain signals from both present day ice melting and Glacial Isostatic Adjustment (GIA). Despite decades of progress in geodynamic modeling and new observations, significant uncertainties remain in both. The key to separate present-day ice mass change and signals from GIA is to include data of different physical characteristics. We designed an approach to separate PDMT and GIA signatures by estimating them simultaneously using globally distributed interdisciplinary data with distinct physical information and a dynamically constructed a priori GIA model. We conducted a high-resolution global reappraisal of present-day ice mass balance with focus on Earth's polar regions and its contribution to global sea-level rise using a combination of ICESat, GRACE gravity, surface geodetic velocity data, and an ocean bottom pressure model. Adding ice altimetry supplies critically needed dual data types over the interiors of ice covered regions to enhance separation of PDMT and GIA signatures, and achieve half an order of magnitude expected higher accuracies for GIA and consequently ice mass balance estimates. The global data based approach can adequately address issues of PDMT and GIA induced geocenter motion and long-wavelength signatures important for large areas such as Antarctica and global mean sea level. In conjunction with the dense altimetry data, we solved for PDMT coefficients up to degree and order 180 by using a higher-resolution GRACE data set, and a high-resolution a priori PDMT model that includes detailed geographic boundaries. The high-resolution approach solves the problem of multiple resolutions in various data types, greatly reduces aliased errors from a low-degree truncation, and at the same time, enhances separation of signatures from adjacent regions such as Greenland and Canadian Arctic territories.

  20. FDI-Unilever Brush Day & Night partnership: 12 years of improving behaviour for better oral health.

    Science.gov (United States)

    Kell, Kathryn; Aymerich, Marie-Anne; Horn, Virginie

    2018-05-01

    Twelve years ago, FDI World Dental Federation and Unilever Oral Care began a partnership to raise awareness of oral health globally. This aim reflects FDI's mission to "lead the world to optimal oral health", and one of the goals set by the Unilever Sustainable Living Plan "to improve health and well-being for more than 1 billion" by 2020. This partnership has developed a series of public health programmes to improve the brushing habits of targeted populations through health promotion and educational campaigns worldwide. Building on the success of the first two phases of the partnership, the third phase (Phase III), named Brush Day & Night, aimed to educate children in brushing twice-daily with fluoride toothpaste via a 21 Day school programme. This article reports the main outcomes of the past 12 years of this partnership, in particular the key outreach and figures of Phase III evaluation. School programmes were implemented in 10 countries, where local teams collected data from children aged between 2 and 12 years to monitor their oral health behaviours using specific indicators. In addition to the school programme, the World Oral Health Day was used as a vehicle to convey oral health awareness to influential governing bodies and the public. As a result, over 4 million people were directly reached by the programme in 2016. © 2018 FDI World Dental Federation.

  1. Discharge on the day of birth, parental response and health and schooling outcomes

    DEFF Research Database (Denmark)

    Sievertsen, Hans Henrik; Wüst, Miriam

    Exploiting the Danish roll-out of same-day discharge policies, we find that treated newborns have a higher probability of first-month hospital readmission. This result may suggest that parents substitute postpartum hospital stays with readmissions. However, a same-day discharge also increases the...

  2. Discharge on the day of birth, parental response and health and schooling outcomes

    DEFF Research Database (Denmark)

    Sievertsen, Hans Henrik; Wüst, Miriam

    2017-01-01

    also find that—in the longer run—a same-day discharge decreases children's 9th grade GPA. This effect is driven by children and mothers, who prior to the policy change would have been least likely to experience a same-day discharge. Using administrative and survey data to assess potential mechanisms...

  3. Adolescent health: a rural community's approach.

    Science.gov (United States)

    Groft, Jean N; Hagen, Brad; Miller, Nancy K; Cooper, Natalie; Brown, Sharon

    2005-01-01

    Significant health problems encountered in adulthood often have their roots in health behaviours initiated during adolescence. In order to reverse this trend, school and health personnel, as well as parents and other community members working with high school students, need to be aware of the health-related beliefs and choices that guide the behaviours of teenagers. Although a wide variety of research has been conducted on this topic among urban adolescents, less is known about the health beliefs and behaviors of adolescents residing in rural areas, particularly in Canada. In general, rural Canadians are less healthy than their urban counterparts. Building on the knowledge and understanding of their own community, key stakeholders were invited to engage in the design and implementation of a participatory action research project aimed at understanding and improving the health of rural adolescents. A group of parents, teachers, students, school administrators and public health nurses engaged in a participatory action research project to better understand determinants of the health of rural adolescents at a high school in Western Canada. Group members developed and administered a health survey to 288 students from a small rural high school, in an effort to identify areas of concern and interest regarding health practices and beliefs of rural adolescents, and to take action on these identified concerns. Results indicated some interesting but potentially worrying trends in this population. For example, while frequent involvement in a physical activity was noted by 75.9% of participants, close to half of the females (48%) described their body image as 'a little overweight' or 'definitely overweight', and approximately 25.8% of respondents noted that they skipped meals most of the time. Differences between the genders were apparent in several categories. For example, more girls smoked (16.2%) than boys (12.3%), and more males (55.0%) than females (41%) had tried illegal

  4. [Academic review of global health approaches: an analytical framework].

    Science.gov (United States)

    Franco-Giraldo, Alvaro

    2015-09-01

    In order to identify perspectives on global health, this essay analyzes different trends from academia that have enriched global health and international health. A database was constructed with information from the world's leading global health centers. The search covered authors on global diplomacy and global health and was performed in PubMed, LILACS, and Google Scholar with the key words "global health" and "international health". Research and training centers in different countries have taken various academic approaches to global health; various interests and ideological orientations have emerged in relation to the global health concept. Based on the mosaic of global health centers and their positions, the review concludes that the new concept reflects the construction of a paradigm of renewal in international health and global health, the pre-paradigmatic stage of which has still not reached a final version.

  5. Economic and Managerial Approach of Health Insurances

    Directory of Open Access Journals (Sweden)

    Marinela BOBOC

    2005-10-01

    Full Text Available The paper represents an analysis in the domain of the social insurances for health care. It emphasizes the necessity and the opportunity ofcreating in Romania a medical service market based on the competing system. In Romania, the social insurances for health care are at their verybeginning. The development of the domain of the private insurances for health care is prevented even by its legislation, due to the lack of a normativeact that may regulate the management of the private insurances for health care. The establishment of the legislation related to the optional insurancesfor health care might lead to some activity norms for the companies which carry out optional insurances for health care. The change of the legislationis made in order to create normative and financial opportunities for the development of the optional medical insurances. This change, as part of thesocial protection of people, will positively influence the development of the medical insurance system. The extension of the segment of the optionalinsurances into the medical insurance segment increases the health protection budget with the value of the financial sources which do not belong tothe budgetary funds.

  6. ECONOMIC AND MANAGERIAL APPROACH OF HEALTH INSURANCES

    Directory of Open Access Journals (Sweden)

    Georgeta Dragomir

    2007-05-01

    Full Text Available The paper represents an analysis in the domain of the social insurances for health care. It emphasizesthe necessity and the opportunity of creating in Romania a medical service market based on the competingsystem. In Romania, the social insurances for health care are at their very beginning. The development of thedomain of the private insurances for health care is prevented even by its legislation, due to the lack of anormative act that may regulate the management of the private insurances for health care. The establishment ofthe legislation related to the optional insurances for health care might lead to some activity norms for thecompanies which carry out optional insurances for health care. The change of the legislation is made in order tocreate normative and financial opportunities for the development of the optional medical insurances. Thischange, as part of the social protection of people, will positively influence the development of the medicalinsurance system. The extension of the segment of the optional insurances into the medical insurance segmentincreases the health protection budget with the value of the financial sources which do not belong to thebudgetary funds.

  7. "Happy feet": evaluating the benefits of a 100-day 10,000 step challenge on mental health and wellbeing.

    Science.gov (United States)

    Hallam, K T; Bilsborough, S; de Courten, M

    2018-01-24

    An increased awareness of the health benefits of walking has emerged with the development and refinement of accelerometer equipment. Evidence is beginning to highlight the value of promoting walking, particularly focusing on the Japanese mark of obtaining 10,000 steps per day. Workplace based step challenges have become popular to engage large cohorts in increasing their daily physical activity in a sustainable and enjoyable way. Findings are now highlighting the positive health effects of these medium-term programs (typically conducted over a few months) in terms of cardiovascular health, reducing diabetes risk and improving lifestyle factors such as weight and blood pressure. As yet, research has not focused on whether similar improvements in psychological health and wellbeing are present. This study investigated the impact of a 100-day, 10,000 step program on signs of depression, anxiety and stress as well as general wellbeing using standardised psychological scales. The results indicated a small but consistent effect on all of these measures of mental health over the term of the program. This effect appeared irrespective of whether a person reached the 10,000 step mark. These results highlight improved mental health and wellbeing in people undertaking this 100-day 10,000 step program and indicates the efficacy and potential of these programs for a modest, yet important improvement in mental health. Notably, targets reached may be less important than participation itself.

  8. 78 FR 17313 - Ninety-Day Waiting Period Limitation and Technical Amendments to Certain Health Coverage...

    Science.gov (United States)

    2013-03-21

    ... health insurance issuer conditions eligibility on any employee's (part-time or full-time) having... the contracting provisions of the Federal Employee Health Benefits Program (FEHBP). OPM has... estimate that 4.1 million new employees receive group health insurance coverage through private sector...

  9. A Discursive Approach to Organizational Health Communication

    DEFF Research Database (Denmark)

    Kjær, Peter; Reff Pedersen, Anne; Svejgaard Pors, Anja

    2016-01-01

    With the increased interest in communication in the fields of healthcare and healthcare management research, it is important to begin to explore and consider the consequences of this engagement with new ideas in communication. In this chapter we describe the expansion of organisational health...... communication, identifying three distinct types of communication ideas and tools: clinical communication, extra-clinical communication and corporate communication. In order to assess the wider implications of health communication, we elaborate a discursive perspective, illustrated by presenting exemplary...

  10. EXECUTIVE SUMMARY / Health: An Ecosystem Approach | IDRC ...

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

    2010-12-20

    Dec 20, 2010 ... IDRC Communications. THE ISSUE. The Ecohealth approach focuses above all on the place of human beings within their environment. .... They also bear on better understanding the interactions between environmental, ...

  11. A "Bioethics" Approach to Teaching Health Law.

    Science.gov (United States)

    Capron, Alexander Morgan

    1988-01-01

    The reasons for offering a course in bioethics to law students and some approaches to take in addressing controversial issues are examined. The use of hypothetical vs. real cases, emphasis on clinical problems, and overall course objectives are discussed. (MSE)

  12. Influence of the day care, home and neighbourhood environment on young children's physical activity and health

    DEFF Research Database (Denmark)

    Christian, Hayley; Maitland, Clover; Enkel, Stephanie

    2016-01-01

    to determine outdoor location of physical activity around the home and neighbourhood for a subsample (n=310). The day care environment will be objectively measured using a validated audit tool. Other potential individual, social and physical environmental influences on preschoolers' physical activity...... such as long day care. Research is required to determine how the design of day care outdoor (and indoor) spaces provides opportunities or constraints for physical activity. A significant evidence gap surrounds what objectively measured attributes of the home and neighbourhood environment influence preschoolers......' physical activity. The PLAY Spaces & Environments for Children's Physical Activity (PLAYCE) study will empirically investigate the relative and cumulative influence of the day care, home and neighbourhood environment on preschoolers' physical activity. METHODS AND ANALYSIS: The PLAYCE study is a cross...

  13. Climate change and human health: a One Health approach.

    Science.gov (United States)

    Patz, Jonathan A; Hahn, Micah B

    2013-01-01

    Climate change adds complexity and uncertainty to human health issues such as emerging infectious diseases, food security, and national sustainability planning that intensify the importance of interdisciplinary and collaborative research. Collaboration between veterinary, medical, and public health professionals to understand the ecological interactions and reactions to flux in a system can facilitate clearer understanding of climate change impacts on environmental, animal, and human health. Here we present a brief introduction to climate science and projections for the next century and a review of current knowledge on the impacts of climate-driven environmental change on human health. We then turn to the links between ecological and evolutionary responses to climate change and health. The literature on climate impacts on biological systems is rich in both content and historical data, but the connections between these changes and human health is less understood. We discuss five mechanisms by which climate changes impacts on biological systems will be felt by the human population: Modifications in Vector, Reservoir, and Pathogen Lifecycles; Diseases of Domestic and Wild Animals and Plants; Disruption of Synchrony Between Interacting Species; Trophic Cascades; and Alteration or Destruction of Habitat. Each species responds to environmental changes differently, and in order to predict the movement of disease through ecosystems, we have to rely on expertise from the fields of veterinary, medical, and public health, and these health professionals must take into account the dynamic nature of ecosystems in a changing climate.

  14. Spirituality and health: A narrativepastoral approach

    Directory of Open Access Journals (Sweden)

    C.J. Truter

    2005-10-01

    Full Text Available Health is much more than the absence of illness; it is rather a “high level wellness” and a life with “meaningful life-possibilities”. This article indicates how meaningful life-possibilities and a high level of wellness can be socially constructed within a process of narrativepastoral therapy for a patient who is chronically ill and therefore cannot be cured. Pastoral care as a spiritual and religious act can play an important role in giving sense and meaning to people’s lives, and can play a preventive role in living with illness. This article furthermore shows how patients’ stories of illness can be centralised by means of narrative therapy and how a pastoral and ethical attitude of love and respect can create a climate conducive to better health and well being. We share how patients’ richer descriptions of their illness can produce a spiritual climate which can contribute to their better health.

  15. The biopsychosocial approach and global mental health: Synergies and opportunities

    Directory of Open Access Journals (Sweden)

    Emmanuel Babalola

    2017-01-01

    Full Text Available The biopsychosocial (BPS approach proposed by Engel four decades ago was regarded as one of the most important developments in medicine and psychiatry in the late 20th century. Unlike the biomedical model, the BPS approach posits that biological, psychological, and social factors play a significant role in disease causation and treatment. This approach brought about a new way of conceptualizing mental health difficulties and engendered changes within research, medical teaching and practice. Global mental health (GMH is a relatively new area of study and practice that seek to bridge inequities and inequality in mental healthcare services provision for people worldwide. The significance of the BPS approach for understanding mental health difficulties is being debated in the context of GMH initiatives. This paper critically evaluates strengths and weaknesses of the BPS approach to mental health difficulties and explores its relevance to GMH initiatives.

  16. 2013 Annual National Digital Rectal Exam Day: impact on prostate health awareness and disease detection

    Directory of Open Access Journals (Sweden)

    Michael E. Chua

    2014-03-01

    Conclusions: Overall, the 2013 “Mag-paDRE” among the 10 training institutions was effective in promoting prostate health awareness. A need to modify the preactivity information dissemination by these institutions can be done to further increase the attendance of targeted population of the prostate health awareness program.

  17. The readmission risk flag: using the electronic health record to automatically identify patients at risk for 30-day readmission.

    Science.gov (United States)

    Baillie, Charles A; VanZandbergen, Christine; Tait, Gordon; Hanish, Asaf; Leas, Brian; French, Benjamin; Hanson, C William; Behta, Maryam; Umscheid, Craig A

    2013-12-01

    Identification of patients at high risk for readmission is a crucial step toward improving care and reducing readmissions. The adoption of electronic health records (EHR) may prove important to strategies designed to risk stratify patients and introduce targeted interventions. To develop and implement an automated prediction model integrated into our health system's EHR that identifies on admission patients at high risk for readmission within 30 days of discharge. Retrospective and prospective cohort. Healthcare system consisting of 3 hospitals. All adult patients admitted from August 2009 to September 2012. An automated readmission risk flag integrated into the EHR. Thirty-day all-cause and 7-day unplanned healthcare system readmissions. Using retrospective data, a single risk factor, ≥ 2 inpatient admissions in the past 12 months, was found to have the best balance of sensitivity (40%), positive predictive value (31%), and proportion of patients flagged (18%), with a C statistic of 0.62. Sensitivity (39%), positive predictive value (30%), proportion of patients flagged (18%), and C statistic (0.61) during the 12-month period after implementation of the risk flag were similar. There was no evidence for an effect of the intervention on 30-day all-cause and 7-day unplanned readmission rates in the 12-month period after implementation. An automated prediction model was effectively integrated into an existing EHR and identified patients on admission who were at risk for readmission within 30 days of discharge. © 2013 Society of Hospital Medicine.

  18. The effect of regular walking and alternate day fasting on health-related factors in overweight and obese females

    Directory of Open Access Journals (Sweden)

    Roya Seighali

    2017-03-01

    Full Text Available Introduction: Obesity is a complex health problem. The aim of this study was to determine the effects of regular walking with alternate day fasting (ADF on health-related factors of overweight and obese females.‎  Methods: 30 healthy inactive, overweight and obese women were divided randomly into three equal groups.  The groups were: control group (BMI: 30.72±4.40 kg/m2; the experimental group I: ADF along with regular walking with 50% to 65% maximal heart rate (BMI: 28.69 ±2.81 kg/m2 and the experimental group II: ADF (BMI: 30.56 ±3.66 kg/m2. Participants were under the diet for six weeks. The diet ADF means that, they had days of fasting and free day (with regular walking, alternately. Two days before and two days after the end of the study, the participants’ fasting blood sugar were measured after 12 hours. Resting heart rate, blood pressure and body composition were assessed in the same day. The collected data were analyzed using paired t-test and ANOVA test. Results: Body mass index in both experimental groups had significant decrease‎ (P

  19. A diagnostic approach to understanding entrepreneurship in health care.

    Science.gov (United States)

    McCleary, Karl J; Rivers, Patrick A; Schneller, Eugene S

    2006-01-01

    Health care is quite different from other industries because of its organizational structure, service delivery, and financing of health services. Balancing costs, quality, and access presents unique challenges for each stakeholder group committed to promoting the health and healing of its citizens. Using the diagnostic approach to health care entrepreneurship, we created a framework from research in the field to understand the predisposing, enabling, and reinforcing factors most relevant to successful entrepreneurship.

  20. A 1-day course to improve the teaching effectiveness of health professions faculty members.

    Science.gov (United States)

    Stein, Susan M; Fujisaki, Brad S; Davis, Shawn E; Maclean, Linda Garrelts

    2012-02-10

    To determine the effect of a 1-day teaching-methods course for pharmacy and nursing faculty members on teaching proficiency and perceptions of effective teaching. A 1-day teaching-methods course was created and presented to 12 pharmacy and nursing faculty members. Participants' teaching sessions were video-recorded pre- and post-course. A panel of educators evaluated pre- and post-course video-recorded teaching presentations to assess teaching effectiveness. Participants completed pre- and post-course self-evaluations and surveys. Panelists' assessments confirmed significant improvement in 7 of 10 domains. Perceptions of teaching efficacy and proficiency to teach effectively improved after completion of the course. A 1-day teaching-methods course, requiring minimal resources, is a valuable development resource that can improve teaching effectiveness through enhanced communication and teaching techniques. Because effective teaching is positively correlated with students' learning, training seminars can be integral to comprehensive quality improvement.

  1. Interpreting the International Right to Health in a Human Rights-Based Approach to Health

    OpenAIRE

    Hunt, Paul

    2016-01-01

    Abstract This article tracks the shifting place of the international right to health, and human rights-based approaches to health, in the scholarly literature and United Nations (UN). From 1993 to 1994, the focus began to move from the right to health toward human rights-based approaches to health, including human rights guidance adopted by UN agencies in relation to specific health issues. There is a compelling case for a human rights-based approach to health, but it runs the risk of playing...

  2. Ventilation, indoor air quality, and human health and comfort in dwellings and day-care centers

    Energy Technology Data Exchange (ETDEWEB)

    Ruotsalainen, R.

    1995-12-31

    The objective of the study was to assess the actual ventilation and indoor air quality in the Finnish building stock (dwellings and day-care centers) with special reference to the existing guideline values. Furthermore, the objective was to evaluate the occurrence of symptoms and perceptions among occupants (adult residents, children, workers) in relation to ventilation system, ventilation rate and dampness. The measurements of ventilation and indoor air quality in the dwellings and day-care centers included ventilation rate, CO{sub 2} concentration, and temperature and humidity. Self- and parent-administered questionnaires were distributed to the occupants inquiring their personal characteristics, occurrence of symptoms of interest, perceived indoor air quality and details of their home and work environments. Airflows and air change rates varied remarkably both in the dwellings and day-care centers. In the majority of the dwellings and day-care centers, the Finnish guideline values of ventilation rates were not achieved. No consistent associations were observed between the magnitude of mechanical ventilation rates and the occurrence of eye, respiratory, skin and general symptoms, that is, symptoms of sick building syndrome (SBS) among the day-care workers. The results indicate that there is much room for improvement in the ventilation and indoor air quality of Finnish dwellings and day-care centers. The control of ventilation, temperature and humidity and the prevention of water damage are important issues on which to concentrate in the future. There is need to improve the quality in all phases of construction: design, installation, adjustment, operation, and maintenance

  3. Day-night contrast as source of health for the human circadian system.

    Science.gov (United States)

    Martinez-Nicolas, Antonio; Madrid, Juan Antonio; Rol, Maria Angeles

    2014-04-01

    Modern societies are characterized by a 24/7 lifestyle (LS) with no environmental differences between day and night, resulting in weak zeitgebers (weak day light, absence of darkness during night, constant environmental temperature, sedentary LS and frequent snacking), and as a consequence, in an impaired circadian system (CS) through a process known as chronodisruption. Both weak zeitgebers and CS impairment are related to human pathologies (certain cancers, metabolic syndrome and affective and cognitive disorders), but little is known about how to chronoenhance the CS. The aim of this work is to propose practical strategies for chronoenhancement, based on accentuating the day/night contrast. For this, 131 young subjects were recruited, and their wrist temperature (WT), activity, body position, light exposure, environmental temperature and sleep were recorded under free-living conditions for 1 week. Subjects with high contrast (HC) and low contrast (LC) for each variable were selected to analyze the HC effect in activity, body position, environmental temperature, light exposure and sleep would have on WT. We found that HC showed better rhythms than LC for every variable except sleep. Subjects with HC and LC for WT also demonstrated differences in LS, where HC subjects had a slightly advanced night phase onset and a general increase in day/night contrast. In addition, theoretical high day/night contrast calculated using mathematical models suggests an improvement by means of LS contrast. Finally, some individuals classified as belonging to the HC group in terms of WT when they are exposed to the LS characteristic of the LC group, while others exhibit WT arrhythmicity despite their good LS habits, revealing two different WT components: an exogenous component modified by LS and another endogenous component that is refractory to it. Therefore, intensifying day/night contrast in subject's LS has proven to be a feasible measure to chronoenhance the CS.

  4. Ventilation, indoor air quality, and human health and comfort in dwellings and day-care centers

    Energy Technology Data Exchange (ETDEWEB)

    Ruotsalainen, R

    1996-12-31

    The objective of the study was to assess the actual ventilation and indoor air quality in the Finnish building stock (dwellings and day-care centers) with special reference to the existing guideline values. Furthermore, the objective was to evaluate the occurrence of symptoms and perceptions among occupants (adult residents, children, workers) in relation to ventilation system, ventilation rate and dampness. The measurements of ventilation and indoor air quality in the dwellings and day-care centers included ventilation rate, CO{sub 2} concentration, and temperature and humidity. Self- and parent-administered questionnaires were distributed to the occupants inquiring their personal characteristics, occurrence of symptoms of interest, perceived indoor air quality and details of their home and work environments. Airflows and air change rates varied remarkably both in the dwellings and day-care centers. In the majority of the dwellings and day-care centers, the Finnish guideline values of ventilation rates were not achieved. No consistent associations were observed between the magnitude of mechanical ventilation rates and the occurrence of eye, respiratory, skin and general symptoms, that is, symptoms of sick building syndrome (SBS) among the day-care workers. The results indicate that there is much room for improvement in the ventilation and indoor air quality of Finnish dwellings and day-care centers. The control of ventilation, temperature and humidity and the prevention of water damage are important issues on which to concentrate in the future. There is need to improve the quality in all phases of construction: design, installation, adjustment, operation, and maintenance

  5. A Global Public Goods Approach to the Health of Migrants.

    Science.gov (United States)

    Widdows, Heather; Marway, Herjeet

    2015-07-01

    This paper explores a global public goods approach to the health of migrants. It suggests that this approach establishes that there are a number of health goods which must be provided to migrants not because these are theirs by right (although this may independently be the case), but because these goods are primary goods which fit the threefold criteria of global public goods. There are two key advantages to this approach: first, it is non-confrontational and non-oppositional, and second, it provides self-interested arguments to provide at least some health goods to migrants and thus appeals to those little moved by rights-based arguments.

  6. The emerging health paradigm in the 21st century: the formative first 1000 days of life

    Directory of Open Access Journals (Sweden)

    Jose Miguel De Angulo

    2016-01-01

    Full Text Available During the 20th Century Western society's thinking regarding health and wellbeing underwent profound and rapid changes. Towards the end of the century, a health paradigm based on social health determinants emerged, providing a strong foundation for influencing priorities in global health. In this paper we will present evidence that supports a new paradigm. It avers that human health and development is founded on infants’ brain architecture and their capacity to transform the brains and lives of adults. Neuroscience now shows how the brain architecture of the person becomes established during the intrauterine period and the first two to three years of life. This brain architecture determines the capacity of the organism to self-regulate its biological, emotional, cognitive, and interactional processes with the environment. The more robust this brain architecture, the more potential and capability that individual has to enjoy physical, emotional, and mental health as well as his/her capacity to contribute to the health and wellbeing of others. We hold that the transformative value of infants to society is biblical. This new understanding can generate a shift towards a focus on early infancy as the best strategy to foster development of healthy and sustainable societies.

  7. Workplace mental health: developing an integrated intervention approach

    Science.gov (United States)

    2014-01-01

    Background Mental health problems are prevalent and costly in working populations. Workplace interventions to address common mental health problems have evolved relatively independently along three main threads or disciplinary traditions: medicine, public health, and psychology. In this Debate piece, we argue that these three threads need to be integrated to optimise the prevention of mental health problems in working populations. Discussion To realise the greatest population mental health benefits, workplace mental health intervention needs to comprehensively 1) protect mental health by reducing work–related risk factors for mental health problems; 2) promote mental health by developing the positive aspects of work as well as worker strengths and positive capacities; and 3) address mental health problems among working people regardless of cause. We outline the evidence supporting such an integrated intervention approach and consider the research agenda and policy developments needed to move towards this goal, and propose the notion of integrated workplace mental health literacy. Summary An integrated approach to workplace mental health combines the strengths of medicine, public health, and psychology, and has the potential to optimise both the prevention and management of mental health problems in the workplace. PMID:24884425

  8. A Discursive Approach to Organizational Health Communication

    DEFF Research Database (Denmark)

    Kjær, Peter; Reff Pedersen, Anne; Svejgaard Pors, Anja

    2016-01-01

    With the increased interest in communication in the fields of healthcare and healthcare management research, it is important to begin to explore and consider the consequences of this engagement with new ideas in communication. In this chapter we describe the expansion of organisational health...... communication, identifying three distinct types of communication ideas and tools: clinical communication, extra-clinical communication and corporate communication. In order to assess the wider implications of health communication, we elaborate a discursive perspective, illustrated by presenting exemplary...... analyses of a) the institutionalisation of communication ideals, b) the communicative management of meaning and c) communication tools as organising technologies. The discursive perspective highlights that organisations and individual healthcare providers should not only look for the desired outcomes...

  9. Investigation of Integrated Vehicle Health Management Approaches

    Science.gov (United States)

    Paris, Deidre

    2005-01-01

    This report is to present the work that was performed during the summer in the Advance Computing Application office. The NFFP (NASA Faculty Fellow Program) had ten summer faculty members working on IVHM (Integrated Vehicle Health Management) technologies. The objective of this project was two-fold: 1) to become familiar with IVHM concepts and key demonstrated IVHM technologies; and 2) to integrate the research that has been performed by IVHM faculty members into the MASTLAB (Marshall Avionic Software Test Lab). IVHM is a NASA-wide effort to coordinate, integrate and apply advanced software, sensors and design technologies to increase the level of intelligence, autonomy, and health state of future vehicles. IVHM is an important concept because it is consistent with the current plan for NASA to go to the moon, mars, and beyond. In order for NASA to become more involved in deep exploration, avionic systems will need to be highly adaptable and autonomous.

  10. Demand side management in a day-ahead wholesale market: A comparison of industrial & social welfare approaches

    International Nuclear Information System (INIS)

    Jiang, Bo; Farid, Amro M.; Youcef-Toumi, Kamal

    2015-01-01

    Highlights: • We compare two demand side management in a day-ahead electricity wholesale market. • We develop and reconcile social welfare & industrial DSM mathematical models. • We show the industrial netload has an additional forecast quantity of baseline. • We analytically and numerically show the model equivalence with accurate baseline. • We numerically demonstrate the baseline errors lead to higher and costlier dispatch. - Abstract: The intermittent nature of renewable energy has been discussed in the context of the operational challenges that it brings to electrical grid reliability. Demand side management (DSM) with its ability to allow customers to adjust electricity consumption in response to market signals has often been recognized as an efficient way to mitigate the variable effects of renewable energy as well as to increase system efficiency and reduce system costs. However, the academic & industrial literature have taken divergent approaches to DSM implementation. While the popular approach among academia adopts a social welfare maximization formulation, the industrial practice compensates customers according to their load reduction from a predefined electricity consumption baseline that would have occurred without DSM. This paper rigorously compares these two different approaches in a day-ahead wholesale market context analytically and in a test case using the same system configuration and mathematical formalism. The comparison of the two models showed that a proper reconciliation of the two models might make them mitigate the stochastic netload in fundamentally the same way, but only under very specific conditions which are rarely met in practice. While the social welfare model uses a stochastic net load composed of two terms, the industrial DSM model uses a stochastic net load composed of three terms including the additional baseline term. DSM participants are likely to manipulate the baseline in order to receive greater financial

  11. A Reasoned Action Approach to Health Promotion

    OpenAIRE

    Fishbein, Martin

    2008-01-01

    This article describes the integrative model of behavioral prediction (IM), the latest formulation of a reasoned action approach. The IM attempts to identify a limited set of variables that can account for a considerable proportion of the variance in any given behavior. More specifically, consistent with the original theory of reasoned action, the IM assumes that intentions are the immediate antecedents of behavior, but in addition, the IM recognizes that environmental factors and skills and ...

  12. 78 FR 78376 - 60-Day Notice of Proposed Information Collection: Exigent Health and Safety Deficiency Correction...

    Science.gov (United States)

    2013-12-26

    ... TTY by calling the toll-free Federal Relay Service at (800) 877-8339. FOR FURTHER INFORMATION CONTACT... access this number via TTY by calling the Federal Information Relay Service at (800) 877-8339. Copies of.... Using the electronic format, PHAs are to notify HUD within three business days of the date of inspection...

  13. Health Impacts of Religious Practices and Beliefs Associated with The Church of Jesus Christ of Latter-Day Saints.

    Science.gov (United States)

    de Diego Cordero, Rocío; Badanta Romero, Bárbara

    2017-08-01

    The aim of the study is to discuss the relationship between lifestyle marked by The Church of Jesus Christ of Latter-day Saints and health. PubMed, CINAHL, PsycINFO, WOS y Scopus were the databases used for this literature review, with these descriptors: "Mormons", "mormons religion", "health". Inclusion criteria were articles with full text available, published between 2005 and 2016, in English or Spanish language. Results show that following the restrictive Mormon doctrine generates beneficial effects for the health. Habits related to toxics and food, as well as social support, from family and Mormon community are an important basis for good health. On the other hand, not following the prescriptions or leaving the group, opposed sexual identities or not fulfilling the roles associated with women are associated with worse mental and physical health.

  14. Mainstream media and the social determinants of health in Canada: is it time to call it a day?

    Science.gov (United States)

    Raphael, Dennis

    2011-06-01

    This article explores the dearth of coverage of the social determinants of health by the Canadian mainstream media. It is argued that this neglect is primarily a reflection of political and economic societal structures that has been associated with increasing corporate control of the mainstream media. Applying a critical political economy lens, it is argued that the barriers to having the Canadian mainstream media report on the social determinants of health are so numerous that it may indeed be 'time to call it a day' in regard to having them assist in the dissemination of social determinants of health findings. Recognizing this reality should spur the development of alternative means of communicating with the public in order to develop a citizens' movement to create health-promoting public policy. Recent dissemination efforts related to the Social Determinants of Health: The Canadian Facts provide an example of how this might be accomplished.

  15. 78 FR 19721 - Request For Public Comment: 60-Day Proposed Information Collection: Indian Health Service Medical...

    Science.gov (United States)

    2013-04-02

    ..., psychologists, optometrists, podiatrists, audiologists, physician assistants, certified registered nurse anesthetists, nurse practitioners, and certified nurse midwives. IHS policy specifically requires physicians... providers become medical staff members, depending on the local health care facility's capabilities and...

  16. 2013 Annual National Digital Rectal Exam Day: impact on prostate health awareness and disease detection

    OpenAIRE

    Chua, Michael E.; Lapitan, Marie Carmela M.; Morales Jr, Marcelino L.; Roque, Aristotle Bernard Maniego; Domingo, John Kenneth

    2014-01-01

    Purpose: “Mag-paDRE” is a yearly prostate health public awareness program initiated by the Philippine Urological Association. This study aimed to describe the demographic and clinical data of the participants in the 2013 “Mag-paDRE” program and to identify factors that will further improve prostate health public awareness. Methods: A descriptive cross-sectional study undertaken to collect and assess the demographic data, International Prostate Symptom Score (IPSS) and digital rectal examinati...

  17. A new approach to criteria for health risk assessment

    International Nuclear Information System (INIS)

    Spickett, Jeffery; Katscherian, Dianne; Goh, Yang Miang

    2012-01-01

    Health Impact Assessment (HIA) is a developing component of the overall impact assessment process and as such needs access to procedures that can enable more consistent approaches to the stepwise process that is now generally accepted in both EIA and HIA. The guidelines developed during this project provide a structured process, based on risk assessment procedures which use consequences and likelihood, as a way of ranking risks to adverse health outcomes from activities subjected to HIA or HIA as part of EIA. The aim is to assess the potential for both acute and chronic health outcomes. The consequences component also identifies a series of consequences for the health care system, depicted as expressions of financial expenditure and the capacity of the health system. These more specific health risk assessment characteristics should provide for a broader consideration of health consequences and a more consistent estimation of the adverse health risks of a proposed development at both the scoping and risk assessment stages of the HIA process. - Highlights: ► A more objective approach to health risk assessment is provided. ► An objective set of criteria for the consequences for chronic and acute impacts. ► An objective set of criteria for the consequences on the health care system. ► An objective set of criteria for event frequency that could impact on health. ► The approach presented is currently being trialled in Australia.

  18. Days out of role due to mental and physical illness in the South African stress and health study.

    Science.gov (United States)

    Mall, Sumaya; Lund, Crick; Vilagut, Gemma; Alonso, Jordi; Williams, David R; Stein, Dan J

    2015-03-01

    Both mental and physical disorders can result in role limitation, such as 'days out of role', which have an important impact on national productivity losses. This paper analyses data from the South African Stress and Health Study (SASH) on the association of both mental and physical disorders with days out of role. Face-to-face interviews were conducted with a representative sample of 4,351 adult South Africans. The World Health Organization's Composite International Diagnostic Interview (WHO-CIDI) was used to assess the presence of 21 mental and physical disorders that were grouped into 10 disorder categories for the analysis: major depressive disorder, any anxiety disorders, any substance abuse disorders, headaches or migraine, arthritis, chronic pain, cardiovascular, respiratory, diabetes and digestive disorders. Multiple regression techniques were used to explore associations between individual disorders, comorbid conditions, and annual days spent out of role. The estimated societal effects of the disorders [population attributable risk proportion (PARP)] were obtained. The majority of respondents who reported a mental or physical disorder also reported another disorder (62.98 %). The average number of disorders reported by respondents who had at least one disorder was 2.3. Overall 12.4 % of respondents reported any days out of role due to mental or physical disorder. Anxiety disorders and depression were associated with highest days out of role (28.2 and 27.2, respectively) followed closely by arthritis and pain (24.7 and 21.7, respectively). Any mental disorder was associated with 23.6 days out of role, while any physical disorder was associated with 15.5 days out of role. Of the mental disorders, anxiety disorders had the highest PARP in relation to days out of role (9.0 %) followed by depression (4.8 %) and substance disorder (3.3. %). More than one-third (37.6 %) of days out of role are attributable to physical disorders and 16.1 % to mental

  19. Sleep Disorders and Complementary Health Approaches : What the Science Says

    Science.gov (United States)

    ... Sleep Disorders and Complementary Health Approaches: What the Science Says Share: April 2014 Clinical Guidelines, Scientific Literature, ... five randomized controlled trials evaluating the efficacy of music-assisted relaxation for sleep quality in adults found ...

  20. Supporting self-management of chronic health conditions: common approaches.

    Science.gov (United States)

    Lawn, Sharon; Schoo, Adrian

    2010-08-01

    The aims of this paper are to provide a description of the principles of chronic condition self-management, common approaches to support currently used in Australian health services, and benefits and challenges associated with using these approaches. We examined literature in this field in Australia and drew also from our own practice experience of implementing these approaches and providing education and training to primary health care professionals and organizations in the field. Using common examples of programs, advantages and disadvantages of peer-led groups (Stanford Courses), care planning (The Flinders Program), a brief primary care approach (the 5As), motivational interviewing and health coaching are explored. There are a number of common approaches used to enhance self-management. No one approach is superior to other approaches; in fact, they are often complimentary. The nature and context for patients' contact with services, and patients' specific needs and preferences are what must be considered when deciding on the most appropriate support mode to effectively engage patients and promote self-management. Choice of approach will also be determined by organizational factors and service structures. Whatever self-management support approaches used, of importance is how health services work together to provide support. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

  1. Valuing Health Effect on Air Pollution : WTP Approach Using CVM

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Tae Yoo; Um, Mi Jung [Seoul National University, Seoul (Korea); Kwak, Seung Jun [Korea University, Seoul (Korea)

    1998-09-01

    Cost-benefit is required for improving air quality efficiently. Benefit in connection with air quality has influence on health effects, a barrier to administration, aesthetic value, and material loss. Among these, health effects are occupying most of them. In this study, the economic value by the people in Seoul was estimated about symptoms of eye irritation, heartburn, and asthma among health effects relating to air pollution by using conditional value measurement (CVM). As a result, 2,580 won/day for eye irritation, 9,000 won/day for heartburn, and 55,400 won/day for asthma were measured. Moreover, in the case of carrying out several CV questions in one survey, it was found out that the estimated results of single variation model and dual variation model were different. (author). 21 refs., 7 tabs.

  2. Substance Use and Mental Health Outcomes for Comorbid Patients in Psychiatric Day Treatment

    Directory of Open Access Journals (Sweden)

    Stephen Magura

    2009-10-01

    Full Text Available The study’s purpose was to determine treatment outcomes for patients who present with drug use vs. those presenting with no drug use at admission to a psychiatric day treatment program. Consecutively admitted patients completed confidential interviews which included psychological distress and quality of life measures and provided urine specimens for toxicology at admission and six month follow-up. Subjects positive by past 30 day self-report or urinalysis were categorized as drug users. Major psychiatric diagnoses were: major depression 25%; bipolar, 13%; other mood 13%; schizoaffective 13%; schizophrenia 13%. Drug use at admission was: cocaine 35%; marijuana 33%; opiates 18%, (methamphetamines, 6% For each of these drugs, the percentage of patients positive at admission who remitted from using the drug significantly exceeded the percentage negative at baseline who initiated using the drug. Overall, there were significant decreases in psychological distress and significant improvement on quality of life, but no change on positive affect. There were no significant differences between drug users and non-drug users on symptom reduction and improvement in quality of life. Psychiatric day treatment appears to benefit comorbid patients by reducing the net number of patients who actively use certain common drugs and by improving psychological status and quality of life to the same degree as for non-drug using patients.

  3. Substance Use and Mental Health Outcomes for Comorbid Patients in Psychiatric Day Treatment

    Directory of Open Access Journals (Sweden)

    Stephen Magura

    2009-01-01

    Full Text Available The study's purpose was to determine treatment outcomes for patients who present with drug use vs. those presenting with no drug use at admission to a psychiatric day treatment program. Consecutively admitted patients completed confidential interviews which included psychological distress and quality of life measures and provided urine specimens for toxicology at admission and six month follow-up. Subjects positive by past 30 day self-report or urinalysis were categorized as drug users. Major psychiatric diagnoses were: major depression 25%; bipolar, 13%; other mood 13%; schizoaffective 13%; schizophrenia 13%. Drug use at admission was: cocaine 35%; marijuana 33%; opiates 18%, (methamphetamines, 6% For each of these drugs, the percentage of patients positive at admission who remitted from using the drug significantly exceeded the percentage negative at baseline who initiated using the drug. Overall, there were significant decreases in psychological distress and significant improvement on quality of life, but no change on positive affect. There were no significant differences between drug users and non-drug users on symptom reduction and improvement in quality of life. Psychiatric day treatment appears to benefit comorbid patients by reducing the net number of patients who actively use certain common drugs and by improving psychological status and quality of life to the same degree as for non-drug using patients.

  4. The Effects of Adult Day Services on Family Caregivers’ Daily Stress, Affect, and Health: Outcomes From the Daily Stress and Health (DaSH) Study

    Science.gov (United States)

    Zarit, Steven H.; Kim, Kyungmin; Femia, Elia E.; Almeida, David M.; Klein, Laura C.

    2014-01-01

    Purpose: We examine the effects of use of adult day service (ADS) by caregivers of individuals with dementia (IWD) on daily stressors, affect, and health symptoms. Participants were interviewed for 8 consecutive days. On some days, the IWD attended an ADS program and on the other days caregivers provide most or all of the care at home. Methods: Participants were 173 family caregivers of IWDs using an ADS program. Daily telephone interviews assessed care-related stressors, noncare stressors, positive events, affect, and health symptoms. Multilevel models with data nested within persons were used to examine effects of ADS use on daily stressor exposure, affect, and health symptoms. Results: Caregivers had lower exposure to care-related stressors on ADS days, more positive experiences, and more noncare stressors. ADS use lowered anger and reduced the impact of noncare stressors on depressive symptoms. Implications: The findings demonstrate that stressors on caregivers are partly lowered, and affect is improved on ADS days, which may provide protection against the effects of chronic stress associated with caregiving. PMID:23690056

  5. 77 FR 72871 - Proposed Collection; Comment Request (60-Day FRN): The Agricultural Health Study: A Prospective...

    Science.gov (United States)

    2012-12-06

    ... data collection projects, the National Institutes of Health (NIH) will publish periodic summaries of proposed projects to be submitted to the Office of Management and Budget (OMB) for review and approval..., including the validity of the methodology and assumptions used; (3) The quality, utility, and clarity of the...

  6. Mental health recovery on care farms and day centres: a qualitative comparative study of users' perspectives

    NARCIS (Netherlands)

    Iancu, Sorana C.; Zweekhorst, Marjolein B. M.; Veltman, Dick J.; van Balkom, Anton J. L. M.; Bunders, Joske F. G.

    2014-01-01

    Mental health services increasingly incorporate the vision of recovery. This qualitative study analysed and compared experiences of recovery on prevocational services, in order to assess if users make progress towards recovery, relative to a staged recovery model. Data were collected through

  7. Mental health recovery on care farms and day centres: a qualitative comparative study of users perspectives

    NARCIS (Netherlands)

    Iancu, S.C.; Zweekhorst, M.B.M.; Veltman, D.J.; van Balkom, A.J.L.M.; Bunders-Aelen, J.G.F.

    2014-01-01

    Purpose: Mental health services increasingly incorporate the vision of recovery. This qualitative study analysed and compared experiences of recovery on prevocational services, in order to assess if users make progress towards recovery, relative to a staged recovery model. Method: Data were

  8. 78 FR 2412 - Request for Public Comment: 30-Day Proposed Information Collection: Indian Health Service Forms...

    Science.gov (United States)

    2013-01-11

    ... Accounting of Disclosures,'' is used to document an individual's request for an accounting of disclosures of...-2) Request for Accounting of Disclosures (OMB Form 15,000 1 10/60 2,500 No. 0917-0030, IHS-913... receive a valid authorization for its use or disclosure of protected health information for other than for...

  9. Impact of a five-day short course on integration of health promotion into practice in north Queensland.

    Science.gov (United States)

    Devine, Susan G; Llewellyn-Jones, Lorraine; Lloyd, Jacqui

    2009-04-01

    Workforce development is one element of health promotion capacity building. This paper describes the extent to which participants in a five-day short course in health promotion, delivered three times in north Queensland during 2007, reported greater adoption of health promotion within their work roles, and the factors that affected the level of adoption. Out of 54 course attendees, 39 completed a post-course survey five to nine months after completing the course (72% response rate). Additionally, 11 course attendees participated in a focus group or phone interview to explore survey findings. The courses succeeded in providing knowledge, skills, confidence and enthusiasm to undertake health promotion work. Eighty per cent of participants stated they had incorporated health promotion into their work frequently or all of the time since undertaking the course. Lack of understanding of health promotion from co-workers and managers, lack of organisational support and commitment, lack of resources, competing clinical priorities, and lack of time were cited as the main barriers for undertaking health promotion. The course met participant training needs. However, similar training across all levels of staff including management may help to develop organisational capacity, thereby building a more knowledgeable workforce that is supported to undertake health promotion as a core part of an organisation's business.

  10. Innovative Approaches to Task Shifting in Mental Health | CRDI ...

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

    Innovative Approaches to Task Shifting in Mental Health. Across the world, it is estimated that mental disorders account for 12% of disability-adjusted life years. This proportion is still increasing and projected to reach 15% by 2020. However, provision of mental health services has not matched the need, especially in ...

  11. Complementary Health Approaches for Smoking Cessation: What the Science Says

    Science.gov (United States)

    ... health professionals Complementary Health Approaches for Smoking Cessation: What the Science Says Share: November 2017 Mind and Body Practices ... as a smoking cessation treatment, authorizing Achieve Life Science, Inc. to proceed with clinical ... What Does the Research Show? A 2016 Cochrane review ...

  12. 2013 Annual National Digital Rectal Exam Day: impact on prostate health awareness and disease detection.

    Science.gov (United States)

    Chua, Michael E; Lapitan, Marie Carmela M; Morales, Marcelino L; Roque, Aristotle Bernard Maniego; Domingo, John Kenneth

    2014-03-01

    "Mag-paDRE" is a yearly prostate health public awareness program initiated by the Philippine Urological Association. This study aimed to describe the demographic and clinical data of the participants in the 2013 "Mag-paDRE" program and to identify factors that will further improve prostate health public awareness. A descriptive cross-sectional study undertaken to collect and assess the demographic data, International Prostate Symptom Score (IPSS) and digital rectal examination findings of the participants in the "Mag-paDRE" conducted in the 10 Philippine Board of Urology (PBU) different accredited training institutions. Descriptive statistics was used to report the proportion of Filipino men aged 40 or older who presented for their first prostate health evaluation. Clinical profile were reviewed and summarized. The study protocol was registered in the Clinicaltrial.gov under Identifier NCT01886547. A total of 925 participants from the 10 PBU accredited training institutions were assessed. Among the 10 training institutions the large tertiary government owned medical center had the highest number of participants and target participants recruited; while the private sectors owned tertiary hospitals have the highest proportion of target participants and cases. According to the predetermined definition of this study, 614 (66%) were considered the target population for the "Mag-paDRE" program. The mean age of the target participants was 58.9±9.9. Only 360 of 614 (59%) were new case, 118 (32.7%) had severe lower urinary tract symptoms (LUTS), 223 (62%) had moderate LUTS, 19 (5.3%) were asymptomatic but with hard prostates, palpable prostate nodules or prostate tenderness. The most bothersome symptoms were incomplete bladder emptying (30.2%), and frequency (22.9%). Overall, the 2013 "Mag-paDRE" among the 10 training institutions was effective in promoting prostate health awareness. A need to modify the preactivity information dissemination by these institutions can be

  13. Towards an integrated approach to health and medicine in Africa

    African Journals Online (AJOL)

    2016-08-18

    Aug 18, 2016 ... As such, a social approach to health-seeking behaviour questions how decisions ... In conclusion, the paper proposes that medicine and the humanities should engage seriously .... mental questions: What story does the integration or separation .... approach which has taken an interest in traditional healing.

  14. Capabilities and Incapabilities of the Capabilities Approach to Health Justice.

    Science.gov (United States)

    Selgelid, Michael J

    2016-01-01

    This first part of this article critiques Sridhar Venkatapuram's conception of health as a capability. It argues that Venkatapuram relies on the problematic concept of dignity, implies that those who are unhealthy lack lives worthy of dignity (which seems politically incorrect), sets a low bar for health, appeals to metaphysically problematic thresholds, fails to draw clear connections between appealed-to capabilities and health, and downplays the importance/relevance of health functioning. It concludes by questioning whether justice entitlements should pertain to the capability for health versus health achievements, challenging Venkatapuram's claims about the strength of health entitlements, and demonstrating that the capabilities approach is unnecessary to address social determinants of health. © 2016 John Wiley & Sons Ltd.

  15. The impact of a peer-led participatory health and safety training program for Latino day laborers in construction.

    Science.gov (United States)

    Williams, Quintin; Ochsner, Michele; Marshall, Elizabeth; Kimmel, Louis; Martino, Carmen

    2010-06-01

    Immigrant Latino day laborers working in residential construction are at particularly high risk of fatal and non-fatal traumatic injury and benefit from targeted training. To understand the impact of a participatory, peer-facilitated health and safety awareness training customized to the needs of Latino day laborers. Baseline surveys exploring exposures, PPE use, attitudes, work practices and work-related injuries were collected from more than 300 New Jersey Latino day laborers in construction prior to their participation in a one day (minimum of six hour) Spanish language health and safety training class. The classes, led by trained worker trainers, engaged participants in a series of tasks requiring teamwork and active problem solving focused on applying safe practices to situations they encounter at their worksites. Follow-up surveys were difficult to obtain among mobile day laborers, and were collected from 70 men (22% response rate) 2-6 months following training. Chi-square analysis was used to compare pre- and post-intervention PPE use, self protective actions, and self-reported injury rates. Focus groups and in-depth interviews addressing similar issues provided a context for discussing the survey findings. At baseline, the majority of day laborers who participated in this study reported great concern about the hazards of their work and were receptive to learning about health and safety despite limited influence over employers. Changes from baseline to follow-up revealed statistically significant differences in the use of certain types of PPE (hard hats, work boots with steel toes, safety harnesses, and visible safety vests), and in the frequency of self-protective work practices (e.g., trying to find out more about job hazards on your own). There was also a suggestive decrease in self-reported injuries (receiving an injury at work serious enough that you had to stop working for the rest of the day) post-training based on small numbers. Sixty-six percent of

  16. Chronic disease risk factors, healthy days and medical claims in South African employees presenting for health risk screening

    Directory of Open Access Journals (Sweden)

    Kolbe-Alexander Tracy L

    2008-07-01

    Full Text Available Abstract Background Non-communicable diseases (NCD accounts for more than a third (37% of all deaths in South Africa. However, this burden of disease can be reduced by addressing risk factors. The aim of this study was to determine the health and risk profile of South African employees presenting for health risk assessments and to measure their readiness to change and improve lifestyle behaviour. Methods Employees (n = 1954 from 18 companies were invited to take part in a wellness day, which included a health-risk assessment. Self-reported health behaviour and health status was recorded. Clinical measures included cholesterol finger-prick test, blood pressure and Body Mass Index (BMI. Health-related age was calculated using an algorithm incorporating the relative risk for all case mortality associated with smoking, physical activity, fruit and vegetable intake, BMI and cholesterol. Medical claims data were obtained from the health insurer. Results The mean percentage of participation was 26% (n = 1954 and ranged from 4% in transport to 81% in the consulting sector. Health-related age (38.5 ± 12.9 years was significantly higher than chronological age (34.9 ± 10.3 yrs (p Conclusion SA employees' health and lifestyle habits are placing them at increased risk for NCD's, suggesting that they may develop NCD's earlier than expected. Inter-sectoral differences for health-related age might provide insight into those companies which have the greatest need for interventions, and may also assist in predicting future medical expenditure. This study underscores the importance of determining the health and risk status of employees which could assist in identifying the appropriate interventions to reduce the risk of NCD's among employees.

  17. Working Together for Mental Health: Evaluation of a one-day mental health course for human service providers

    Science.gov (United States)

    Grootemaat, Pam; Gillan, Cathie; Holt, Gillian; Forward, Wayne; Heywood, Narelle; Willis, Sue

    2006-01-01

    Background The Working Together For Mental Health course is an 8-hour course designed to demystify mental illness and mental health services. The main target group for the course is people working in human service organisations who provide services for people with mental illness. Methods A questionnaire was administered to all participants attending the course during 2003 (n = 165). Participants completed the questionnaire before and immediately after the course, and at three month follow-up. Results A response rate of 69% was achieved with 114 people completing the questionnaire on all three occasions. The responses showed a significant improvement in the self-assessed knowledge and confidence of participants to provide human services to people with a mental health problem or disorder, three months after the course. There was no significant improvement in participants' attitudes or beliefs about people with a mental health problem or disorder at three month follow-up; however, participants' attitudes were largely positive before entering the course. Conclusion The Working Together For Mental Health course was successful in improving participants' confidence and knowledge around providing human services to people with a mental health illness. PMID:17074097

  18. [Health services research under internal (urological) control: utopia or order of the day?].

    Science.gov (United States)

    Weber, A

    2014-12-01

    Health services research investigates the structures and processes of the healthcare system under routine daily conditions. Comprehensive scientific knowledge of healthcare services research is necessary to accomplish a management tailored to the needs of the complex healthcare system. Under, over and incorrect supply should be avoided and healthcare provision should be further developed in line with supply and demand while remaining financially feasible. Additionally, cooperation should be structurally constructed across sectorial boundaries of health services resulting in the development of a transparent manageable process. A special focus in urology in this process is initially the representation of the quality of results in the reality of treatment of the most commonly occurring urological tumors. The organizational structures and technical instrumentation for these challenges are only rudimentary and the necessary measures are currently also not financially sustained.

  19. [Amebiasis and amebic liver abscess in Mexico: a present-day public health problem].

    Science.gov (United States)

    Escandón Romero, C; García Manzo, N T; Escobedo de la Peña, J; Hernández Ramos, J M; Olvera Alvarez, J; Cabral Soto, J

    1996-01-01

    Amebiasis still remains as a major public health problem in the world. It is one of the most common reasons for medical consult. There are more than half a million cases of amebiasis just at the Mexican Institute of the Social Security. There is still a lack of epidemiologic information on amebiasis in Mexico. To describe the secular trend fro amebiasis and for amebic liver abscess in the Mexican population, as well as in those covered by IMSS Solidaridad. An ecologic trend study was carried on. Incidence rate of amebiasis in all of its forms of presentation, and of amebic liver abscess, were plotted against each year for the 1986-1994 period. Amebiasis incidence in all of its forms of presentation showed a stable trend in this period, as it was seen with amebic liver abscess. Amebiasis is more common in the first years of life. On the contrary, amebic liver abscess showed an inverted 'J' pattern; its occurrence is higher in the extreme years of life. Fatality rates have shown a descendent trend. Amebiasis reflects socioeconomic conditions in Mexico and the fact that Mexican is still an endless culture. There is a need to promote health education, better diagnostic procedures and detection of asymptomatic carriers. Health policies for mothers that are asymptomatic carriers should be reviewed, due to the high rates of amebiasis and amebic liver abscess in children under one year of age.

  20. What Health-Related Information Flows through You Every Day? A Content Analysis of Microblog Messages on Air Pollution

    Science.gov (United States)

    Yang, Qinghua; Yang, Fan; Zhou, Chun

    2015-01-01

    Purpose: The purpose of this paper is to investigate how the information about haze, a term used in China to describe the air pollution problem, is portrayed on Chinese social media by different types of organizations using the theoretical framework of the health belief model (HBM). Design/methodology/approach: A content analysis was conducted…

  1. Tropospheric Ozone Assessment Report: Present-day ozone distribution and trends relevant to human health

    Directory of Open Access Journals (Sweden)

    Zoë L. Fleming

    2018-02-01

    Full Text Available This study quantifies the present-day global and regional distributions (2010–2014 and trends (2000–2014 for five ozone metrics relevant for short-term and long-term human exposure. These metrics, calculated by the Tropospheric Ozone Assessment Report, are: 4th highest daily maximum 8-hour ozone (4MDA8; number of days with MDA8 > 70 ppb (NDGT70, SOMO35 (annual Sum of Ozone Means Over 35 ppb and two seasonally averaged metrics (3MMDA1; AVGMDA8. These metrics were explored at ozone monitoring sites worldwide, which were classified as urban or non-urban based on population and nighttime lights data. Present-day distributions of 4MDA8 and NDGT70, determined predominantly by peak values, are similar with highest levels in western North America, southern Europe and East Asia. For the other three metrics, distributions are similar with North–South gradients more prominent across Europe and Japan. Between 2000 and 2014, significant negative trends in 4MDA8 and NDGT70 occur at most US and some European sites. In contrast, significant positive trends are found at many sites in South Korea and Hong Kong, with mixed trends across Japan. The other three metrics have similar, negative trends for many non-urban North American and some European and Japanese sites, and positive trends across much of East Asia. Globally, metrics at many sites exhibit non-significant trends. At 59% of all sites there is a common direction and significance in the trend across all five metrics, whilst 4MDA8 and NDGT70 have a common trend at ~80% of all sites. Sensitivity analysis shows AVGMDA8 trends differ with averaging period (warm season or annual. Trends are unchanged at many sites when a 1995–2014 period is used; although fewer sites exhibit non-significant trends. Over the longer period 1970–2014, most Japanese sites exhibit positive 4MDA8/SOMO35 trends. Insufficient data exist to characterize ozone trends for the rest of Asia and other world regions.

  2. Ecological risk assessment and carcinogen health risk assessment of arsenic in soils from part area of the Daye City, China

    Science.gov (United States)

    Li, F.; Wang, T.; Xiao, M. S.; Cai, Y.; Zhuang, Z. Y.

    2018-01-01

    Soils in four sampling sites from part area of the Daye City were collected. Concentrations of arsenic (As) in soils in sampling sites were detected by Atomic Fluorescence Spectrometry, ecological risk was calculated by potential ecological risk index (RI) and human health risk was measured by human health risk assessment model established by USEPA. The results showed that, the total content of As in soils in Daye was decreased in the order of S4 (66.58 mg/kg)>S2 (44.73 mg/kg)>S3 (34.86 mg/kg) >S1 (21.84 mg/kg), concentrations in all sampling sites were higher than background values of Hubei Province. The potential risk and human health risk were decreased in the order of S4>S2>S3>S1 and S4>S3>S2>S1, respectively. Specially, S1, S2 and S3 were at low potential ecological risk while S4 was at moderate ecological risk. But there was no carcinogenic risk for human exposure to As in soil in Daye.

  3. Public health terminology: Hindrance to a Health in All Policies approach?

    Science.gov (United States)

    Synnevåg, Ellen S; Amdam, Roar; Fosse, Elisabeth

    2018-02-01

    National public health policies in Norway are based on a Health in All Policies (HiAP) approach. At the local level, this means that public health, as a cross-sectional responsibility, should be implemented in all municipal sectors by integrating public health policies in municipal planning and management systems. The paper investigates these local processes, focusing on the use of public health terminology and how this terminology is translated from national to local contexts. We ask whether the terms 'public health' and 'public health work' are suitable when implementing an HiAP approach. A qualitative case study based on analyses of interviews and planning documents was performed in three Norwegian municipalities. The results present dilemmas associated with using public health terminology when implementing an HiAP approach. On the one hand, the terms are experienced as wide, complex, advanced and unnecessary. On the other hand, the terms are experienced as important for a systematic approach towards understanding public health ideology and cross-sectional responsibility. One municipality used alternative terminology. This paper promotes debate about the appropriateness of using the terms 'public health' and 'public health work' at the local level. It suggests that adaptation is suitable and necessary, unless it compromises knowledge, responsibility and a systematic approach. This study concludes that the use of terminology is a central factor when implementing the Norwegian Public Health Act at the local level.

  4. Improved nutrition in the first 1000 days and adult human capital and health.

    Science.gov (United States)

    Martorell, Reynaldo

    2017-03-01

    The aim of this article is to review why the first 1000 days of life are a vulnerable period of human development and the long-term effects of a nutrition experiment carried out in Guatemala (1969-1977). In 1969-77, a supplement called Atole, containing high quality protein, energy and micronutrients, was provided to women during pregnancy and lactation and to children nutritional requirements, greater susceptibility to infections, high sensitivity to programming effects and full dependence on others for care, nutrition, and social interaction. Compared with Fresco, Atole improved total nutrient intakes (protein, energy, and micronutrients) and reduced stunting, but only in children nutrition intervention. This provides a powerful argument for promoting improvements in nutrition in pregnant women and young children in low income countries. © 2017 Wiley Periodicals, Inc.

  5. Internal contamination: what challenges for tomorrow? Proceedings of the Research and Health Section technical day

    International Nuclear Information System (INIS)

    Berard, Philippe; Lecoix, Geraldine; Menetrier, Florence; Menetrier, Florence; Leiterer, Alexandra; Gremy, Olivier; Mougnard, Philippe; Gonin, Michele; Paquet, Francois; Davesne, Estelle; Bertho, Jean-Marc; Metivier, Henri; Abergel, Rebecca

    2015-10-01

    The Research and Health Section of the French Society of Radiation Protection (SFRP) organized a technical meeting on the radiation protection aspects of dismantlement, from the dismantling work to the risk, the measurement of body contamination, the potentially harmful health effects, the available medical treatments, the actual needs and the developments in progress. This document brings together the abstracts and the presentations (slides) of the different talks given at the meeting: 1 - Situation: what radionuclides, what situations? (Philippe BERARD, CEA); 2 - Dismantling workplace experience feedback with internal contamination hazard (Philippe MOUGNARD, AREVA); 3 - Experience feedback on internal exposure monitoring at power plants in France (Michele GONIN, EDF); 4 - Evolution of routine and intervention measurement methods (Geraldine LECOIX, CEA); 5 - Evolution of radiation dose calculation models (Francois PAQUET, IRSN); 6 - Taking uncertainties into account in internal contamination monitoring protocols (Estelle DAVESNE, IRSN); 7 - Radionuclides behaviour and effects in men (Florence MENETRIER, CEA); 8 - The plutonium case (Henri METIVIER, SFRP); 9 - Cesium-137 and internal contamination: status and perspectives (Jean-Marc BERTHO, IRSN); 10 - Iodine and thyroid (Florence MENETRIER, CEA); 11 - Actual treatments and research pathways (Alexandra LEITERER, CEA); 12 - Radionuclide contamination treatment: new developments in the US (Rebecca ABERGEL, Berkeley USA); 13 - Internal contaminations treatment: French recent effort for its improvement (Olivier GREMY, CEA)

  6. eHealth Technology Competencies for Health Professionals Working in Home Care to Support Older Adults to Age in Place: Outcomes of a Two-Day Collaborative Workshop.

    Science.gov (United States)

    Barakat, Ansam; Woolrych, Ryan D; Sixsmith, Andrew; Kearns, William D; Kort, Helianthe S M

    2013-01-01

    The demand for care is increasing, whereas in the near future the number of people working in professional care will not match with the demand for care. eHealth technology can help to meet the growing demand for care. Despite the apparent positive effects of eHealth technology, there are still barriers to technology adoption related to the absence of a composite set of knowledge and skills among health care professionals regarding the use of eHealth technology. The objective of this paper is to discuss the competencies required by health care professionals working in home care, with eHealth technologies such as remote telecare and ambient assisted living (AAL), mobile health, and fall detection systems. A two-day collaborative workshop was undertaken with academics across multiple disciplines with experience in working on funded research regarding the application and development of technologies to support older people. The findings revealed that health care professionals working in home care require a subset of composite skills as well as technology-specific competencies to develop the necessary aptitude in eHealth care. This paper argues that eHealth care technology skills must be instilled in health care professionals to ensure that technologies become integral components of future care delivery, especially to support older adults to age in place. Educating health care professionals with the necessary skill training in eHealth care will improve service delivery and optimise the eHealth care potential to reduce costs by improving efficiency. Moreover, embedding eHealth care competencies within training and education for health care professionals ensures that the benefits of new technologies are realized by casting them in the context of the larger system of care. These care improvements will potentially support the independent living of older persons at home. This paper describes the health care professionals' competencies and requirements needed for the use of eHealth

  7. Global Handwashing Day 2012: a qualitative content analysis of Chinese social media reaction to a health promotion event.

    Science.gov (United States)

    Fung, Isaac Chun-Hai; Cai, Jingxian; Hao, Yi; Ying, Yuchen; Chan, Benedict Shing Bun; Tse, Zion Tsz Ho; Fu, King-Wa

    2015-01-01

    Global Handwashing Day (GHD) is a handwashing promotion campaign organized by the Global Public-Private Partnership of Handwashing with Soap. In China, it has been promoted by the Chinese public health authorities, international organizations and multinational corporations through various channels including social media such as Sina Weibo, the leading Chinese microblogging site similar to Twitter. The objective of this study is to qualitatively assess Chinese social media users' reactions to a health promotion campaign using Global Handwashing Day (GHD) 2012 as an example. We conducted a qualitative content analysis of 552 Weibo posts generated on GHD 2012 by Weibo users with 1000 or more followers with the Chinese keyword for "handwashing." We categorized the Weibo posts into groups by keywords that frequently appeared in the data set. These groups were either exact reposts of an original post, or they conveyed similar information. We observed the interconnections between traditional media and social media in handwashing promotion. Social media were found to serve as amplifiers of contents provided by traditional media. We observed the contextualization of global hygiene messages in a unique national social media market in China. Our study showed that social media and traditional media are two interconnected arms of the GHD campaign in China. Our analysis demonstrated that public health campaigns in China can be evaluated using social media data. The themes and topics identified in this study will help public health practitioners evaluate future social media handwashing promotion campaigns.

  8. Beyond Techno-Utopia: Critical Approaches to Digital Health Technologies

    Directory of Open Access Journals (Sweden)

    Deborah Lupton

    2014-12-01

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

  9. The impact of common mental and physical health conditions on days out of role: costs for the individual and society.

    Directory of Open Access Journals (Sweden)

    Corina Benjet

    2013-05-01

    Full Text Available Objective. To estimate the individual and societal costs of common mental and physical health conditions in the Mexican population with regards to the number of days out of role. Materials and methods. 5 826 adults were evaluated in 2001-2002 with the Composite International Diagnostic Interview and the WHO Disability Assessment Schedule. General linear models were used to estimate individuallevel effects. Societal-level effects were estimated with the population attributable risk proportion which takes into account prevalence and comorbidity of disorders. Results. The conditions with the strongest individual-level effects were major depression, post-traumatic stress disorder and bipolar disorder. The strongest societal-level effects were associated with major depression, pain, insomnia and cardiovascular conditions. Conclusion. The findings suggest the importance of investing in mental health expenditure to a level commensurate with the costs to society of mental health disorders.

  10. Environmental Health assessment 200 Days after Earthquake-Affected Region in East Azerbaijan Earthquake, North-Western of Iran, 2012

    Directory of Open Access Journals (Sweden)

    Alihossein Zeinalzadeh

    2017-04-01

    Full Text Available Evaluating of health status and explore the challenges of health problems that threaten human life following disasters and major earthquakes providing windows of opportunities for health care providers in future planning of disasters. The main purpose of this report was to survey the environmental sanitation statues after 200 days of the affected populations in earthquakes of East Azerbaijan, northwestern of Iran, 2012. The survey was carried out in earthquake zones 200 days after the occurrence of the earthquake. A single stage cluster sampling from among 95 villages damaged in the earthquake of 2012 East Azerbaijan of three towns Ahar, Varzeghan and Heris were selected. The data were collected with questionnaire, site visits and evaluation of water and sanitation. In a twin Earthquake, East Azerbaijan province that 399 villages of Ahar, Varzeghan, Heris, Tabriz and Kaleibar cities were affected and 356 (89.2 % villages were destroyed between 30-100%.  Evaluation of water and sanitation infrastructure after 200 days, shown that only half of these villages consumed healthy water with high coverage and adequate. Half of the villages in 200 days after the earthquake were covered safe drinking water (treated drinking water. The bacteriological quality of drinking-water supply of the affected area was assessed in randomly collected 146 samples from this region and ten (6.8% reported as unsuitable. Solid waste management facilities in residents have not been acceptable that affect public health. Solid waste disposal was done by district residents (cooperation rural residents 68.4%, 36.8% and 76.3% in Ahar, Varzeghan and Heris, respectively. Overall, the impact of infectious and communicable diseases after Earthquake was reported 42.1% (16 villages in the Varzeghan. The lack of geographical view with a focus in mountainous and rural areas, partial support and dispersion of earthquake-stricken people in affected villages and lack of participatory need

  11. Effects of different endurance exercise modalities on migraine days and cerebrovascular health in episodic migraineurs: A randomized controlled trial.

    Science.gov (United States)

    Hanssen, H; Minghetti, A; Magon, S; Rossmeissl, A; Rasenack, M; Papadopoulou, A; Klenk, C; Faude, O; Zahner, L; Sprenger, T; Donath, L

    2018-03-01

    Aerobic exercise training is a promising complementary treatment option in migraine and can reduce migraine days and improve retinal microvascular function. Our aim was to elucidate whether different aerobic exercise programs at high vs moderate intensities distinctly affect migraine days as primary outcome and retinal vessel parameters as a secondary. In this randomized controlled trial, migraine days were recorded by a validated migraine diary in 45 migraineurs of which 36 (female: 28; age: 36 (SD:10)/BMI: 23.1 (5.3) completed the training period (dropout: 20%). Participants were assigned (Strata: age, gender, fitness and migraine symptomatology) to either high intensity interval training (HIT), moderate continuous training (MCT), or a control group (CON). Intervention groups trained twice a week over a 12-week intervention period. Static retinal vessel analysis, central retinal arteriolar (CRAE) and venular (CRVE) diameters, as well as the arteriolar-to-venular diameter ratio (AVR) were obtained for cerebrovascular health assessment. Incremental treadmill testing yielded maximal and submaximal fitness parameters. Overall, moderate migraine day reductions were observed (ηP2 = .12): HIT revealed 89% likely beneficial effects (SMD = 1.05) compared to MCT (SMD = 0.50) and CON (SMD = 0.59). Very large intervention effects on AVR improvement (ηP2 = 0.27), slightly favoring HIT (SMD=-0.43) over CON (SMD=0), were observed. HIT seems more effective for migraine day reduction and improvement of cerebrovascular health compared to MCT. Intermittent exercise programs of higher intensities may need to be considered as an additional treatment option in migraine patients. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  12. Living Day by Day

    Science.gov (United States)

    Kaplan, Rachel L.; Khoury, Cynthia El; Field, Emily R. S.; Mokhbat, Jacques

    2016-01-01

    We examined the meaning of living with HIV/AIDS among women in Lebanon. Ten women living with HIV/AIDS (WLWHA) described their experiences via semistructured in-depth interviews. They navigated a process of HIV diagnosis acceptance that incorporated six overlapping elements: receiving the news, accessing care, starting treatment, navigating disclosure decisions, negotiating stigma, and maintaining stability. Through these elements, we provide a framework for understanding three major themes that were constructed during data analysis: Stand by my side: Decisions of disclosure; Being “sick” and feeling “normal”: Interacting with self, others, and society; and Living day by day: focusing on the present. We contribute to the existing literature by providing a theoretical framework for understanding the process of diagnosis and sero-status acceptance among WLWHA. This was the first study of its kind to examine the meaning of living with HIV/AIDS among women in a Middle Eastern country. PMID:28462340

  13. Living Day by Day

    Directory of Open Access Journals (Sweden)

    Rachel L. Kaplan

    2016-05-01

    Full Text Available We examined the meaning of living with HIV/AIDS among women in Lebanon. Ten women living with HIV/AIDS (WLWHA described their experiences via semistructured in-depth interviews. They navigated a process of HIV diagnosis acceptance that incorporated six overlapping elements: receiving the news, accessing care, starting treatment, navigating disclosure decisions, negotiating stigma, and maintaining stability. Through these elements, we provide a framework for understanding three major themes that were constructed during data analysis: Stand by my side: Decisions of disclosure; Being “sick” and feeling “normal”: Interacting with self, others, and society; and Living day by day: focusing on the present. We contribute to the existing literature by providing a theoretical framework for understanding the process of diagnosis and sero-status acceptance among WLWHA. This was the first study of its kind to examine the meaning of living with HIV/AIDS among women in a Middle Eastern country.

  14. Improving Scotland's health: time for a fresh approach?

    Science.gov (United States)

    Stone, D H

    2012-05-01

    Scotland's health remains the worst in the UK. There are several probable reasons for this. Of those that are amenable to change, health improvement policy has been excessively preoccupied with targeting individuals perceived to be 'at risk' rather than adopting a whole population perspective. Environmental as opposed to behavioural approaches to health improvement have been relatively neglected. To meet the challenge of Scotland's poor health more effectively in the future, new strategic thinking is necessary. Three initial steps are required: recognize that current approaches are inadequate and that fresh ideas are needed; identify the principles that should underlie future strategy development; translate these principles into achievable operational objectives. Five principles of a revitalized strategy to improve the health of Scotland in the future are proposed. These are start early and sustain effort; create a healthy and safe environment; reduce geographical as well as social inequalities in health; adopt an evidence-based approach to public health interventions; use epidemiology to assess need, plan interventions and monitor progress. These principles may then be translated into achievable operational policy and practice objectives.

  15. Working 9-5: Causal Relationships Between Singers' "Day Jobs" and Their Performance Work, With Implications for Vocal Health.

    Science.gov (United States)

    Bartlett, Irene; Wilson, Pat H

    2017-03-01

    It is acknowledged generally that professional contemporary commercial music (CCM) singers engage in supplementary employment ("the day job") to achieve and maintain a reliable living wage. In this paper, consideration is given to the impact of such nonperformance employment on CCM's sustainable vocal health. Collected data from a survey of 102 professional contemporary gig singers were analysed using descriptive statistical procedures from the Statistical Package for the Social Sciences. Although these data provided descriptions of the personal characteristics of individuals in the sample, the inclusion of open format questions encouraged participants to report details of their "lived" experience. Additionally, a meta-analysis of a range of associated literature was undertaken. Sixty-five participants (N = 102) reported that in addition to their heavy performance voice use, they were employed in "other" work (the "day job") where their speaking voice loads were high. In responding to open-ended questions, many proffered written comments that were unprompted. The collected data from this element of the research study are reported here. We propose that at least some causal factors of singers' reported voice problems may lie in the misuse or overuse of their everyday speaking voice (as demanded by their "day job") rather than a misuse of their singing voice. These findings have practical application to all whose concern is care for the vocal or emotional health and performance longevity of professional singers. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  16. Reducing Technology-Induced Errors: Organizational and Health Systems Approaches.

    Science.gov (United States)

    Borycki, Elizabeth M; Senthriajah, Yalini; Kushniruk, Andre W; Palojoki, Sari; Saranto, Kaija; Takeda, Hiroshi

    2016-01-01

    Technology-induced errors are a growing concern for health care organizations. Such errors arise from the interaction between healthcare and information technology deployed in complex settings and contexts. As the number of health information technologies that are used to provide patient care rises so will the need to develop ways to improve the quality and safety of the technology that we use. The objective of the panel is to describe varying approaches to improving software safety from and organizational and health systems perspective. We define what a technology-induced error is. Then, we discuss how software design and testing can be used to improve health information technologies. This discussion is followed by work in the area of monitoring and reporting at a health district and national level. Lastly, we draw on the quality, safety and resilience literature. The target audience for this work are nursing and health informatics researchers, practitioners, administrators, policy makers and students.

  17. A new complementary approach for oral health and diabetes management

    DEFF Research Database (Denmark)

    Cinar, Ayse Basak; Freeman, Ruth; Schou, Lone

    2018-01-01

    BACKGROUND: Health coaching (HC) is based on 'partnering with clients in a thought-provoking and creative process that inspires them to maximise their personal and professional potential' to adopt healthy lifestyles through 'building awareness and empowerment'. This study's objective is to assess......, for the first time to our knowledge, the effectiveness of HC compared with health education (HE) using clinical and subjective measures among type 2 diabetes (DM2) patients in Turkey and Denmark. METHODS: This stratified random prospective study selected type 2 diabetes patients in Turkey (n = 186) (TR) (2010...... management and health outcomes. There is a need for common health promotion strategies with behavioural interventions such as health coaching for the management of type 2 diabetes that focus on multidisciplinary approaches including oral health....

  18. Comparison of surface mass balance of ice sheets simulated by positive-degree-day method and energy balance approach

    Directory of Open Access Journals (Sweden)

    E. Bauer

    2017-07-01

    Full Text Available Glacial cycles of the late Quaternary are controlled by the asymmetrically varying mass balance of continental ice sheets in the Northern Hemisphere. Surface mass balance is governed by processes of ablation and accumulation. Here two ablation schemes, the positive-degree-day (PDD method and the surface energy balance (SEB approach, are compared in transient simulations of the last glacial cycle with the Earth system model of intermediate complexity CLIMBER-2. The standard version of the CLIMBER-2 model incorporates the SEB approach and simulates ice volume variations in reasonable agreement with paleoclimate reconstructions during the entire last glacial cycle. Using results from the standard CLIMBER-2 model version, we simulated ablation with the PDD method in offline mode by applying different combinations of three empirical parameters of the PDD scheme. We found that none of the parameter combinations allow us to simulate a surface mass balance of the American and European ice sheets that is similar to that obtained with the standard SEB method. The use of constant values for the empirical PDD parameters led either to too much ablation during the first phase of the last glacial cycle or too little ablation during the final phase. We then substituted the standard SEB scheme in CLIMBER-2 with the PDD scheme and performed a suite of fully interactive (online simulations of the last glacial cycle with different combinations of PDD parameters. The results of these simulations confirmed the results of the offline simulations: no combination of PDD parameters realistically simulates the evolution of the ice sheets during the entire glacial cycle. The use of constant parameter values in the online simulations leads either to a buildup of too much ice volume at the end of glacial cycle or too little ice volume at the beginning. Even when the model correctly simulates global ice volume at the last glacial maximum (21 ka, it is unable to simulate

  19. Employing a Qualitative Description Approach in Health Care Research

    Science.gov (United States)

    Bradshaw, Carmel; Atkinson, Sandra; Doody, Owen

    2017-01-01

    A qualitative description design is particularly relevant where information is required directly from those experiencing the phenomenon under investigation and where time and resources are limited. Nurses and midwives often have clinical questions suitable to a qualitative approach but little time to develop an exhaustive comprehension of qualitative methodological approaches. Qualitative description research is sometimes considered a less sophisticated approach for epistemological reasons. Another challenge when considering qualitative description design is differentiating qualitative description from other qualitative approaches. This article provides a systematic and robust journey through the philosophical, ontological, and epistemological perspectives, which evidences the purpose of qualitative description research. Methods and rigor issues underpinning qualitative description research are also appraised to provide the researcher with a systematic approach to conduct research utilizing this approach. The key attributes and value of qualitative description research in the health care professions will be highlighted with the aim of extending its usage. PMID:29204457

  20. Employing a Qualitative Description Approach in Health Care Research.

    Science.gov (United States)

    Bradshaw, Carmel; Atkinson, Sandra; Doody, Owen

    2017-01-01

    A qualitative description design is particularly relevant where information is required directly from those experiencing the phenomenon under investigation and where time and resources are limited. Nurses and midwives often have clinical questions suitable to a qualitative approach but little time to develop an exhaustive comprehension of qualitative methodological approaches. Qualitative description research is sometimes considered a less sophisticated approach for epistemological reasons. Another challenge when considering qualitative description design is differentiating qualitative description from other qualitative approaches. This article provides a systematic and robust journey through the philosophical, ontological, and epistemological perspectives, which evidences the purpose of qualitative description research. Methods and rigor issues underpinning qualitative description research are also appraised to provide the researcher with a systematic approach to conduct research utilizing this approach. The key attributes and value of qualitative description research in the health care professions will be highlighted with the aim of extending its usage.

  1. Alcoholism and its Effects: an Approach Based on Health Psychology

    Directory of Open Access Journals (Sweden)

    Maria de las Mercedes Pretel Olite

    2014-11-01

    Full Text Available Alcoholism is a complex biopsychosocial disorder that requires a specialised and multidisciplinary approach focusing on both the patient and the family. Alcohol consumption is the most important addiction worldwide due to its prevalence and impact. Therefore, the main objective of a primary care physician should be to facilitate the referral of patients and their families to a structured treatment, support and guidance program during the whole detoxification process. In every health area in Cienfuegos, there are community mental health centers with a staff trained to deal with these disorders in addicts and their family. A literature review was conducted to establish the relationship between alcohol consumption and its harmful effects on health, family and society, using an approach based on Health Psychology.

  2. School health approach to teaching and learning of students

    Directory of Open Access Journals (Sweden)

    Yu.S. Lukianova

    2015-01-01

    Full Text Available Purpose: disclosure of health-ways for teaching and learning of students. Material: analysis of the publications of domestic and foreign authors. Results: The article is devoted to the implementation of healthy way approach to the educational process, namely, the rational organization of training aimed at keeping the dynamics of human health, the prevention of mental fatigue and overload, increase adaptive reserves of the body of the person; intensification of teaching and learning of students (application-is controversial dialogue, training, game forms and methods of training, participation in project activities, the work of pedagogical workshops that stimulates emotional accommodation and understanding of knowledge, helps students acquire personal-relevant knowledge and experience; use of health effect of artistic and practical (music, painting activities of students. Conclusions: highlights the key towards the implementation of health-promoting approach to the educational process.

  3. [Health promotion in day-care centres in Reykjavík--intervention and result of actions].

    Science.gov (United States)

    Gudmarsdóttir, Agústa; Tómasson, Kristinn

    2007-03-01

    The purpose of the study was to compare wellbeing, health and work environment before and after intervention among employees of Reykjavík city day-care centre. The study is a prospective interventions study. In the year 2000 employees of 16 day-care centres responded to a questionnaire regarding work environment, health and wellbeing. Work environment evaluation was completed and the centre classified into four groups accordingly. Subsequently, the "equipment was renewed" noise protection improved and the employee received education concerning occupational health. Six months, after interventions, in the year 2002 the same questionnaire was readministered. Response rate in 2002 was 88% (n=267) but 90% in the year 2000. Work environment had improved. More employees had received instruction on good workposture and good work technique than 2 years earlier. Fewer employees used awkward posture than before. Better workspace resulted in reduced number of symptoms, also for the youngest employees. Symptoms were also fewer where unskilled employees were in majority and where the fewest of them had received proper education on work posture. In the year 2002, psychosocial wellbeing was better or equal than two years earlier. This was associated with better education and higher age even despite less workspace. Employees awareness towards noise was greatly improved. It is possible to improve work methods and work environment of employees with goal directed intervention, thus laying the ground for wellbeing at work. The interplay between the factors education and age is complex, though. Thus it is important, that all workplaces, adopt the process of "risk assessment", intervention, and then reassessment of the work environment. By doing so the goals of health promotion and good occupational health can be reached.

  4. Cost approach of health care entity intangible asset valuation.

    Science.gov (United States)

    Reilly, Robert F

    2012-01-01

    degree of marketability; and The degree of variation in the range of value indications. Valuation analysts value health care intangible assets for a number of reasons. In addition to regulatory compliance reasons, these reasons include various transaction, taxation, financing, litigation, accounting, bankruptcy, and planning purposes. The valuation analyst should consider all generally accepted intangible asset valuation approaches, methods, and procedures. Many valuation analysts are more familiar with market approach and income approach valuation methods. However, there are numerous instances when cost approach valuation methods are also applicable to the health care intangible asset valuation. This discussion summarized the analyst's procedures and considerations with regard to the cost approach. The cost approach is often applicable to the valuation of intangible assets in the health care industry. However, the cost approach is only applicable if the valuation analyst (1) appropriately considers all of the cost components and (2) appropriately identifies and quantifies all obsolescence allowances. Regardless of the health care intangible asset or the reason for the valuation, the analyst should be familiar with all generally accepted valuation approaches and methods. And, the valuation analyst should have a clear, convincing, and cogent rationale for (1) accepting each approach and method applied and (2) rejecting each approach and method not applied. That way, the valuation analyst will best achieve the purpose and objective of the health care intangible asset valuation.

  5. Religious Engagement in a Risky Family Model Predicting Health in Older Black and White Seventh-day Adventists.

    Science.gov (United States)

    Morton, Kelly R; Lee, Jerry W; Haviland, Mark G; Fraser, Gary E

    2012-11-01

    In a structural equation model, associations among latent variables - Child Poverty, Risky Family exposure, Religious Engagement, Negative Social Interactions, Negative Emotionality, and Perceived Physical Health - were evaluated in 6,753 Black and White adults aged 35-106 years (M = 60.5, SD = 13.0). All participants were members of the Seventh-day Adventist church surveyed in the Biopsychosocial Religion and Health Study (BRHS). Child Poverty was positively associated with both Risky Family exposure (conflict, neglect, abuse) and Religious Engagement (intrinsic religiosity, religious coping, religiousness). Risky Family was negatively associated with Religious Engagement and positively associated with both Negative Social Interactions (intrusive, failed to help, insensitive, rejecting) and Negative Emotionality (depression, negative affect, neuroticism). Religious Engagement was negatively associated with Negative Emotionality and Negative Social Interactions at a given level of risky family. Negative Social Interactions was positively associated with Negative Emotionality, which had a direct, negative effect on Perceived Physical Health. All constructs had indirect effects on Perceived Physical Health through Negative Emotionality. The effects of a risky family environment appear to be enduring, negatively affecting one's adult religious life, emotionality, social interactions, and perceived health. Religious engagement, however, may counteract the damaging effects of early life stress.

  6. Gross domestic product and health expenditure associated with incidence, 30-day fatality, and age at stroke onset: a systematic review.

    Science.gov (United States)

    Sposato, Luciano A; Saposnik, Gustavo

    2012-01-01

    Differences in definitions of socioeconomic status and between study designs hinder their comparability across countries. We aimed to analyze the correlation between 3 widely used macrosocioeconomic status indicators and clinical outcomes. We selected population-based studies reporting incident stroke risk and/or 30-day case-fatality according to prespecified criteria. We used 3 macrosocioeconomic status indicators that are consistently defined by international agencies: per capita gross domestic product adjusted for purchasing power parity, total health expenditures per capita at purchasing power parity, and unemployment rate. We examined the correlation of each macrosocioeconomic status indicator with incident risk of stroke, 30-day case-fatality, proportion of hemorrhagic strokes, and age at stroke onset. Twenty-three articles comprising 30 population-based studies fulfilled the eligibility criteria. Age-adjusted incident risk of stroke using the standardized World Health Organization World population was associated to lower per capita gross domestic product adjusted for purchasing power parity (ρ=-0.661, P=0.027, R(2)=0.32) and total health expenditures per capita at purchasing power parity (ρ=-0.623, P=0.040, R(2)=0.26). Thirty-day case-fatality rates and proportion of hemorrhagic strokes were also related to lower per capita gross domestic product adjusted for purchasing power parity and total health expenditures per capita at purchasing power parity. Moreover, stroke occurred at a younger age in populations with low per capita gross domestic product adjusted for purchasing power parity and total health expenditures per capita at purchasing power parity. There was no correlation between unemployment rates and outcome measures. Lower per capita gross domestic product adjusted for purchasing power parity and total health expenditures per capita at purchasing power parity were associated with higher incident risk of stroke, higher case-fatality, a greater

  7. Integrated Approaches to Occupational Health and Safety: A Systematic Review.

    Science.gov (United States)

    Cooklin, A; Joss, N; Husser, E; Oldenburg, B

    2017-09-01

    The study objective was to conduct a systematic review of the effectiveness of integrated workplace interventions that combine health promotion with occupational health and safety. Electronic databases (n = 8), including PsychInfo and MEDLINE, were systematically searched. Studies included were those that reported on workplace interventions that met the consensus definition of an "integrated approach," published in English, in the scientific literature since 1990. Data extracted were occupation, worksite, country, sample size, intervention targets, follow-up period, and results reported. Quality was assessed according to American College of Occupational and Environmental Medicine Practice Guidelines. Heterogeneity precluded formal meta-analyses. Results were classified according to the outcome(s) assessed into five categories (health promotion, injury prevention, occupational health and safety management, psychosocial, and return-on-investment). Narrative synthesis of outcomes was performed. A total of 31 eligible studies were identified; 23 (74%) were (quasi-)experimental trials. Effective interventions were most of those aimed at improving employee physical or mental health. Less consistent results were reported from integrated interventions targeting occupational health and safety management, injury prevention, or organizational cost savings. Integrated approaches have been posed as comprehensive solutions to complex issues. Empirical evidence, while still emerging, provides some support for this. Continuing investment in, and evaluation of, integrated approaches are worthwhile.

  8. Microcredit and the social determinants of health: a conceptual approach.

    Science.gov (United States)

    Salt, Rebekah

    2011-01-01

    Social determinants of health, such as human behavior, environment, and socioeconomics, contribute to health disparities at the individual and population levels. The association between socioeconomics and health is established, and it is acknowledged that people with a lower socioeconomic status experience poorer health. The impetus of microcredit programs is to provide financial alternatives for low-income populations, the majority of whom are women with limited or no access to traditional lending, to start small businesses, generate income, and progress toward self-sufficiency. The income-health link within the context of microcredit has been internationally acknowledged; however, there is scarce research in this area in the United States. This article presents a review of the conceptual approach used to explore the microcredit and health link from a public health nursing perspective. Establishing conceptual foundations can enhance research focused on targeted interventions aimed at lasting change in social and health status. Exploring the link between microcredit and health can enrich research efforts and may offer innovative strategies and interventions to improve health-promoting capacity in impoverished groups. © 2011 Wiley Periodicals, Inc.

  9. O cotidiano do cuidado infantil em comunidades rurais do Estado da Bahia: uma abordagem qualitativa Day-to-day child care in rural communities in the State of Bahia, Brazil: a qualitative approach

    Directory of Open Access Journals (Sweden)

    Micheli Dantas Soares

    2008-12-01

    Full Text Available OBJETIVOS: compreender as experiências e sentidos do cuidado infantil, por quem o agencia no espaço doméstico. MÉTODOS: foi utilizado o aporte teórico oriundo da fenomenologia na análise e interpretação dos textos extraídos das entrevistas semi-estruturadas, realizadas com as responsáveis por prover o cuidado no espaço das 10 unidades domésticas escolhidas, na sua totalidade composta por mulheres. A investigação sobre cuidado infantil foi realizada no município de Caldas de Cipó, Bahia, Brasil. RESULTADOS: entre as várias dimensões do cuidado infantil, o alimentar constitui-se como uma das principais preocupações das agentes, sobretudo pela condição de pobreza em que as mesmas vivem. A garantia da comida conforma o elemento chave do cuidado alimentar. As experiências do cuidar, informadas pelas agentes, dialogam não só com as suas situações biográficas, como também com relações que guardam com o mundo cotidiano, num tempo e espaço particularizados. CONCLUSÕES: pelo sentido existencial que caracteriza o cuidado, os resultados deste estudo sugerem um novo enfoque na condução das políticas e ações de educação em saúde para as mulheres cuidadoras.OBJECTIVES: understand the experience and the meaning of child care for those who practice it in the home. METHODS: a phenomenological theoretical approach was used to analyze and interpret extracts from semi-structured interviews conducted with those responsible for the child care in 10 households in the city of Caldas de Cipó, in the State of Bahia, Brazil. RESULTS: of the various aspects of the child care, nutrition was the one of greatest concern to interviewees, given the conditions of poverty in which they live. The provision of food supplies is a key element of nutrition. The nature of the caring experience was connected not only with the personal history of the individual but also with their relationship to the day-to-day world of a particular time and space

  10. Exploring relationships among social integration, social isolation, self-rated health, and demographics among Latino day laborers.

    Science.gov (United States)

    Steel, Kenneth C; Fernandez-Esquer, Maria Eugenia; Atkinson, John S; Taylor, Wendell C

    2018-05-01

    Research indicates social integration and social isolation are related to health, and Latino day laborers (LDLs) tend to be socially isolated and, thus, at high risk for adverse health consequences. relationships among social isolation, social integration, self-rated health (SRH), and demographics were examined in a sample of LDLs to contribute to the literature on social networks and health in this and other migrant populations. We analyzed data from 324 LDLs who participated in Proyecto SHILOS (Salud del Hombre Inmigrante Latino), a Houston-based survey of Latino immigrant men's health. Based on the literature, we hypothesized SRH would be (1) positively associated with social integration and (2) negatively associated with social isolation. All proposed measures were first entered into a correlation matrix to identify significant bivariate relationships (p ≤ .05, two-tailed). Associations between variables that were directly correlated with SRH and variables that were, in turn, proximally associated with these variables were then used to develop a structural equation path model of SRH. Individual paths in the model were measured for significance, and goodness of fit was assessed by the model chi-square, the Comparative Fit Index, and the Root Mean Square Error of Approximation. Inconsistent with the first hypothesis, SRH was negatively associated with social integration, as measured by the number of trusted friends. Consistent with the second hypothesis, SRH was negatively associated with social isolation, as measured by needing someone to talk to. More frequent contact with family was also negatively associated with social isolation. Our findings suggest social integration may not always protect and promote health. Therefore, assessing the quality of LDLs' different relationships, not just the quantity, is vital. Future studies should further analyze the effects that social resources have on perceptions of social isolation and health in LDLs and other

  11. Self-reported health and sleep complaints among nursing personnel working under 12 h night and day shifts.

    Science.gov (United States)

    Portela, Luciana F; Rotenberg, Lúcia; Waissmann, William

    2004-01-01

    This cross-sectional exploratory study involved health care workers of various skill types and levels. We tested the hypothesis that the prevalence of diseases, sleep complaints, and insufficient time for nonprofessional activities (family, leisure, and rest) are higher among night than day workers. Data collection was carried out in two public hospitals using questionnaires and other forms. Night work was explored as a risk factor, considering a night worker as one who had at least one night job on the occasion of the research. Data were assessed by a univariate analysis. The association between work schedule and the dependent variables--health conditions, sleep complaints, and insufficient time for nonprofessional activities--was evaluated through the estimation of the prevalence ratio, with a confidence interval of 95%. Two hundred and fifty-eight female nursing personnel participated; 41.5% were moonlighters, and only 20 worked a shift of less than 12h in length. Reports of migraine and need of medical care the 2 weeks before the survey were more prevalent among day than night workers (PR=0.71; CI=0.55-0.92 and PR=0.71; CI=0.52-0.95, respectively). Migraine headaches occurred less frequently among night than day workers as confirmed by comparing the reports of the night workers and day workers whose work history was always day shifts (PR = 0.74; CI = 0.57-0.96). Reports of mild emotional disorders (mild depression, tension, anxiety, or insomnia) were less frequent among night (PR=0.76; CI=0.59-0.98) and ex-night workers (PR=0.68; CI=0.50-0.91) than day workers who never had worked a night job. The healthy worker effect does not seem to explain the results of the comparisons between day and night workers. The possible role of exposure by day workers to some risk factors, such as stress, was suggested as an explanation for these results. No significant difference was observed between night and day workers as to sleep complaints, a result that may have been

  12. Ethics education for health professionals: a values based approach.

    Science.gov (United States)

    Godbold, Rosemary; Lees, Amanda

    2013-11-01

    It is now widely accepted that ethics is an essential part of educating health professionals. Despite a clear mandate to educators, there are differing approaches, in particular, how and where ethics is positioned in training programmes, underpinning philosophies and optimal modes of assessment. This paper explores varying practices and argues for a values based approach to ethics education. It then explores the possibility of using a web-based technology, the Values Exchange, to facilitate a values based approach. It uses the findings of a small scale study to signal the potential of the Values Exchange for engaging, meaningful and applied ethics education. Copyright © 2013 Elsevier Ltd. All rights reserved.

  13. Oral and General Health Promotion for Children: A Holistic Approach

    DEFF Research Database (Denmark)

    Cinar, Ayse Basak

    Inequalities in oral and general health have been rising globally; WHO calls for adoption of an integrated approach to their promotion as both share common risk factors. However, research about this issue among children is scarce. Based on the associations of such a research found in common for a...... to adopt healthy lifestyles, both in economically developing and developed countries. This book should be especially useful to researchers, professionals in dentistry and medicine, policy makers, and anyone else involved in provision of better health to community....... Turkish and Finnish children, this book underlies that oral health is turning out to be part of the global health culture, regardless of cultural differences and different oral health care systems. The book, further, by most recent literature, provides a review of 'Significance of Oral Health, Concept......Inequalities in oral and general health have been rising globally; WHO calls for adoption of an integrated approach to their promotion as both share common risk factors. However, research about this issue among children is scarce. Based on the associations of such a research found in common for all...

  14. How to achieve a collaborative approach in health promotion

    DEFF Research Database (Denmark)

    Pals, Regitze Anne Saurbrey; Hempler, Nana Folmann

    2018-01-01

    (n = 15), professionals (n = 21) and users' family members (n = 12). Data were analysed using systematic text condensation. RESULTS: Users provided three recommendations for establishing a collaborative approach in communication about health: (1) involving users in deciding the agenda and setting...

  15. Adult Learning in Health and Safety: Some Issues and Approaches.

    Science.gov (United States)

    O Fathaigh, Mairtin

    This document, which was developed for presentation at a seminar on adult learning and safety, examines approaches to occupational safety and health (OSH) learning/training in the workplace. Section 1 examines selected factors affecting adults' learning in workplace OSH programs. The principal dimensions along which individual adult learners will…

  16. Validity of various epidemiological approaches to assessing radon health risk

    International Nuclear Information System (INIS)

    Conrath, S.M.

    1990-01-01

    In this paper various epidemiologic study designs are defined and evaluated for their utility in assessing radon health risk. The strengths and limitations of these approaches are addressed. Common pitfalls and errors of epidemiologic method are delineated with examples of causes and remedies

  17. A Systems Approach to Evaluate One Health Initiatives

    DEFF Research Database (Denmark)

    Rüegg, Simon R.; Nielsen, Liza Rosenbaum; Buttigieg, Sandra C.

    2018-01-01

    (1) and (3) including ready-to-use Microsoft Excel spreadsheets for the assessment of “the One-Health-ness”. We also provide an overview of Element (2), and refer to the NEOH handbook for further details, also regarding Element (4) (http://neoh.onehealthglobal.net). The presented approach helps...

  18. A stage of change approach to reducing occupational ill health.

    Science.gov (United States)

    Whysall, Z; Haslam, C; Haslam, R

    2006-11-01

    Interventions targeted by stage of change have been shown to improve the efficacy of public health promotion initiatives in areas such as smoking cessation, alcohol reduction, and mammography screening. Targeted interventions are designed to tackle the key attitudes, beliefs, and intentions that underpin an individual's health-related behavior. Work-related ill health is an increasingly serious issue, the most common cause of which in both the UK and the US is musculoskeletal disorders. This study examined whether the stage approach could be applied to workplace interventions aimed at improving occupational health. A total of 24 multi-component occupational interventions aimed at reducing musculoskeletal disorders were monitored over a period of 4-6 months. In half of these cases, approaches were targeted according to workers' stage of change. Targeted interventions were found to be significantly more effective in promoting risk awareness and desired behavior change among workers. Significant reductions were also found in self-reported musculoskeletal discomfort among workers having received targeted interventions. No significant differences were found in self-reported musculoskeletal discomfort among workers following standard interventions. Stage-matched approaches may offer scope for substantially improving the efficacy of occupational health and safety interventions by increasing the uptake, implementation, and maintenance of risk-reducing measures.

  19. [Individuals and changes in health organizations: a psychosociological approach].

    Science.gov (United States)

    Azevedo, Creuza da Silva; Braga Neto, Francisco Campos; Sá, Marilene de Castilho

    2002-01-01

    The Brazilian health sector has undergone a severe crisis, affecting the case-resolving capacity, efficiency and governability of the health system as a whole and health organizations in particular. Although innovative management systems and tools have been encouraged, such innovations are limited in their ability to spawn organizational change, especially with regard to the challenge of enabling individual adherence to institutional projects and relations involving individuals and organizations. This paper focuses on the French psychosociological approach for analyzing and intervening in organizations, one of whose main thinkers is Eugène Enriquez. In its view of contemporary organizations, this approach focuses on the conflict between reproduction and creation as the main problem to be solved by management processes. While an organization is essentially seen as a place of order and repetition, organizational change implies the challenge of bringing creative individuals into the organization's project, avoiding the trap of controlling their minds and behavior.

  20. Halting the obesity epidemic: a public health policy approach.

    Science.gov (United States)

    Nestle, M; Jacobson, M F

    2000-01-01

    Traditional ways of preventing and treating overweight and obesity have almost invariably focused on changing the behavior of individuals, an approach that has proven woefully inadequate, as indicated by the rising rates of both conditions. Considering the many aspects of American culture that promote obesity, from the proliferation of fast-food outlets to almost universal reliance on automobiles, reversing current trends will require a multifaceted public health policy approach as well as considerable funding. National leadership is needed to ensure the participation of health officials and researchers, educators and legislators, transportation experts and urban planners, and businesses and nonprofit groups in formulating a public health campaign with a better chance of success. The authors outline a broad range of policy recommendations and suggest that an obesity prevention campaign might be funded, in part, with revenues from small taxes on selected products that provide "empty" calories-such as soft drinks-or that reduce physical activity-such as automobiles.

  1. Global Ozone Distribution relevant to Human Health: Metrics and present day levels from the Tropospheric Ozone Assessment Report (TOAR)

    Science.gov (United States)

    Fleming, Z. L.; Doherty, R. M.; von Schneidemesser, E.; Cooper, O. R.; Malley, C.; Colette, A.; Xu, X.; Pinto, J. P.; Simpson, D.; Schultz, M. G.; Hamad, S.; Moola, R.; Solberg, S.; Feng, Z.

    2017-12-01

    Using stations from the TOAR surface ozone database, this study quantifies present-day global and regional distributions of five ozone metrics relevant for both short-term and long-term human exposure. These metrics were explored at ozone monitoring sites globally, and re-classified for this project as urban or non-urban using population densities and night-time lights. National surface ozone limit values are usually related to an annual number of exceedances of daily maximum 8-hour running mean (MDA8), with many countries not even having any ozone limit values. A discussion and comparison of exceedances in the different ozone metrics, their locations and the seasonality of exceedances provides clues as to the regions that potentially have more serious ozone health implications. Present day ozone levels (2010-2014) have been compared globally and show definite geographical differences (see Figure showing the annual 4th highest MDA8 for present day ozone for all non-urban stations). Higher ozone levels are seen in western compared to eastern US, and between southern and northern Europe, and generally higher levels in east Asia. The metrics reflective of peak concentrations show highest values in western North America, southern Europe and East Asia. A number of the metrics show similar distributions of North-South gradients, most prominent across Europe and Japan. The interquartile range of the regional ozone metrics was largest in East Asia, higher for urban stations in Asia but higher for non-urban stations in Europe and North America. With over 3000 monitoring stations included in this analysis and despite the higher densities of monitoring stations in Europe, north America and East Asia, this study provides the most comprehensive global picture to date of surface ozone levels in terms of health-relevant metrics.

  2. A Mixed-Methods Study of the Recovery Concept, "A Meaningful Day," in Community Mental Health Services for Individuals with Serious Mental Illnesses.

    Science.gov (United States)

    Myers, Neely A L; Smith, Kelly; Pope, Alicia; Alolayan, Yazeed; Broussard, Beth; Haynes, Nora; Compton, Michael T

    2016-10-01

    The recovery concept encompasses overcoming or managing one's illness, being physically and emotionally healthy, and finding meaningful purpose through work, school, or volunteering, which connects one to others in mutually fulfilling ways. Using a mixed-methods approach, we studied the emphasis on "a meaningful day" in the new Opening Doors to Recovery (ODR) program in southeast Georgia. Among 100 participants, we measured the meaningful day construct using three quantitative items at baseline (hospital discharge) and at 4-, 8-, and 12-month follow-up, finding statistically significant linear trends over time for all three measures. Complementary qualitative interviews with 30 individuals (ODR participants, family members, and ODR's Community Navigation Specialists and program leaders) revealed themes pertaining to companionship, productivity, achieving stability, and autonomy, as well as the concern about insufficient resources. The concept of "a meaningful day" can be a focus of clinical attention and measured as a person-centered outcome for clients served by recovery-oriented community mental health services.

  3. Health Risk Assessment of Vegetables Grown on the Contaminated Soils in Daye City of Hubei Province, China

    Directory of Open Access Journals (Sweden)

    Jun Yang

    2017-11-01

    Full Text Available China is an agriculturally-producing country and the safety of its vegetables will have an extensive attention at home and abroad. Recently, contamination of soils and vegetables caused by mining activities is of great social concern because of the potential risk to human health, especially to the residents whom live near metal or metalloid mines. In this study, 18 topsoil and 141 vegetable samples were collected from the contaminated areas in Daye City Hubei Province, China and the concentrations of copper (Cu, zinc (Zn, arsenic (As, cadmium (Cd and lead (Pb were analyzed. A self-designed questionnaire was assigned to obtain the exposure scenario and the USEPA health risk assessment model was adopted to assess two type of risks (non-carcinogenic risks and carcinogenic risks of vegetables to humans. The results showed that the average contents of metal(loids in soils exceeded the background value of Daye City. The average contents of metal(loids, especially As, Cd, Pb, in three kinds of vegetables were significantly higher than the permissible values based on Chinese national standard. Leafy vegetables had relatively higher concentrations and the transfer factors of As (0.015, Cd (0.080 and Pb (0.003 were comparable to leguminous and fruit vegetables. Leguminous vegetables had relatively higher concentrations and transfer factors of Cu (0.032 and Zn (0.094 than leafy and fruit vegetables. The transfer factors from soil to plants follows a decreasing order as Cd (0.068, Zn (0.047 > Cu (0.023 > As (0.006, Pb (0.002. Furthermore, health risk assessment revealed the following results: the non-carcinogenic risk decreased in the order of children, adult, adolescent, while the carcinogenic risk followed a decreasing order of adult, adolescent, children; the calculated carcinogenic and non-carcinogenic risk of the metal(loids by vegetable consumption decreased in the order of leafy vegetables > fruit vegetables > leguminous vegetables. The relatively

  4. Developing a curriculum framework for global health in family medicine: emerging principles, competencies, and educational approaches.

    Science.gov (United States)

    Redwood-Campbell, Lynda; Pakes, Barry; Rouleau, Katherine; MacDonald, Colla J; Arya, Neil; Purkey, Eva; Schultz, Karen; Dhatt, Reena; Wilson, Briana; Hadi, Abdullahel; Pottie, Kevin

    2011-07-22

    Recognizing the growing demand from medical students and residents for more comprehensive global health training, and the paucity of explicit curricula on such issues, global health and curriculum experts from the six Ontario Family Medicine Residency Programs worked together to design a framework for global health curricula in family medicine training programs. A working group comprised of global health educators from Ontario's six medical schools conducted a scoping review of global health curricula, competencies, and pedagogical approaches. The working group then hosted a full day meeting, inviting experts in education, clinical care, family medicine and public health, and developed a consensus process and draft framework to design global health curricula. Through a series of weekly teleconferences over the next six months, the framework was revised and used to guide the identification of enabling global health competencies (behaviours, skills and attitudes) for Canadian Family Medicine training. The main outcome was an evidence-informed interactive framework http://globalhealth.ennovativesolution.com/ to provide a shared foundation to guide the design, delivery and evaluation of global health education programs for Ontario's family medicine residency programs. The curriculum framework blended a definition and mission for global health training, core values and principles, global health competencies aligning with the Canadian Medical Education Directives for Specialists (CanMEDS) competencies, and key learning approaches. The framework guided the development of subsequent enabling competencies. The shared curriculum framework can support the design, delivery and evaluation of global health curriculum in Canada and around the world, lay the foundation for research and development, provide consistency across programmes, and support the creation of learning and evaluation tools to align with the framework. The process used to develop this framework can be applied

  5. Developing a curriculum framework for global health in family medicine: emerging principles, competencies, and educational approaches

    Directory of Open Access Journals (Sweden)

    Wilson Briana

    2011-07-01

    Full Text Available Abstract Background Recognizing the growing demand from medical students and residents for more comprehensive global health training, and the paucity of explicit curricula on such issues, global health and curriculum experts from the six Ontario Family Medicine Residency Programs worked together to design a framework for global health curricula in family medicine training programs. Methods A working group comprised of global health educators from Ontario's six medical schools conducted a scoping review of global health curricula, competencies, and pedagogical approaches. The working group then hosted a full day meeting, inviting experts in education, clinical care, family medicine and public health, and developed a consensus process and draft framework to design global health curricula. Through a series of weekly teleconferences over the next six months, the framework was revised and used to guide the identification of enabling global health competencies (behaviours, skills and attitudes for Canadian Family Medicine training. Results The main outcome was an evidence-informed interactive framework http://globalhealth.ennovativesolution.com/ to provide a shared foundation to guide the design, delivery and evaluation of global health education programs for Ontario's family medicine residency programs. The curriculum framework blended a definition and mission for global health training, core values and principles, global health competencies aligning with the Canadian Medical Education Directives for Specialists (CanMEDS competencies, and key learning approaches. The framework guided the development of subsequent enabling competencies. Conclusions The shared curriculum framework can support the design, delivery and evaluation of global health curriculum in Canada and around the world, lay the foundation for research and development, provide consistency across programmes, and support the creation of learning and evaluation tools to align with the

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

    Science.gov (United States)

    Lee, Kelley; Brumme, Zabrina L

    2013-10-01

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

  7. Revolutionary impact of PET and PET-CT on the day-to-day practice of medicine and its great potential for improving future health care

    International Nuclear Information System (INIS)

    Basu, S.; Alavi, A.

    2009-01-01

    In this communication, we present an overview of the impact and advantages of PET and PET-CT fusion imaging in the practice of medicine. We also discuss the evolution of this promising molecular imaging technique since its inception and the future prospects of the combined structure-function approach. Superior contrast resolution, accurate quantification and above all optimal image quality aid in improved diagnosis of many serious disorders including cancer. We speculate that this powerful imaging approach will almost completely replace most other conventional methods in the future. Currently, 18[F]-fluorodeoxyglucose (FDG) is the main radiopharmaceutical employed for PET studies around the globe. With the availability of high quality PET images on a routine basis in most centres around the world and the likelihood that several other useful PET tracers will be approved in the near future for routine clinical applications, this technique will likely become essential in almost any medical disorder. (authors)

  8. Assessment of the use of xerogenic medications for chronic medical and dental conditions among adult day health participants.

    Science.gov (United States)

    Lam, Annie; Kiyak, Asuman; Gossett, Allison M; McCormick, Lawrence

    2009-10-01

    To describe the health conditions, dental problems, and use of xerogenic medications among dental patients in adult day health (ADH) centers. Cross-sectional descriptive study. ADH centers in King County, Washington. ADH clients who were patients of a mobile dental service. Pharmacist-conducted chart reviews and in-person medication reviews with patients. Demographic description, mean numbers of medical and dental problems, medications, xerogenic medications used per subject, and identification of xerogenic medications by therapeutic class. At five sites, 97 patients were interviewed (average age 73.8 +/- 11.8 years, 61% female); ethnicities included: Asian-American (37.1%), Caucasian (30.9%), Russian (29%), and African-American (3%). Mean numbers of chronic health problems, medications, and xerogenic medications per patient were 5.2 +/- 2.7, 10.9 +/- 4.4, and 3.3 +/- 1.8, respectively. Antidepressants were the most commonly used xerogenic medication, followed by antipsychotics, antiemetics, analgesics, and antihistamines. Among 74 patients who received dental treatment, 33 (44.6%) wore dentures. Among 58 patients with teeth, a mean number of 2.8 dental problems per patient was identified. Dental caries (51.7%) was the most prevalent problem, followed by periodontitis (29.3%), soft tissue lesions (10.3%), gingivitis (5.2%), and candidiasis (3.4%). Multiple systemic diseases, use of multiple xerogenic medications, and poor oral health were prevalent among the ADH clients in this study. However, self-reports of dry mouth were unrelated to number of xerogenic medications or oral conditions. Further research is needed to determine the association between self-reported dry mouth, chronic health conditions, use of xerogenic medications, tooth loss, and/or denture use.

  9. Improving work functioning and mental health of health care employees using an e-mental health approach to workers' health surveillance: pretest-posttest study

    NARCIS (Netherlands)

    Ketelaar, Sarah M.; Nieuwenhuijsen, Karen; Bolier, Linda; Smeets, Odile; Sluiter, Judith K.

    2014-01-01

    Mental health complaints are quite common in health care employees and can have adverse effects on work functioning. The aim of this study was to evaluate an e-mental health (EMH) approach to workers' health surveillance (WHS) for nurses and allied health professionals. Using the waiting-list group

  10. [Child health and international cooperation: A paediatric approach].

    Science.gov (United States)

    Sobrino Toro, M; Riaño Galan, I; Bassat, Q; Perez-Lescure Picarzo, J; de Aranzabal Agudo, M; Krauel Vidal, X; Rivera Cuello, M

    2015-05-01

    The international development cooperation in child health arouses special interest in paediatric settings. In the last 10 10 years or so, new evidence has been presented on factors associated with morbidity and mortality in the first years of life in the least developed countries. This greater knowledge on the causes of health problems and possible responses in the form of interventions with impact, leads to the need to disseminate this information among concerned professional pediatricians. Serious efforts are needed to get a deeper insight into matters related to global child health and encourage pediatricians to be aware and participate in these processes. This article aims to provide a social pediatric approach towards international cooperation and child health-related matters. Copyright © 2014 Asociación Española de Pediatría. Published by Elsevier España, S.L.U. All rights reserved.

  11. [Environmental justice as an approach to tackle environmental health inequalities].

    Science.gov (United States)

    Bolte, Gabriele; Bunge, Christiane; Hornberg, Claudia; Köckler, Heike

    2018-06-01

    Current international studies show that environment-related diseases disproportionately affect vulnerable people. This is a case of environmental injustice. Environmental justice goes beyond the mere description of environment- and health-related social inequalities by comprising two dimensions of justice as a normative approach: distributional and procedural justice. Attempts to explain the link between social circumstances, the environment and health deal with both the socially unequal distribution of environmental hazards and environmental resources (exposure variation) and social differences in vulnerability to the health effects of environmental exposures (effect modification). Integrated monitoring approaches provide the basis for deriving interventions under various aspects of environmental justice. Parting from public health research and embedded in the Health in All Policies (HiAP) concept, environmental justice has now been taken up in a number of fields, including politics, administration and practice. There are strategic considerations and attempts to anchor it in politics at the federal, state and the communal level, both by government and non-government groups. Health-promoting urban development is a core field for intervention. The Soziale Stadt (Social City) programme for promoting urban planning and construction as well as place oriented sectoral planning make an important contribution by helping to focus on urban spaces with multiple health hazards and to implement target group-oriented participation processes. There continues to be a need to develop methods and systematically implemented evaluations of political strategies and corresponding interventions regarding their effects on inequalities in health and environmental justice.

  12. [The "health promotion" approach, a strategic alternative to teenagers' health in the Democratic Republic of Congo?].

    Science.gov (United States)

    Nsakala, Gabriel Vodiena; Coppieters, Yves

    2014-01-01

    This paper describes a review of the possibilities of improving HIV/AIDS prevention and reproductive health of teenagers and adolescents in the Democratic Republic of Congo (DRC). This approach was based on compilation of institutional, political, legislative and national strategy data. The document review was completed by information collected from 15 key informants and by direct observation of the work of peer educators and community workers, allowing evaluation of the possibilities of development of the priority domains of the Ottawa Charter for Health Promotion in young adolescents. Health promotion interventions for adolescents are globally ensured institutionally by three specialized programmes of the Ministry of Health, in collaboration with numerous national and international partners. Organized operationally outside of the primary health care circuit, strategic actions are more specifically directed towards acquisition of knowledge than individual skills by means of IEC (information, education and communication) and (BCC) (behaviour change communication) approaches, but with disappointing results. Although traces of these five priority domains of the Ottawa Charter are perceptible in the national response to the health problems of adolescents, the work of the various actors is not coordinated and organized in compliance with health promotion guidelines. The training of health workers appears to be a major determinant to structure this response around a dynamic federating the actions of all stakeholders to orient them towards the options of the health promotion approach.

  13. Improving Work Functioning and Mental Health of Health Care Employees Using an E-Mental Health Approach to Workers' Health Surveillance: Pretest–Posttest Study

    OpenAIRE

    Sarah M. Ketelaar; Karen Nieuwenhuijsen; Linda Bolier; Odile Smeets; Judith K. Sluiter

    2014-01-01

    Background: Mental health complaints are quite common in health care employees and can have adverse effects on work functioning. The aim of this study was to evaluate an e-mental health (EMH) approach to workers' health surveillance (WHS) for nurses and allied health professionals. Using the waiting-list group of a previous randomized controlled trial with high dropout and low compliance to the intervention, we studied the pre- and posteffects of the EMH approach in a larger group of particip...

  14. A strategic approach to workforce development for local public health.

    Science.gov (United States)

    Bryant, Beverley; Ward, Megan

    2017-11-09

    In 2009, Peel Public Health set a vision to transform the work of public health from efficient delivery of public health services as defined by provincial mandate to the robust analysis of the health status of the local population and selection and implementation of programming to achieve best health outcomes. A strategic approach to the workforce was a key enabler. PPH is a public health unit in Ontario that serves 1.4 million people. An organization-wide strategic workforce development program was instituted. It is theory-based, evidence-informed and data-driven. A first step was a conceptual framework, followed by interventions in workforce planning, human resources management, and capacity development. The program was built on evidence reviews, theory, and public health core competencies. Interventions spread across the employee work-life span. Capacity development based on the public health core competencies is a main focus, particularly analytical capacity to support decision-making. Employees gain skill and knowledge in comprehensive population health. Leadership evolves as work shifts to the analysis of health status and development of interventions. Effective human resource processes ensure appropriate job design, recruitment and orientation. Analysis of the workforce leads to vigorous employee development to ensure a strong pool of potential leadership successors. Theory, research evidence, and data provide a robust foundation for workforce development. Competencies are important inputs to job descriptions, recruitment, training, and human resource processes. A comprehensive workforce development strategy enables the development of a skilled workforce capable of responding to the needs of the population it serves.

  15. An innovative approach to interdisciplinary occupational safety and health education.

    Science.gov (United States)

    Rosen, Mitchel A; Caravanos, Jack; Milek, Debra; Udasin, Iris

    2011-07-01

    The New York and New Jersey Education and Research Center (ERC) provides a range of graduate continuing education for occupational safety and health (OSH) professionals in training. A key element of the education is to provide interdisciplinary training to industrial hygienists, ergonomists, occupational medicine physicians and other health and safety trainees to prepare them for the collaboration required to solve the complex occupational health and safety problems they will face in their careers. This center has developed an innovative interdisciplinary training approach that provides an historical aspect, while allowing the graduate students to identify solutions to occupational issues from a multi-disciplinary approach. The ERC developed a tour that brings students to sites of historical and/or contemporary significance in the occupational safety and health and environmental fields. The ERC has conducted five tours, and has included 85 students and residents as participants. 80% of participants rated the tour as providing a high amount of OSH knowledge gained. 98% of the participants felt the goal of providing interdisciplinary education was achieved. This tour has been successful in bridging the OSH fields to better understand how occupational and environmental exposures have occurred, in order to prevent future exposures so that workplace conditions and health can be improved. Copyright © 2011 Wiley-Liss, Inc.

  16. Some Innovative Approaches for Public Health and Epidemiology Informatics.

    Science.gov (United States)

    Toubiana, L; Griffon, N

    2016-11-10

    Summarize excellent current research published in 2015 in the field of Public Health and Epidemiology Informatics. The complete 2015 literature concerning public health and epidemiology informatics has been searched in PubMed and Web of Science, and the returned references were reviewed by the two section editors to select 14 candidate best papers. These papers were then peer-reviewed by external reviewers to allow the editorial team an enlightened selection of the best papers. Among the 1,272 references retrieved from PubMed and Web of Science, three were finally selected as best papers. The first one presents a language agnostic approach for epidemic event detection in news articles. The second paper describes a system using big health data gathered by a statewide system to forecast emergency department visits. The last paper proposes a rather original approach that uses machine learning to solve the old issue of outbreak detection and prediction. The increasing availability of data, now directly from health systems, will probably lead to a boom in public health surveillance systems and in large-scale epidemiologic studies.

  17. Reframing women's health in nursing education: a feminist approach.

    Science.gov (United States)

    Morse, G G

    1995-01-01

    To operate from a feminist paradigm is a new way of thinking for nurse educators. Feminist perspectives in nursing provide a new stage of consciousness--one that values women's voices, their way of knowing, and their life experiences, and, most important, one that challenges traditional patriarchal practices. Furthermore, nursing curricula with feminist perspectives provides a biopsychosocial approach that encourages the full recognition of variables that can influence women's health, such as socioeconomic status, racial and ethnic background, and biobehavioral factors. The debate in medicine over a specialty in women's health is not unique. The history of academia abounds with descriptions of struggles to establish new fields and disciplines. Recent specialties, such as pediatrics and gerontology, which are distinguished by age rather than specific organ or system, struggled for establishment and recognition. Historically, nursing curricula has emulated the biomedical model that is reductionistic and contradictory to nursing's holistic mission. Rather than classifying women's health into a separate entity, women's health may be introduced into present curricula by employing feminist ideals and pedagogy throughout the curriculum. This approach would provide a mechanism to explore women's health issues that were previously minimally addressed at best, or not addressed at all. More important, students would be provided with an opportunity to examine the societal effects of racism, sexism, and classism, and this education would potentially lead to a growing awareness of concerns specific to women and minorities.

  18. Days out-of-role due to common physical and mental health problems: Results from the Sao Paulo Megacity Mental Health Survey, Brazil

    Directory of Open Access Journals (Sweden)

    Laura Helena Andrade

    2013-11-01

    Full Text Available OBJECTIVES: To investigate the relative importance of common physical and mental disorders with regard to the number of days out-of-role (DOR; number of days for which a person is completely unable to work or carry out normal activities because of health problems in a population-based sample of adults in the São Paulo Metropolitan Area, Brazil. METHODS: The São Paulo Megacity Mental Health Survey was administered during face-to-face interviews with 2,942 adult household residents. The presence of 8 chronic physical disorders and 3 classes of mental disorders (mood, anxiety, and substance use disorders was assessed for the previous year along with the number of days in the previous month for which each respondent was completely unable to work or carry out normal daily activities due to health problems. Using multiple regression analysis, we examined the associations of the disorders and their comorbidities with the number of days out-of-role while controlling for socio-demographic variables. Both individual-level and population-level associations were assessed. RESULTS: A total of 13.1% of the respondents reported 1 or more days out-of-role in the previous month, with an annual median of 41.4 days out-of-role. The disorders considered in this study accounted for 71.7% of all DOR; the disorders that caused the greatest number of DOR at the individual-level were digestive (22.6, mood (19.9, substance use (15.0, chronic pain (16.5, and anxiety (14.0 disorders. The disorders associated with the highest population-attributable DOR were chronic pain (35.2%, mood (16.5%, and anxiety (15.0% disorders. CONCLUSIONS: Because pain, anxiety, and mood disorders have high effects at both the individual and societal levels, targeted interventions to reduce the impairments associated with these disorders have the highest potential to reduce the societal burdens of chronic illness in the São Paulo Metropolitan Area.

  19. A queer-theoretical approach to community health psychology.

    Science.gov (United States)

    Easpaig, Bróna R Nic Giolla; Fryer, David M; Linn, Seònaid E; Humphrey, Rhianna H

    2014-01-01

    Queer-theoretical resources offer ways of productively rethinking how central concepts such as 'person-context', 'identity' and 'difference' may be understood for community health psychologists. This would require going beyond consideration of the problems with which queer theory is popularly associated to cautiously engage with the aspects of this work relevant to the promotion of collective practice and engaging with processes of marginalisation. In this article, we will draw upon and illustrate the queer-theoretical concepts of 'performativity' and 'cultural intelligibility' before moving towards a preliminary mapping of what a queer-informed approach to community health psychology might involve.

  20. 27-day variation in solar-terrestrial parameters: Global characteristics and an origin based approach of the signals

    Science.gov (United States)

    Poblet, Facundo L.; Azpilicueta, Francisco

    2018-05-01

    The Earth and the near interplanetary medium are affected by the Sun in different ways. Those processes generated in the Sun that induce perturbations into the Magnetosphere-Ionosphere system are called geoeffective processes and show a wide range of temporal variations, like the 11-year solar cycle (long term variations), the variation of ∼27 days (recurrent variations), solar storms enduring for some days, particle acceleration events lasting for some hours, etc. In this article, the periodicity of ∼27 days associated with the solar synodic rotation period is investigated. The work is mainly focused on studying the resulting 27-day periodic signal in the magnetic activity, by the analysis of the horizontal component of the magnetic field registered on a set of 103 magnetic observatories distributed around the world. For this a new method to isolate the periodicity of interest has been developed consisting of two main steps: the first one consists of removing the linear trend corresponding to every calendar year from the data series, and the second one of removing from the resulting series a smoothed version of it obtained by applying a 30-day moving average. The result at the end of this process is a data series in which all the signal with periods larger than 30 days are canceled. The most important characteristics observed in the resulting signals are two main amplitude modulations: the first and most prominent related to the 11-year solar cycle and the second one with a semiannual pattern. In addition, the amplitude of the signal shows a dependence on the geomagnetic latitude of the observatory with a significant discontinuity at approx. ±60°. The processing scheme was also applied to other parameters that are widely used to characterize the energy transfer from the Sun to the Earth: F10.7 and Mg II indices and the ionospheric vertical total electron content (vTEC) were considered for radiative interactions; and the solar wind velocity for the non

  1. Urbanism, climate change and health: systems approaches to governance.

    Science.gov (United States)

    Capon, Anthony G; Synnott, Emma S; Holliday, Sue

    2009-01-01

    Effective action on climate change health impacts and vulnerability will require systems approaches and integrated policy and planning responses from a range of government agencies. Similar responses are needed to address other complex problems, such as the obesity epidemic. Local government, with its focus on the governance of place, will have a key role in responding to these convergent agendas. Industry can also be part of the solution - indeed it must be, because it has a lead role in relevant sectors. Understanding the co-benefits for health of climate mitigation actions will strengthen the case for early action. There is a need for improved decision support tools to inform urban governance. These tools should be based on a systems approach and should incorporate a spatial perspective.

  2. A systemic approach to understanding mental health and services.

    Science.gov (United States)

    Cohen, Mark

    2017-10-01

    In the UK mental health and associated NHS services face considerable challenges. This paper aims to form an understanding both of the complexity of context in which services operate and the means by which services have sought to meet these challenges. Systemic principles as have been applied to public service organisations with reference to interpersonal relations, the wider social culture and its manifestation in service provision. The analysis suggests that the wider culture has shaped service demand and the approaches adopted by services resulting in a number of unintended consequences, reinforcing loops, increased workload demands and the limited value of services. The systemic modelling of this situation provides a necessary overview prior to future policy development. The paper concludes that mental health and attendant services requires a systemic understanding and a whole system approach to reform. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  3. Subjective health complaints, functional ability, fear avoidance beliefs, and days on sickness benefits after work rehabilitation - a mediation model.

    Science.gov (United States)

    Øyeflaten, Irene; Opsahl, Jon; Eriksen, Hege R; Braathen, Tore Norendal; Lie, Stein Atle; Brage, Søren; Ihlebæk, Camilla M; Breivik, Kyrre

    2016-05-23

    Long-term sick leave and withdrawal from working life is a concern in western countries. In Norway, comprehensive inpatient work rehabilitation may be offered to sick listed individuals at risk of long-term absence from work. Knowledge about prognostic factors for work outcomes after long-term sick leave and work rehabilitation is still limited. The aim of this study was to test a mediation model for various hypothesized biopsychosocial predictors of continued sick leave after inpatient work rehabilitation. One thousand one hundred fifty-five participants on long-term sick leave from eight different work rehabilitation clinics answered comprehensive questionnaires at arrival to the clinic, and were followed with official register data on sickness benefits for 3 years. Structural equation models were conducted, with days on sickness benefits after work rehabilitation as the outcome. Fear avoidance beliefs for work mediated the relation between both musculoskeletal complaints and education on days on sickness benefits after work rehabilitation. The relation between musculoskeletal complaints and fear avoidance beliefs for work was furthermore fully mediated by poor physical function. Previous sick leave had a strong independent effect on continued sick leave after work rehabilitation. Fear avoidance beliefs for work did not mediate the small effect of pseudoneurological complaints on continued sick leave. Poor coping/interaction ability was neither related to continued sick leave nor fear avoidance beliefs for work. The mediation model was partly supported by the data, and provides some possible new insight into how fear avoidance beliefs for work and functional ability may intervene with subjective health complaints and days on sickness benefits after work rehabilitation.

  4. Soil Health Assessment Approaches and the Cornell Framework

    Science.gov (United States)

    van Es, Harold

    2016-04-01

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

  5. An effective approach for choosing an electronic health record.

    Science.gov (United States)

    Rowley, Robert

    2009-01-01

    With government stimulus money becoming available to encourage healthcare facilities to adopt electronic health record (EHR) systems, the decision to move forward with implementing an EHR system has taken on an urgency not previously seen. The EHR landscape is evolving rapidly and the underlying technology platform is becoming increasingly interconnected. One must make sure that an EHR decision does not lock oneself into technology obsolescence. The best approach for evaluating an EHR is on the basis of:usability, interoperability, and affordability.

  6. Inequalities in health: approaches by health authorities in an English health region.

    Science.gov (United States)

    McCarron, P; Yates, B

    2000-06-01

    In 1995 the Department of Health published Variations in health: what can the Department of Health do? This recommended that health authorities should have a comprehensive plan for identifying and tackling variations in health. We investigated how health authorities in the South and West Region were taking forward this work. Semi-structured interviews and reviews of documentation were conducted in all health authorities in the South and West Region of England. All health authorities viewed tackling inequalities in health as important; however, explicit strategies did not exist and Health of the Nation targets were a vehicle for determining priorities of inequalities. Explicit corporate commitment was often weak. Analyses were being conducted to determine the magnitude of local health inequalities and to assist in designing appropriate interventions. The importance of alliance working was highlighted; much work was being done although success was variable. Efforts are being made throughout the South and West region to tackle inequalities in health. Although strategic vision at the corporate level was often lacking, there was evidence of commitment to taking the inequalities agenda forward within public health directorates. Strengthening of primary care and alliance working roles is essential. Recent national strategy documents, forthcoming legislation, and a review of health inequalities recognize the health effects of inequalities and require health authorities to collaborate with local partners to tackle these, and will offer opportunities to improve corporate commitment and alliance working. Uptake and success of these opportunities will have a major influence on progress in tackling health inequalities.

  7. Applying the health action process approach (HAPA) to the choice of health products: An exploratory study

    DEFF Research Database (Denmark)

    Krutulyte, Rasa; Grunert, Klaus G.; Scholderer, Joachim

    This paper presents the results of a qualitative pilot study that aimed to uncovering Danish consumers' motives for choosing health food. Schwarzer's (1992) health action process approach (HAPA) was applied to understand the process by which people chose health products. The research focused...... on the role of the behavioural intention predictors such as risk perception, outcome expectations and self-efficacy. The model has been proved to be a useful framework for understanding consumer choosing health food and is substantial in the further application of dietary choice issues....

  8. Evidence-based approach for continuous improvement of occupational health.

    Science.gov (United States)

    Manzoli, Lamberto; Sotgiu, Giovanni; Magnavita, Nicola; Durando, Paolo

    2015-01-01

    It was recognized early on that an Evidence-Based Medicine (EBM) approach could be applied to Public Health (PH), including the area of Occupational Health (OH). The aim of Evidence-Based Occupational Health (EBOH) is to ensure safety, health, and well-being in the workplace. Currently, high-quality research is necessary in order to provide arguments and scientific evidence upon which effective, efficient, and sustainable preventive measures and policies are to be developed in the workplace in Western countries. Occupational physicians need to integrate available scientific evidence and existing recommendations with a framework of national employment laws and regulations. This paper addresses the state of the art of scientific evidence available in the field (i.e., efficacy of interventions, usefulness of education and training of workers, and need of a multidisciplinary strategy integrated within the national PH programs) and the main critical issues for their implementation. Promoting good health is a fundamental part of the smart, inclusive growth objectives of Europe 2020 - Europe's growth strategy: keeping people healthy and active for longer has a positive impact on productivity and competitiveness. It appears clear that health quality and safety in the workplace play a key role for smart, sustainable, and inclusive growth in Western countries.

  9. Toward a national health risk management approach in Australia.

    Science.gov (United States)

    O'Donnell, Carol

    2002-01-01

    There has been increasing international consensus about the importance of competition for achieving national growth and community well-being. The Australian government accordingly has introduced policies to promote such competition. Major legislative review and many public inquiries have assisted implementation of national competition policy and the development of national goals and standards related to international agreements to promote health and sustainable development. Since the 1980s, Australia has had legislation that requires the identification and control of health risks arising at work. The management structures necessary for coordinated delivery of national programs designed for effective identification and control of health risks arising in communities to achieve national health and development goals are still being developed, however. Major difficulties related to this development are discussed. National health development programs should be approached primarily through establishment of regional partnerships between bodies responsible for managing community health, local government, and employment placement, in consultation with other relevant organizations and the community. Related research and evaluation programs are required.

  10. Aspirin administered to women at 100 mg every other day produces less platelet inhibition than aspirin administered at 81 mg per day: implications for interpreting the women's health study.

    Science.gov (United States)

    Swaim, Lisa; Hillman, Robert S

    2009-07-01

    We aimed to determine the relative level of platelet inhibition achieved with low-dose aspirin (81 mg daily) compared with a very low-dose (100 mg every other day). The Womens Health Study (WHS) found that a dose of 100 mg every other day of aspirin provided protection against stroke as primary prophylaxis, but not myocardial infarction. In the United States, the most commonly prescribed dose of aspirin for primary prophylaxis is 81 mg per day. As a result, it is important to know whether these doses are equivalent before extrapolating the results of the WHS to women in the U.S. To achieve this goal, we have studied the effects of these two dosing regimens on platelet function in healthy women meeting the WHS inclusion criteria using a randomized design. We enrolled 49 healthy female volunteers and used a sequential, crossover design to compare the two regimens. The participants received a 17-day course of each aspirin-dosing regimen separated by a 7-day washout period. The degree of platelet inhibition was measured on days 14-17 of each dosing regimen using a point-of-care platelet function assay utilizing arachidonic acid to activate platelets (VerifyNow-Aspirin). Participants platelet response, expressed as Aspirin Response Unit (ARU) attained a significantly greater level of platelet inhibition on days 14-17 while taking aspirin 81 mg daily compared to aspirin 100 mg every other day (31.3% vs. 12.7%, P or=550 ARU, a value correlated with clinical outcomes in several studies, with the 100 mg every other day regimen (72.0% vs. 6.4% with 81 mg daily, P day regimen also resulted in more day-to-day variability in platelet function (P = 0.0002). We found significantly less inhibition of platelet function with the dose used in the WHS than the usual U.S. dose. We observed that the degree of platelet inhibition was significantly less with aspirin 100 mg every other day compared with aspirin 81 mg daily, suggesting that results of the Women's Health Study may have

  11. MD Anderson's Population Health Approaches to Cancer Prevention.

    Science.gov (United States)

    Foxhall, Lewis; Moreno, Mark; Hawk, Ernest

    2018-02-01

    Texas's size and unique population demographics present challenges to addressing the state's cancer burden. The University of Texas MD Anderson Cancer Center is one of 69 National Cancer Institute-designated cancer centers across the United States. While these centers traditionally have focused on research, education and training, and providing research-driven patient care, they are in a unique position to collaboratively advance population health through cancer control. Unlike the traditional academic model of a three-legged stool representing research, education, and patient care, MD Anderson's mission includes a fourth leg that incorporates population health approaches. MD Anderson has leveraged state- and national-level data and freely available resources to develop population-health priorities and a set of evidence-based actions across policy, public and professional education, and community-based clinical service domains to address these priorities. Population health approaches complement dissemination and implementation research and treatment, and will be increasingly needed to address the growing cancer burden in Texas and the nation.

  12. A rights-based approach to accessing health determinants.

    Science.gov (United States)

    Perkins, Fran

    2009-03-01

    This commentary summarizes the experience and learnings from a site visit in May 2008 to a drop-in centre for vulnerable women in downtown Cairo run by El-Shehab Institution for Comprehensive Development, which provides street outreach for the prevention of Sexually Transmitted Infection (STI). The Centre successfully provides services and support for women, many of who are displaced or refugees and are from the most marginalized areas in Cairo. Through a rights-based approach to the work, the Centre helps people living in the slums fight and win the right to access clean water, sewerage and electrical power in their communities. An individual-based approach to human rights is also used. In the last year El-Shehab have helped 67 women go to court and win their marriage rights from husbands who have abandoned them. Their approach is an example of a successful way to achieve access to basic health determinants.

  13. Risk assessment and management approaches on mental health units.

    Science.gov (United States)

    Woods, P

    2013-11-01

    This exploratory and descriptive study took place in one Canadian province. The study aimed to: (1) to identify and describe the nature and extent of current risk assessment and management approaches used in the adult inpatient mental health and forensic units; and (2) to identify good practice and shortfalls in the nature and extent of the approaches currently utilized. Data were collected from 48 participants through nine focus groups. Participants reported that they used a clinical approach to risk assessment. They had also not considered risk assessment and management as a proactive structured process. Education and training was also limited and skills were developed over time through practice. Five keys issues are discussed as important: reliance on clinical judgement alone is not the best choice to make; the need to consider risk as a whole concept; risk management being more reactive than proactive; education and training; and client involvement in risk assessment. © 2012 John Wiley & Sons Ltd.

  14. Impact of a 7-Day Field Training on Oral Health Condition in Japan Ground Self-Defense Force Personnel.

    Science.gov (United States)

    Yamashita, Koji; Nishiyama, Takeshi; Nagata, Emi; Ramadhani, Atik; Kawada-Matsuo, Miki; Komatsuzawa, Hitoshi; Oho, Takahiko

    2017-07-01

    In the Japan Ground Self-Defense Force (JGSDF), personnel periodically perform intensive training that mimics the conditions seen in battle and during natural disasters. Military training involves intensive, stressful conditions, and changes in immune responses have been found in personnel following training. Good oral condition is important for military personnel to fulfill their duties; however, they have difficulty performing daily oral care under training conditions. In this study, we investigated the impact of a 7-day field training on the oral health status of JGSDF personnel by comparing their oral condition before and just after training. The participants were 59 male and 3 female JGSDF personnel undergoing a 7-day field training. All personnel provided informed written consent to participate, and this study was approved by the ethics committee of the Kagoshima University Graduate School of Medical and Dental Sciences. Oral health behaviors before and during the training period were surveyed using a self-administered questionnaire. Dental caries was assessed before training in terms of decayed, missing and filled teeth (DMFT), and periodontal condition was examined before and immediately after training using the community periodontal index (CPI). The presence of eight species of bacteria in dental plaque, including commensal streptococci that are early colonizers on the tooth surface, cariogenic bacteria, and periodontopathic bacteria, was determined using real-time polymerase chain reaction. We also assessed antibacterial factors and a stress marker in saliva samples. Sample collection was performed before and just after training. In addition to difference analysis between groups, logistic regression analysis was performed to examine the association between each health behavior and periodontal deterioration. The frequency of toothbrushing decreased, and snacking increased during the training period. Thirty-five personnel (56.5%) showed an increase in

  15. Stakeholder participation in health impact assessment: A multicultural approach

    International Nuclear Information System (INIS)

    Negev, Maya; Davidovitch, Nadav; Garb, Yaakov; Tal, Alon

    2013-01-01

    The literature on impact assessment (HIA) registers the importance of stakeholder participation in the assessment process, but still lacks a model for engaging stakeholders of diverse ethnic, professional and sectorial backgrounds. This paper suggests that the multicultural approach can contribute to HIA through a revision of the generic 5-step HIA model, and its implementation in a metropolitan plan in Southern Israel. The health issue scoped by the stakeholders in the HIA is related to land uses in the vicinity of the national hazardous industry and hazardous waste site. The stakeholders were representatives of the diverse populations at stake, including rural Bedouins and Jewish city dwellers, as well as representatives from the public sector, private sector, non-governmental organizations and academia. The case study revealed that a multicultural stakeholder participation process helps to uncover health issues known to the community which were not addressed in the original plan, and provides local knowledge regarding health conditions that is especially valuable when scientific data is uncertain or absent. It enables diverse stakeholders to prioritize the health issues that will be assessed. The case study also reveals ways in which the model needs revisions and improvements such as in recruitment of diverse participants. This paper presents a multicultural model of HIA and discusses some of the challenges that are faced when HIA is implemented in the context of current decision-making culture. -- Highlights: • We revised the generic HIA model in light of the multicultural approach. • We tested the model in a case study of zoning a hazardous industry site. • Multicultural stakeholder participation uncovers health issues known to communities. • It enables community prioritization of health issues. • We present a model for multicultural stakeholder participation in HIA

  16. Stakeholder participation in health impact assessment: A multicultural approach

    Energy Technology Data Exchange (ETDEWEB)

    Negev, Maya, E-mail: mayane@tau.ac.il [Hartog School of Government and Policy, Faculty of Social Sciences, Tel Aviv University, P.O.B. 39040, Tel Aviv 69978 (Israel); Davidovitch, Nadav, E-mail: nadavd@bgu.ac.il [Department of Health Systems Management, Faculty of Health Sciences, Ben-Gurion University, P.O.B. 653, Be' er Sheva 84105 (Israel); Garb, Yaakov, E-mail: ygarb@bgu.ac.il [Swiss Institute for Dryland Environmental Research, The Jacob Blaustein Institutes for Desert Research, Ben-Gurion University of the Negev, Sede Boqer 84990 (Israel); Tal, Alon, E-mail: alontal@bgu.ac.il [Mitrani Department of Dryland Ecology, Swiss Institute for Dryland Environmental Research, The Jacob Blaustein Institutes for Desert Research, Ben-Gurion University of the Negev, Sede Boqer 84990 (Israel)

    2013-11-15

    The literature on impact assessment (HIA) registers the importance of stakeholder participation in the assessment process, but still lacks a model for engaging stakeholders of diverse ethnic, professional and sectorial backgrounds. This paper suggests that the multicultural approach can contribute to HIA through a revision of the generic 5-step HIA model, and its implementation in a metropolitan plan in Southern Israel. The health issue scoped by the stakeholders in the HIA is related to land uses in the vicinity of the national hazardous industry and hazardous waste site. The stakeholders were representatives of the diverse populations at stake, including rural Bedouins and Jewish city dwellers, as well as representatives from the public sector, private sector, non-governmental organizations and academia. The case study revealed that a multicultural stakeholder participation process helps to uncover health issues known to the community which were not addressed in the original plan, and provides local knowledge regarding health conditions that is especially valuable when scientific data is uncertain or absent. It enables diverse stakeholders to prioritize the health issues that will be assessed. The case study also reveals ways in which the model needs revisions and improvements such as in recruitment of diverse participants. This paper presents a multicultural model of HIA and discusses some of the challenges that are faced when HIA is implemented in the context of current decision-making culture. -- Highlights: • We revised the generic HIA model in light of the multicultural approach. • We tested the model in a case study of zoning a hazardous industry site. • Multicultural stakeholder participation uncovers health issues known to communities. • It enables community prioritization of health issues. • We present a model for multicultural stakeholder participation in HIA.

  17. Taking health needs seriously: against a luck egalitarian approach to justice in health.

    Science.gov (United States)

    Nielsen, Lasse

    2013-08-01

    In recent works, Shlomi Segall suggests and defends a luck egalitarian approach to justice in health. Concurring with G. A. Cohen's mature position he defends the idea that people should be compensated for "brute luck", i.e. the outcome of actions that it would be unreasonable to expect them to avoid. In his defense of the luck egalitarian approach he seeks to rebut the criticism raised by Norman Daniels that luck egalitarianism is in some way too narrow and in another too wide to uphold justice in health and health care distribution. He points out that a pluralistic outline of luck egalitarianism taking into account the moral requirement of meeting everyone's basic needs can avoid this line of criticism. In this article I argue against the application of such pluralistic luck egalitarianism in matters of health distribution. First of all, Segall has not shown that luck egalitarianism handles well health distributions above a threshold of basic needs. Secondly, his way of avoiding Elizabeth Anderson's abandonment objection is theoretically problematic. Finally, I argue that luck egalitarianism in general fails to acknowledge the moral foundation of health and health care as a basic human entitlement. Thus I conclude that luck egalitarianism fails to take health needs seriously and that it cannot therefore uphold justice in health.

  18. A comprehensive approach to women’s health: lessons from the Mexican health reform

    Directory of Open Access Journals (Sweden)

    Frenk Julio

    2012-12-01

    Full Text Available Abstract Background This paper discusses the way in which women’s health concerns were addressed in Mexico as part of a health system reform. Discussion The first part sets the context by examining the growing complexity that characterizes the global health field, where women’s needs occupy center stage. Part two briefly describes a critical conceptual evolution, i.e. from maternal to reproductive to women’s health. In the third and last section, the novel “women and health” (W&H approach and its translation into policies and programs in the context of a structural health reform in Mexico is discussed. W&H simultaneously focuses on women’s health needs and women’s critical roles as both formal and informal providers of health care, and the links between these two dimensions. Summary The most important message of this paper is that broad changes in health systems offer the opportunity to address women’s health needs through innovative approaches focused on promoting gender equality and empowering women as drivers of change.

  19. Improving Work Functioning and Mental Health of Health Care Employees Using an E-Mental Health Approach to Workers' Health Surveillance: Pretest–Posttest Study

    Directory of Open Access Journals (Sweden)

    Sarah M. Ketelaar

    2014-12-01

    Conclusion: The EMH approach to WHS improves the work functioning and mental health of nurses and allied health professionals. However, because we found small effects and participation in the offered EMH interventions was low, there is ample room for improvement.

  20. The productivity of mental health care: an instrumental variable approach.

    Science.gov (United States)

    Lu, Mingshan

    1999-06-01

    BACKGROUND: Like many other medical technologies and treatments, there is a lack of reliable evidence on treatment effectiveness of mental health care. Increasingly, data from non-experimental settings are being used to study the effect of treatment. However, as in a number of studies using non-experimental data, a simple regression of outcome on treatment shows a puzzling negative and significant impact of mental health care on the improvement of mental health status, even after including a large number of potential control variables. The central problem in interpreting evidence from real-world or non-experimental settings is, therefore, the potential "selection bias" problem in observational data set. In other words, the choice/quantity of mental health care may be correlated with other variables, particularly unobserved variables, that influence outcome and this may lead to a bias in the estimate of the effect of care in conventional models. AIMS OF THE STUDY: This paper addresses the issue of estimating treatment effects using an observational data set. The information in a mental health data set obtained from two waves of data in Puerto Rico is explored. The results using conventional models - in which the potential selection bias is not controlled - and that from instrumental variable (IV) models - which is what was proposed in this study to correct for the contaminated estimation from conventional models - are compared. METHODS: Treatment effectiveness is estimated in a production function framework. Effectiveness is measured as the improvement in mental health status. To control for the potential selection bias problem, IV approaches are employed. The essence of the IV method is to use one or more instruments, which are observable factors that influence treatment but do not directly affect patient outcomes, to isolate the effect of treatment variation that is independent of unobserved patient characteristics. The data used in this study are the first (1992

  1. Pacific connections for health, ecosystems and society: new approaches to the land-water-health nexus.

    Science.gov (United States)

    Parkes, Margot W

    2016-03-01

    Renewed effort to understand the social-ecological context of health is drawing attention to the dynamics of land and water resources and their combined influence on the determinants of health. A new area of research, education and policy is emerging that focuses on the land-water-health nexus: this orientation is applicable from small wetlands through to large-scale watersheds or river basins, and draws attention to the benefits of combined land and water governance, as well as the interrelated implications for health, ecological and societal concerns. Informed by research precedents, imperatives and collaborations emerging in Canada and parts of Oceania, this review profiles three integrative, applied approaches that are bringing attention to the importance the land-water-health nexus within the Pacific Basin: wetlands and watersheds as intersectoral settings to address land-water-health dynamics; tools to integrate health, ecological and societal dynamics at the land-water-health nexus; and indigenous leadership that is linking health and well-being with land and water governance. Emphasis is given to key characteristics of a new generation of inquiry and action at the land-water-health nexus, as well as capacity-building, practice and policy opportunities to address converging environmental, social and health objectives linked to the management and governance of land and water resources.

  2. Measuring health indicators and allocating health resources: a DEA-based approach.

    Science.gov (United States)

    Yang, Chih-Ching

    2016-02-03

    This paper suggests new empirical DEA models for the measurement of health indicators and the allocation of health resources. The proposed models were developed by first suggesting a population-based health indicator. By introducing the suggested indicator into DEA models, a new approach that solves the problem of health resource allocation has been developed. The proposed models are applied to an empirical study of Taiwan's health system. Empirical findings show that the suggested indicator can successfully accommodate the differences in health resource demands between populations, providing more reliable performance information than traditional indicators such as physician density. Using our models and a commonly used allocation mechanism, capitation, to allocate medical expenditures, it is found that the proposed model always obtains higher performance than those derived from capitation, and the superiority increases as allocated expenditures rise.

  3. Evaluation of a 'virtual' approach to commissioning health research.

    Science.gov (United States)

    McCourt, Christine A; Morgan, Philip A; Youll, Penny

    2006-10-18

    The objective of this study was to evaluate the implementation of a 'virtual' (computer-mediated) approach to health research commissioning. This had been introduced experimentally in a DOH programme--the 'Health of Londoners Programme'--in order to assess whether is could enhance the accessibility, transparency and effectiveness of commissioning health research. The study described here was commissioned to evaluate this novel approach, addressing these key questions. A naturalistic-experimental approach was combined with principles of action research. The different commissioning groups within the programme were randomly allocated to either the traditional face-to-face mode or the novel 'virtual' mode. Mainly qualitative data were gathered including observation of all (virtual and face-to-face) commissioning meetings; semi-structured interviews with a purposive sample of participants (n = 32/66); structured questionnaires and interviews with lead researchers of early commissioned projects. All members of the commissioning groups were invited to participate in collaborative enquiry groups which participated actively in the analysis process. The virtual process functioned as intended, reaching timely and relatively transparent decisions that participants had confidence in. Despite the potential for greater access using a virtual approach, few differences were found in practice. Key advantages included physical access, a more flexible and extended time period for discussion, reflection and information gathering and a more transparent decision-making process. Key challenges were the reduction of social cues available in a computer-mediated medium that require novel ways of ensuring appropriate dialogue, feedback and interaction. However, in both modes, the process was influenced by a range of factors and was not technology driven. There is potential for using computer-mediated communication within the research commissioning process. This may enhance access

  4. Evaluation of a 'virtual' approach to commissioning health research

    Directory of Open Access Journals (Sweden)

    Morgan Philip A

    2006-10-01

    Full Text Available Abstract Background The objective of this study was to evaluate the implementation of a 'virtual' (computer-mediated approach to health research commissioning. This had been introduced experimentally in a DOH programme – the 'Health of Londoners Programme' – in order to assess whether is could enhance the accessibility, transparency and effectiveness of commissioning health research. The study described here was commissioned to evaluate this novel approach, addressing these key questions. Methods A naturalistic-experimental approach was combined with principles of action research. The different commissioning groups within the programme were randomly allocated to either the traditional face-to-face mode or the novel 'virtual' mode. Mainly qualitative data were gathered including observation of all (virtual and face-to-face commissioning meetings; semi-structured interviews with a purposive sample of participants (n = 32/66; structured questionnaires and interviews with lead researchers of early commissioned projects. All members of the commissioning groups were invited to participate in collaborative enquiry groups which participated actively in the analysis process. Results The virtual process functioned as intended, reaching timely and relatively transparent decisions that participants had confidence in. Despite the potential for greater access using a virtual approach, few differences were found in practice. Key advantages included physical access, a more flexible and extended time period for discussion, reflection and information gathering and a more transparent decision-making process. Key challenges were the reduction of social cues available in a computer-mediated medium that require novel ways of ensuring appropriate dialogue, feedback and interaction. However, in both modes, the process was influenced by a range of factors and was not technology driven. Conclusion There is potential for using computer-mediated communication within

  5. Public health approach to birth defects: the Argentine experience.

    Science.gov (United States)

    Bidondo, María Paz; Groisman, Boris; Barbero, Pablo; Liascovich, Rosa

    2015-04-01

    Birth defects are a global problem, but their impact is particularly severe in low and middle income countries, where the conditions for prevention, treatment, and rehabilitation are more critical. The epidemiological transition in the infant mortality causes, and the concern of the community and the mass media about the teratogenic risk of environmental pollutants, has made health authorities aware of the importance of birth defects in Argentina. The objective of this paper is to outline those actions specifically taken in Argentina aimed at the prevention of birth defects at a national level. Firstly, we focus on birth defects in Argentina on a general basis, and then we present different laws and actions taken in terms of surveillance and public health programs, primary, secondary, and tertiary prevention. Finally, we present the Teratology Information Service "Fetal Health Line", and the genetic services organization and health professionals training by the National Center of Medical Genetics and the National Program of Genetics Network. In conclusion, in the country, several programs focus on different approaches to the problem, and the challenge is to coordinate the teamwork between them. Finally, we list tips to address birth defects from the public health perspective.

  6. Taking Health Needs Seriously: Against a Luck Egalitarian Approach to Justice in Health

    DEFF Research Database (Denmark)

    Nielsen, Lasse

    2013-01-01

    In recent works, Shlomi Segall suggests and defends a luck egalitarian approach to justice in health. Concurring with G. A. Cohen’s mature position he defends the idea that people should be compensated for “brute luck”, i.e. the outcome of actions that it would be unreasonable to expect them...... to avoid. In his defense of the luck egalitarian approach he seeks to rebut the criticism raised by Norman Daniels that luck egalitarianism is in some way too narrow and in another too wide to uphold justice in health and health care distribution. He points out that a pluralistic outline of luck...... egalitarianism taking into account the moral requirement of meeting everyone’s basic needs can avoid this line of criticism. In this article I argue against the application of such pluralistic luck egalitarianism in matters of health distribution. First of all, Segall has not shown that luck egalitarianism...

  7. Days out of role due to common physical and mental conditions: results from the Northern Ireland study of health and stress.

    Science.gov (United States)

    Ennis, Edel; O'Neill, S; Murphy, S; Bunting, B

    2016-11-01

    Days out of role due to health problems are a major source of lost human capital. We examined the relative importance of common physical and mental disorders in accounting for days out of role in Northern Ireland using the Northern Ireland Study of Health and Stress (NISHS) WHO World Mental Health (WMH) Survey. Face-to-face interviews were carried out with 4340 respondents (68.4 % response rate). Multiple regression analysis estimated associations of specific chronic physical disorders and mental disorders conditions and comorbidities with days out of role controlling for basic socio-demographics. Overall, 16.8 % of respondents had at least one day totally out of role in the previous year. The strongest population-level effect was associated with arthritis, which accounted for 23.5 % of all days out of role. The strongest individual-level effects (days out of role per year) were associated with any anxiety disorder (32.3) arthritis (26.1) and pain (22.0). The 11 conditions accounted for 93 % of all days out of role, as measured by population attributable risk proportions (PARPs). Common health conditions, including mental disorders, make up a large proportion of the number of days out of role and should be addressed to substantially increase overall productivity.

  8. Towards an integrated approach to health and medicine in Africa.

    Science.gov (United States)

    Batisai, Kezia

    2016-12-01

    This article frames the intersections of medicine and humanities as intrinsic to understanding the practice of health care in Africa. Central to this manuscript, which draws on empirical findings on the interplay between HIV and AIDS and alternative medicine in Zimbabwe is the realisation that very limited research has been undertaken to examine 'HIV/AIDS patient behaviour' with respect to choice of therapy on the continent [Bene, M. & Darkoh, M. B. K. (2014). The Constraints of Antiretroviral Uptake in Rural Areas: The Case of Thamaga and Surrounding Villages, Botswana. Journal of Social Aspects of HIV/AIDS, 11(1), 167-177. doi: 10.1080/17290376.2014.972057 ; Chavunduka, G. (1998). Professionalisation of Traditional Medicine in Zimbabwe, Harare, Jongwe Printers; O'Brien, S. & Broom, A. (2014). HIV in (and out of) the Clinic: Biomedicine, Traditional Medicine and Spiritual Healing in Harare. Journal of Social Aspects of HIV/AIDS, 11(1), 94-104. doi: 10.1080/17290376.2014.938102 ]. As such, a social approach to health-seeking behaviour questions how decisions about alternative therapies including herbal remedies, traditional healing and faith healing are made. The paper unpacks the realities around how people living with HIV and AIDS - who span different age groups and profess various religious backgrounds, faced with an insurmountable health challenge against a background of limited resources and no cure for the virus - often experience shifts in health-seeking behaviour. Grappling with seemingly simple questions about 'when, where and how to seek medical attention', the paper provides pointers to therapy choices and health-seeking behaviour; and it serves as a route into deeper and intense healthcare practice explorations. In conclusion, the paper proposes that medicine and the humanities should engage seriously with those social aspects of HIV and AIDS which call for an integrated approach to healthcare practice in Africa. If combined, medicine and the humanities

  9. State mental health policy: Maryland's shared leadership approach to mental health transformation: partnerships that work.

    Science.gov (United States)

    Semansky, Rafael M

    2012-07-01

    In 2005, Maryland received a mental health transformation grant from the Substance Abuse and Mental Health Services Administration. Maryland's transformation efforts have differed from those in other grantee states and have evolved into a shared leadership approach that harnesses the power of leaders from all sectors of the community. This column describes Maryland's reform efforts, focusing in particular on the development of the position of a peer employment specialist to improve placement of consumers in employment. This shared leadership approach has the potential to enhance long-term sustainability of reform initiatives and uses fewer state resources.

  10. Three Nontraditional Approaches to Improving the Capacity, Accessibility, and Quality of Mental Health Services: An Overview.

    Science.gov (United States)

    Grant, Kiran L; Simmons, Magenta Bender; Davey, Christopher G

    2018-01-16

    To provide evidence for wider use of peer workers and other nonprofessionals, the authors examined three approaches to mental health service provision-peer support worker (PSW) programs, task shifting, and mental health first-aid and community advocacy organizations-summarizing their effectiveness, identifying similarities and differences, and highlighting opportunities for integration. Relevant articles obtained from PubMed, MEDLINE, and Google Scholar searches are discussed. Studies indicate that PSWs can achieve outcomes equal to or better than those achieved by nonpeer mental health professionals. PSWs can be particularly effective in reducing hospital admissions and inpatient days and engaging severely ill patients. When certain care tasks are given to individuals with less training than professionals (task shifting), these staff members can provide psychoeducation, engage service users in treatment, and help them achieve symptom reduction and manage risk of relapse. Mental health first-aid and community organizations can reduce stigma, increase awareness of mental health issues, and encourage help seeking. Most PSW programs have reported implementation challenges, whereas such challenges are fewer in task-shifting programs and minimal in mental health first-aid. Despite challenges in scaling and integrating these approaches into larger systems, they hold promise for improving access to and quality of care. Research is needed on how these approaches can be combined to expand a community's capacity to provide care. Because of the serious shortage of mental health providers globally and the rising prevalence of mental illness, utilizing nontraditional providers may be the only solution in both low- and high-resource settings, at least in the short term.

  11. An integrated approach to preventing cardiovascular disease: community-based approaches, health system initiatives, and public health policy

    Directory of Open Access Journals (Sweden)

    Tina Karwalajtys

    2010-09-01

    Full Text Available Tina Karwalajtys1, Janusz Kaczorowski2,31Department of Family Medicine, McMaster University, Hamilton, ON, Canada; 2Primary Care & Community Research, Child & Family Research Institute, Vancouver, BC, Canada; 3Department of Family Practice, University of British Columbia, Vancouver, BC, CanadaAbstract: Cardiovascular disease (CVD is largely the product of interactions among modifiable risk factors that are common in developed nations and increasingly of concern in developing countries. Hypertension is an important precursor to the development of CVD, and although detection and treatment rates have improved in recent years in some jurisdictions, effective strategies and policies supporting a shift in distribution of risk factors at the population level remain paramount. Challenges in managing cardiovascular health more effectively include factors at the patient, provider, and system level. Strategies to reduce hypertension and CVD should be population based, incorporate multilevel, multicomponent, and socioenvironmental approaches, and integrate community resources with public health and clinical care. There is an urgent need to improve monitoring and management of risk factors through community-wide, primary care-linked initiatives, increase the evidence base for community-based prevention strategies, further develop and evaluate promising program components, and develop new approaches to support healthy lifestyle behaviors in diverse age, socioeconomic, and ethnocultural groups. Policy and system changes are critical to reduce risk in populations, including legislation and public education to reduce dietary sodium and trans-fatty acids, food pricing policies, and changes to health care delivery systems to explicitly support prevention and management of CVD.Keywords: risk factors, blood pressure determination, community health services, community health planning, public health practice

  12. Integrated approach to assess ecosystem health in harbor areas.

    Science.gov (United States)

    Bebianno, M J; Pereira, C G; Rey, F; Cravo, A; Duarte, D; D'Errico, G; Regoli, F

    2015-05-01

    Harbors are critical environments with strategic economic importance but with potential environmental impact: health assessment criteria are a key issue. An ecosystem health status approach was carried out in Portimão harbor as a case-study. Priority and specific chemical levels in sediments along with their bioavailability in mussels, bioassays and a wide array of biomarkers were integrated in a biomarker index (IBR index) and the overall data in a weight of evidence (WOE) model. Metals, PAHs, PCBs and HCB were not particularly high compared with sediment guidelines and standards for dredging. Bioavailability was evident for Cd, Cu and Zn. Biomarkers proved more sensitive namely changes of antioxidant responses, metallothioneins and vittellogenin-like proteins. IBR index indicated that site 4 was the most impacted area. Assessment of the health status by WOE approach highlighted the importance of integrating sediment chemistry, bioaccumulation, biomarkers and bioassays and revealed that despite some disturbance in the harbor area, there was also an impact of urban effluents from upstream. Environmental quality assessment in harbors. Copyright © 2015 Elsevier B.V. All rights reserved.

  13. [Ethnographic approaches to research and intervention in mental health].

    Science.gov (United States)

    Nunes, Mônica de Oliveira; de Torrenté, Maurice

    2013-10-01

    The specifics of ethnographic approaches to mental health research are examined, highlighting the motives why the type of knowledge produced by ethnography is relevant to the context of Psychiatric Reform and the biomedicalization of existence. The discussion is focused on interpretation-based ethnography in the field of mental health, stressing the theoretical and methodological foundations of a comprehensive form of apprehending the scope of mental health as an object akin to a clinic of the individual. The centrality of social and cultural aspects in the ethnographic approach and the inflexions mediated by the type of ethnographic methodological undertaking is stressed. Lastly, the ethnography of madness is seen as a fitting example that substantiates some of these characteristics. The contention is that accessing psychotic persons (and others who may speak about these experiences) from varied areas of their daily life, situated in their various social inscriptions, while confronting these interpretations with other interpretative dimensions of their social reality and within the logic linked to local psychologies, is a pertinent procedure, from whence certain aspects of an understanding of madness (or causes of its incomprehension) can emerge.

  14. Family-Based Approaches to Cardiovascular Health Promotion.

    Science.gov (United States)

    Vedanthan, Rajesh; Bansilal, Sameer; Soto, Ana Victoria; Kovacic, Jason C; Latina, Jacqueline; Jaslow, Risa; Santana, Maribel; Gorga, Elio; Kasarskis, Andrew; Hajjar, Roger; Schadt, Eric E; Björkegren, Johan L; Fayad, Zahi A; Fuster, Valentin

    2016-04-12

    Cardiovascular disease is the leading cause of mortality in the world, and the increasing burden is largely a consequence of modifiable behavioral risk factors that interact with genomics and the environment. Continuous cardiovascular health promotion and disease prevention throughout the lifespan is critical, and the family is a central entity in this process. In this review, we describe the potential rationale and mechanisms that contribute to the importance of family for cardiovascular health promotion, focusing on: 1) mutual interdependence of the family system; 2) shared environment; 3) parenting style; 4) caregiver perceptions; and 5) genomics. We conclude that family-based approaches that target both caregivers and children, encourage communication among the family unit, and address the structural and environmental conditions in which families live and operate are likely to be the most effective approach to promote cardiovascular health. We describe lessons learned, future implications, and applications to ongoing and planned studies. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  15. Gender in health technology assessment: pilot study on agency approaches.

    Science.gov (United States)

    Panteli, Dimitra; Zentner, Annette; Storz-Pfennig, Philipp; Busse, Reinhard

    2011-07-01

    Gender as a social construct is a recognized health determinant. Because best practice in reporting health technology assessment (HTA) clearly specifies the need to appraise a technology's social impact within the target population, the extent to which gender issues are taken into account in HTA production is of interest, not only in light of equitable practices but also for reasons of effectiveness. The aim of this study is to provide a first assessment of the degree of gender sensitivity shown by HTA agencies around the world today. The Web sites of sixty HTA agencies were analyzed. The consideration of gender aspects was specifically looked for in each agency's general mission statement, its priority setting process, and its methodological approach. Additionally, specific gender-oriented initiatives not belonging to any of the aforementioned categories were identified. Of the sixty agencies, less than half mention a commitment to addressing the social implication of health technologies. Only fifteen institutions make information on their priority setting principles available on their Web sites and gender was an issue in two of those cases. Data on methodology were obtainable online from 18 agencies, two of which mentioned gender issues explicitly. Finally, gender-oriented initiatives were identified by thirteen agencies. A gender-sensitive approach is apparently rarely adopted in current HTA production. Exceptional practices and relevant tools do exist and could serve as examples to be promoted by international collaborative networks.

  16. A multi-method approach to evaluate health information systems.

    Science.gov (United States)

    Yu, Ping

    2010-01-01

    Systematic evaluation of the introduction and impact of health information systems (HIS) is a challenging task. As the implementation is a dynamic process, with diverse issues emerge at various stages of system introduction, it is challenge to weigh the contribution of various factors and differentiate the critical ones. A conceptual framework will be helpful in guiding the evaluation effort; otherwise data collection may not be comprehensive and accurate. This may again lead to inadequate interpretation of the phenomena under study. Based on comprehensive literature research and own practice of evaluating health information systems, the author proposes a multimethod approach that incorporates both quantitative and qualitative measurement and centered around DeLone and McLean Information System Success Model. This approach aims to quantify the performance of HIS and its impact, and provide comprehensive and accurate explanations about the casual relationships of the different factors. This approach will provide decision makers with accurate and actionable information for improving the performance of the introduced HIS.

  17. The Public Health Exposome: A Population-Based, Exposure Science Approach to Health Disparities Research

    Science.gov (United States)

    Juarez, Paul D.; Matthews-Juarez, Patricia; Hood, Darryl B.; Im, Wansoo; Levine, Robert S.; Kilbourne, Barbara J.; Langston, Michael A.; Al-Hamdan, Mohammad Z.; Crosson, William L.; Estes, Maurice G.; Estes, Sue M.; Agboto, Vincent K.; Robinson, Paul; Wilson, Sacoby; Lichtveld, Maureen Y.

    2014-01-01

    The lack of progress in reducing health disparities suggests that new approaches are needed if we are to achieve meaningful, equitable, and lasting reductions. Current scientific paradigms do not adequately capture the complexity of the relationships between environment, personal health and population level disparities. The public health exposome is presented as a universal exposure tracking framework for integrating complex relationships between exogenous and endogenous exposures across the lifespan from conception to death. It uses a social-ecological framework that builds on the exposome paradigm for conceptualizing how exogenous exposures “get under the skin”. The public health exposome approach has led our team to develop a taxonomy and bioinformatics infrastructure to integrate health outcomes data with thousands of sources of exogenous exposure, organized in four broad domains: natural, built, social, and policy environments. With the input of a transdisciplinary team, we have borrowed and applied the methods, tools and terms from various disciplines to measure the effects of environmental exposures on personal and population health outcomes and disparities, many of which may not manifest until many years later. As is customary with a paradigm shift, this approach has far reaching implications for research methods and design, analytics, community engagement strategies, and research training. PMID:25514145

  18. The Public Health Exposome: A Population-Based, Exposure Science Approach to Health Disparities Research

    Directory of Open Access Journals (Sweden)

    Paul D. Juarez

    2014-12-01

    Full Text Available The lack of progress in reducing health disparities suggests that new approaches are needed if we are to achieve meaningful, equitable, and lasting reductions. Current scientific paradigms do not adequately capture the complexity of the relationships between environment, personal health and population level disparities. The public health exposome is presented as a universal exposure tracking framework for integrating complex relationships between exogenous and endogenous exposures across the lifespan from conception to death. It uses a social-ecological framework that builds on the exposome paradigm for conceptualizing how exogenous exposures “get under the skin”. The public health exposome approach has led our team to develop a taxonomy and bioinformatics infrastructure to integrate health outcomes data with thousands of sources of exogenous exposure, organized in four broad domains: natural, built, social, and policy environments. With the input of a transdisciplinary team, we have borrowed and applied the methods, tools and terms from various disciplines to measure the effects of environmental exposures on personal and population health outcomes and disparities, many of which may not manifest until many years later. As is customary with a paradigm shift, this approach has far reaching implications for research methods and design, analytics, community engagement strategies, and research training.

  19. Examining the global health arena: strengths and weaknesses of a convention approach to global health challenges.

    Science.gov (United States)

    Haffeld, Just Balstad; Siem, Harald; Røttingen, John-Arne

    2010-01-01

    The article comprises a conceptual framework to analyze the strengths and weaknesses of a global health convention. The analyses are inspired by Lawrence Gostin's suggested Framework Convention on Global Health. The analytical model takes a starting-point in events tentatively following a logic sequence: Input (global health funding), Processes (coordination, cooperation, accountability, allocation of aid), Output (definition of basic survival needs), Outcome (access to health services), and Impact (health for all). It then examines to what degree binding international regulations can create order in such a sequence of events. We conclude that a global health convention could be an appropriate instrument to deal with some of the problems of global health. We also show that some of the tasks preceding a convention approach might be to muster international support for supra-national health regulations, negotiate compromises between existing stakeholders in the global health arena, and to utilize WHO as a platform for further discussions on a global health convention. © 2010 American Society of Law, Medicine & Ethics, Inc.

  20. The Power of Programming and the EarlyNutrition project: opportunities for health promotion by nutrition during the first thousand days of life and beyond.

    Science.gov (United States)

    Koletzko, Berthold; Brands, Brigitte; Chourdakis, Michael; Cramer, Simone; Grote, Veit; Hellmuth, Christian; Kirchberg, Franca; Prell, Christine; Rzehak, Peter; Uhl, Olaf; Weber, Martina

    2014-01-01

    At The Power of Programming 2014 Conference, researchers from multiple disciplines presented and discussed the effects of early nutrition and other environmental cues during the first thousand days of life and beyond on the lifelong risk of noncommunicable diseases. This paper aims to summarize the concepts and some of the first achievements of the EarlyNutrition research project that initiated the conference. The EarlyNutrition consortium is a multinational, multidisciplinary research collaboration of researchers from Europe, the USA, and Australia. A focus is placed on exploration of the developmental origins of obesity, adiposity, and related health outcomes. Here we report on the first findings of experimental approaches, cohort studies, randomized clinical trials, and systematic reviews of current information, as well as position papers, which have all been developed with the involvement of project partners. We conclude that the EarlyNutrition project has successfully established itself during the first 2 project years as a very strong platform for collaborative research on early programming effects. The first results, available already at this early stage of the project, point to great opportunities for health prevention strategies via the implementation of dietary and lifestyle modifications, with large effect sizes. Further results are expected which should support improved recommendations and related policies for optimized nutrition and lifestyle choices before and during pregnancy, in infancy, and in early childhood. © 2014 S. Karger AG, Basel.

  1. Correcting for day of the week and public holiday effects: improving a national daily syndromic surveillance service for detecting public health threats.

    Science.gov (United States)

    Buckingham-Jeffery, Elizabeth; Morbey, Roger; House, Thomas; Elliot, Alex J; Harcourt, Sally; Smith, Gillian E

    2017-05-19

    As service provision and patient behaviour varies by day, healthcare data used for public health surveillance can exhibit large day of the week effects. These regular effects are further complicated by the impact of public holidays. Real-time syndromic surveillance requires the daily analysis of a range of healthcare data sources, including family doctor consultations (called general practitioners, or GPs, in the UK). Failure to adjust for such reporting biases during analysis of syndromic GP surveillance data could lead to misinterpretations including false alarms or delays in the detection of outbreaks. The simplest smoothing method to remove a day of the week effect from daily time series data is a 7-day moving average. Public Health England developed the working day moving average in an attempt also to remove public holiday effects from daily GP data. However, neither of these methods adequately account for the combination of day of the week and public holiday effects. The extended working day moving average was developed. This is a further data-driven method for adding a smooth trend curve to a time series graph of daily healthcare data, that aims to take both public holiday and day of the week effects into account. It is based on the assumption that the number of people seeking healthcare services is a combination of illness levels/severity and the ability or desire of patients to seek healthcare each day. The extended working day moving average was compared to the seven-day and working day moving averages through application to data from two syndromic indicators from the GP in-hours syndromic surveillance system managed by Public Health England. The extended working day moving average successfully smoothed the syndromic healthcare data by taking into account the combined day of the week and public holiday effects. In comparison, the seven-day and working day moving averages were unable to account for all these effects, which led to misleading smoothing

  2. Correcting for day of the week and public holiday effects: improving a national daily syndromic surveillance service for detecting public health threats

    Directory of Open Access Journals (Sweden)

    Elizabeth Buckingham-Jeffery

    2017-05-01

    Full Text Available Abstract Background As service provision and patient behaviour varies by day, healthcare data used for public health surveillance can exhibit large day of the week effects. These regular effects are further complicated by the impact of public holidays. Real-time syndromic surveillance requires the daily analysis of a range of healthcare data sources, including family doctor consultations (called general practitioners, or GPs, in the UK. Failure to adjust for such reporting biases during analysis of syndromic GP surveillance data could lead to misinterpretations including false alarms or delays in the detection of outbreaks. The simplest smoothing method to remove a day of the week effect from daily time series data is a 7-day moving average. Public Health England developed the working day moving average in an attempt also to remove public holiday effects from daily GP data. However, neither of these methods adequately account for the combination of day of the week and public holiday effects. Methods The extended working day moving average was developed. This is a further data-driven method for adding a smooth trend curve to a time series graph of daily healthcare data, that aims to take both public holiday and day of the week effects into account. It is based on the assumption that the number of people seeking healthcare services is a combination of illness levels/severity and the ability or desire of patients to seek healthcare each day. The extended working day moving average was compared to the seven-day and working day moving averages through application to data from two syndromic indicators from the GP in-hours syndromic surveillance system managed by Public Health England. Results The extended working day moving average successfully smoothed the syndromic healthcare data by taking into account the combined day of the week and public holiday effects. In comparison, the seven-day and working day moving averages were unable to account for all

  3. Finding toxicological information: An approach for occupational health professionals

    Directory of Open Access Journals (Sweden)

    Franco Giuliano

    2008-08-01

    Full Text Available Abstract Background It can be difficult for occupational health professionals to assess which toxicological databases available on the Internet are the most useful for answering their questions. Therefore we evaluated toxicological databases for their ability to answer practical questions about exposure and prevention. We also propose recommended practices for searching for toxicological properties of chemicals. Methods We used a systematic search to find databases available on the Internet. Our criteria for the databases were the following: has a search engine, includes factual information on toxic and hazardous chemicals harmful for human health, and is free of charge. We developed both a qualitative and a quantitative rating method, which was used by four independent assessors to determine appropriateness, the quality of content, and ease of use of the database. Final ratings were based on a consensus of at least two evaluators. Results Out of 822 results we found 21 databases that met our inclusion criteria. Out of these 21 databases 14 are administered in the US, five in Europe, one in Australia, and one in Canada. Nine are administered by a governmental organization. No database achieved the maximum score of 27. The databases GESTIS, ESIS, Hazardous Substances Data Bank, TOXNET and NIOSH Pocket Guide to Chemical Hazards all scored more than 20 points. The following approach was developed for occupational health professionals searching for the toxicological properties of chemicals: start with the identity of the chemical; then search for health hazards, exposure route and measurement; next the limit values; and finally look for the preventive measures. Conclusion A rating system of toxicological databases to assess their value for occupational health professionals discriminated well between databases in terms of their appropriateness, quality of information, and ease of use. Several American and European databases yielded high scores and

  4. Integrated approach for managing health risks at work--the role of occupational health nurses.

    Science.gov (United States)

    Marinescu, Luiza G

    2007-02-01

    Currently, many organizations are using a department-centered approach to manage health risks at work. In such a model, segregated departments are providing employee benefits such as health insurance, workers' compensation, and short- and long-term disability or benefits addressing work-life issues. In recent years, a new model has emerged: health and productivity management (HPM). This is an employee-centered, integrated approach, designed to increase efficiency, reduce competition for scarce resources, and increase employee participation in prevention activities. Evidence suggests that corporations using integrated HPM programs achieve better health outcomes for their employees, with consequent increased productivity and decreased absenteeism. Occupational health nurses are well positioned to assume leadership roles in their organizations by coordinating efforts and programs across departments that offer health, wellness, and safety benefits. To assume their role as change agents to improve employees' health, nurses should start using the language of business more often by improving their communication skills, computer skills, and ability to quantify and articulate results of programs and services to senior management.

  5. General health workers' description of mental health problems and treatment approaches used in Papua New Guinea.

    Science.gov (United States)

    Koka, Betty E; Deane, Frank P; Lyons, Geoffrey Cb; Lambert, Gordon

    2014-11-01

    Papua New Guinea is a developing country with limited resources for specialist mental health services. Little is known about the mental health and treatment services of Papua New Guinea. The aim of this study was to clarify the presenting mental health problems encountered by Papua New Guinean health workers and the common treatment approaches used. A total of 203 Papua New Guinean health workers completed a retrospective quantitative survey about their three most recent mental health patients. The survey asked about presenting symptomatology, diagnoses (including culture-bound diagnoses) and treatment approaches. The major presenting mental health problems for males included schizophrenia, substance use disorder, sorcery and spirit possession. Depression was the most common diagnoses for women, followed by sorcery and somatisation. Over 65% of patients were prescribed psychotropic medication, over 50% received some form of psychological intervention and 28% were receiving traditional treatments. Somatic symptoms are common among both male and female Papua New Guineans; however, males may be more likely to present with psychotic symptoms and females with mood-related problems. Schizophrenia and depression are commonly identified with substance use disorder more problematic among males. Culture-specific explanations and treatment are commonly used. © The Author(s) 2013.

  6. Optimization of human, animal, and environmental health by using the One Health approach.

    Science.gov (United States)

    Sleeman, Jonathan M; DeLiberto, Thomas; Nguyen, Natalie

    2017-08-31

    Emerging diseases are increasing burdens on public health, negatively affecting the world economy, causing extinction of species, and disrupting ecological integrity. One Health recognizes that human, domestic animal, and wildlife health are interconnected within ecosystem health and provides a framework for the development of multidisciplinary solutions to global health challenges. To date, most health-promoting interventions have focused largely on single-sector outcomes. For example, risk for transmission of zoonotic pathogens from bush-meat hunting is primarily focused on human hygiene and personal protection. However, bush-meat hunting is a complex issue promoting the need for holistic strategies to reduce transmission of zoonotic disease while addressing food security and wildlife conservation issues. Temporal and spatial separation of humans and wildlife, risk communication, and other preventative strategies should allow wildlife and humans to co-exist. Upstream surveillance, vaccination, and other tools to prevent pathogen spillover are also needed. Clear multi-sector outcomes should be defined, and a systems-based approach is needed to develop interventions that reduce risks and balance the needs of humans, wildlife, and the environment. The ultimate goal is long-term action to reduce forces driving emerging diseases and provide interdisciplinary scientific approaches to management of risks, thereby achieving optimal outcomes for human, animal, and environmental health.

  7. Optimization of human, animal, and environmental health by using the One Health approach

    Science.gov (United States)

    Sleeman, Jonathan M.; DeLiberto, Thomas; Nguyen, Natalie T.

    2017-01-01

    Emerging diseases are increasing burdens on public health, negatively affecting the world economy, causing extinction of species, and disrupting ecological integrity. One Health recognizes that human, domestic animal, and wildlife health are interconnected within ecosystem health and provides a framework for the development of multidisciplinary solutions to global health challenges. To date, most health-promoting interventions have focused largely on single-sector outcomes. For example, risk for transmission of zoonotic pathogens from bush-meat hunting is primarily focused on human hygiene and personal protection. However, bush-meat hunting is a complex issue promoting the need for holistic strategies to reduce transmission of zoonotic disease while addressing food security and wildlife conservation issues. Temporal and spatial separation of humans and wildlife, risk communication, and other preventative strategies should allow wildlife and humans to co-exist. Upstream surveillance, vaccination, and other tools to prevent pathogen spillover are also needed. Clear multi-sector outcomes should be defined, and a systems-based approach is needed to develop interventions that reduce risks and balance the needs of humans, wildlife, and the environment. The ultimate goal is long-term action to reduce forces driving emerging diseases and provide interdisciplinary scientific approaches to management of risks, thereby achieving optimal outcomes for human, animal, and environmental health.

  8. Collaborative Visual Analytics: A Health Analytics Approach to Injury Prevention.

    Science.gov (United States)

    Al-Hajj, Samar; Fisher, Brian; Smith, Jennifer; Pike, Ian

    2017-09-12

    Background : Accurate understanding of complex health data is critical in order to deal with wicked health problems and make timely decisions. Wicked problems refer to ill-structured and dynamic problems that combine multidimensional elements, which often preclude the conventional problem solving approach. This pilot study introduces visual analytics (VA) methods to multi-stakeholder decision-making sessions about child injury prevention; Methods : Inspired by the Delphi method, we introduced a novel methodology-group analytics (GA). GA was pilot-tested to evaluate the impact of collaborative visual analytics on facilitating problem solving and supporting decision-making. We conducted two GA sessions. Collected data included stakeholders' observations, audio and video recordings, questionnaires, and follow up interviews. The GA sessions were analyzed using the Joint Activity Theory protocol analysis methods; Results : The GA methodology triggered the emergence of ' common g round ' among stakeholders. This common ground evolved throughout the sessions to enhance stakeholders' verbal and non-verbal communication, as well as coordination of joint activities and ultimately collaboration on problem solving and decision-making; Conclusion s : Understanding complex health data is necessary for informed decisions. Equally important, in this case, is the use of the group analytics methodology to achieve ' common ground' among diverse stakeholders about health data and their implications.

  9. Collaborative Visual Analytics: A Health Analytics Approach to Injury Prevention

    Directory of Open Access Journals (Sweden)

    Samar Al-Hajj

    2017-09-01

    Full Text Available Background: Accurate understanding of complex health data is critical in order to deal with wicked health problems and make timely decisions. Wicked problems refer to ill-structured and dynamic problems that combine multidimensional elements, which often preclude the conventional problem solving approach. This pilot study introduces visual analytics (VA methods to multi-stakeholder decision-making sessions about child injury prevention; Methods: Inspired by the Delphi method, we introduced a novel methodology—group analytics (GA. GA was pilot-tested to evaluate the impact of collaborative visual analytics on facilitating problem solving and supporting decision-making. We conducted two GA sessions. Collected data included stakeholders’ observations, audio and video recordings, questionnaires, and follow up interviews. The GA sessions were analyzed using the Joint Activity Theory protocol analysis methods; Results: The GA methodology triggered the emergence of ‘common ground’ among stakeholders. This common ground evolved throughout the sessions to enhance stakeholders’ verbal and non-verbal communication, as well as coordination of joint activities and ultimately collaboration on problem solving and decision-making; Conclusions: Understanding complex health data is necessary for informed decisions. Equally important, in this case, is the use of the group analytics methodology to achieve ‘common ground’ among diverse stakeholders about health data and their implications.

  10. Studying integrated health care systems with a structurationist approach

    Science.gov (United States)

    Demers, Louis; Arseneault, Stéphane; Couturier, Yves

    2010-01-01

    Introduction To implement an integrated health care system is not an easy task and to ensure its sustainability is yet more difficult. Aim Discuss how a structurationist approach can shed light on the stakes of these processes and guide the managers of such endeavours. Theory and method Structuration theory [1] has been used by numerous authors to cast new light on complex organizational phenomena. One of the central tenets of this theory is that social systems, such as integrated health care systems, are recurrent social practices across time-space and are characterized by structural properties which simultaneously constrain and enable the constitutive social actors who reproduce and transform the system through their practices. We will illustrate our theoretical standpoint with empirical material gathered during the study of an integrated health care system for the frail elderly in Quebec, Canada. This system has been implemented in 1997 and is still working well in 2010. Results and conclusion To implement an integrated health care system that is both effective and sustainable, its managers must shrewdly allow for the existing system and progressively introduce changes in the way managers and practitioners at work in the system view their role and act on a daily basis.

  11. The effects of terrorism on adult mental health: a public health preparedness approach

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    Sameera S. Karnik

    2014-01-01

    Full Text Available Terrorism is a disruptive man-made disaster event challenging human health and wellbeing. It is a hostile activity which brings about much casualty, even death. It not only causes physical casualties but also brings about psychological morbidity and can lead to long term mental disorders. The effects of terrorist attacks on people’s psychological health covers a wide range such as acute stress symptoms to long term disorders like Post-traumatic Stress Disorder (PTSD. The psychological disorder due to traumatic distress is treated with psychotherapies such as psychosocial intervention, psychological debriefing, psychological first aid care, psychological counseling services, and psychoeducation. Government is supporting state and local public health departments to develop efficient public health preparedness planning programs in case of emergency situations. There are some newer approaches working towards enhancing health security and managing responses to a psychological impact of a disaster event like a terrorist attack.

  12. Building research and evaluation capacity in population health: the NSW Health approach.

    Science.gov (United States)

    Edwards, Barry; Stickney, Beth; Milat, Andrew; Campbell, Danielle; Thackway, Sarah

    2016-02-01

    Issue addressed An organisational culture that values and uses research and evaluation (R&E) evidence to inform policy and practice is fundamental to improving health outcomes. The 2016 NSW Government Program Evaluation Guidelines recommend investment in training and development to improve evaluation capacity. The purpose of this paper is to outline the approaches taken by the NSW Ministry of Health to develop R&E capacity and assess these against existing models of practice. Method The Ministry of Health's Centre for Epidemiology and Evidence (CEE) takes an evidence-based approach to building R&E capacity in population health. Strategies are informed by: the NSW Population Health Research Strategy, R&E communities of practice across the Ministry and health Pillar agencies and a review of the published evidence on evaluation capacity building (ECB). An internal survey is conducted biennially to monitor research activity within the Ministry's Population and Public Health Division. One representative from each of the six centres that make up the Division coordinates completion of the survey by relevant staff members for their centre. Results The review identified several ECB success factors including: implementing a tailored multifaceted approach; an organisational commitment to R&E; and offering experiential training and ongoing technical support to the workforce. The survey of research activity found that the Division funded a mix of research assets, research funding schemes, research centres and commissioned R&E projects. CEE provides technical advice and support services for staff involved in R&E and in 2015, 22 program evaluations were supported. R&E capacity building also includes a series of guides to assist policy makers, practitioners and researchers to commission, undertake and use policy-relevant R&E. Staff training includes workshops on critical appraisal, program logic and evaluation methods. From January 2013 to June 2014 divisional staff published 84

  13. Prevention of Youth Violence: A Public Health Approach.

    Science.gov (United States)

    Sood, Aradhana Bela; Berkowitz, Steven J

    2016-04-01

    The causes of youth violence are multifactorial and include biological, individual, familial, social, and economic factors. The influence of parents, family members, and important adults can shape the beliefs of the child toward violence in a significant manner. However, the influence of school and the neighborhood also have an important role in attitudes and behaviors of children toward violence. The complexity of factors related to violence requires a comprehensive public health approach. This article focuses on evidence-based models of intervention to reduce violence while emphasizing collective impact as a guiding principle. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Why health care corruption needs a new approach.

    Science.gov (United States)

    Radin, Dagmar

    2016-07-01

    While corruption has been at the center of academic studies and on the agenda of international organizations for a couple of decades, in the health care sector corruption has not generated much interest or progress. At the centre of this issue is the lack of an interdisciplinary approach, which is warranted given the complexity of the issue and the lack of cooperation between STET scientifically rigorous academics and policy-makers, leaving room for more cooperation and progress. © The Author(s) 2015.

  15. Mount Sinai Hospital's approach to Ontario's Health System Funding Reform.

    Science.gov (United States)

    Chalk, Tyler; Lau, Davina; Morgan, Matthew; Dietrich, Sandra; Beduz, Mary Agnes; Bell, Chaim M

    2014-01-01

    In April 2012, the Ontario government introduced Health System Funding Reform (HSFR), a transformational shift in how hospitals are funded. Mount Sinai Hospital recognized that moving from global funding to a "patient-based" model would have substantial operational and clinical implications. Adjusting to the new funding environment was set as a top corporate priority, serving as the strategic basis for re-examining and redesigning operations to further improve both quality and efficiency. Two years into HSFR, this article outlines Mount Sinai Hospital's approach and highlights key lessons learned. Copyright © 2014 Longwoods Publishing.

  16. "Meatless days" or "less but better"? Exploring strategies to adapt Western meat consumption to health and sustainability challenges.

    Science.gov (United States)

    de Boer, Joop; Schösler, Hanna; Aiking, Harry

    2014-05-01

    Adapting Western meat consumption to health and sustainability challenges requires an overall reduction of industrially produced animal proteins plus a partial replacement by plant proteins. Combining insights on food, environment, and consumers, this paper aims to explore change strategies that may help to meet these challenges, such as promoting smaller portions of meat ("less"), smaller portions using meat raised in a more sustainable manner ("less but better"), smaller portions and eating more vegetable protein ("less and more varied"), and meatless meals with or without meat substitutes ("veggie-days"). The underlying logic of the strategies was clarified by analyzing dietary choices. A nationwide sample of 1083 Dutch consumers provided information on current eating practices and potential changes. The results show that strategies to change meat eating frequencies and meat portion sizes will appeal to overlapping but partly different segments of consumers and that these strategies can be applied to address consumers in terms of their own preferences. The strategies appeared to have different strengths and weaknesses, making them complementary pathways to facilitate step-by-step changes in the amounts and the sources of protein consumed. Copyright © 2014 Elsevier Ltd. All rights reserved.

  17. Defining ‘sensitive’ health status: a systematic approach using health code terminologies.

    Directory of Open Access Journals (Sweden)

    Andy Boyd

    2017-04-01

    We have demonstrated a systematic and partially interoperable approach to defining ‘sensitive’ health information. However, any such exercise is likely to include decisions which will be open to interpretation and open to change over time. As such, the application of this technique should be embedded within an appropriate governance framework which can accommodate misclassification while minimising potential patient harm.

  18. An integrated approach to preventing cardiovascular disease: community-based approaches, health system initiatives, and public health policy.

    Science.gov (United States)

    Karwalajtys, Tina; Kaczorowski, Janusz

    2010-01-01

    Cardiovascular disease (CVD) is largely the product of interactions among modifiable risk factors that are common in developed nations and increasingly of concern in developing countries. Hypertension is an important precursor to the development of CVD, and although detection and treatment rates have improved in recent years in some jurisdictions, effective strategies and policies supporting a shift in distribution of risk factors at the population level remain paramount. Challenges in managing cardiovascular health more effectively include factors at the patient, provider, and system level. Strategies to reduce hypertension and CVD should be population based, incorporate multilevel, multicomponent, and socioenvironmental approaches, and integrate community resources with public health and clinical care. There is an urgent need to improve monitoring and management of risk factors through community-wide, primary care-linked initiatives, increase the evidence base for community-based prevention strategies, further develop and evaluate promising program components, and develop new approaches to support healthy lifestyle behaviors in diverse age, socioeconomic, and ethnocultural groups. Policy and system changes are critical to reduce risk in populations, including legislation and public education to reduce dietary sodium and trans-fatty acids, food pricing policies, and changes to health care delivery systems to explicitly support prevention and management of CVD.

  19. The nutritional health of New Zealand vegetarian and non-vegetarian Seventh-day Adventists: selected vitamin, mineral and lipid levels.

    Science.gov (United States)

    Harman, S K; Parnell, W R

    1998-03-27

    To determine whether adult non-vegetarian Seventh-day Adventists differ in selected nutrition related health aspects from adult vegetarian Seventh-day Adventists. One hundred and forty-one Seventh-day Adventist church members responded to a general health questionnaire. Forty-seven sex and age matched subjects (23 non-vegetarians and 24 vegetarians) were selected for further investigation. Blood lipids, serum vitamin B12, folate, haemoglobin and ferritin levels were measured along with stature, weight and blood pressure. A quantitative 7-day diet record was also completed. Body mass index was similar between the non-vegetarian and vegetarian groups but diastolic blood pressure was higher for non-vegetarian than vegetarian males. Even though the dietary vitamin B12 intake was significantly lower (p Seventh-day Adventists appear likely to enjoy a lower risk of nutrition related chronic degenerative disease than the average New Zealander and have a satisfactory iron and vitamin B12 status.

  20. Influence of day length and temperature on the content of health-related compounds in broccoli (Brassica oleracea L. var. italica).

    Science.gov (United States)

    Steindal, Anne Linn Hykkerud; Mølmann, Jørgen; Bengtsson, Gunnar B; Johansen, Tor J

    2013-11-13

    Vegetables grown at different latitudes are exposed to various temperatures and day lengths, which can affect the content of health- and sensory-related compounds in broccoli florets. A 2 × 2 factorial experiment was conducted under controlled growth conditions, with contrasting temperatures (15/9 and 21/15 °C) and day lengths (12 and 24 h), to investigate the effect on glucosinolates, vitamin C, flavonols, and soluble sugars. Aliphatic glucosinolates, quercetin, and kaempferol were at their highest levels at high temperatures combined with a 12 h day. Levels of total glucosinolates, d-glucose, and d-fructose were elevated by high temperatures. Conversely, the content of vitamin C was highest with a 12 h day length combined with 15/9 °C. Our results indicate that temperature and day length influence the contents of health-related compounds in broccoli florets in a complex way, suggesting no general superiority of any of the contrasting growth conditions.

  1. Achieving universal health coverage in South Africa through a district health system approach: conflicting ideologies of health care provision.

    Science.gov (United States)

    Fusheini, Adam; Eyles, John

    2016-10-07

    Universal Health Coverage (UHC) has emerged as a major goal for health care delivery in the post-2015 development agenda. It is viewed as a solution to health care needs in low and middle countries with growing enthusiasm at both national and global levels. Throughout the world, however, the paths of countries to UHC have differed. South Africa is currently reforming its health system with UHC through developing a national health insurance (NHI) program. This will be practically achieved through a decentralized approach, the district health system, the main vehicle for delivering services since democracy. We utilize a review of relevant documents, conducted between September 2014 and December 2015 of district health systems (DHS) and UHC and their ideological underpinnings, to explore the opportunities and challenges, of the district health system in achieving UHC in South Africa. Review of data from the NHI pilot districts suggests that as South Africa embarks on reforms toward UHC, there is a need for a minimal universal coverage and emphasis on district particularity and positive discrimination so as to bridge health inequities. The disparities across districts in relation to health profiles/demographics, health delivery performance, management of health institutions or district management capacity, income levels/socio-economic status and social determinants of health, compliance with quality standards and above all the burden of disease can only be minimised through positive discrimination by paying more attention to underserved and disadavantaged communities. We conclude that in South Africa the DHS is pivotal to health reform and UHC may be best achieved through minimal universal coverage with positive discrimination to ensure disparities across districts in relation to disease burden, human resources, financing and investment, administration and management capacity, service readiness and availability and the health access inequalities are consciously

  2. Environment and Health in Children Day Care Centres (ENVIRH – Study rationale and protocol

    Directory of Open Access Journals (Sweden)

    J. Araújo-Martins

    2014-11-01

    Full Text Available Background: Indoor air quality (IAQ is considered an important determinant of human health. The association between exposure to volatile organic compounds, particulate matter, house dust mite, molds and bacteria in day care centers (DCC is not completely clear. The aim of this project was to study these effects. Methods – study design: This study comprised two phases. Phase I included an evaluation of 45 DCCs (25 from Lisbon and 20 from Oporto, targeting 5161 children. In this phase, building characteristics, indoor CO2 and air temperature/relative humidity, were assessed. A children's respiratory health questionnaire derived from the ISAAC (International Study on Asthma and Allergies in Children was also distributed. Phase II encompassed two evaluations and included 20 DCCs selected from phase I after a cluster analysis (11 from Lisbon and 9 from Oporto, targeting 2287 children. In this phase, data on ventilation, IAQ, thermal comfort parameters, respiratory and allergic health, airway inflammation biomarkers, respiratory virus infection patterns and parental and child stress were collected. Results: In Phase I, building characteristics, occupant behavior and ventilation surrogates were collected from all DCCs. The response rate of the questionnaire was 61.7% (3186 children.Phase II included 1221 children. Association results between DCC characteristics, IAQ and health outcomes will be provided in order to support recommendations on IAQ and children's health. A building ventilation model will also be developed. Discussion: This paper outlines methods that might be implemented by other investigators conducting studies on the association between respiratory health and indoor air quality at DCC. Resumo: Antecedentes: A qualidade do ar interior (IAQ é considerada um determinante importante da saúde humana. A associação entre a exposição a compostos orgânicos voláteis, partículas, ácaros, bolores e bactérias em

  3. [The approach of sciences of complexity in health services administration].

    Science.gov (United States)

    Fajardo-Ortiz, Guillermo; Ortiz-Montalvo, Armando

    2013-01-01

    Historically, health services administration has been managed under a Taylorist, Fayolist, humanist and bureaucratic focus approach. However, today dynamic and competitive behaviors that require others approaches in management are developing. Because of the social, scientific and technological changes that are occurring, it is necessary to abandon hierarchical and authoritarian schemes, "up and down" lines, prescriptive rules and order line up must be left behind. Health services administration is an adapted complex system that is not proportional, neither predictable in direction or magnitude. A new proposal is to focus on the sciences of complexity, where the social factors, materials, economics, human and ethics coincide with order and disorder, reason and unreason, and in which we must accept that the phenomenon that emerges creates different organizing different structures from the addition or subtraction of components. There is distance in the process of cause and direct effect. The mirage from the sciences of complexity are trans-disciplinary and we have accepted this in others branches of knowledge, such as quantum physics, non-linear mathematics and cybernetics, so we have to accept the influence of entropy, non-entropy, attractors, the theory of chaos and fractals.

  4. Integrating Depression Care Management into Medicare Home Health Reduces Risk of 30 and 60 Day Hospitalization: The Depression CAREPATH Cluster-Randomized Trial

    Science.gov (United States)

    Bruce, Martha L.; Lohman, Matthew C.; Greenberg, Rebecca L.; Bao, Yuhua; Raue, Patrick J.

    2016-01-01

    OBJECTIVES To determine whether a depression care management intervention among Medicare home health recipients decreases risks of hospitalization. DESIGN Cluster-randomized trial. Nurse teams were randomized to Intervention (12 teams) or Enhanced Usual Care (EUC; 9 teams). SETTING Six home health agencies from distinct geographic regions. Patients were interviewed at home and by telephone. PARTICIPANTS Patients age>65 who screened positive for depression on nurse assessments (N=755), and a subset who consented to interviews (N=306). INTERVENTION The Depression CAREPATH (CARE for PATients at Home) guides nurses in managing depression during routine home visits. Clinical functions include weekly symptom assessment, medication management, care coordination, patient education, and goal setting. Researchers conducted biweekly telephone conferences with team supervisors. MEASUREMENTS The study examined acute-care hospitalization and days to hospitalization. H1 used data from the home health record to examine hospitalization over 30-day and 60-day periods while a home health patient. H2 used data from both home care record and research assessments to examine 30-day hospitalization from any setting. RESULTS The adjusted hazard ratio (HR) of being admitted to hospital directly from home health within 30 days of start of home health care was 0.65 (p=.013) for CAREPATH compared to EUC patients, and 0.72 (p=.027) within 60 days. In patients referred to home health directly from hospital, the relative hazard of being rehospitalized was approximately 55% lower (HR = 0.45, p=.001) among CAREPATH patients. CONCLUSION Integrating CAREPATH depression care management into routine nursing practice reduces hospitalization and rehospitalization risk among older adults receiving Medicare home health nursing services. PMID:27739067

  5. Integrated System Health Management: Foundational Concepts, Approach, and Implementation.

    Science.gov (United States)

    Figueroa, Fernando; Schmalzel, John; Walker, Mark; Venkatesh, Meera; Kapadia, Ravi; Morris, Jon; Turowski, Mark; Smith, Harvey

    2009-01-01

    Implementation of integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. It is akin to having a team of experts who are all individually and collectively observing and analyzing a complex system, and communicating effectively with each other in order to arrive to an accurate and reliable assessment of its health. We present concepts, procedures, and a specific approach as a foundation for implementing a credible ISHM capability. The capability stresses integration of DIaK from all elements of a system. The intent is also to make possible implementation of on-board ISHM capability, in contrast to a remote capability. The information presented is the result of many years of research, development, and maturation of technologies, and of prototype implementations in operational systems (rocket engine test facilities). The paper will address the following topics: 1. ISHM Model of a system 2. Detection of anomaly indicators. 3. Determination and confirmation of anomalies. 4. Diagnostic of causes and determination of effects. 5. Consistency checking cycle. 6. Management of health information 7. User Interfaces 8. Example implementation ISHM has been defined from many perspectives. We define it as a capability that might be achieved by various approaches. We describe a specific approach that has been matured throughout many years of development, and pilot implementations. ISHM is a capability that is achieved by integrating data, information, and knowledge (DIaK) that might be distributed throughout the system elements (which inherently implies capability to manage DIaK associated with distributed sub-systems). DIaK must be available to any element of a system at the right time and in accordance with a meaningful context. ISHM Functional Capability Level (FCL) is measured by how well a system performs the following

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

    Directory of Open Access Journals (Sweden)

    Akindayomi Yinka

    2008-10-01

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

  7. Best practices for online Canadian prenatal health promotion: A public health approach.

    Science.gov (United States)

    Chedid, Rebecca A; Terrell, Rowan M; Phillips, Karen P

    2017-11-04

    Prenatal health promotion provides information regarding pregnancy risks, protective behaviours and clinical and community resources. Typically, women obtain prenatal health information from health care providers, prenatal classes, peers/family, media and increasingly, Internet sites and mobile apps. Barriers to prenatal health promotion and related services include language, rural/remote location, citizenship and disability. Online public health platforms represent the capacity to reach underserved women and can be customised to address the needs of a heterogeneous population of pregnant women. Canadian government-hosted websites and online prenatal e-classes were evaluated to determine if accessible, inclusive, comprehensive and evidence-based prenatal health promotion was provided. Using a multijurisdictional approach, federal, provincial/territorial, municipal and public health region-hosted websites, along with affiliated prenatal e-classes, were evaluated based on four criteria: comprehensiveness, evidence-based information, accessibility and inclusivity. Online prenatal e-classes, federal, provincial/territorial and public health-hosted websites generally provided comprehensive and evidence-based promotion of essential prenatal topics, in contrast to municipal-hosted websites which provided very limited prenatal health information. Gaps in online prenatal health promotion were identified as lack of French and multilingual content, targeted information and representations of Indigenous peoples, immigrants and women with disabilities. Canadian online prenatal health promotion is broadly comprehensive and evidence-based, but fails to address the needs of non-Anglophones and represent the diverse population of Canadian pregnant women. It is recommended that agencies enhance the organisation of website pregnancy portals/pages and collaborate with other jurisdictions and community groups to ensure linguistically accessible, culturally-competent and inclusive

  8. Towards an integrated approach to health and medicine in Africa

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    Kezia Batisai

    2016-01-01

    Full Text Available This article frames the intersections of medicine and humanities as intrinsic to understanding the practice of health care in Africa. Central to this manuscript, which draws on empirical findings on the interplay between HIV and AIDS and alternative medicine in Zimbabwe is the realisation that very limited research has been undertaken to examine ‘HIV/AIDS patient behaviour’ with respect to choice of therapy on the continent [Bene, M. & Darkoh, M. B. K. (2014. The Constraints of Antiretroviral Uptake in Rural Areas: The Case of Thamaga and Surrounding Villages, Botswana. SAHARA-J: Journal of Social Aspects of HIV/AIDS, 11(1, 167–177. doi:10.1080/17290376.2014.972057; Chavunduka, G. (1998. Professionalisation of Traditional Medicine in Zimbabwe, Harare, Jongwe Printers; O’Brien, S. & Broom, A. (2014. HIV in (and out of the Clinic: Biomedicine, Traditional Medicine and Spiritual Healing in Harare. SAHARA-J: Journal of Social Aspects of HIV/AIDS, 11(1, 94–104. doi:10.1080/17290376.2014.938102]. As such, a social approach to health-seeking behaviour questions how decisions about alternative therapies including herbal remedies, traditional healing and faith healing are made. The paper unpacks the realities around how people living with HIV and AIDS – who span different age groups and profess various religious backgrounds, faced with an insurmountable health challenge against a background of limited resources and no cure for the virus – often experience shifts in health-seeking behaviour. Grappling with seemingly simple questions about ‘when, where and how to seek medical attention’, the paper provides pointers to therapy choices and health-seeking behaviour; and it serves as a route into deeper and intense healthcare practice explorations. In conclusion, the paper proposes that medicine and the humanities should engage seriously with those social aspects of HIV and AIDS which call for an integrated approach to healthcare practice in

  9. Kaizen: ergonomics approach to occupational health and safety.

    Science.gov (United States)

    Kumashiro, Masaharu

    2011-12-01

    Kaizen (work improvement) is the forte of Japanese industry. Kaizen activities were born in the early 20th century under the name efficiency research. These activities were the beginning of industrial engineering (IE). Later on people began to rethink the single-minded devotion to improving productivity. Then the job re-design concept was developed. The main target of kaizen in the area of occupational health and safety in Japanese manufacturing is the improvement of inadequate working posture followed by the improvement of work for transporting and lifting heavy objects. Unfortunately, the kaizen activities undertaken by most Japanese companies are still focused on improving productivity and quality. The know-how for promoting kaizen activities that integrate the three aspects of IE, occupational health, and ergonomics is not being accumulated, however. In particular, the IE techniques should be incorporated into kaizen activities aimed at occupational safety and health, and the quantitative assessment of workload is required. In addition, it is important for on-the-job kaizen training in the ERGOMA Approach for production supervisors, who are the main advocates of IE kaizen.

  10. A network approach for researching partnerships in health.

    Science.gov (United States)

    Lewis, Jenny M

    2005-10-07

    The last decade has witnessed a significant move towards new modes of governing that are based on coordination and collaboration. In particular, local level partnerships have been widely introduced around the world. There are few comprehensive approaches for researching the effects of these partnerships. The aim of this paper is to outline a network approach that combines structure and agency based explanations to research partnerships in health. Network research based on two Primary Care Partnerships (PCPs) in Victoria is used to demonstrate the utility of this approach. The paper examines multiple types of ties between people (structure), and the use and value of relationships to partners (agency), using interviews with the people involved in two PCPs--one in metropolitan Melbourne and one in a rural area. Network maps of ties based on work, strategic information and policy advice, show that there are many strong connections in both PCPs. Not surprisingly, PCP staff are central and highly connected. Of more interest are the ties that are dependent on these dedicated partnership staff, as they reveal which actors become weakly linked or disconnected without them. Network measures indicate that work ties are the most dispersed and strategic information ties are the most concentrated around fewer people. Divisions of general practice are weakly linked, while local government officials and Department of Human Services (DHS) regional staff appear to play important bridging roles. Finally, the relationships between partners have changed and improved, and most of those interviewed value their new or improved links with partners. Improving service coordination and health promotion planning requires engaging people and building strong relationships. Mapping ties is a useful means for assessing the strengths and weaknesses of partnerships, and network analysis indicates concentration and dispersion, the importance of particular individuals, and the points at which they

  11. The effect of an occupational therapy mental health day treatment centre on the use of inpatient services in the Western Cape, South Africa.

    Science.gov (United States)

    Engelbrecht, Riekie; Plastow, Nicola; Botha, Ulla; Niehaus, Djh; Koen, Liezl

    2018-04-27

    The aim of this study was to determine whether attendance at an occupational therapy-led day treatment centre for mental health care users affects the use of inpatient services in South Africa. A retrospective pre-test/post-test quasi-experimental study design was used to compare admissions and days spent in hospital during the 24 months before and after attendance at the centre, using the hospital's electronic records. Total population sampling yielded data for 44 mental health care users who made first contact with the service between July 2009 and June 2010. Data were compared using the Kruskal-Wallis test, Wilcoxon Signed Ranks test and Mann-Whitney U test. There was a significant decrease in the number of admissions (z = -4.093, p = 0.00) and the number of days spent in hospital (z = -4.730, p = 0.00). Participants were admitted to psychiatric care 33 times less in the 24 months' post-intervention, indicating a medium effect (r = 0.436). They also spend 2569 days less in hospital, indicating a large effect (r = 0.504). The findings suggest that an occupational therapy-led day treatment centre could be effective in reducing the use of inpatient mental health services in South Africa. Implications for Rehabilitation Attendance at an occupational therapy-led community day treatment centre decreases the number of admissions and number of days spent in hospital and is therefore beneficial to mental health care users and service providers. The study indicates that the successful implementation of a community day treatment centre for mental health care users on the grounds of a tertiary hospital by utilising existing resources is possible.

  12. Skin Protection Behaviors among Young Male Latino Day Laborers: An Exploratory Study Using a Social Cognitive Approach

    Directory of Open Access Journals (Sweden)

    Javier F. Boyas

    2016-01-01

    Full Text Available Latino Day Laborers (LDLs are employed in occupations where multiple work hazards exist. One such hazard is the overexposure to solar ultraviolet radiation for continuous periods of time. Regular sun exposure can put individuals at increased risk of developing skin cancers, especially without adequate protection. The purpose of this cross-sectional exploratory study was to use a social cognitive framework to assess skin protective behaviors among LDLs. A community-based nonrandom and purposive sample of LDLs was recruited in two states: Mississippi and Illinois. The study sample consisted of 137 male participants, of which the majority were of Mexican ancestry (72%. The average age was 35.40 (SD=9.89 years. Results demonstrated that a substantial number of LDLs do not adequately practice sun protection behaviors on a regular basis. The skin cancer knowledge scores were very modest. The most frequently indicated barriers towards sun protection were “inconvenient,” “forget to use,” and “not being able to reapply sunscreen.” Overall, LDLs had moderate confidence in their abilities to adopt successful sun protection strategies. This study underscores the need for intervention programs aimed at LDLs to reduce extended time in the sun and increase use of sun protective measures when working outdoors.

  13. A Control-Based Multidimensional Approach to the Role of Optimism in the Use of Dementia Day Care Services.

    Science.gov (United States)

    Contador, Israel; Fernández-Calvo, Bernardino; Palenzuela, David L; Campos, Francisco Ramos; Rivera-Navarro, Jesús; de Lucena, Virginia Menezes

    2015-11-01

    We examined whether grounded optimism and external locus of control are associated with admission to dementia day care centers (DCCs). A total of 130 informal caregivers were recruited from the Alzheimer's Association in Salamanca (northwest Spain). All caregivers completed an assessment protocol that included the Battery of Generalized Expectancies of Control Scales (BEEGC-20, acronym in Spanish) as well as depression and burden measures. The decision of the care setting at baseline assessment (own home vs DCC) was considered the main outcome measure in the logistic regression analyses. Grounded optimism was a preventive factor for admission (odds ratio [OR]: 0.34 and confidence interval [CI]: 0.15-0.75), whereas external locus of control (OR: 2.75, CI: 1.25-6.03) increased the probabilities of using DCCs. Depression mediated the relationship between optimism and DCCs, but this effect was not consistent for burden. Grounded optimism promotes the extension of care at home for patients with dementia. © The Author(s) 2013.

  14. Evidence-Based Evaluation of Complementary Health Approaches for Pain Management in the United States.

    Science.gov (United States)

    Nahin, Richard L; Boineau, Robin; Khalsa, Partap S; Stussman, Barbara J; Weber, Wendy J

    2016-09-01

    Although most pain is acute and resolves within a few days or weeks, millions of Americans have persistent or recurring pain that may become chronic and debilitating. Medications may provide only partial relief from this chronic pain and can be associated with unwanted effects. As a result, many individuals turn to complementary health approaches as part of their pain management strategy. This article examines the clinical trial evidence for the efficacy and safety of several specific approaches-acupuncture, manipulation, massage therapy, relaxation techniques including meditation, selected natural product supplements (chondroitin, glucosamine, methylsulfonylmethane, S-adenosylmethionine), tai chi, and yoga-as used to manage chronic pain and related disability associated with back pain, fibromyalgia, osteoarthritis, neck pain, and severe headaches or migraines. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  15. Implementing a nationwide quality improvement approach in health services.

    Science.gov (United States)

    Sahel, Amina; DeBrouwere, Vincent; Dujardin, Bruno; Kegels, Guy; Belkaab, Nejoua; Alaoui Belghiti, Abdelali

    2015-01-01

    The purpose of this paper is to present an innovative quality improvement intervention developed in Morocco and discuss its implementation. Until 2004, the Moroccan Ministry of Health (MoH) encouraged pilots of quality improvement approaches but none of them were revealed to be sustainable. Internal assessments pinpointed factors such as lack of recognition of the participating team's efforts and lack of pressure on managers to become more accountable. In 2005, Morocco opted for an intervention called "Quality Contest" (QC) targeting health centres, hospitals and health district offices and combining quality measurement with structures ranking, performance disclosure and reward system. The QC is organized every 18 months. After the self-assessment and external audit step, the participating structures are ranked according to their scores. Their performances are then disseminated and the highest performing structures are rewarded. The results showed an improvement in performance among participating structures, constructive exchange of successful experiences between structures, as well as communication of constraints, needs and expectations between MoH managers at central and local levels; the use of peer-auditors was appreciated as it enabled an exchange of best practices between auditors and audited teams but this was mitigated by the difficulty of ensuring their neutrality; and the recognition of efforts was appreciated but seemed insufficient to ensure a sense of justice and maintain motivation. This intervention is an example of MoH leadership that has succeeded in introducing transparency and accountability mechanisms (ranking and performance disclosure) as leverage to change the management culture of the public health services; setting up a reward system to reinforce motivation and adapting continuously the intervention to enhance its sustainability and acceptability.

  16. [The Common Risk Factor Approach - An Integrated Population- and Evidence-Based Approach for Reducing Social Inequalities in Oral Health].

    Science.gov (United States)

    Heilmann, A; Sheiham, A; Watt, R G; Jordan, R A

    2016-10-01

    Worldwide, non-communicable diseases including dental caries and periodontal diseases, remain a major public health problem. Moreover, there is a social gradient in health across society that runs from the top to the bottom in a linear, stepwise fashion. Health promoting behaviours become more difficult to sustain further down the social ladder. Oral health inequalities also exist in Germany. Earlier explanations of social inequalities have mainly focused on individual lifestyle factors, ignoring the broader social determinants of health and disease. Until recently, the dominant approaches to general health promotion focused on actions to reduce specific diseases, separating oral health from general health. An alternative approach is the common risk factor approach (CRFA) where risk factors common to a number of major chronic diseases, including diseases of the mouth and teeth, are tackled. The CRFA focuses on the common underlying determinants of health to improve the overall health of populations, thereby reducing social inequalities. The main implication of the CRFA for oral health policies is to work in partnership with a range of other sectors and disciplines. Oral health issues need to be integrated with recommendations to promote general health. Improvements in oral health and a reduction in oral health inequalities are more likely by working in partnership across sectors and disciplines using strategies that focus upstream on the underlying determinants of oral diseases. © Georg Thieme Verlag KG Stuttgart · New York.

  17. Effects of statewide health promotion in primary schools on children’s sick days, visits to a physician and parental absence from work: a cluster-randomized trial

    Directory of Open Access Journals (Sweden)

    Dorothea Kesztyüs

    2016-12-01

    Full Text Available Abstract Background Based on the World Health Organization’s global school health initiative we investigate intervention effects of statewide health promotion in schools on the numbers of children’s sick days and visits to a physician, and parental days off work due to child illness. Methods Cluster-randomized trial with 1-year follow-up in primary schools in the state of Baden-Württemberg, Germany. Anthropometric measurements of first and second grade school children were taken by trained staff. Parents filled in questionnaires for information about socio-demographics, health-related variables, numbers of children’s sick days, visits to a physician, and days parents had to stay off work to care for a sick child. Longitudinal differences in the outcome variables were calculated between baseline and follow-up. Intraclass correlation coefficients were determined to quantify a possible clustering of data in schools. Accordingly, linear models and linear mixed models were applied to identify relationships and ascertain significances. Results Data from 1943 children (1st grade n = 1024, 6.6 ± 0.4 years old; 2nd grade n = 919, 7.6 ± 0.4 years old were available at baseline. Unadjusted differences regarding both grades were found between mean longitudinal changes in intervention and control group in children’s sick days (−3.2 ± 7.1 vs. -2.3 ± 5.6, p = 0.013, and maternal days off work (−0.9 ± 2.4 vs. -0.5 ± 2.8, p = 0.019. The intervention effect on sick days was adjusted in a linear regression for baseline values, gender and migration background and confirmed for first grade children (B = −0.83, p = 0.003. The intervention effect on maternal days off work lost its significance after adjusting for baseline values. No significant differences were detected in the numbers of children’s visits to a physician and paternal days off work. Conclusions School-based health promotion

  18. Effects of statewide health promotion in primary schools on children's sick days, visits to a physician and parental absence from work: a cluster-randomized trial.

    Science.gov (United States)

    Kesztyüs, Dorothea; Lauer, Romy; Traub, Meike; Kesztyüs, Tibor; Steinacker, Jürgen Michael

    2016-12-12

    Based on the World Health Organization's global school health initiative we investigate intervention effects of statewide health promotion in schools on the numbers of children's sick days and visits to a physician, and parental days off work due to child illness. Cluster-randomized trial with 1-year follow-up in primary schools in the state of Baden-Württemberg, Germany. Anthropometric measurements of first and second grade school children were taken by trained staff. Parents filled in questionnaires for information about socio-demographics, health-related variables, numbers of children's sick days, visits to a physician, and days parents had to stay off work to care for a sick child. Longitudinal differences in the outcome variables were calculated between baseline and follow-up. Intraclass correlation coefficients were determined to quantify a possible clustering of data in schools. Accordingly, linear models and linear mixed models were applied to identify relationships and ascertain significances. Data from 1943 children (1 st grade n = 1024, 6.6 ± 0.4 years old; 2 nd grade n = 919, 7.6 ± 0.4 years old) were available at baseline. Unadjusted differences regarding both grades were found between mean longitudinal changes in intervention and control group in children's sick days (-3.2 ± 7.1 vs. -2.3 ± 5.6, p = 0.013), and maternal days off work (-0.9 ± 2.4 vs. -0.5 ± 2.8, p = 0.019). The intervention effect on sick days was adjusted in a linear regression for baseline values, gender and migration background and confirmed for first grade children (B = -0.83, p = 0.003). The intervention effect on maternal days off work lost its significance after adjusting for baseline values. No significant differences were detected in the numbers of children's visits to a physician and paternal days off work. School-based health promotion slightly reduces sick days in first grade children. Subsequently, parents may not

  19. Day Care: Other Countries.

    Science.gov (United States)

    Hjartarson, Freida; And Others

    This collection of 5 bilingual papers on day care programs in foreign countries (China, the Soviet Union, and 3 Scandinavian countries) is part of a series of papers on various aspects of day care published by the Canadian Department of Health and Welfare. Each paper is presented in both English and French. Paper I considers day care services in…

  20. Social determinants approaches to public health: from concept to practice

    National Research Council Canada - National Science Library

    Blas, Erik; Sommerfeld, Johannes; Sivasankara Kurup, A

    2011-01-01

    ... social determinants and health equity issues in 13 public health programmes, and identified possible entry points for interventions to address those social determinants and inequities at the levels of socioeconomic context, exposure, vulnerability, health outcomes and health consequences.-- Publisher's description.

  1. Organization of health care for the patients with benign diseases: the problem of one-day hospitalization

    Directory of Open Access Journals (Sweden)

    L. V. Kochorova

    2013-01-01

    Full Text Available The article analises the volume of medical care to the citizens of St. Petersburg, suffering with benign diseases and hospitalized for one day. It is shown,that the level of one-day hospitalization is a marker of not approved hospitalization and unreasonable spending of funds in the state system of obligatory insurance.

  2. Holistic approach to fraud management in health insurance

    Directory of Open Access Journals (Sweden)

    Štefan Furlan

    2008-12-01

    Full Text Available Fraud present an immense problem for health insurance companies and the only way to fight fraud is by using specialized fraud management systems. The current research community focussed great efforts on different fraud detection techniques while neglecting other also important activities of fraud management. We propose a holistic approach that focuses on all 6 activities of fraud management, namely, (1 deterrence, (2 prevention, (3 detection, (4 investigation, (5 sanction and redress, and (6 monitoring. The main contribution of the paper are 15 key characteristics of a fraud management system, which enable construction of a fraud management system that provides effective and efficient support to all fraud management activities. We base our research on literature review, interviews with experts from different fields, and a case study. The case study provides additional confirmation to expert opinions, as it puts our holistic framework into practice.

  3. Pricing Energy and Ancillary Services in a Day-Ahead Market for a Price-Taker Hydro Generating Company Using a Risk-Constrained Approach

    Directory of Open Access Journals (Sweden)

    Perica Ilak

    2014-04-01

    Full Text Available This paper analyzes a price-taker hydro generating company which participates simultaneously in day-ahead energy and ancillary services markets. An approach for deriving marginal cost curves for energy and ancillary services is proposed, taking into consideration price uncertainty and opportunity cost of water, which can later be used to determine hourly bid curves. The proposed approach combines an hourly conditional value-at-risk, probability of occurrence of automatic generation control states and an opportunity cost of water to determine energy and ancillary services marginal cost curves. The proposed approach is in a linear constraint form and is easy to implement in optimization problems. A stochastic model of the hydro-economic river basin is presented, based on the actual Vinodol hydropower system in Croatia, with a complex three-dimensional relationship between the power produced, the discharged water, and the head of associated reservoir.

  4. Integrating Depression Care Management into Medicare Home Health Reduces Risk of 30- and 60-Day Hospitalization: The Depression Care for Patients at Home Cluster-Randomized Trial.

    Science.gov (United States)

    Bruce, Martha L; Lohman, Matthew C; Greenberg, Rebecca L; Bao, Yuhua; Raue, Patrick J

    2016-11-01

    To determine whether a depression care management intervention in Medicare home health recipients decreases risk of hospitalization. Cluster-randomized trial. Nurse teams were randomized to intervention (12 teams) or enhanced usual care (EUC; 9 teams). Six home health agencies from distinct geographic regions. Home health recipients were interviewed at home and over the telephone. Individuals aged 65 and older who screened positive for depression on nurse assessments (N = 755) and a subset who consented to interviews (n = 306). The Depression CARE for PATients at Home (CAREPATH) guides nurses in managing depression during routine home visits. Clinical functions include weekly symptom assessment, medication management, care coordination, patient education, and goal setting. Researchers conducted telephone conferences with team supervisors every 2 weeks. Hospitalization while receiving home health services was assessed using data from the home health record. Hospitalization within 30 days of starting home health, regardless of how long recipients received home health services, was assessed using data from the home care record and research assessments. The relative hazard of being admitted to the hospital directly from home health was 35% lower within 30 days of starting home health care (hazard ratio (HR) = 0.65, P = .01) and 28% lower within 60 days (HR = 0.72, P = .03) for CAREPATH participants than for participants receiving EUC. In participants referred to home health directly from the hospital, the relative hazard of being rehospitalized was approximately 55% lower (HR = 0.45, P = .001) for CAREPATH participants. Integrating CAREPATH depression care management into routine nursing practice reduces hospitalization and rehospitalization risk in older adults receiving Medicare home health nursing services. © 2016, Copyright the Authors Journal compilation © 2016, The American Geriatrics Society.

  5. The Effects of Modern-Day Cropland and Pasture Management on Vegetation Fire: An Earth System Modeling Approach

    Science.gov (United States)

    Rabin, S. S.; Malyshev, S.; Shevliakova, E.; Pacala, S. W.

    2014-12-01

    Fire is a major component of the global carbon cycle, with some estimates of the associated emissions reaching 2.5 PgC/yr. This and the other impacts of biomass burning have driven efforts to improve its simulation in Earth system models. Recent global fire models usually include both bioclimatic and anthropogenic drivers of fire, with the latter (via population density and sometimes economic status) serving to increase or suppress burned area. Some models have added the representation of fire used in deforestation and cropland management, the extent and seasonal timing of which may not be accounted for by the usual approach to anthropogenic influence. Human land use can also limit fire by fragmenting landscapes, but this process is not included in most global models. Moreover, although people often use fire to manage grazing lands for livestock, these practices have not been explicitly modeled (except as performed by pre-industrial societies). This could be important for regions such as sub-Saharan Africa, where the seasonality of pasture burning tends to differ from that of other lands, potentially influencing savanna-forest dynamics. Recent efforts elucidating the effects of cropland and pasture on fire regimes at regional scales provide insight into these processes. Using this new understanding, we have developed a fire model with structurally distinct modules for burning of croplands, pasture, and primary and secondary lands, as well as fire use for deforestation. Parameters for each are rigorously constrained using remote-sensing observations of burned area. This structure allows us to disentangle agricultural practices and fragmentation effects from the endogenous processes driving fire on non-agricultural land, resulting in a better ability to simulate how fire works at large scales. This is critical for modeling the future of fire and all the parts of the Earth system that it affects, including vegetation distributions, nutrient cycling, and biosphere

  6. A multifaceted approach to maximize erectile function and vascular health.

    Science.gov (United States)

    Meldrum, David R; Gambone, Joseph C; Morris, Marge A; Ignarro, Louis J

    2010-12-01

    To review the role of various factors influencing vascular nitric oxide (NO) and cyclic GMP, and consequently, erectile function and vascular health. Pertinent publications are reviewed. Daily moderate exercise stimulates vascular NO production. Maintenance of normal body weight and waist/hip ratio allows NO stimulation by insulin. Decreased intake of fat, sugar, and simple carbohydrates rapidly converted to sugar reduces the adverse effects of fatty acids and sugar on endothelial NO production. Omega-3 fatty acids stimulate endothelial NO release. Antioxidants boost NO production and prevent NO breakdown. Folic acid, calcium, vitamin C, and vitamin E support the biochemical pathways leading to NO release. Cessation of smoking and avoidance of excessive alcohol preserve normal endothelial function. Moderate use of alcohol and certain proprietary supplements may favorably influence erectile and vascular function. Treatment of any remaining testosterone deficit will both increase erectile function and reduce any associated metabolic syndrome. After production of NO and cyclic GMP are improved, use of phosphodiesterase-5 inhibitors should result in greater success in treating remaining erectile dysfunction. Recent studies have also suggested positive effects of phosphodiesterase-5 inhibitors on vascular function. A multifaceted approach will maximize both erectile function and vascular health. Copyright © 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  7. Urban green spaces assessment approach to health, safety and environment

    Directory of Open Access Journals (Sweden)

    B. Akbari Neisiani

    2016-04-01

    Full Text Available The city is alive with dynamic systems, where parks and urban green spaces have high strategic importance which help to improve living conditions. Urban parks are used as visual landscape with so many benefits such as reducing stress, reducing air pollution and producing oxygen, creating opportunities for people to participate in physical activities, optimal environment for children and decreasing noise pollution. The importance of parks is such extent that are discussed as an indicator of urban development. Hereupon the design and maintenance of urban green spaces requires integrated management system based on international standards of health, safety and the environment. In this study, Nezami Ganjavi Park (District 6 of Tehran with the approach to integrated management systems have been analyzed. In order to identify the status of the park in terms of the requirements of the management system based on previous studies and all Tehran Municipality’s considerations, a check list has been prepared and completed by park survey and interview with green space experts. The results showed that the utility of health indicators were 92.33 % (the highest and environmental and safety indicators were 72 %, 84 % respectively. According to SWOT analysis in Nezami Ganjavi Park some of strength points are fire extinguishers, first aid box, annual testing of drinking water and important weakness is using unseparated trash bins also as an opportunities, there are some interesting factors for children and parents to spend free times. Finally, the most important threat is unsuitable park facilities for disabled.

  8. Mental health literacy in secondary schools: a Canadian approach.

    Science.gov (United States)

    Kutcher, Stan; Bagnell, Alexa; Wei, Yifeng

    2015-04-01

    "Mental health literacy is an integral component of health literacy and has been gaining increasing attention as an important focus globally for mental health interventions. In Canada, youth mental health is increasingly recognized as a key national health concern and has received more focused attention than ever before within our health system. This article outlines 2 unique homegrown initiatives to address youth mental health literacy within Canadian secondary schools." Copyright © 2015 Elsevier Inc. All rights reserved.

  9. “Happy feet”: evaluating the benefits of a 100-day 10,000 step challenge on mental health and wellbeing

    OpenAIRE

    Hallam, K. T.; Bilsborough, S.; de Courten, M.

    2018-01-01

    Background An increased awareness of the health benefits of walking has emerged with the development and refinement of accelerometer equipment. Evidence is beginning to highlight the value of promoting walking, particularly focusing on the Japanese mark of obtaining 10,000 steps per day. Workplace based step challenges have become popular to engage large cohorts in increasing their daily physical activity in a sustainable and enjoyable way. Findings are now highlighting the positive health ef...

  10. Dinosaur Day!

    Science.gov (United States)

    Nakamura, Sandra; Baptiste, H. Prentice

    2006-01-01

    In this article, the authors describe how they capitalized on their first-grade students' love of dinosaurs by hosting a fun-filled Dinosaur Day in their classroom. On Dinosaur Day, students rotated through four dinosaur-related learning stations that integrated science content with art, language arts, math, and history in a fun and time-efficient…

  11. Effects of genetically modified T2A-1 rice on the GI health of rats after 90-day supplement

    OpenAIRE

    Yuan, Yanfang; Xu, Wentao; He, Xiaoyun; Liu, Haiyan; Cao, Sishuo; Qi, Xiaozhe; Huang, Kunlun; Luo, Yunbo

    2013-01-01

    Bacillus thuringiensis insecticidal toxin (Bt) rice will be commercialized as a main food source. Traditional safety assessments on genetically modified products pay little attention on gastrointestinal (GI) health. More data about GI health of Bt rice must be provided to dispel public' doubts about the potential effects on human health. We constructed an improved safety assessment animal model using a basic subchronic toxicity experiment, measuring a range of parameters including microflora ...

  12. Primary care in the village. An approach to village self-help health programmes.

    Science.gov (United States)

    Suyadi, A; Sadjimin, T; Rohde, J E

    1977-07-01

    The health clinic run in Kalirandu, Indonesia, by Foster Parents Plan, a private philanthropic welfare organization is described. In 1974 the Plan was serving 3000 families through 4 clinics, providing general curative services, pre- and postnatal services, family planning, dental care, and referral to the local urban hospital where needed. Each clinic treated about 100 patients per day at a cost of $1 per client family per month. However, few inocculations were given and few preventive health checks were requested. When the number of Plan families grew to 9500 while the population of the served communities grew to 400,000 with no increase in clinic budget, a different approach was tried. Instead of serving only the families helped direactly by the Plan, a total community service was developed. Plan personnel began to encourage use of the government health clinics. A rural health insurance system was developed which entitles the families to preventive health services. Plan medical staff and the local health center trained volunteers from Kalirandu in the use of a few simple medicines. The volunteers were selected by the village headmen and generally have elementary school education and a position of responsibility. This health "kader" works without payment and has 10-15 families living near him for whom he is responsible. At the time of writing there were over 500 kaders trained. Inservice courses are conducted to keep them up-to-date. An acceptors club was formed to motivate use of family planning. Seeking a more active role in village life, the acceptors club then took on child nutrition as a project, weighing children and reminding mothers of inoculations. The self-help momentum is spreading to housing and better farming practices, which is providing more vegetable gardens and better sources of Vitamin A. It is emphasized that this type of group responsibility cannot be imposed from outside. It is community leaders within that provide the motivation for self

  13. Improvement of fungal disease identification and management: combined health systems and public health approaches.

    Science.gov (United States)

    Cole, Donald C; Govender, Nelesh P; Chakrabarti, Arunaloke; Sacarlal, Jahit; Denning, David W

    2017-12-01

    More than 1·6 million people are estimated to die of fungal diseases each year, and about a billion people have cutaneous fungal infections. Fungal disease diagnosis requires a high level of clinical suspicion and specialised laboratory testing, in addition to culture, histopathology, and imaging expertise. Physicians with varied specialist training might see patients with fungal disease, yet it might remain unrecognised. Antifungal treatment is more complex than treatment for bacterial or most viral infections, and drug interactions are particularly problematic. Health systems linking diagnostic facilities with therapeutic expertise are typically fragmented, with major elements missing in thousands of secondary care and hospital settings globally. In this paper, the last in a Series of eight papers, we describe these limitations and share responses involving a combined health systems and public health framework illustrated through country examples from Mozambique, Kenya, India, and South Africa. We suggest a mainstreaming approach including greater integration of fungal diseases into existing HIV infection, tuberculosis infection, diabetes, chronic respiratory disease, and blindness health programmes; provision of enhanced laboratory capacity to detect fungal diseases with associated surveillance systems; procurement and distribution of low-cost, high-quality antifungal medicines; and concomitant integration of fungal disease into training of the health workforce. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Finding and Evaluating Online Resources on Complementary Health Approaches

    Science.gov (United States)

    ... health care provider. Read more information about health fraud Protecting Yourself (FDA) El Fraude en la Salud ( ... Torre-Díez I, López-Coronado M. Privacy and security in mobile health apps: a review and recommendations. ...

  15. Effect of a 21-day balneotherapy program on blood cell counts, ponogen levels, and blood biochemical indexes in servicemen in sub-health condition.

    Science.gov (United States)

    Xu, Li; Wu, Lin; Liu, Tingting; Xing, Wenrong; Cao, Xinsheng; Zhang, Shu; Su, Zongyi

    2017-09-01

    [Purpose] The aim of our study was to explore the changes in the blood of servicemen in sub-health conditions during a 21-day balneotherapy program. [Subjects and Methods] For this study, 129 servicemen in sub-health condition were recruited. The subjects were randomly divided into either the balneotherapy group (70) or the control group (59). Subjects in the balneotherapy group received whole-body immersion bath therapy in thermomineral water (30 min daily) for 21 days. Their blood samples were examined 1 day before and after balneotherapy. The parameters studied included mean corpuscular hemoglobin (MCH), mean corpuscular hemoglobin concentration (MCHC), white blood cell (WBC), lactic acid (LAC), alanine aminotransferase (ALT), glucose (GLU), and triglycerides (TG) levels. [Results] After 21 days of balneotherapy, MCH levels and MCHC increased significantly and WBC counts increased significantly. LAC levels decreased significantly. ALT, GLU, and TG levels decreased significantly. In the control group, there were no statistical differences before and after tap water baths following the same procedure. [Conclusion] A 21-day balneotherapy program significantly improved blood cell counts and blood biochemical indexes and reduced ponogen levels in servicemen in sub-health condition.

  16. The effectiveness of vaccine day and educational interventions on influenza vaccine coverage among health care workers at long-term care facilities.

    Science.gov (United States)

    Kimura, Akiko C; Nguyen, Christine N; Higa, Jeffrey I; Hurwitz, Eric L; Vugia, Duc J

    2007-04-01

    We examined barriers to influenza vaccination among long-term care facility (LTCF) health care workers in Southern California and developed simple, effective interventions to improve influenza vaccine coverage of these workers. In 2002, health care workers at LTCFs were surveyed regarding their knowledge and attitudes about influenza and the influenza vaccine. Results were used to develop 2 interventions, an educational campaign and Vaccine Day (a well-publicized day for free influenza vaccination of all employees at the worksite). Seventy facilities were recruited to participate in an intervention trial and randomly assigned to 4 study groups. The combination of Vaccine Day and an educational campaign was most effective in increasing vaccine coverage (53% coverage; prevalence ratio [PR]=1.45; 95% confidence interval [CI]=1.24, 1.71, compared with 27% coverage in the control group). Vaccine Day alone was also effective (46% coverage; PR= 1.41; 95% CI=1.17, 1.71). The educational campaign alone was not effective in improving coverage levels (34% coverage; PR=1.18; 95% CI=0.93, 1.50). Influenza vaccine coverage of LTCF health care workers can be improved by providing free vaccinations at the worksite with a well-publicized Vaccine Day.

  17. Governance and mental health: contributions for public policy approach.

    Science.gov (United States)

    Díaz-Castro, Lina; Arredondo, Armando; Pelcastre-Villafuerte, Blanca Estela; Hufty, Marc

    2017-01-30

    To analyze the conceptualization of the term governance on public mental health programs. In this systematic review, we analyzed the scientific literature published in the international scenario during 15 years (from 2000 to 2015). The databases analyzed were: Medline, CINAHL, PsycINFO and PubMed. Governance and mental health were the descriptors. We included relevant articles according to our subject of study and levels of analysis: (i) the concept of governance in mental health; (ii) process and decision spaces; (iii) strategic and pertinent actors who operate in the functioning of the health system, and (iv) social regulations. We excluded letters to the editor, news articles, comments and case reports, incomplete articles and articles whose approach did not include the object of study of this review. We have found five conceptualizations of the term governance on mental health in the area of provision policies and service organization. The agents were both those who offer and those who receive the services: we identified several social norms. The concept of governance in mental health includes standards of quality and attention centered on the patient, and incorporates the consumers of mental healthcare in the decision-making process. Analizar la conceptualización del término gobernanza en las políticas de salud mental. En esta revisión sistemática se analizó literatura científica publicada en el ámbito internacional durante 15 años (de 2000 hasta 2015). Las bases de datos analizadas fueron: Medline, CINAHL, PsycINFO y PubMed. Los descriptores fueron gobernanza y salud mental. Fueron incluidos artículos relevantes de acuerdo a nuestro objeto de estudio y niveles de análisis: (i) concepto de gobernanza en salud mental; (ii) proceso y espacios de decisión; (iii) actores estratégicos y de interés que intervienen en el funcionamiento del sistema de salud, y (iv) normas sociales. Se excluyeron cartas al editor, noticias, comentarios y reporte de caso

  18. The Effects of the Practice of the Newstart Health Regimen on Faculty Stress among Faculty at Seventh-Day Adventist Colleges and Universities

    Science.gov (United States)

    Ashley, George; Cort, Malcolm

    2007-01-01

    Utilizing an availability sample of (n = 124) faculty from three postsecondary Seventh-day Adventists institutions that promote a healthy lifestyle philosophy encapsulated in the acronym NEWSTART, this study explored effects of this health/religious regimen on faculty stress among this group. The findings reported in this paper indicate that three…

  19. 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.

  20. Effects of genetically modified T2A-1 rice on the GI health of rats after 90-day supplement.

    Science.gov (United States)

    Yuan, Yanfang; Xu, Wentao; He, Xiaoyun; Liu, Haiyan; Cao, Sishuo; Qi, Xiaozhe; Huang, Kunlun; Luo, Yunbo

    2013-01-01

    Bacillus thuringiensis insecticidal toxin (Bt) rice will be commercialized as a main food source. Traditional safety assessments on genetically modified products pay little attention on gastrointestinal (GI) health. More data about GI health of Bt rice must be provided to dispel public' doubts about the potential effects on human health. We constructed an improved safety assessment animal model using a basic subchronic toxicity experiment, measuring a range of parameters including microflora composition, intestinal permeability, epithelial structure, fecal enzymes, bacterial activity, and intestinal immunity. Significant differences were found between rice-fed groups and AIN93G-fed control groups in several parameters, whereas no differences were observed between genetically modified and non-genetically modified groups. No adverse effects were found on GI health resulting from genetically modified T2A-1 rice. In conclusion, this study may offer a systematic safety assessment model for GM material with respect to the effects on GI health.

  1. Rapid Business Transformations in Health Care: A Systems Approach

    Science.gov (United States)

    Shulaiba, Refaat A.

    2011-01-01

    The top two priorities of health care business leaders are to constantly improve the quality of health care while striving to contain and reduce the high cost of health care. The Health Care industry, similar to all businesses, is motivated to deliver innovative solutions that accelerate business transformation and increase business capabilities. …

  2. Machine learning approaches to the social determinants of health in the health and retirement study.

    Science.gov (United States)

    Seligman, Benjamin; Tuljapurkar, Shripad; Rehkopf, David

    2018-04-01

    Social and economic factors are important predictors of health and of recognized importance for health systems. However, machine learning, used elsewhere in the biomedical literature, has not been extensively applied to study relationships between society and health. We investigate how machine learning may add to our understanding of social determinants of health using data from the Health and Retirement Study. A linear regression of age and gender, and a parsimonious theory-based regression additionally incorporating income, wealth, and education, were used to predict systolic blood pressure, body mass index, waist circumference, and telomere length. Prediction, fit, and interpretability were compared across four machine learning methods: linear regression, penalized regressions, random forests, and neural networks. All models had poor out-of-sample prediction. Most machine learning models performed similarly to the simpler models. However, neural networks greatly outperformed the three other methods. Neural networks also had good fit to the data ( R 2 between 0.4-0.6, versus learning models, nine variables were frequently selected or highly weighted as predictors: dental visits, current smoking, self-rated health, serial-seven subtractions, probability of receiving an inheritance, probability of leaving an inheritance of at least $10,000, number of children ever born, African-American race, and gender. Some of the machine learning methods do not improve prediction or fit beyond simpler models, however, neural networks performed well. The predictors identified across models suggest underlying social factors that are important predictors of biological indicators of chronic disease, and that the non-linear and interactive relationships between variables fundamental to the neural network approach may be important to consider.

  3. Prioritizing health: a systematic approach to scoping determinants in health impact assessment

    Directory of Open Access Journals (Sweden)

    Lindsay McCallum

    2016-08-01

    Full Text Available The determinants of health are those factors that have the potential to affect health, either positively or negatively, and include a range of personal, social, economic, and environmental factors. In the practice of Health Impact Assessment (HIA, the stage at which the determinants of health are considered for inclusion is during the scoping step. The scoping step is intended to identify how the HIA will be carried out and to set the boundaries (e.g., temporal and geographical for the assessment. There are several factors that can help to inform the scoping process, many of which are considered in existing HIA tools and guidance; however, a systematic method of prioritizing determinants was found to be lacking. In order to analyze existing HIA scoping tools that are available, a systematic literature review was conducted including both primary and grey literature. A total of 10 HIA Scoping tools met the inclusion/exclusion criteria and were carried forward for comparative analysis. The analysis focused on minimum elements and practice standards of HIA scoping that have been established in the field. The analysis determined that existing approaches lack a clear, systematic method of prioritization of health determinants for inclusion in HIA. This finding led to the development of a Systematic HIA Scoping tool that addressed this gap. The decision matrix tool uses factors such as impact, public concern and data availability to prioritize health determinants. Additionally, the tool allows for identification of data gaps and provides a transparent method for budget allocation and assessment planning. In order to increase efficiency and improve utility, the tool was programmed into Microsoft Excel. Future work in the area of HIA methodology development is vital to the ongoing success of the practice and utilization of HIA as a reliable decision-making tool.

  4. 75 FR 65357 - Request for Public Comment: 30-Day Proposed Information Collection: Office of Urban Indian Health...

    Science.gov (United States)

    2010-10-22

    ... reporting on annual trends. Affected Public: Title V funded urban Indian health programs. Type of... information collected in a useful and timely fashion; (c) the accuracy of public burden estimate (the...

  5. Regional Projections of Extreme Apparent Temperature Days in Africa and the Related Potential Risk to Human Health

    CSIR Research Space (South Africa)

    Garland, Rebecca M

    2015-10-01

    Full Text Available Regional climate modelling was used to produce high resolution climate projections for Africa, under a “business as usual scenario”, that were translated into potential health impacts utilizing a heat index that relates apparent temperature...

  6. Applying the reasoned action approach to understanding health protection and health risk behaviors.

    Science.gov (United States)

    Conner, Mark; McEachan, Rosemary; Lawton, Rebecca; Gardner, Peter

    2017-12-01

    The Reasoned Action Approach (RAA) developed out of the Theory of Reasoned Action and Theory of Planned Behavior but has not yet been widely applied to understanding health behaviors. The present research employed the RAA in a prospective design to test predictions of intention and action for groups of protection and risk behaviors separately in the same sample. To test the RAA for health protection and risk behaviors. Measures of RAA components plus past behavior were taken in relation to eight protection and six risk behaviors in 385 adults. Self-reported behavior was assessed one month later. Multi-level modelling showed instrumental attitude, experiential attitude, descriptive norms, capacity and past behavior were significant positive predictors of intentions to engage in protection or risk behaviors. Injunctive norms were only significant predictors of intention in protection behaviors. Autonomy was a significant positive predictor of intentions in protection behaviors and a negative predictor in risk behaviors (the latter relationship became non-significant when controlling for past behavior). Multi-level modelling showed that intention, capacity, and past behavior were significant positive predictors of action for both protection and risk behaviors. Experiential attitude and descriptive norm were additional significant positive predictors of risk behaviors. The RAA has utility in predicting both protection and risk health behaviors although the power of predictors may vary across these types of health behavior. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Is two days of intermittent energy restriction per week a feasible weight loss approach in obese males? A randomised pilot study.

    Science.gov (United States)

    Conley, Marguerite; Le Fevre, Lauren; Haywood, Cilla; Proietto, Joseph

    2018-02-01

    The 5:2 diet (two non-consecutive days of 2460 KJ (600 calories) and 5 days of ad libitum eating per week) is becoming increasingly popular. This pilot study aimed to determine whether the 5:2 diet can achieve ≥5% weight loss and greater improvements in weight and biochemical markers than a standard energy-restricted diet (SERD) in obese male war veterans. A total of 24 participants were randomised to consume either the 5:2 diet or a SERD (2050 KJ (500 calorie) reduction per day) for 6 months. Weight, waist circumference (WC), fasting blood glucose, blood lipids, blood pressure and dietary intake were measured at baseline, 3 and 6 months by a blinded investigator. After 6 months, participants in both groups significantly reduced body weight (P = fasting blood glucose or blood lipids in either dietary group. Results suggest that the 5:2 diet is a successful but not superior weight loss approach in male war veterans when compared to a SERD. Future research is needed to determine the long-term effectiveness of the 5:2 diet and its effectiveness in other population groups. © 2017 Dietitians Association of Australia.

  8. [Evaluation of a Two-day Hospital On-site Training Program for Community Pharmacists: Approach to Facilitate Collaboration among Community Healthcare Professionals].

    Science.gov (United States)

    Sumi, Masaki; Hasegawa, Chiaki; Morii, Hiroaki; Hoshino, Nobuo; Okunuki, Yumi; Kanemoto, Kashie; Horie, Miya; Okamoto, Haruka; Yabuta, Naoki; Matsuda, Masashi; Kamiya, Takaki; Sudo, Masatomo; Masuda, Kyouko; Iwashita, Yuri; Matsuda, Kaori; Motooka, Yoshiko; Hira, Daiki; Morita, Shin-Ya; Terada, Tomohiro

    2018-01-01

     The importance of community-based care systems has increased due to the highly aging population and diversity of disease. To enhance the cooperation among healthcare professionals in community-based care systems, a two-day on-site training program for community pharmacists based on a multidisciplinary team approach was conducted at the Medical Science Hospital of Shiga University from April 2015 to March 2017. There were two professional courses in this training program: the palliative care course and nutrition support course. Both courses consisted of common pharmaceutical care training as follows: regional cooperation among healthcare professionals, pharmacist's clinical activities in the ward, pressure ulcer care, infection control, and aseptic technique for parenteral solutions. Each course was limited to 2 participants. A questionnaire was given to participants in the training program. Seventy-five pharmacists participated in the training and all of them answered the questionnaire. According to the questionnaire, 86% of participants felt that 2 days was an appropriate term for the training program. Positive answers regarding the content of each program and overall satisfaction were given by 100% and 99% of the participants, respectively. In the categorical classification of free comments regarding the expected change in pharmacy practice after the training, both "support for patients under nutritional treatment" and "cooperation with other medical staff" were answered by 24 participants. These results suggested that the 2-day on-site training for community pharmacists facilitated cooperation among healthcare professionals in the community.

  9. A theory-informed approach to mental health care capacity building for pharmacists.

    Science.gov (United States)

    Murphy, Andrea L; Gardner, David M; Kutcher, Stan P; Martin-Misener, Ruth

    2014-01-01

    Pharmacists are knowledgeable, accessible health care professionals who can provide services that improve outcomes in mental health care. Various challenges and opportunities can exist in pharmacy practice to hinder or support pharmacists' efforts. We used a theory-informed approach to development and implementation of a capacity-building program to enhance pharmacists' roles in mental health care. Theories and frameworks including the Consolidated Framework for Implementation Research, the Theoretical Domains Framework, and the Behaviour Change Wheel were used to inform the conceptualization, development, and implementation of a capacity-building program to enhance pharmacists' roles in mental health care. The More Than Meds program was developed and implemented through an iterative process. The main program components included: an education and training day; use of a train-the-trainer approach from partnerships with pharmacists and people with lived experience of mental illness; development of a community of practice through email communications, a website, and a newsletter; and use of educational outreach delivered by pharmacists. Theories and frameworks used throughout the program's development and implementation facilitated a means to conceptualize the component parts of the program as well as its overall presence as a whole from inception through evolution in implementation. Using theoretical foundations for the program enabled critical consideration and understanding of issues related to trialability and adaptability of the program. Theory was essential to the underlying development and implementation of a capacity-building program for enhancing services by pharmacists for people with lived experience of mental illness. Lessons learned from the development and implementation of this program are informing current research and evolution of the program.

  10. Implementing a Public Health Approach to Addressing Mental Health Needs in a University Setting: Lessons and Challenges

    Science.gov (United States)

    Parcover, Jason; Mays, Sally; McCarthy, Amy

    2015-01-01

    The mental health needs of college students are placing increasing demands on counseling center resources, and traditional outreach efforts may be outdated or incomplete. The public health model provides an approach for reaching more students, decreasing stigma, and addressing mental health concerns before they reach crisis levels. Implementing a…

  11. Fellowship Program in Health System Improvement: A novel approach integrating leadership development and patient-centred health system transformation.

    Science.gov (United States)

    Philippon, Donald J; Montesanti, Stephanie; Stafinski, Tania

    2018-03-01

    This article highlights a novel approach to professional development, integrating leadership, development and patient-centred health system transformation in the new Fellowship Program in Health System Improvement offered by the School of Public Health at the University of Alberta. Early assessment of the program is also provided.

  12. How to achieve a collaborative approach in health promotion: preferences and ideas of users of mental health services.

    Science.gov (United States)

    Pals, Regitze Anne Saurbrey; Hempler, Nana Folmann

    2018-02-12

    Collaborative approaches to consensus building or decision-making are beneficial in health-promoting activities targeting users of mental health services (users). However, little is known about how to achieve a collaborative approach in practice. The purpose of this study was to explore: (1) users' preferences and ideas related to achieving a collaborative approach in health-related communication and (2) perspectives of healthcare and social work professionals and family members on users' ideas and preferences. Data were collected through interactive workshops with users (n = 15), professionals (n = 21) and users' family members (n = 12). Data were analysed using systematic text condensation. Users provided three recommendations for establishing a collaborative approach in communication about health: (1) involving users in deciding the agenda and setting for health-promoting activities; (2) exchanging knowledge between users and professionals about health and values; and (3) exploring users' motivation for change. Users and professionals had diverging perceptions of the value of establishing a collaborative approach. Professionals regarded relationship building and health promotion as separate phenomena, whereas users perceived relationship building as inherently health promoting. Family members of users requested specific guidance and support with regard to clarifying and fulfilling the best possible support role as a family member. The findings suggest that a collaborative approach in health promotion may be difficult to achieve without a focus on professional development for healthcare and social work professionals. © 2018 Nordic College of Caring Science.

  13. Quasi-experimental Study of Systematic Screening for Family Planning Services among Postpartum Women Attending Village Health and Nutrition Days in Jharkhand, India.

    Science.gov (United States)

    Balasubramaniam, Sudharsanam; Kumar, Somesh; Sethi, Reena; Charurat, Elaine; Lalchandani, Kamlesh; Schuster, Anne; Sood, Bulbul

    2018-01-25

    Systematic screening helps increase family planning uptake through integration with other services, including immunization. Though successfully demonstrated at health facilities, this strategy has not been demonstrated in communities. This study assessed the effectiveness of systematic screening to increase postpartum family planning use during community health days in India without adversely affecting immunization services. The study was conducted during 180 individual Village Health and Nutrition Days in Jharkhand, India. All health workers were trained in postpartum family planning counseling. Intervention providers were also trained in systematic screening. 217 postpartum women aged 15-49 years participated in baseline and endline exit interviews and routine service statistics were analyzed from 2,485 facility visits at affiliated health centers. No difference in family planning service use was found in the intervention group, but significantly fewer interviewed women reported receiving family planning services at endline in the comparison group (p = 0.014). Family planning acceptance at affiliated health centers increased significantly in intervention areas (p family planning services when integrated with community-based services in Jharkhand.

  14. Adult Day Services

    Science.gov (United States)

    ... Home Health Aide Semi Private Private $25,000 Adult Day Servi Acesssisted Living Home Care Nursing Homes $0 1. General information based on industry views of various members of the National Adult ...

  15. Knowledge, attitude and practice of oral health promoting factors among caretakers of children attending day-care centers in Kubang Kerian, Malaysia: A preliminary study

    Directory of Open Access Journals (Sweden)

    Mani S

    2010-06-01

    Full Text Available Background and Aim: The role of caretakers at day-care centers has become more imperative in promoting oral health care in children since many new mothers opt to work outside their homes, leaving their children at day-care centers. The aim of this study is to assess the knowledge, attitude and practice of oral health promoting factors among secondary caretakers of children attending day-care centers. Settings and Design: This was a cross-sectional exploratory study conducted among secondary caretakers in Kubang Kerian, Malaysia. Materials and Methods: Thirty-four caretakers fulfilling the inclusion and exclusion criteria participated in the study. The data were collected using a self-administered questionnaire addressing various aspects of knowledge, attitude and practice of oral health in children. Analysis was done using SPSS version 12.0. Results: The knowledge of factors causing dental caries was found to be good among majority of the caretakers, but the concepts of transmissibility of caries and effect of hidden sugars were not evident. Seventy one percent did not know that frequent bottle feeding could cause tooth decay. Attitudes seemed to be governed by the cultural practices of the region rather than the knowledge obtained. The knowledge was not translated to practice adequately. Giving sweetened liquid in bottles was practiced by 53% of the caretakers. Conclusion: Implementation of nursery-based oral health promotion programs for secondary caretakers is needed to counteract early childhood caries.

  16. [The question of interdisciplinary work in the daily work of a nurse in a mental health day care center].

    Science.gov (United States)

    Mello, R

    1998-01-01

    This study aim is the nurses perceptions inside the mental health daily attention centre and the interdisciplinary aspect their work. This study has emerged from the necessity of understanding the work and participation of the nurses who act in those new places together with a interdisciplinary group, taking into consideration that graduation does not educate nurses for this kind of work. The interdisciplinary work has been seen as a sine qua non condition for optimising care for people who suffer from serious psychological illness as it is in the II National Conference of Mental Health, the Caracas Conference and the Health Ministry 224 Edict. Quantitative study has been used in order to value each nurse experience as well as his/her professional history in Mental Care Exercise.

  17. Bananas, pesticides and health in southwestern Ecuador: A scalar narrative approach to targeting public health responses.

    Science.gov (United States)

    Brisbois, Benjamin

    2016-02-01

    Public health responses to agricultural pesticide exposure are often informed by ethnographic or other qualitative studies of pesticide risk perception. In addition to highlighting the importance of structural determinants of exposure, such studies can identify the specific scales at which pesticide-exposed individuals locate responsibility for their health issues, with implications for study and intervention design. In this study, an ethnographic approach was employed to map scalar features within explanatory narratives of pesticides and health in Ecuador's banana-producing El Oro province. Unstructured observation, 14 key informant interviews and 15 in-depth semi-structured interviews were carried out during 8 months of fieldwork in 2011-2013. Analysis of interview data was informed by human geographic literature on the social construction of scale. Individual-focused narratives of some participants highlighted characteristics such as carelessness and ignorance, leading to suggestions for educational interventions. More structural explanations invoked farm-scale processes, such as uncontrolled aerial fumigations on plantations owned by elites. Organization into cooperatives helped to protect small-scale farmers from 'deadly' banana markets, which in turn were linked to the Ecuadorian nation-state and actors in the banana-consuming world. These scalar elements interacted in complex ways that appear linked to social class, as more well-off individuals frequently attributed the health problems of other (poorer) people to individual behaviours, while providing more structural explanations of their own difficulties. Such individualizing narratives may help to stabilize inequitable social structures. Research implications of this study include the possibility of using scale-focused qualitative research to generate theory and candidate levels for multi-level models. Equity implications include a need for public health researchers planning interventions to engage with

  18. A "one health" approach to address emerging zoonoses: the HALI project in Tanzania.

    OpenAIRE

    Jonna A K Mazet; Deana L Clifford; Peter B Coppolillo; Anil B Deolalikar; Jon D Erickson; Rudovick R Kazwala

    2009-01-01

    Jonna Mazet and colleagues describe their work in the Tanzania-based HALI Project, which adopts the ?One Health? approach to address emerging zoonoses and that recognizes the interconnectedness of human, animal, and environmental health.

  19. Bajenu Gox: A Community Approach to Maternal and Child Health in ...

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

    Bajenu Gox: A Community Approach to Maternal and Child Health in ... the Bajenu Gox Initiative's contribution to improving maternal and child health across Senegal. ... Canada's International Development Research Centre (IDRC), and the ...

  20. in_focus - Health: An Ecosystem Approach | IDRC - International ...

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

    It recognizes the inextricable links between humans and their biophysical, social, and economic ... Home · Resources · Publications ... Reconciling an ecosystem's health with the health of its human inhabitants is a new area of research, ...

  1. A multidimensional approach to case mix for home health services

    Science.gov (United States)

    Manton, Kenneth G.; Hausner, Tony

    1987-01-01

    Developing a case-mix methodology for home health services is more difficult than developing one for hospitalization and acute health services, because the determinants of need for home health care are more complex and because of the difficulty in defining episodes of care. To evaluate home health service case mix, a multivariate grouping methodology was applied to records from the 1982 National Long-Term Care Survey linked to Medicare records on home health reimbursements. Using this method, six distinct health and functional status dimensions were identified. These dimensions, combined with factors describing informal care resources and local market conditions, were used to explain significant proportions of the variance (r2 = .45) of individual differences in Medicare home health reimbursements and numbers of visits. Though the data were not collected for that purpose, the high level of prediction strongly suggests the feasibility of developing case-mix strategies for home health services. PMID:10312187

  2. Design health village with the approach of sustainable architecture ...

    African Journals Online (AJOL)

    Journal Home > Vol 8, No 3 (2016) > ... a natural environment and away from the pollution of urban life , traditional medical care, hydrotherapy, sports and ... Keywords: Health; city health; smart; sustainability in architecture; architectural design ...

  3. Social determinants approaches to public health: from concept to practice

    National Research Council Canada - National Science Library

    Blas, Erik; Sommerfeld, Johannes; Sivasankara Kurup, A

    2011-01-01

    The thirteen case studies presented in this publication describe experiences with implementing public health programs that intend to address social determinants and to have a great impact on health equity...

  4. Lifestyle and metabolic approaches to maximizing erectile and vascular health.

    Science.gov (United States)

    Meldrum, D R; Gambone, J C; Morris, M A; Esposito, K; Giugliano, D; Ignarro, L J

    2012-01-01

    Oxidative stress and inflammation, which disrupt nitric oxide (NO) production directly or by causing resistance to insulin, are central determinants of vascular diseases including ED. Decreased vascular NO has been linked to abdominal obesity, smoking and high intakes of fat and sugar, which all cause oxidative stress. Men with ED have decreased vascular NO and circulating and cellular antioxidants. Oxidative stress and inflammatory markers are increased in men with ED, and all increase with age. Exercise increases vascular NO, and more frequent erections are correlated with decreased ED, both in part due to stimulation of endothelial NO production by shear stress. Exercise and weight loss increase insulin sensitivity and endothelial NO production. Potent antioxidants or high doses of weaker antioxidants increase vascular NO and improve vascular and erectile function. Antioxidants may be particularly important in men with ED who smoke, are obese or have diabetes. Omega-3 fatty acids reduce inflammatory markers, decrease cardiac death and increase endothelial NO production, and are therefore critical for men with ED who are under age 60 years, and/or have diabetes, hypertension or coronary artery disease, who are at increased risk of serious or even fatal cardiac events. Phosphodiesterase inhibitors have recently been shown to improve antioxidant status and NO production and allow more frequent and sustained penile exercise. Some angiotensin II receptor blockers decrease oxidative stress and improve vascular and erectile function and are therefore preferred choices for lowering blood pressure in men with ED. Lifestyle modifications, including physical and penile-specific exercise, weight loss, omega-3 and folic acid supplements, reduced intakes of fat and sugar, and improved antioxidant status through diet and/or supplements should be integrated into any comprehensive approach to maximizing erectile function, resulting in greater overall success and patient

  5. Distance learning approach to train health sciences students at the ...

    African Journals Online (AJOL)

    Background: The University of Nairobi (UoN) College of Health Sciences (CHS) established Partnership for Innovative Medical Education in Kenya (PRIME-K) programmeme to enhance health outcomes in Kenya through extending the reach of medical training outside Nairobi to help health sciences students enhance their ...

  6. Extrapolation in human health hazard characterization: a probabilistic approach

    NARCIS (Netherlands)

    Bokkers, B.G.H.

    2009-01-01

    A classical deterministic risk assessment often uses conservative, worst-case assumptions to estimate the possible health risk in humans. When such an assessment shows an unacceptable human health risk, a more realistic risk assessment may be needed to estimate the actual health impact in the

  7. Collaboration, Competencies and the Classroom: A Public Health Approach

    Science.gov (United States)

    Waller, Lauren E.; Papadopoulos, Andrew

    2015-01-01

    The University of Guelph Master of Public Health program is a professional degree program that seeks to prepare graduates to meet complex public health needs by developing their proficiency in the 36 public health core competencies. Provision of experiential learning opportunities, such as a semester-long practicum, is part of student development.…

  8. A new axiomatic approach to the evaluation of population health

    DEFF Research Database (Denmark)

    Hougaard, Jens Leth; Moreno-Ternero, Juan D.; Østerdal, Lars Peter Raahave

    2013-01-01

    In this paper we explore the implications of normative principles for the evaluation of population health. We formalize those principles as axioms for social preferences over distributions of health for a given population. We single out several focal population health evaluation functions, which...

  9. Radiochemistry days

    International Nuclear Information System (INIS)

    1998-09-01

    This document provides the 44 papers (transparencies used during the presentations and posters) presented at the Radiochemistry Days, held September 3-4, 1998 in Nantes, France. The main studied topics were problematic questions concerning the nuclear fuel cycle and in particular the management, storage of radioactive wastes and the environmental impact. (O.M.)

  10. "Meatless days" or "less but better"? Exploring strategies to adapt Western meat consumption to health and sustainability challenges

    NARCIS (Netherlands)

    de Boer, J.; Schösler, H.; Aiking, H.

    2014-01-01

    Adapting Western meat consumption to health and sustainability challenges requires an overall reduction of industrially produced animal proteins plus a partial replacement by plant proteins. Combining insights on food, environment, and consumers, this paper aims to explore change strategies that may

  11. Decision science: a scientific approach to enhance public health budgeting.

    Science.gov (United States)

    Honoré, Peggy A; Fos, Peter J; Smith, Torney; Riley, Michael; Kramarz, Kim

    2010-01-01

    The allocation of resources for public health programming is a complicated and daunting responsibility. Financial decision-making processes within public health agencies are especially difficult when not supported with techniques for prioritizing and ranking alternatives. This article presents a case study of a decision analysis software model that was applied to the process of identifying funding priorities for public health services in the Spokane Regional Health District. Results on the use of this decision support system provide insights into how decision science models, which have been used for decades in business and industry, can be successfully applied to public health budgeting as a means of strengthening agency financial management processes.

  12. Primary health services at district level in South Africa: a critique of the primary health care approach

    Directory of Open Access Journals (Sweden)

    Dookie Sunitha

    2012-07-01

    Full Text Available Abstract Background The rhetoric of primary health care philosophy in the district health system is widely cited as a fundamental component of the health transformation process in post-apartheid South Africa. Despite South Africa’s progress and attempts at implementing primary health care, various factors still limit its success. Discussion Inconsistencies and poor understanding of primary care and primary health care raises unrealistic expectations in service delivery and health outcomes, and blame is apportioned when expectations are not met. It is important for all health practitioners to consider the contextual influences on health and ill-health and to recognise the role of the underlying determinants of ill-health, namely, social, economic and environmental influences. The primary health care approach provides a strong framework for this delivery but it is not widely applied. There is a need for renewed political and policy commitments toward quality primary health care delivery, re-orientation of health care workers, integration of primary health care activities into other community-based development, improved management skills and effective coordination at all levels of the health system. There should also be optimal capacity building, and skills development in problem-solving, communication, networking and community participation. Summary A well-functioning district health system is required for the re-engineering of primary health care. This strategy requires a strong leadership, a strengthening of the current district heath system and a greater emphasis on health promotion, prevention, and community participation and empowerment.

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

    Science.gov (United States)

    Leung, Zee; Middleton, Dean; Morrison, Karen

    2012-05-16

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

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

    Science.gov (United States)

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

    2016-01-01

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

  15. Pamphlet day

    OpenAIRE

    Eastwood, Phil; Dunne, Chris; Fowler, Stephen

    2017-01-01

    Pamphlet Day: A Political Protest Pamphlet and Zine Event focused around the occupation of Loughborough Public Library, Granby Street, Loughborough, LE11 3DZ, UK. ABSTRACT “Throughout the 20th Century artists have engaged provocatively with text, images and performance, publishing writings, pamphlets, and manifestos that challenge the status quo.” (1) Loughborough Echo, May 2017 https://www.loughboroughecho.net/whats-on/arts-culture-news/pamphlet-art-feature-events-13038989 A s...

  16. Does Surgical Approach Affect Outcomes in Total Hip Arthroplasty Through 90 Days of Follow-Up? A Systematic Review With Meta-Analysis.

    Science.gov (United States)

    Miller, Larry E; Gondusky, Joseph S; Bhattacharyya, Samir; Kamath, Atul F; Boettner, Friedrich; Wright, John

    2018-04-01

    The choice between anterior approach (AA) and posterior approach (PA) in primary total hip arthroplasty (THA) is controversial. Previous reviews have predominantly relied on data from retrospective studies. This systematic review included prospective studies comparing postoperative outcomes through 90 days of AA vs PA in primary THA. Outcomes were pain severity, narcotic usage, hip function using Harris Hip Score, and complications. Random effects meta-analysis was performed for all outcomes. Efficacy data were reported as standardized mean difference (SMD) where values of 0.2, 0.5, 0.8, and 1.0 were defined as small, medium, large, and very large effect sizes, respectively. Complications were reported as the absolute risk difference (RD) where a positive value implied higher risk with AA and a lower value implied lower risk with AA. A total of 13 prospective comparative studies (7 randomized) with patients treated with AA (n = 524) or PA (n = 520) were included. The AA was associated with lower pain severity (SMD = -0.37, P SMD = -0.36, P = .002), and improved hip function (SMD = 0.31, P = .002) compared to PA. No differences between surgical approaches were observed for dislocation (RD = 0.2%, P = .87), fracture (RD = 0.2%, P = .87), hematoma (RD = 0%, P = .99), infection (RD = 0.2%, P = .85), thromboembolic event (RD = -0.9%, P = .42), or reoperation (RD = 1.3%, P = .26). Conclusions of this study were unchanged when subjected to sensitivity analyses. In this systematic review and meta-analysis of prospective studies comparing postoperative outcomes through 90 days of AA vs PA in primary THA, patients treated with AA reported less pain, consumed fewer narcotics, and reported better hip function. No statistical differences in complication rates were detected between AA and PA. Ultimately, the choice of surgical approach in primary THA should consider preference and experience of the surgeon as well as preference and anatomy of the patient

  17. An overall approach to health care for indigenous peoples.

    Science.gov (United States)

    King, Malcolm

    2009-12-01

    Indigenous peoples across all the continents of the globe live with major gaps in health status and health outcomes associated with well-described social determinants of health, such as poverty and poor education. Indigenous peoples face additional health determinant issues associated with urbanization, isolation from traditional territories, and loss of cultural continuity. Indigenous children are particularly vulnerable as they grow up in isolation from their cultural and social roots and yet are also separated from the mainstream environment of their society. Programs to address these difficult health issues should be viewed as complex clinical interventions with health researchers, social scientists, and clinicians working together with Indigenous peoples to identify the most pressing needs and most appropriate and workable solutions that will result in effective policies and practices.

  18. Marketing in home health care. A practical approach.

    Science.gov (United States)

    Freitag, E M

    1988-06-01

    Home health marketing brings special problems and opportunities. One cannot rely on physical factors such as the physical plant and food service of a hospital or on the durability of a consumer product to judge home health. Opportunities exist within home health to identify activities that carry marketing value. Applying marketing principles to activities such as intake, customer service and public relations allows the home health agency to build referrals by meeting the wants and needs of the market. The home health organization needs to consider different wants and needs of those involved in the home health transaction: the decision maker, the purchaser, and the user. The success of the marketing function in meeting the organization's objectives will be aided by the placement of marketing at the senior management level.

  19. Training Physicians toward a Dignifying Approach in Adolescents' Health Care: A Promising Simulation-Based Medical Education Program.

    Science.gov (United States)

    Hardoff, Daniel; Gefen, Assaf; Sagi, Doron; Ziv, Amitai

    2016-08-01

    Human dignity has a pivotal role within the health care system. There is little experience using simulation-based medical education (SBME) programs that focus on human dignity issues in doctor-patient relationships. To describe and assess a SBME program aimed at improving physicians' competence in a dignifying approach when encountering adolescents and their parents. A total of 97 physicians participated in 8 one-day SMBE workshops that included 7 scenarios of typical adolescent health care dilemmas. These issues could be resolved if the physician used an appropriate dignifying approach toward the patient and the parents. Debriefing discussions were based on video recordings of the scenarios. The effect of the workshops on participants' approach to adolescent health care was assessed by a feedback questionnaire and on 5-point Likert score questionnaires administered before the workshop and 3 months after. All participants completed both the pre-workshop and the feedback questionnaires and 41 (42%) completed the post-workshop questionnaire 3 months later. Practice and competence topics received significantly higher scores in post-workshop questionnaires (P simulation-based workshop may improve physicians' communication skills and sense of competence in addressing adolescents' health care issues which require a dignifying approach toward both the adolescent patients and their parents. This dignity-focused methodology may be expanded to improve communication skills of physicians from various disciplines.

  20. Reproductive rights approach to reproductive health in developing countries

    OpenAIRE

    Pillai, Vijayan Kumara; Gupta, Rashmi

    2011-01-01

    Background: Research on reproductive health in developing countries focuses mostly on the role of economic development on various components of reproductive health. Cross-sectional and empirical research studies in particular on the effects of non-economic factors such as reproductive rights remain few and far between. Objective: This study investigates the influence of two components of an empowerment strategy, gender equality, and reproductive rights on women’s reproductive health in develo...

  1. Does the social gradient remain in the dietary habits of a health-conscious population? A study of Seventh-Day Adventists in West Malaysia.

    Science.gov (United States)

    Tan, Min Min; Chan, Carina K Y; Reidpath, Daniel D

    2017-12-01

    Socioeconomic status (SES) is a strong predictor of health, and individuals with higher SES generally have better health than those with lower SES. One of the pathways that SES influences health is through health behaviors, such as dietary intake, and a higher SES has been associated with a better diet. The purpose of this study was to determine whether there was a social gradient in dietary habits among the Seventh-Day Adventists, a group of conservative Christians, where healthy eating is part of the doctrinal teaching. Data from a survey of 574 Adventists residing in West Malaysia, aged 18-80 years, were analyzed. Dietary habits were measured using the Nutrition subscale of Health Promoting Lifestyle Profile II. Education and income were significantly associated with dietary habits before and after controlling for demographics. There was a gradient of association; a higher level of education and higher income were associated with better dietary habits. However, only education remained significantly associated with dietary habits when the other two socioeconomic variables were included. Employment was not significantly associated with dietary habits before or after controlling for demographic variables and the other two sociodemographic variables. This study showed that education is the strongest predictor of healthy diet, and a social gradient in dietary habits still exists even among health-conscious population. © The Author 2016. Published by Oxford University Press on behalf of Faculty of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  2. A 40-Day Journey to Better Health: Utilizing the DanielFast to Improve Health Outcomes in Urban Church-Based Settings

    Directory of Open Access Journals (Sweden)

    Nicole A. Vaughn

    2018-03-01

    Full Text Available Background: As the costs associated with obesity increase, it is vital to evaluate the effectiveness of chronic disease prevention among underserved groups, particularly in urban settings. This research study evaluated Philadelphia area Keystone First members and church participants enrolled in a group health education program to determine the impact of the Daniel Fast on physical health and the adoption of healthy behaviors. Methods: Participants attended six-weekly health education sessions in two participating churches, and were provided with a digital healthy eating platform. Results: There was a statistically significant decrease from baseline to post assessment for weight, waist circumference and cholesterol. Participants reported a significant improvement in their overall well-being, social and physical functioning, vitality and mental health. Conclusion: Results of this study demonstrate that dietary recommendations and comprehensive group health education delivered in churches and reinforced on a digital platform can improve physical health, knowledge and psychosocial outcomes.

  3. Effects of organic complexed or inorganic Co, Cu, Mn and Zn supplementation during a 45-day preconditioning period on productive and health responses of feeder cattle.

    Science.gov (United States)

    Lippolis, K D; Cooke, R F; Silva, L G T; Schubach, K M; Brandao, A P; Marques, R S; Larson, C K; Russell, J R; Arispe, S A; DelCurto, T; Bohnert, D W

    2017-11-01

    This experiment evaluated production and health parameters among cattle offered concentrates containing inorganic or organic complexed sources of supplemental Cu, Co, Mn and Zn during a 45-day preconditioning period. In total, 90 Angus×Hereford calves were weaned at 7 months (day -1), sorted by sex, weaning BW and age (261±2 kg; 224±2 days), and allocated to 18 drylot pens (one heifer and four steers per pen) on day 0; thus, all pens had equivalent initial BW and age. Pens were randomly assigned to receive a corn-based preconditioning concentrate containing: (1) Cu, Co, Mn and Zn sulfate sources (INR), (2) Cu, Mn, Co and Zn complexed organic source (AAC) or (3) no Cu, Co, Mn and Zn supplementation (CON). From day 0 to 45, cattle received concentrate treatments (2.7 kg/animal daily, as-fed basis) and had free-choice access to orchardgrass (Dactylis glomerata L.), long-stem hay and water. The INR and AAC treatments were formulated to provide the same daily amount of Co, Cu, Mn and Zn at a 50-, 16-, 8- and ninefold increase, respectively, compared with the CON treatment. On day 46, cattle were transported to a commercial feedlot, maintained as a single pen, and offered a free-choice receiving diet until day 103. Calf full BW was recorded on days -1 and 0, 45 and 46, and 102 and 103 for average daily gain (ADG) calculation. Liver biopsy was performed on days 0 (used as covariate), 22 and 45. Cattle were vaccinated against respiratory pathogens on days 15, 29 and 46. Blood samples were collected on days 15, 29, 45, 47, 49, 53 and 60. During preconditioning, mean liver concentrations of Co, Zn and Cu were greater (P⩽0.03) in AAC and INR compared with CON. No treatment effects were detected (P⩾0.17) for preconditioning feed intake, ADG or feed efficiency. No treatment effects were detected (P⩾0.48) for plasma concentrations of antibodies against Mannheimia haemolytica, bovine viral diarrhea types 1 and 2 viruses. Plasma haptoglobin concentrations were similar

  4. [Health promotion effectiveness: developing and testing a system for routine evaluation in health education, workplace health promotion and setting approach supplied by the German statutory health insurance agencies].

    Science.gov (United States)

    Kliche, T; Riemann, K; Bockermann, C; Niederbühl, K; Wanek, V; Koch, U

    2011-04-01

    The aim of the study was to develop and test a routine evaluation system for all health promotion and education activities funded by the German statutory health insurance companies. The system aims at measuring both individual health effects and the complex organisational effects of setting projects. Measurement instruments were developed synoptically and tested in three field tests (2003-2008). In order to assess the impact of individual health training, 212 courses of the health insurance companies were evaluated. To assess the setting approach, 56 schools participating in a health-promotion project were included, and for workplace health-promotion 6 projects of different health insurance companies were included. The research design was an observational study. Instead of control groups, individual data were compared to reference values for gender- and age-matched groups from national health surveys. The studies consisted of baseline and final assessment (T1/T2), complemented by a follow-up (T3), all adapted to the time of intervention (i. e., 3-24 months for T1/T2 and 3-18 months for T2/T3). The evaluation system provides multilevel-measurement based upon validated questionnaires for health-related structures and processes in institutions, and for the participating individual's subjective health, health problems, health-related quality of life, workplace and institutional satisfaction. Controlling for central confounders is also possible (input and dosage, age, gender, educational background). Thus, short but valid measurement instruments of high usability are available to evaluate the effectiveness of prevention, health promotion and education. © Georg Thieme Verlag KG Stuttgart · New York.

  5. Improving work functioning and mental health of health care employees using an e-mental health approach to workers' health surveillance: pretest-posttest study.

    Science.gov (United States)

    Ketelaar, Sarah M; Nieuwenhuijsen, Karen; Bolier, Linda; Smeets, Odile; Sluiter, Judith K

    2014-12-01

    Mental health complaints are quite common in health care employees and can have adverse effects on work functioning. The aim of this study was to evaluate an e-mental health (EMH) approach to workers' health surveillance (WHS) for nurses and allied health professionals. Using the waiting-list group of a previous randomized controlled trial with high dropout and low compliance to the intervention, we studied the pre- and posteffects of the EMH approach in a larger group of participants. We applied a pretest-posttest study design. The WHS consisted of online screening on impaired work functioning and mental health followed by online automatically generated personalized feedback, online tailored advice, and access to self-help EMH interventions. The effects on work functioning, stress, and work-related fatigue after 3 months were analyzed using paired t tests and effect sizes. One hundred and twenty-eight nurses and allied health professionals participated at pretest as well as posttest. Significant improvements were found on work functioning (p = 0.01) and work-related fatigue (p Work functioning had relevantly improved in 30% of participants. A small meaningful effect on stress was found (Cohen d = .23) in the participants who had logged onto an EMH intervention (20%, n = 26). The EMH approach to WHS improves the work functioning and mental health of nurses and allied health professionals. However, because we found small effects and participation in the offered EMH interventions was low, there is ample room for improvement.

  6. Admission to day stay early parenting program is associated with improvements in mental health and infant behaviour: A prospective cohort study

    Directory of Open Access Journals (Sweden)

    Rowe Heather

    2012-08-01

    Full Text Available Abstract Background Australia’s Early Parenting Services support families and intervene early in mental health problems in parents. The Victorian Early Parenting Strategy, a platform for government policy recommended a stronger evidence base for early parenting services. Tweddle Child and Family Health Service (TCFHS is a not-for-profit public sector early parenting centre, which provides residential, day stay, home visiting and outreach programs. This study aimed i to examine the health, social circumstances and presenting needs of clients attending the Tweddle Day Stay Program (DSP with infants under 12 months old and ii to assess the parent mental health and infant behaviour outcomes and the factors associated with program success. Methods A cohort of clients was recruited prior to admission and followed-up 8 weeks after discharge. Data were collected using standardised measures in a study specific questionnaire at baseline, participant’s Tweddle records and a follow-up telephone interview. Health, social circumstances and presenting needs of clients were described. Changes in parents’ symptoms of depression and infants’ sleep and settling between admission and follow-up were calculated. Multiple regression analyses were conducted to examine factors associated with changes in primary outcomes. Results Of the total 162 clients who were eligible and invited to participate, 115 (72% were recruited. Parents admitted to the DSP had worse general self-reported physical and mental health than community samples. Infants of DSP participants were no more likely to be premature or have low birth weight, but significantly more unsettled than other community samples. Participants’ mental health and their infants’ behaviours were significantly improved after DSP admission. In multivariate analysis, higher depression score at baseline and greater educational attainment were significantly associated with improvements in parents’ mental

  7. A Collaborative Approach to Poverty Reduction and Health ...

    African Journals Online (AJOL)

    proach to health improvement, and augmenting student's communication and organisational skills. Description. A key activity for student nurses is assessing the needs of local communities and creating effective responses. During their community placement 3rd year student nurses from KSNM carried out a health needs ...

  8. Canada's health care system: A relevant approach for South Africa ...

    African Journals Online (AJOL)

    Background. While countries such as the USA, South Africa and China debate health reforms to improve access to care while rationalising costs, Canada's health care system has emerged as a notable option. In the USA, meaningful discussion of the advantages and disadvantages of the Canadian system has been ...

  9. Abstract: A Collaborative Approach to Poverty Reduction and Health ...

    African Journals Online (AJOL)

    Active participation in a community initiative enabled students to become more reflective and responsive in their own practice. It also created a learning environment which empowered them to act collaboratively in order to improve the broader determinants of health. Key words: health improvement, collaborative working, ...

  10. An Informatics Approach to Establishing a Sustainable Public Health Community

    Science.gov (United States)

    Kriseman, Jeffrey Michael

    2012-01-01

    This work involved the analysis of a public health system, and the design, development and deployment of enterprise informatics architecture, and sustainable community methods to address problems with the current public health system. Specifically, assessment of the Nationally Notifiable Disease Surveillance System (NNDSS) was instrumental in…

  11. A dynamic approach to communication in health literacy education

    NARCIS (Netherlands)

    Veenker, Herman; Paans, Wolter

    2016-01-01

    Background: Research within the framework of Self-Determination Theory (SDT) indicates that patients' autonomy is to be considered a critical health care outcome in its own right since it promotes improved mental and physical health. This paper presents an analysis of studies addressing

  12. An apple plus a Brazil nut a day keeps the doctors away: antioxidant capacity of foods and their health benefits.

    Science.gov (United States)

    Ferrari, Carlos Kusano Bucalen; Percário, Sandro; Silva, José Carlos Costa Baptista; da Silva Torres, Elizabeth Aparecida Ferraz

    2016-01-01

    Antioxidant-rich foods scavenge free radicals and other reactive species, decreasing the risk of different non-communicable chronic diseases. The objective of this study was to review the content of total antioxidant capacity of commonly foods comparing with experimental data and to explore the health benefits due to foods with moderate to high TAC. The TAC was analytically measured using the "Total Antioxidant Capacity" (NX2332) test from Randox® (UK) by spectrometry at 600 nm. Brazil nut (Bertholletia excelsa), "guaraná" (Paullinia cupana Kunth) powder, ready to drink boiled coffee (Coffea arabica L.), and milk chocolate (made from seeds of Theobroma cacao) had the highest TAC values, followed by collard greens (Brassica oleracea L.), beets (Beta vulgaris L.), apples (Malus domestica Borkh.), bananas (Musa paradisiaca), common beans (Phaseolus vulgaris), oranges (Citrus sinensis (L.) Osbeck), onions (Allium cepa L.), and lettuce (Lactuca sativa L.). Other foods also showed antioxidant capacity. The binomial antioxidant capacity of foods and health was extensively discussed according to science literature. Based on the high TAC content of Brazil nuts, guaraná, coffee, chocolate, collard greens, apples, beets, beans, oranges, onions and other foods, their regular dietary intake is strongly recommended to reduce the risk of chronic non-communicable diseases.

  13. PHYSICAL CULTURE AND HEALTH CULTURE – INNOVATIONAL CULTUROLOGICAL APPROACH

    Directory of Open Access Journals (Sweden)

    Grujo Bjeković

    2008-08-01

    Full Text Available Inaugural discusses of metatheoretical innovatinal forming of upgrading the cultural health and pedagogical technology of children’s and youth’s health progress and protection systems in the system of generally educational and health-school organizations. Establishment of a dynamical cumulative knowledge exchange and cooperative harmonization of the pedagogues of teaching obligations in the constitution of knowledge management educational space on rising health culture, physicality, and enriching sport and recreative lifestyle. Working out of con ceptual structural-functional scheme of health management measures in school and of evaluation of psychophysical and functional potentials, from the aspect of personalorientation. Establishment of complex system monitoring for physical development and physical capabilities and achieved results in domain of self-organized sport and sport-recreative selected activities.

  14. Social scientists in public health: a fuzzy approach

    Directory of Open Access Journals (Sweden)

    Juliana Luporini do Nascimento

    2015-05-01

    Full Text Available This study aims to describe and analyze the presence of social scientists, anthropologists, sociologists and political scientists in the field of public health. A survey by the Lattes Curriculum and sites of Medical Colleges, Institutes of Health Research Collective, seeking professionals who work in healthcare and have done some stage of their training in the areas of social sciences. In confluence with Norbert Elias' concepts of social networks and configuration of interdependence it was used fuzzy logic, and the tool free statistical software R version 2.12.0 which enabled a graphic representation of social scientists interdependence in the field of social sciences-health-social sciences. A total of 238 professionals were ready in 6 distinct clusters according to the distance or closer of each professional in relation to public health and social sciences. The work was shown with great analytical and graphical representation possibilities for social sciences of health, in using this innovative quantitative methodology.

  15. Public Health's Approach to Systemic Racism: a Systematic Literature Review.

    Science.gov (United States)

    Castle, Billie; Wendel, Monica; Kerr, Jelani; Brooms, Derrick; Rollins, Aaron

    2018-05-04

    Recently, public health has acknowledged racism as a social determinant of health. Much evidence exists on the impact of individual-level racism and discrimination, with little to no examination of racism from the standpoint of systems and structures. The purpose of this systematic literature review is to analyze the extent to which public health currently addresses systemic racism in the published literature. Utilizing the PRISMA guidelines, this review examines three widely used databases to examine published literature covering the topic as well as implications for future research and practice. A total of 85 articles were included in the review analysis after meeting study criteria. Across numerous articles, the terms racism and systemic racism are largely absent. A critical need exists for an examination of the historical impact of systemic racism on the social determinants of health and health of marginalized populations.

  16. Influence of the day care, home and neighbourhood environment on young children's physical activity and health: protocol for the PLAYCE observational study.

    Science.gov (United States)

    Christian, Hayley; Maitland, Clover; Enkel, Stephanie; Trapp, Georgina; Trost, Stewart G; Schipperijn, Jasper; Boruff, Bryan; Lester, Leanne; Rosenberg, Michael; Zubrick, Stephen R

    2016-12-08

    The early years are a critical period in a child's health and development, yet most preschool children fail to meet physical activity guidelines. Outside of the home and neighbourhood, children spend a large proportion of time within early childhood education and care (ECEC) services such as long day care. Research is required to determine how the design of day care outdoor (and indoor) spaces provides opportunities or constraints for physical activity. A significant evidence gap surrounds what objectively measured attributes of the home and neighbourhood environment influence preschoolers' physical activity. The PLAY Spaces & Environments for Children's Physical Activity (PLAYCE) study will empirically investigate the relative and cumulative influence of the day care, home and neighbourhood environment on preschoolers' physical activity. The PLAYCE study is a cross-sectional observational study (April 2015 to April 2018) of 2400 children aged 2-5 years attending long day care in metropolitan Perth, Western Australia. Accelerometers will measure physical activity with indoor physical activity measured using radio frequency identification. Global positioning systems will be used to determine outdoor location of physical activity around the home and neighbourhood for a subsample (n=310). The day care environment will be objectively measured using a validated audit tool. Other potential individual, social and physical environmental influences on preschoolers' physical activity will be collected by geographic information systems measures, parent and day care educator surveys. Ethical approval has been granted by The University of Western Australia Human Ethics Research Committee, approval number RA/4/1/7417. Findings will be published in international peer-reviewed journals and presented at international conferences. Key findings will be disseminated to stakeholders, collaborators, policymakers and practitioners working in the ECEC sector. Day care centre directors

  17. Management of environmental health issues for the 2004 Athens Olympic Games: is enhanced integrated environmental health surveillance needed in every day routine operation?

    Directory of Open Access Journals (Sweden)

    Chervoni Julia

    2006-12-01

    Full Text Available Abstract Background Management of environmental health issues is an integral part of public health systems. An active integrated environmental health surveillance and response system was developed for the Athens Olympics to monitor and prevent exposure to environmental hazards. The potential for permanent implementation of the program was examined. Methods The environmental health surveillance and response system included standardization, computerization and electronic transmission of data concerning environmental inspections of 17 site categories (restaurants, swimming pools etc of public health interest, drinking and recreational water examinations and suggested corrective actions. The Olympic Planning Unit integrated and centrally managed data from 13 public health agencies, recommended, supervised and coordinated prompt corrective actions. Methods used to test the effectiveness of the program were the assessment of water quality test and inspection results trends over time using linear regression and epidemiological surveillance findings. Results Between January 2003 and September the 30th, 2004, 196 inspectors conducted 8562 inspections, collected 5024 water samples and recommended 17 027 corrective actions. In 10 cruise ships used as floating hotels inspectors conducted 10 full inspections, 2 re-inspections, and 27 follow-up inspections. Unsatisfactory inspection results (r = 0.44, p Conclusion Lessons learned for future events include timely implementation and installation of communication processes, and rapid and coordinated response to unsatisfactory inspection results. Routine national programs need to adopt enhanced environmental health surveillance aimed at public health decision-making, but with a different perspective.

  18. Management of environmental health issues for the 2004 Athens Olympic Games: is enhanced integrated environmental health surveillance needed in every day routine operation?

    Science.gov (United States)

    Hadjichristodoulou, Christos; Mouchtouri, Varvara; Vaitsi, Vasiliki; Kapoula, Christina; Vousoureli, Anastasia; Kalivitis, Isidiros; Chervoni, Julia; Papastergiou, Panagiotis; Vasilogiannakopoulos, Antonios; Daniilidis, Vasilis D; Kremastinou, Jenny

    2006-12-18

    Management of environmental health issues is an integral part of public health systems. An active integrated environmental health surveillance and response system was developed for the Athens Olympics to monitor and prevent exposure to environmental hazards. The potential for permanent implementation of the program was examined. The environmental health surveillance and response system included standardization, computerization and electronic transmission of data concerning environmental inspections of 17 site categories (restaurants, swimming pools etc) of public health interest, drinking and recreational water examinations and suggested corrective actions. The Olympic Planning Unit integrated and centrally managed data from 13 public health agencies, recommended, supervised and coordinated prompt corrective actions. Methods used to test the effectiveness of the program were the assessment of water quality test and inspection results trends over time using linear regression and epidemiological surveillance findings. Between January 2003 and September the 30th, 2004, 196 inspectors conducted 8562 inspections, collected 5024 water samples and recommended 17 027 corrective actions. In 10 cruise ships used as floating hotels inspectors conducted 10 full inspections, 2 re-inspections, and 27 follow-up inspections. Unsatisfactory inspection results (r = 0.44, p quality tests (r = 0.39, p restaurant which accommodated athletes during a test event. Lessons learned for future events include timely implementation and installation of communication processes, and rapid and coordinated response to unsatisfactory inspection results. Routine national programs need to adopt enhanced environmental health surveillance aimed at public health decision-making, but with a different perspective.

  19. Understanding and Measuring LGBTQ Pathways to Health: A Scoping Review of Strengths-Based Health Promotion Approaches in LGBTQ Health Research.

    Science.gov (United States)

    Gahagan, Jacqueline; Colpitts, Emily

    2017-01-01

    Health research traditionally has focused on the health risks and deficits of lesbian, gay, bisexual, transgender, and queer (LGBTQ) populations, obscuring the determinants that can promote health across the life course. Recognizing, appropriately measuring, and rendering visible these determinants of health is paramount to informing appropriate and engaging health policies, services, and systems for LGBTQ populations. The overarching purpose of this article is to provide an overview of the findings of a scoping review aimed at exploring strengths-based health promotion approaches to understanding and measuring LGBTQ health. Specifically, this scoping review examined peer-reviewed, published academic literature to determine (a) existing methodological frameworks for studying LGBTQ health from a strengths-based health promotion approach, and (b) suggestions for future methodological approaches for studying LGBTQ health from a strengths-based health promotion approach. The findings of this scoping review will be used to inform the development of a study aimed at assessing the health of and improving pathways to health services among LGBTQ populations in Nova Scotia, Canada.

  20. Collaboration, Competencies and the Classroom: A Public Health Approach

    Directory of Open Access Journals (Sweden)

    Lauren E. Wallar

    2015-03-01

    Full Text Available The University of Guelph Master of Public Health program is a professional degree program that seeks to prepare graduates to meet complex public health needs by developing their proficiency in the 36 public health core competencies. Provision of experiential learning opportunities, such as a semester-long practicum, is part of student development. In the Fall 2013 semester, a new opportunity was introduced in which small groups of students were paired with local public health professionals to complete a capstone business plan assignment that addressed a current public health issue. However, the impact of this external collaboration on the student learning experience was unknown. To address this, quantitative and qualitative information about students’ perceived proficiency in the core competencies and their learning experiences was collected using a pre/post survey and focus groups, respectively. A post-assignment survey was also administered to participating local public health professionals in which they assessed their group’s proficiency in the core competencies, and provided additional feedback. The results of this study showed that students had unique learning experiences with enhanced proficiency in different areas including policy and program planning, implementation and evaluation, assessment and analysis, and partnerships, collaboration and advocacy. Managing and communicating expectations was important throughout the learning experience. By using realistic community-based assignments, graduate public health programs can enrich students’ learning experiences by creating an environment for students to apply their classroom knowledge and gain practical knowledge and skills.

  1. Incremental health expenditure and lost days of normal activity for individuals with mental disorders: results from the São Paulo Megacity Study.

    Science.gov (United States)

    Chiavegatto Filho, Alexandre Dias Porto; Wang, Yuan-Pang; Campino, Antonio Carlos Coelho; Malik, Ana Maria; Viana, Maria Carmen; Andrade, Laura Helena

    2015-08-05

    With the recent increase in the prevalence of mental disorders in developing countries, there is a growing interest in the study of its consequences. We examined the association of depression, anxiety and any mental disorders with incremental health expenditure, i.e. the linear increase in health expenditure associated with mental disorders, and lost days of normal activity. We analyzed the results from a representative sample survey of residents of the Metropolitan Region of São Paulo (n = 2,920; São Paulo Megacity Mental Health Survey), part of the World Mental Health (WMH) Survey Initiative, coordinated by the World Health Organization and performed in 28 countries. The instrument used for obtaining the individual results, including the assessment of mental disorders, was the WMH version of the Composite International Diagnostic Interview 3.0 (WMH-CIDI 3.0) that generates psychiatric diagnoses according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. Statistical analyses were performed by multilevel generalized least squares (GLS) regression models. Sociodemographic determinants such as income, age, education and marital status were included as controls. Depression, anxiety and any mental disorders were consistently associated with both incremental health expenditure and missing days of normal activity. Depression was associated with an incremental annual expenditure of R$308.28 (95% CI: R$194.05-R$422.50), or US$252.48 in terms of purchasing power parity (PPP). Anxiety and any mental disorders were associated with a lower, but also statistically significant, incremental annual expenditure (R$177.82, 95% CI: 79.68-275.97; and R$180.52, 95% CI: 91.13-269.92, or US$145.64 and US$147.85 in terms of PPP, respectively). Most of the incremental health costs associated with mental disorders came from medications. Depression was independently associated with higher incremental health expenditure than the two most prevalent chronic

  2. Approach to Health Supporting System Using Traditional Chinese Medicine

    Science.gov (United States)

    Watsuji, Tadashi; Shinohara, Shoji; Arita, Seizaburo

    The primary prevention of disease related to the lifestyle is an essential theme in medical research. Preventing before it arises is the important concept in traditional Chinese medicine (TCM). Since TCM, which emphasizes individual physical condition in medical treatment, has recently attracted considerable attention globally, objective diagnostic methods in TCM have been investigated in this work. Firstly, the fuzzy theory was applied to develop a tongue diagnosis supporting system based on the tongue diagnosis in TCM. Secondly, the usefulness of TCM health questionnaire was examined to identify individual physical condition. Our results suggest that the TCM health questionnaire is useful in the construction of a health supporting system based on TCM.

  3. A New Approach to Health Services and Pharmacy in Cuba.

    Science.gov (United States)

    Sánchez, Alina M

    2015-12-01

    In December 17, 2014, U.S. President Barack Obama surprised the world by announcing his intention to enter into negotiations aimed at reestablishing diplomatic relations with Cuba. Since then, expectations and interest regarding the health system of that country have increased. This report focuses on the Cuban health and pharmacy systems from a practical and educational standpoint. Pharmaceutical services, strengths, opportunities, and challenges are described. Cuba's new trends toward patient-centered care are analyzed to provide insights for developing pharmaceutical care practice and implementing policies suitable for practice in all health care settings. © 2015 Pharmacotherapy Publications, Inc.

  4. Planning and management for health in periods of economic stringency and instability: a contingency approach.

    Science.gov (United States)

    van der Werff, A

    1986-01-01

    The mid-1970s marked the end of the longest period of uninterrupted economic growth in history, and initiated in Europe--and other parts of the world--a period of economic stagnation and instability. Along with the prosperity explosion of the past, the pattern of health problems has changed and is still changing. Moreover, the demand for health care has kept on rising, without much improvement of health status in general. Thus, there is a critical need to rethink policies, and to ensure that future changes occur within the limits of shrinking resources and the allotted time-span. In particular, the change in priorities envisaged by the Health for All 2000 (HFA 2000) strategies will need to take place against the background of an ageing population, social instability, and continuing development of new lifestyles and persistent economic scarcity. It is by analysing that background that this article seeks to make recommendations as to how health planning and management might successfully cope with the policy reorientation of the HFA 2000 strategy. The structure of this article is as follows. Firstly, the changes taking place in planning conditions will be reviewed, and form the basis of a framework for subsequent analysis of the planning environment. Following this framework, some of the conflicts likely to be faced in planning and management will be discussed, many of which are the consequence of economic stringency and instability. Also the requirements for an improvement of the effectiveness and efficiency of planning will be identified. Finally, a limited number of approaches to planning will be considered, for their appropriateness to the present-day economic circumstances. The point of view elucidated throughout is that there is no single solution which is 'best' under all circumstances. The conclusion, rather, is that the selection of particular theory or method of planning and management should depend both on the objectives of the decision maker and on the

  5. Preparing mental health professionals for new directions in mental health practice: Evaluating the sensory approaches e-learning training package.

    Science.gov (United States)

    Meredith, Pamela; Yeates, Harriet; Greaves, Amanda; Taylor, Michelle; Slattery, Maddy; Charters, Michelle; Hill, Melissa

    2018-02-01

    The application of sensory modulation approaches in mental health settings is growing in recognition internationally. However, a number of barriers have been identified as limiting the implementation of the approach, including workplace culture and a lack of accessible and effective sensory approaches training. The aim of this project was to investigate the efficacy of providing this training through a custom-designed e-learning package. Participants in the present study were predominately nurses and occupational therapists working in mental health settings in Queensland, Australia. Data were collected from 121 participants using an online survey. Significant improvements were found between pre- and post-training in participants' real and perceived levels of knowledge, their perceived levels of confidence, and their attitudes towards using sensory modulation approaches in mental health settings. The findings of the study suggest that the custom-designed sensory approaches e-learning package is an effective, accessible, acceptable, and usable method to train health professionals in sensory modulation approaches. As this study is the first to analyse the efficacy of an e-learning sensory approaches package, the results are considered preliminary, and further investigation is required. © 2017 Australian College of Mental Health Nurses Inc.

  6. 'Changing climate, changing health, changing stories' profile: using an EcoHealth approach to explore impacts of climate change on inuit health.

    Science.gov (United States)

    Harper, S L; Edge, V L; Cunsolo Willox, A

    2012-03-01

    Global climate change and its impact on public health exemplify the challenge of managing complexity and uncertainty in health research. The Canadian North is currently experiencing dramatic shifts in climate, resulting in environmental changes which impact Inuit livelihoods, cultural practices, and health. For researchers investigating potential climate change impacts on Inuit health, it has become clear that comprehensive and meaningful research outcomes depend on taking a systemic and transdisciplinary approach that engages local citizens in project design, data collection, and analysis. While it is increasingly recognised that using approaches that embrace complexity is a necessity in public health, mobilizing such approaches from theory into practice can be challenging. In 2009, the Rigolet Inuit Community Government in Rigolet, Nunatsiavut, Canada partnered with a transdisciplinary team of researchers, health practitioners, and community storytelling facilitators to create the Changing Climate, Changing Health, Changing Stories project, aimed at developing a multi-media participatory, community-run methodological strategy to gather locally appropriate and meaningful data to explore climate-health relationships. The goal of this profile paper is to describe how an EcoHealth approach guided by principles of transdisciplinarity, community participation, and social equity was used to plan and implement this climate-health research project. An overview of the project, including project development, research methods, project outcomes to date, and challenges encountered, is presented. Though introduced in this one case study, the processes, methods, and lessons learned are broadly applicable to researchers and communities interested in implementing EcoHealth approaches in community-based research.

  7. Leading Comorbidity associated with 30-day post-anesthetic mortality in geriatric surgical patients in Taiwan: a retrospective study from the health insurance data

    Directory of Open Access Journals (Sweden)

    Chun-Lin Chu

    2017-10-01

    Full Text Available Abstract Background Elderly patients with aged physical status and increased underlying disease suffered from more postoperative complication and mortality. We design this retrospective cohort study to investigate the relationship between existing comorbidity of elder patients and 30 day post-anesthetic mortality by using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM from Health Insurance Database. Methods Patients aged above 65 years old who received anesthesia between 2000 and 2010 were included from 1 million Longitudinal Health Insurance Database in (LHID 2005 in Taiwan. We use age, sex, type of surgery to calculate propensity score and match death group and survival one with 1:4 ratio (death: survival = 1401: 5823. Multivariate logistic model with stepwise variable selection was employed to investigate the factors affecting death 30 days after anesthesia. Results Thirty seven comorbidities can independently predict the post-anesthetic mortality. In our study, the leading comorbidities predict post-anesthetic mortality is chronic renal disease (OR = 2.806, acute myocardial infarction (OR = 4.58, and intracranial hemorrhage (OR = 3.758. Conclusions In this study, we present the leading comorbidity contributing to the postoperative mortality in elderly patients in Taiwan from National Health Insurance Database. Chronic renal failure is the leading contributing comorbidity of 30 days mortality after anesthesia in Taiwan which can be explained by the great number of hemodialysis and prolong life span under National Taiwan Health Insurance. Large scale database can offer enormous information which can help to improve quality of medical care.

  8. Leading Comorbidity associated with 30-day post-anesthetic mortality in geriatric surgical patients in Taiwan: a retrospective study from the health insurance data.

    Science.gov (United States)

    Chu, Chun-Lin; Chiou, Hung-Yi; Chou, Wei-Han; Chang, Po-Ya; Huang, Yi-You; Yeh, Huei-Ming

    2017-10-24

    Elderly patients with aged physical status and increased underlying disease suffered from more postoperative complication and mortality. We design this retrospective cohort study to investigate the relationship between existing comorbidity of elder patients and 30 day post-anesthetic mortality by using International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) from Health Insurance Database. Patients aged above 65 years old who received anesthesia between 2000 and 2010 were included from 1 million Longitudinal Health Insurance Database in (LHID) 2005 in Taiwan. We use age, sex, type of surgery to calculate propensity score and match death group and survival one with 1:4 ratio (death: survival = 1401: 5823). Multivariate logistic model with stepwise variable selection was employed to investigate the factors affecting death 30 days after anesthesia. Thirty seven comorbidities can independently predict the post-anesthetic mortality. In our study, the leading comorbidities predict post-anesthetic mortality is chronic renal disease (OR = 2.806), acute myocardial infarction (OR = 4.58), and intracranial hemorrhage (OR = 3.758). In this study, we present the leading comorbidity contributing to the postoperative mortality in elderly patients in Taiwan from National Health Insurance Database. Chronic renal failure is the leading contributing comorbidity of 30 days mortality after anesthesia in Taiwan which can be explained by the great number of hemodialysis and prolong life span under National Taiwan Health Insurance. Large scale database can offer enormous information which can help to improve quality of medical care.

  9. Campaigning for a fact-based approach to health journalism.

    Science.gov (United States)

    2017-04-01

    Gary Schwitzer argues that - when it comes to reporting on health and medicine - the news media in the United States of America are often out of touch with the public they purport to serve. He talks to Fiona Fleck.

  10. Community health promotion approaches within institutions for disabled

    DEFF Research Database (Denmark)

    Holm, Jesper

    From a two years study of 3 special educational institutions for disabled in Zealand, Denmark, we have done qualitative studies of the focus-areas that the institutions have pointed out as their Best Practices of Health Promotion in everyday life. We have in general followed research questions......: What practices do special institutions for people with developmental disabilities believe to be health promoting, and will a research based reconstruction of these practices with health promotion concepts have anything to offer for professionals in this area? How will the involved parties experience...... each other practices and is possible to establish a mutual institutional learning process, as a surplus to normal quality control (NPM)? What understandings of psyche, individual, mind-body-spirit, health promotion etc. are involved in these practices, and how do they relate to the institutional...

  11. Health care: development of data for a marketing approach.

    Science.gov (United States)

    Stitt, V J

    1985-06-01

    Marketing in health care is a relatively new process. It is a business tool that can serve a very useful purpose. Health care management has become aware of the usefulness of marketing in long-range planning. Through a well-thought-out marketing plan, the provider will not be leaving the future to chance. A well-conceived, patient-oriented, competitor-aware marketing plan should place the medical practice at a strategic advantage as the health care industry joins other industries in the competitive marketplace for the consumer's dollar.The ever-increasing political and regulatory environment that the health care field is undergoing emphasizes the need for the inclusion of marketing skills, such as cost containment, in the medical curriculum. It should be the obligation of the training facilities as well as medical societies to respond to this need by providing the education that will enable black providers to survive in this competitive environment.

  12. The Good Life: A Holistic Approach to the Health of the Population

    OpenAIRE

    Shahtahmasebi, Said

    2006-01-01

    The idea of a holistic approach towards public health planning presented itself through a food-related and trivial curiosity. It is, however, emphasized that food and nutrition are only one aspect of public health. The aim is to reintroduce a holistic approach to achieve sustainable public health with emphasis on the interpretation of the term “holistic”. Holistic decision making is not a new phenomenon and has historical basis. In line with shifts in social norms, decision making has evolved...

  13. Prioritizing zoonotic diseases in Ethiopia using a one health approach

    Directory of Open Access Journals (Sweden)

    Emily G. Pieracci

    2016-12-01

    Discussion: Multi-sectoral collaborations strengthen disease surveillance system development in humans and animals, enhance laboratory capacity, and support implementation of prevention and control strategies. To facilitate this, the creation of a One Health-focused Zoonotic Disease Unit is recommended. Enhancement of public health and veterinary laboratories, joint outbreak and surveillance activities, and intersectoral linkages created to tackle the prioritized zoonotic diseases will undoubtedly prepare the country to effectively address newly emerging zoonotic diseases.

  14. Approaches to Reducing Federal Spending on Military Health Care

    Science.gov (United States)

    2014-01-01

    medical school, the Uniformed Services University of the Health Sciences (USUHS), while expanding the number of scholarships provided to students... actuaries esti- 8. Department of Defense, Evaluation of the TRICARE Program— Access, Cost and Quality: Fiscal Year 2013 Report to Congress (February...DoD’s Uniformed Services University of the Health Sciences —would be closed. 4. See Congressional Budget Office, Lessons from Medicare’s Demonstration

  15. Reproductive rights approach to reproductive health in developing countries

    Directory of Open Access Journals (Sweden)

    Vijayan K. Pillai

    2011-12-01

    Full Text Available Research on reproductive health in developing countries focuses mostly on the role of economic development on various components of reproductive health. Cross-sectional and empirical research studies in particular on the effects of non-economic factors such as reproductive rights remain few and far between.This study investigates the influence of two components of an empowerment strategy, gender equality, and reproductive rights on women's reproductive health in developing countries. The empowerment strategy for improving reproductive health is theoretically situated on a number of background factors such as economic and social development.Cross-national socioeconomic and demographic data from a number of international organizations on 142 developing countries are used to test a model of reproductive rights and reproductive health.The findings suggest that both economic and democratic development have significant positive effects on levels of gender equality. The level of social development plays a prominent role in promoting reproductive rights. It is found that reproductive rights channel the influences of social structural factors and gender equality on reproductive health.

  16. Reproductive rights approach to reproductive health in developing countries.

    Science.gov (United States)

    Pillai, Vijayan K; Gupta, Rashmi

    2011-01-01

    Research on reproductive health in developing countries focuses mostly on the role of economic development on various components of reproductive health. Cross-sectional and empirical research studies in particular on the effects of non-economic factors such as reproductive rights remain few and far between. This study investigates the influence of two components of an empowerment strategy, gender equality, and reproductive rights on women's reproductive health in developing countries. The empowerment strategy for improving reproductive health is theoretically situated on a number of background factors such as economic and social development. Cross-national socioeconomic and demographic data from a number of international organizations on 142 developing countries are used to test a model of reproductive rights and reproductive health. The findings suggest that both economic and democratic development have significant positive effects on levels of gender equality. The level of social development plays a prominent role in promoting reproductive rights. It is found that reproductive rights channel the influences of social structural factors and gender equality on reproductive health.

  17. Medication therapy disease management: Geisinger's approach to population health management.

    Science.gov (United States)

    Jones, Laney K; Greskovic, Gerard; Grassi, Dante M; Graham, Jove; Sun, Haiyan; Gionfriddo, Michael R; Murray, Michael F; Manickam, Kandamurugu; Nathanson, Douglas C; Wright, Eric A; Evans, Michael A

    2017-09-15

    Pharmacists' involvement in a population health initiative focused on chronic disease management is described. Geisinger Health System has cultivated a culture of innovation in population health management, as highlighted by its ambulatory care pharmacy program, the Medication Therapy Disease Management (MTDM) program. Initiated in 1996, the MTDM program leverages pharmacists' pharmacotherapy expertise to optimize care and improve outcomes. MTDM program pharmacists are trained and credentialed to manage over 16 conditions, including atrial fibrillation (AF) and multiple sclerosis (MS). Over a 15-year period, Geisinger Health Plan (GHP)-insured patients with AF whose warfarin therapy was managed by the MTDM program had, on average, 18% fewer emergency department (ED) visits and 18% fewer hospitalizations per year than GHP enrollees with AF who did not receive MTDM services, with 23% lower annual total care costs. Over a 2-year period, GHP-insured patients with MS whose pharmacotherapy was managed by pharmacists averaged 28% fewer annual ED visits than non-pharmacist-managed patients; however, the mean annual total care cost was 21% higher among MTDM clinic patients. The Geisinger MTDM program has evolved over 20 years from a single pharmacist-run anticoagulation clinic into a large program focused on managing the health of an ever-growing population. Initial challenges in integrating pharmacists into the Geisinger patient care framework as clinical experts were overcome by demonstrating the MTDM program's positive impact on patient outcomes. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  18. Workplace health in dental care - a salutogenic approach.

    Science.gov (United States)

    Lindmark, U; Wagman, P; Wåhlin, C; Rolander, B

    2018-02-01

    The purpose was to explore self-reported psychosocial health and work environments among different dental occupations and workplaces from a salutogenic perspective. A further purpose was to analyse possible associations between three salutogenic measurements: The Sense of Coherence questionnaire (SOC), the Salutogenic Health Indicator Scale (SHIS) and the Work Experience Measurement Scale (WEMS). Employees in the Public Dental Service in a Swedish county council (n = 486) were invited to respond to a self-reported web survey including demographics, work-related factors, the SOC, the SHIS and the WEMS. This study showed positive associations between employee characteristics and self-reported overall psychosocial health as well as experienced work environment. Autonomy was reported more among men than women (P better health (SOC, SHIS) and experienced more autonomy, better management and more positive to reorganization than other dental professions. Dental hygienists and nurses experienced less time pressure than dentists (P ≤ 0.007). Better health and positive work experiences were also seen in smaller clinics (P ≤ 0.29). Dental professionals reported a high degree of overall psychosocial health as well as a positive work experience. Some variations could be seen between employee characteristics such as gender, years in dental care, professionals, managing position and workplace size. Identify resources and processes at each workplace are important and should be included in the employee's/employers dialogue. © 2016 The Authors. International Journal of Dental Hygiene Published by John Wiley & Sons Ltd.

  19. NGO management and health care financing approaches in the Eastern Democratic Republic of the Congo.

    Science.gov (United States)

    Dijkzeul, D; Lynch, C A

    2006-01-01

    The role of cost-sharing in health care is a crucial, yet contentious issue. In conflict situations, cost-sharing becomes even more controversial as health and other institutions are failing. In such situations, NGOs manage health programmes which aim to aid populations in crisis and improve or at least sustain a deteriorating health system. This study looks at the issue of cost-sharing in the wider context of utilization rates and management approaches of three NGOs in the chronic, high-mortality crisis of the eastern DRC. Approaches to increase access to health care were found to exist, yet cost-recovery, even on the basis of maximum utilization rates, would only partially sustain the health system in the eastern DRC. Factors external to the direct management of NGO health programs, such as the wider economic and security situation, local management structures, and international donor policies, need to be taken into account for establishing more integrated management and financing approaches.

  20. Melding Infant Mental Health and Multisystemic Therapy Approaches to Community-Based Treatment

    Science.gov (United States)

    Willoughby, Jay C.; Carubia, Beau A.; Murgolo, Marisa A.; Carter, Debbie R.; Frankel, Karen A.

    2013-01-01

    A recent partnership between the Irving Harris Program in Child Development and Infant Mental Health and the Community Based Psychiatry Program at University of Colorado Hospital joined two different approaches to child mental health treatment: infant mental health and multisystemic therapy (MST). This article illustrates the compatibility of…

  1. The impact of shift work on the psychological and physical health of nurses in a general hospital: a comparison between rotating night shifts and day shifts.

    Science.gov (United States)

    Ferri, Paola; Guadi, Matteo; Marcheselli, Luigi; Balduzzi, Sara; Magnani, Daniela; Di Lorenzo, Rosaria

    2016-01-01

    Shift work is considered necessary to ensure continuity of care in hospitals and residential facilities. In particular, the night shift is one of the most frequent reasons for the disruption of circadian rhythms, causing significant alterations of sleep and biological functions that can affect physical and psychological well-being and negatively impact work performance. The aim of this study was to highlight if shift work with nights, as compared with day work only, is associated with risk factors predisposing nurses to poorer health conditions and lower job satisfaction. This cross-sectional study was conducted from June 1, 2015 to July 31, 2015 in 17 wards of a general hospital and a residential facility of a northern Italian city. This study involved 213 nurses working in rotating night shifts and 65 in day shifts. The instrument used for data collection was the "Standard Shift Work Index," validated in Italian. Data were statistically analyzed. The response rate was 86%. The nurses engaged in rotating night shifts were statistically significantly younger, more frequently single, and had Bachelors and Masters degrees in nursing. They reported the lowest mean score in the items of job satisfaction, quality and quantity of sleep, with more frequent chronic fatigue, psychological, and cardiovascular symptoms in comparison with the day shift workers, in a statistically significant way. Our results suggest that nurses with rotating night schedule need special attention due to the higher risk for both job dissatisfaction and undesirable health effects.

  2. The Case for "Environment in All Policies": Lessons from the "Health in All Policies" Approach in Public Health.

    Science.gov (United States)

    Browne, Geoffrey R; Rutherfurd, Ian D

    2017-02-01

    Both public health, and the health of the natural environment, are affected by policy decisions made across portfolios as diverse as finance, planning, transport, housing, education, and agriculture. A response to the interdependent character of public health has been the "health in all policies" (HiAP) approach. With reference to parallels between health and environment, this paper argues that lessons from HiAP are useful for creating a new integrated environmental management approach termed "environment in all polices" (EiAP). This paper covers the theoretical foundations of HiAP, which is based on an understanding that health is strongly socially determined. The paper then highlights how lessons learned from HiAP's implementation in Finland, California, and South Australia might be applied to EiAP. It is too early to learn from evaluations of HiAP, but it is apparent that there is no single tool kit for its application. The properties that are likely to be necessary for an effective EiAP approach include a jurisdiction-specific approach, ongoing and strong leadership from a central agency, independent analysis, and a champion. We then apply these properties to Victoria (Australia) to demonstrate how EiAP might work. We encourage further exploration of the feasibility of EiAP as an approach that could make explicit the sometimes surprising environmental implications of a whole range of strategic policies. Citation: Browne GR, Rutherfurd ID. 2017. The case for "environment in all policies": lessons from the "health in all policies" approach in public health. Environ Health Perspect 125:149-154; http://dx.doi.org/10.1289/EHP294.

  3. Security and privacy preserving approaches in the eHealth clouds with disaster recovery plan.

    Science.gov (United States)

    Sahi, Aqeel; Lai, David; Li, Yan

    2016-11-01

    Cloud computing was introduced as an alternative storage and computing model in the health sector as well as other sectors to handle large amounts of data. Many healthcare companies have moved their electronic data to the cloud in order to reduce in-house storage, IT development and maintenance costs. However, storing the healthcare records in a third-party server may cause serious storage, security and privacy issues. Therefore, many approaches have been proposed to preserve security as well as privacy in cloud computing projects. Cryptographic-based approaches were presented as one of the best ways to ensure the security and privacy of healthcare data in the cloud. Nevertheless, the cryptographic-based approaches which are used to transfer health records safely remain vulnerable regarding security, privacy, or the lack of any disaster recovery strategy. In this paper, we review the related work on security and privacy preserving as well as disaster recovery in the eHealth cloud domain. Then we propose two approaches, the Security-Preserving approach and the Privacy-Preserving approach, and a disaster recovery plan. The Security-Preserving approach is a robust means of ensuring the security and integrity of Electronic Health Records, and the Privacy-Preserving approach is an efficient authentication approach which protects the privacy of Personal Health Records. Finally, we discuss how the integrated approaches and the disaster recovery plan can ensure the reliability and security of cloud projects. Copyright © 2016 Elsevier Ltd. All rights reserved.

  4. SOCIAL MARKETING : A NEW APPROACH IN MENTAL HEALTH RESEARCH

    Science.gov (United States)

    Tiwari, S.C.

    1998-01-01

    Social marketing has a proven role in marketing and many manufacturing establishments/ organizations have been marketing their products incorporating social marketing research. Social marketing has its root in the ground fact that the perceptions and expectations of the consumers are important in influencing buying behaviour. The principles of social marketing, therefore, have been extensively utilized in the areas of consumer products. These are also used in several other fields for modifying behaviours such as civil administration, public establishments etc. In health sector social marketing has not found appropriate application whereas it could be utilized in an effective way for creating awareness, formulating health related policies, their implementation and for preventing a variety of illnesses/abnormal behaviours etc. With this background knowledge about social marketing, the author hypothesized that abnormal behaviours could be modified, health education packages could be developed to make more acceptable and effective and desired behaviours could be induced if perceptions and expectations of the community (consumers) are known a prioriori and their expectations are incorporated in programmes and policies. Thus, the author utilizing the concepts of social marketing for understanding community′s perceptions and expectations regarding issues of health, and for incorporating the same in health related programmes and policies, introduced this research concept in medical field in this country. The important findings of three research projects based on the concepts of social marketing research and their implications have been discussed. PMID:21494494

  5. Approach to evaluating health level and adaptation possibilities in schoolchildren

    Directory of Open Access Journals (Sweden)

    O.V. Andrieieva

    2014-02-01

    Full Text Available Purpose: substantiate the results of theoretical and practical investigations aimed at improving the health of students. Material: the study involved 187 children including 103 boys and 84 girls aged 7-10 years. Results: through a rapid assessment of physical health it was found that pupils of primary school age have an average level of the functional state of the organism, with a minimum resistance to risk factors (chronic non-infective diseases, etc.. For the first time, a technique for determining the level of adaptation and reserve capacity of school students proposed by Ukrainian hygienists was used in physical culture and sports practice. Conclusions: the technique reveals strain in adaptation mechanisms that corresponds to donozological condition. An idea is proposed that Nordic walking, through the positive impact on the body of aerobic mode of energy supply, is able to increase the reserve-adaptive capabilities of primary school students by improvement of their health as well as to solve the problems of health formation and health care in the physical education of youth.

  6. Effects of 10,000 steps a day on physical and mental health in overweight participants in a community setting: a preliminary study

    Directory of Open Access Journals (Sweden)

    Kornanong Yuenyongchaiwat

    2016-01-01

    Full Text Available ABSTRACT Background Being overweight is associated not only with physical health problems, but also with risk of mental health problems. Increased physical activity (PA has been recommended for the prevention of cardiovascular disease; however, little is known about the effect of walking on physical and mental health outcomes. Objective The purpose of the study was to explore the effectiveness of a pedometer-based PA intervention on physical and mental health states. Method Thirty-five overweight participants with body mass index (BMI ≥25 kg•m–2 were selected and assigned to a 12-week pedometer-based walking program (10,000 steps•d–1. The profile of mood states, BMI, waist circumference (WC, body fat percentage (%BF, and lean body mass (LBM were measured before and after the 12-week intervention. The number of step counts was recorded 5 days a week in a diary booklet. Results The 30 participants who accumulated 10,000 steps•d–1 had significantly lower anxiety, depression, anger, fatigue, confusion, and total mood distress scores compared with measurements taken prior to the intervention. Further, the participants had higher vigor scores compared to baseline. Regarding physical health, the participants who accrued 10,000 steps a day had significantly lower body weight, WC, BMI, and %BP. After adjustment for gender, height, and daily steps at follow-up, changes in WC were negatively associated with depression, fatigue, confusion, and total mood distress. Conclusions An increase in PA by accumulating at least 10,000 steps•d–1 over a 12-week period improves physical and mood states in sedentary, overweight individuals.

  7. Effects of 10,000 steps a day on physical and mental health in overweight participants in a community setting: a preliminary study.

    Science.gov (United States)

    Yuenyongchaiwat, Kornanong

    2016-01-01

    Being overweight is associated not only with physical health problems, but also with risk of mental health problems. Increased physical activity (PA) has been recommended for the prevention of cardiovascular disease; however, little is known about the effect of walking on physical and mental health outcomes. The purpose of the study was to explore the effectiveness of a pedometer-based PA intervention on physical and mental health states. Thirty-five overweight participants with body mass index (BMI) ≥25 kg•m-2 were selected and assigned to a 12-week pedometer-based walking program (10,000 steps•d-1). The profile of mood states, BMI, waist circumference (WC), body fat percentage (%BF), and lean body mass (LBM) were measured before and after the 12-week intervention. The number of step counts was recorded 5 days a week in a diary booklet. The 30 participants who accumulated 10,000 steps•d-1 had significantly lower anxiety, depression, anger, fatigue, confusion, and total mood distress scores compared with measurements taken prior to the intervention. Further, the participants had higher vigor scores compared to baseline. Regarding physical health, the participants who accrued 10,000 steps a day had significantly lower body weight, WC, BMI, and %BP. After adjustment for gender, height, and daily steps at follow-up, changes in WC were negatively associated with depression, fatigue, confusion, and total mood distress. An increase in PA by accumulating at least 10,000 steps•d-1 over a 12-week period improves physical and mood states in sedentary, overweight individuals.

  8. An innovative approach study “Health students example”

    Directory of Open Access Journals (Sweden)

    Akyurt Nuran

    2017-01-01

    Full Text Available Globalization; A process of international integration arising from the exchange of products, ideas, cultures and worldviews. Globalization is an economic as well as political, technological and cultural process. As in other areas, technological developments have brought innovations into the training of health care workers, as well as access to information and the use of this information. These developments necessitated new orientations in the education systems of health students. In this study, the effects of computer assisted instructions involving the topics of medical and vocational terminology course on the attitudes and academic achievement levels of students’ use of medical and vocational terms were investigated. Marmara University Health Services Vocational School Medical Imaging students constitute the sample of the research. In the experimental group, medical and vocational terminology topics were processed and tested by computer aided instruction method for 12 weeks.

  9. INNOVATIVE APPROACH IN THE COMPULSORY HEALTH INSURANCE TARIFF SETTING

    Directory of Open Access Journals (Sweden)

    M. Yu. Zasypkin

    2015-02-01

    Full Text Available Development of a single channel financing in the health system of the Russian Federation based on the standards of the compulsory health insurance (CHI requires a single channel financing of the health system through the CHI as one of the main direction using payment of the medical services in the form of so-called «full» tariff [1-12].It is not a secret that for many years the medical services tariff in the CHI system contained from only five items of expenditures (salary, charges on payroll, soft goods and clothing, medicines, bandages, other medical expenses, and food. On one hand, such defective tariff was based on the parallel government financing of the medical institutions (MIs, on the other hand, because of this tariff, the manager was hoppled in the control of the financial flows.

  10. Risk factor investigation for cardiovascular health through WHO STEPS approach in Ardabil, Iran

    Directory of Open Access Journals (Sweden)

    Mashadi-Abdollahi H

    2011-07-01

    Full Text Available H Sadeghi-Bazargani1,2, H Jafarzadeh3, M Fallah4, S Hekmat3, J Bashiri3, GH Hosseingolizadeh3, MS Soltanmohammadzadeh3, A Mortezazadeh3, A Shaker3, M Danehzan3, A Zohouri3, O Khosravi3, R Nasimidoust3, N Malekpour3, E Kharazmi4, M Babaei3, M Nadirmohammadi3, H Mashhadi-Abdollahi51Neuroscience Research Center, 2Statistics and Epidemiology Department, Faculty of Health and Nutrition, Tabriz University of Medical Sciences, Tabriz, Iran; 3Public Health Department, Ardabil University of Medical Sciences, Ardabil, Iran; 4Tampere School of Public Health, University of Tampere, Tampere, Finland; 5National Public Health Management Center (NPMC, Tabriz University of Medical Sciences, Tabriz, IranObjectives: Reliable evidence is the keystone for any noncommunicable disease (NCD prevention plan to be initiated. In this study we carried out a risk factor investigation based on the WHO Stepwise approach to Surveillance (STEPS.Methods: The study was conducted out on 1000 adults between 15 and 64 years of age living in Ardabil province, north-west Iran during 2006, based on the WHO STEPS approach to surveillance of risk factors for NCD. At this stage only the first and second steps were carried out. Data were collected through standard questionnaires and methods analyzed using STATA version 8 statistical software package.Results: 29.0% of men and 2.6% of women were current daily tobacco smokers. The mean number of manufactured cigarettes smoked per day was 18.9 among current daily smokers. Smoking was most prevalent among men of low-income families and those of lower education. The mean body mass index (BMI was 26.6 kg/m2, and was significantly correlated with systolic blood pressure. 58.9% were overweight or obese; 18.0% had raised blood pressure and 3.7% had isolated systolic hypertension. The mean number of servings of fruit consumed per day was 1.1; 33.1% had low levels of activity. Combined risk factor analysis showed that 4.1% of participants were in the

  11. The Anthropological Cinema and Approach the Health of Indigenous Folk

    Directory of Open Access Journals (Sweden)

    Diana Milena BERRÍO CUARTAS

    2017-03-01

    Full Text Available The article aims to address the concept of anthropological or ethnographic cinema and its relevance in Latin America. As an example of anthropological cinema has been chosen Gerónima, Argentina film, directed by Raul Tosso, released in 1986 and based on the book by psychiatrist Jorge Luis Pellegrini. Gerónima relate the story of an Indian family intervened by a team of public health. The objectives are to present some ways of exploring cultural diversity in the film industry and analyze how health and preventive and curative interventions in different socio?cultural contexts values.

  12. An approach to tackle visual display unit user health problems

    International Nuclear Information System (INIS)

    McCallum, H.M.; Heaton, B.

    1992-01-01

    Reported health hazards from video display units (VDUs) vary from headaches to miscarriage and there is some concern that health problems experienced by VDU users could be associated with extra-low-frequency (ELF) electromagnetic field emissions. While investigating an individual case of 'VDU Syndrome' a procedure was developed which could be used to investigate and evaluate other complaints of a similar type. A relationship between the number of hours monitor work and severity of symptoms was observed along with a cyclic nature to the operator's sensitivity to VDU work. (author)

  13. Innovative approaches for improving maternal and newborn health--A landscape analysis.

    Science.gov (United States)

    Lunze, Karsten; Higgins-Steele, Ariel; Simen-Kapeu, Aline; Vesel, Linda; Kim, Julia; Dickson, Kim

    2015-12-17

    Essential interventions can improve maternal and newborn health (MNH) outcomes in low- and middle-income countries, but their implementation has been challenging. Innovative MNH approaches have the potential to accelerate progress and to lead to better health outcomes for women and newborns, but their added value to health systems remains incompletely understood. This study's aim was to analyze the landscape of innovative MNH approaches and related published evidence. Systematic literature review and descriptive analysis based on the MNH continuum of care framework and the World Health Organization health system building blocks, analyzing the range and nature of currently published MNH approaches that are considered innovative. We used 11 databases (MedLine, Web of Science, CINAHL, Cochrane, Popline, BLDS, ELDIS, 3ie, CAB direct, WHO Global Health Library and WHOLIS) as data source and extracted data according to our study protocol. Most innovative approaches in MNH are iterations of existing interventions, modified for contexts in which they had not been applied previously. Many aim at the direct organization and delivery of maternal and newborn health services or are primarily health workforce interventions. Innovative approaches also include health technologies, interventions based on community ownership and participation, and novel models of financing and policy making. Rigorous randomized trials to assess innovative MNH approaches are rare; most evaluations are smaller pilot studies. Few studies assessed intervention effects on health outcomes or focused on equity in health care delivery. Future implementation and evaluation efforts need to assess innovations' effects on health outcomes and provide evidence on potential for scale-up, considering cost, feasibility, appropriateness, and acceptability. Measuring equity is an important aspect to identify and target population groups at risk of service inequity. Innovative MNH interventions will need innovative

  14. Mapping of health facilities in Jimeta Metropolis: a digital approach ...

    African Journals Online (AJOL)

    In planning for any suitable development in any field, the primary requirement is the relevant data and maps. This is one of the major problems hindering the proper planning and monitoring of the various health facilities located in Jimeta metropolis. Survey techniques -were employed for the acquisition of data, GPS was ...

  15. Innovative Approaches to Task Shifting in Mental Health | IDRC ...

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

    Across the world, it is estimated that mental disorders account for 12% of disability-adjusted life years. This proportion is still increasing and projected to reach 15% by 2020. However, provision of mental health services has not matched the need, especially in low-income countries where it is estimated that 90% of people ...

  16. The Public Health Approach to Campus Suicide Prevention

    Science.gov (United States)

    Jodoin, Elizabeth C.; Robertson, Jason

    2013-01-01

    The perception that college students are coming to campus with more severe psychological concerns than in the past has been empirically supported on college campuses (Benton and others, 2003). Approximately 20 percent of all adolescents have a diagnosable mental health disorder (Kessler and others, 2005), many of which then continue on to college…

  17. Governance Analytical Framework : an Approach to Health Systems ...

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

    Researchers will develop and test a methodology - Governance Analytical Framework - for analyzing and assessing the influence of governance pattern on health ... IDRC and the São Paulo Research Foundation (FAPESP) signed a scientific and technological cooperation agreement to support joint research projects in ...

  18. [Assessment and prevention of zoonoses: "one health approach"].

    Science.gov (United States)

    Bonizzi, Luigi; Guarino, Marcella; Roncada, Paola; Colosio, Claudio

    2013-01-01

    Zoonotic pathologies represent diseases that can be transmittable from animals to humans and vice versa. In most cases zoonotic agents are bacteria or viruses and represent a huge problem for health. Zoonosis could represent easily solvable diseases such as simple infections or even deathly such as prion infections. They could be directly transmittable as tuberculosis or brucellosis or indirectly transmittable through vectors as biological fluids or foods from animal production. The increasing production and the globalization of animal food production have caused the spread of zoonosis worldwide turning this topic into a global problem. It is necessary to enforce the actual scientific collaboration between all countries in order to counteract the spread of these pathologies. About this topic WHO, FAO and OIE took part to the world project "one health" highlighting as most important topics the research on Rabies virus, influenza virus and on antibiotic resistance. In particular antibiotic resistance represents one of the most important topics of the last decade due to the inappropriate use of antibiotics, from animal production to human health. This last topic represents a serious problem for health system worldwide. This paper is mainly based on zoonoses such as avian flu, BSE and brucellosis and will describe the strategies used to limit their expansion.

  19. in_focus - Health: An Ecosystem Approach | CRDI - Centre de ...

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

    Côte d'Ivoire | Kenya | Brazil | Ecuador (Pesticides) | India | Ethiopia | Nepal | Mexico (Air Pollution) | Mexico (Malaria) | Cuba | Chile | Ecuador (Mining). Ecohealth Works Series: Agricultural Transformation · Environmental Pollution · Health in Urban Environments · Infectious Diseases. Lasting Impacts: Ecohealth: Improving ...

  20. Mixed-methods approaches in health research in Nepal

    OpenAIRE

    Simkhada, Padam; Van Teijlingen, Edwin; Wasti, Sharada Prasad; Sathian, B.

    2014-01-01

    Combining and integrating a mixture of qualitative and quantitative methods in one single study is widely used in health and social care research in high-income countries. This editorial adds a few words of advice to the novice mixed-methods researcher in Nepal.

  1. Type 2 Diabetes: Primary Health Care Approach for Prevention ...

    African Journals Online (AJOL)

    Although there is no evidence of benefit in health outcomes from large-scale population screening for impaired glucose tolerance (IGT) or impaired fasting glucose (IFG), screening of high-risk individuals has merit. During prolonged periods of dysglycaemia that precede diabetes, individuals remain largely asymptomatic.

  2. A predictive analytics approach to reducing 30-day avoidable readmissions among patients with heart failure, acute myocardial infarction, pneumonia, or COPD.

    Science.gov (United States)

    Shams, Issac; Ajorlou, Saeede; Yang, Kai

    2015-03-01

    Hospital readmission has become a critical metric of quality and cost of healthcare. Medicare anticipates that nearly $17 billion is paid out on the 20 % of patients who are readmitted within 30 days of discharge. Although several interventions such as transition care management have been practiced in recent years, the effectiveness and sustainability depends on how well they can identify patients at high risk of rehospitalization. Based on the literature, most current risk prediction models fail to reach an acceptable accuracy level; none of them considers patient's history of readmission and impacts of patient attribute changes over time; and they often do not discriminate between planned and unnecessary readmissions. Tackling such drawbacks, we develop a new readmission metric based on administrative data that can identify potentially avoidable readmissions from all other types of readmission. We further propose a tree-based classification method to estimate the predicted probability of readmission that can directly incorporate patient's history of readmission and risk factors changes over time. The proposed methods are validated with 2011-12 Veterans Health Administration data from inpatients hospitalized for heart failure, acute myocardial infarction, pneumonia, or chronic obstructive pulmonary disease in the State of Michigan. Results shows improved discrimination power compared to the literature (c-statistics >80 %) and good calibration.

  3. Health Effects of Digital Textbooks on School-Age Children: A Grounded Theory Approach

    OpenAIRE

    Seomun, GA; Lee, JA; Kim, EY; Im, MY; Kim, M; Park, SA; Lee, Y

    2013-01-01

    This qualitative study used the grounded theory approach to analyze digital textbook-related health experiences of school-age children. In-depth interviews were held with 40 elementary school students who had used digital textbooks for at least a year. Data analysis revealed a total of 56 concepts, 20 subcategories, and 11 categories related to digital textbook health issues, the central phenomena being "health-related experiences." Students' health-related experiences were classified into "p...

  4. [The systemic approach to the health protection in the workers of industrial enterprises].

    Science.gov (United States)

    Oransky, I E; Razumov, A N; Fedorov, A A

    This paper presents the results of the systemic approach to the protection of health and prophylaxis of disability in the workers of industrial enterprises. The leading role in the technologies of rehabilitation (both short-term and long-term one) is played by the natural and physical therapeutic factors. The priority in the implementation of the therapeutic and health-promoting measures is given to the treatment based on the spa and health resort facilities as well as the factory health centers.

  5. Multiple approaches to understanding and preventing elder abuse: Introduction to the cross-disciplinary National Institutes of Health workshop.

    Science.gov (United States)

    Saylor, Katherine Witte

    2016-01-01

    On October 30, 2015, the National Institutes of Health (NIH) convened a workshop, "Multiple Approaches to Understanding and Preventing Elder Abuse," in Bethesda, Maryland. The workshop brought together experts from across disciplines to discuss research challenges, opportunities, and lessons learned from other fields. Participants included experts in elder abuse, child abuse, intimate partner violence (IPV), emergency medicine, and neuroscience. In this special issue of the Journal of Elder Abuse and Neglect, participants address topics explored before, during, and after the day-long workshop.

  6. Complex families, the social determinants of health and psychosocial interventions: Deconstruction of a day in the life of hospital social workers.

    Science.gov (United States)

    Muskat, Barbara; Craig, Shelley L; Mathai, Biju

    2017-09-01

    The roles of hospital social workers are delineated in the literature; however, their daily interventions have only been described anecdotally. This study analyzes the daily work of social workers in a pediatric hospital through a survey completed which examined factors related to interventions utilized and time spent per case over a 1-day period. Length and types of interventions were associated with the social determinants of health, time since diagnosis, biopsychosocial issues, and perception of complexity. The study offers a snapshot of the personalized expertise, provided by social workers that addresses complex contextual and biopsychosocial concerns of patient and families.

  7. Inclusion of the equity focus and social determinants of health in health care education programmes in Colombia: a qualitative approach.

    Science.gov (United States)

    Hernández-Rincón, Erwin H; Pimentel-González, Juan P; Orozco-Beltrán, Domingo; Carratalá-Munuera, Concepción

    2016-06-01

    The Pan American Health Organization (PAHO) and the Colombian Ministry of Health and Social Protection have determined a need for an approach to include Equity Focus (EF) and Social Determinants of Health (SDH) in health training programmes in Colombia. We studied the incorporation of EF and SDH in the curricula of several universities in Colombia to identify opportunities to strengthen their inclusion. Qualitative methodology was performed in two stages: (i) initial exploration (self-administered questionnaires and review of curricula) and (ii) validation of the information (semi-structured interviews). The inclusion of the EF and SDH in university curricula is regarded as an opportunity to address social problems. This approach addresses a broad cross-section of the curriculum, especially in the subjects of public health and Primary Health Care (PHC), where community outreach generates greater internalization by students. The dominance of the biomedical model of study plans and practice scenarios focusing on disease and little emphasis on community outreach are factors that limit the inclusion of the approach. The inclusion of EF and SDH in university curricula in Colombia has primarily focused on increasing the knowledge of various subjects oriented towards understanding the social dynamics or comprehensiveness of health and disease and, in some programmes, through practical courses in community health and PHC. Increased integration of EF and SDH in subjects or modules with clinical orientation is recommended. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  8. Gesundes Kinzigtal Integrated Care: improving population health by a shared health gain approach and a shared savings contract

    Directory of Open Access Journals (Sweden)

    H. Hildebrandt

    2010-06-01

    Full Text Available Introduction: Integrated care solutions need supportive financial incentives. In this paper we describe the financial architecture and operative details of the integrated pilot Gesundes Kinzigtal.Description of integrated care case: Located in Southwest Germany, Gesundes Kinzigtal is one of the few population-based integrated care approaches in Germany, organising care across all health service sectors and indications. The system serving around half of the population of the region is run by a regional health management company (Gesundes Kinzigtal GmbH in coope­ration with the physicians' network in the region (MQNK, a German health care management company with a background in medical sociology and health economics (OptiMedis AG and with two statutory health insurers (among them is the biggest health insurer in Southwest Germany: AOK Baden-Württemberg.Discussion and (preliminary conclusion: The shared savings contract between Gesundes Kinzigtal GmbH and the two health insurers, providing financial incentives for managers and health care providers to realize a sub­stantial efficiency gain, could be an appropriate contractual base of Gesundes Kinzigtal's population health gain approach. This approach is based on the assumption that a more effective trans-sector organisation of Germany's health care system and increased investments in well-designed preventive programmes will lead to a reduction in  morbidity, and in particular to a reduced incidence and prevalence of chronic diseases. This, in turn, is to lead to a comparative reduction in health care cost. Although the comparative cost in the Kinzigtal region has been reduced from the onset of Gesundes Kinzigtal Integrated Care, only future research will have to demonstrate whether - and to what extent - cost reduction may be attributed to a real population health gain.

  9. Gesundes Kinzigtal Integrated Care: improving population health by a shared health gain approach and a shared savings contract

    Directory of Open Access Journals (Sweden)

    H. Hildebrandt

    2010-06-01

    Full Text Available Introduction: Integrated care solutions need supportive financial incentives. In this paper we describe the financial architecture and operative details of the integrated pilot 'Gesundes Kinzigtal'. Description of integrated care case: Located in Southwest Germany, 'Gesundes Kinzigtal' is one of the few population-based integrated care approaches in Germany, organising care across all health service sectors and indications. The system serving around half of the population of the region is run by a regional health management company (Gesundes Kinzigtal GmbH in coope­ration with the physicians' network in the region (MQNK, a German health care management company with a background in medical sociology and health economics (OptiMedis AG and with two statutory health insurers (among them is the biggest health insurer in Southwest Germany: AOK Baden-Württemberg. Discussion and (preliminary conclusion: The shared savings contract between Gesundes Kinzigtal GmbH and the two health insurers, providing financial incentives for managers and health care providers to realize a sub­stantial efficiency gain, could be an appropriate contractual base of Gesundes Kinzigtal's population health gain approach. This approach is based on the assumption that a more effective trans-sector organisation of Germany's health care system and increased investments in well-designed preventive programmes will lead to a reduction in  morbidity, and in particular to a reduced incidence and prevalence of chronic diseases. This, in turn, is to lead to a comparative reduction in health care cost. Although the comparative cost in the Kinzigtal region has been reduced from the onset of Gesundes Kinzigtal Integrated Care, only future research will have to demonstrate whether - and to what extent - cost reduction may be attributed to a real population health gain.

  10. Developing an evidence-based approach to Public Health Nutrition: translating evidence into policy.

    Science.gov (United States)

    Margetts, B; Warm, D; Yngve, A; Sjöström, M

    2001-12-01

    The aim of this paper is to highlight the importance of an evidence-based approach to the development, implementation and evaluation of policies aimed at improving nutrition-related health in the population. Public Health Nutrition was established to realise a population-level approach to the prevention of the major nutrition-related health problems world-wide. The scope is broad and integrates activity from local, national, regional and international levels. The aim is to inform and develop coherent and effective policies that address the key rate-limiting steps critical to improving nutrition-related public health. This paper sets out the rationale for an evidence-based approach to Public Health Nutrition developed under the umbrella of the European Network for Public Health Nutrition.

  11. Understanding men's health and illness: a gender-relations approach to policy, research, and practice.

    Science.gov (United States)

    Schofield, T; Connell, R W; Walker, L; Wood, J F; Butland, D L

    2000-05-01

    Men's health has emerged as an important public concern that may require new kinds of healthcare interventions and increased resources. Considerable uncertainty and confusion surround prevailing understandings of men's health, particularly those generated by media debate and public policy, and health research has often operated on oversimplified assumptions about men and masculinity. A more useful way of understanding men's health is to adopt a gender-relations approach. This means examining health concerns in the context of men's and women's interactions with each other, and their positions in the larger, multidimensional structure of gender relations. Such an approach raises the issue of differences among men, which is a key issue in recent research on masculinity and an important health issue. The gender-relations approach offers new ways of addressing practical issues of healthcare for men in college environments.

  12. Pushing the boundaries of research on human resources for health: fresh approaches to understanding health worker motivation.

    Science.gov (United States)

    Bhatnagar, Aarushi; Scott, Kerry; Govender, Veloshnee; George, Asha

    2018-04-01

    A country's health workforce plays a vital role not only in serving the health needs of the population but also in supporting economic prosperity. Moreover, a well-funded and well-supported health workforce is vital to achieving universal health coverage and Sustainable Development Goal 3 to ensure healthy lives and promote well-being for all at all ages. This perspective article highlights the potential of underutilized health policy and systems research (HPSR) approaches for developing more effective human resources for health policy. The example of health worker motivation is used to showcase four types of HPSR (exploratory, influence, explanatory and emancipatory) that move beyond describing the extent of a problem. Most of the current literature aiming to understand determinants and dynamics of motivation is descriptive in nature. While this is an important basis for all research pursuits, it often gives little information about mechanisms to improve motivation and strategies for intervention. Motivation is an essential determinant of health worker performance, particularly for those working in difficult conditions, such as those facing many health workers in low- and middle-income countries. Motivation mediates health workforce performance in multiple ways: internally governing health worker behaviour; informing decisions on becoming a health worker; workplace location and ability to perform; and influencing willingness to engage politically. The four fresh research approaches described can help policy-makers better understand why health workers behave the way they do, how interventions can improve performance, the mechanisms that lead to change, and strategies for empowering health workers to be agents of change themselves.

  13. Family characteristics and health behaviour as antecedents of school nurses' concerns about adolescents' health and development: a path model approach.

    Science.gov (United States)

    Poutiainen, Hannele; Levälahti, Esko; Hakulinen-Viitanen, Tuovi; Laatikainen, Tiina

    2015-05-01

    Family socio-economic factors and parents' health behaviours have been shown to have an impact on the health and well-being of children and adolescents. Family characteristics have also been associated with school nurses' concerns, which arose during health examinations, about children's and adolescents' physical health and psychosocial development. Parental smoking has also been associated with smoking in adolescents. The aim of this study was to determine to what extent school nurses' concerns about adolescents' physical health and psychosocial development related to family characteristics are mediated through parents' and adolescents' own health behaviours (smoking). A path model approach using cross-sectional data was used. In 2008-2009, information about health and well-being of adolescents was gathered at health examinations of the Children's Health Monitoring Study. Altogether 1006 eighth and ninth grade pupils in Finland participated in the study. The associations between family characteristics, smoking among parents and adolescents and school nurses' concerns about adolescents' physical health and psychosocial development were examined using a structural equation model. Paternal education had a direct, and, through fathers' and boys' smoking, an indirect association with school nurses' concerns about the physical health of boys. Paternal labour market status and family income were only indirectly associated with concerns about the physical health of boys by having an effect on boys' smoking through paternal smoking, and a further indirect effect on concerns about boys' health. In girls, only having a single mother was strongly associated with school nurses' concerns about psychosocial development through maternal and adolescent girl smoking. Socio-economic family characteristics and parental smoking influence adolescent smoking and are associated with school nurses' concerns about adolescents' physical health and psychosocial development. The findings

  14. The Biopsychosocial-Digital Approach to Health and Disease: Call for a Paradigm Expansion.

    Science.gov (United States)

    Ahmadvand, Alireza; Gatchel, Robert; Brownstein, John; Nissen, Lisa

    2018-05-18

    Digital health is an advancing phenomenon in modern health care systems. Currently, numerous stakeholders in various countries are evaluating the potential benefits of digital health solutions at the individual, population, and/or organizational levels. Additionally, driving factors are being created from the customer-side of the health care systems to push health care providers, policymakers, or researchers to embrace digital health solutions. However, health care providers may differ in their approach to adopt these solutions. Health care providers are not assumed to be appropriately trained to address the requirements of integrating digital health solutions into daily everyday practices and procedures. To adapt to the changing demands of health care systems, it is necessary to expand relevant paradigms and to train human resources as required. In this article, a more comprehensive paradigm will be proposed, based on the 'biopsychosocial model' of assessing health and disease, originally introduced by George L Engel. The "biopsychosocial model" must be leveraged to include a "digital" component, thus suggesting a 'biopsychosocial-digital' approach to health and disease. Modifications to the "biopsychosocial" model and transition to the "biopsychosocial-digital" model are explained. Furthermore, the emerging implications of understanding health and disease are clarified pertaining to their relevance in training human resources for health care provision and research. ©Alireza Ahmadvand, Robert Gatchel, John Brownstein, Lisa Nissen. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 18.05.2018.

  15. The common risk factor approach: a rational basis for promoting oral health.

    Science.gov (United States)

    Sheiham, A; Watt, R G

    2000-12-01

    Conventional oral health education is not effective nor efficient. Many oral health programmes are developed and implemented in isolation from other health programmes. This often leads, at best to a duplication of effort, or worse, conflicting messages being delivered to the public. In addition, oral health programmes tend to concentrate on individual behaviour change and largely ignore the influence of socio-political factors as the key determinants of health. Based upon the general principles of health promotion this paper presents a rationale for an alternative approach for oral health policy. The common risk factor approach addresses risk factors common to many chronic conditions within the context of the wider socio-environmental milieu. Oral health is determined by diet, hygiene, smoking, alcohol use, stress and trauma. As these causes are common to a number of other chronic diseases, adopting a collaborative approach is more rational than one that is disease specific. The common risk factor approach can be implemented in a variety of ways. Food policy development and the Health Promoting Schools initiative are used as examples of effective ways of promoting oral health.

  16. REGIONAL DIFFERENCES IN ATTITUDES THAT MAY AFFECT HEALTH BEHAVIOR AND WILLINGNESS TO PARTICIPATE IN RESEARCH AMONG BLACK SEVENTH-DAY ADVENTISTS

    Science.gov (United States)

    Lampkin, Andy; Yancey, Antronette; Wilson, Colwick; Fraser, Gary E.

    2012-01-01

    Objective To identify the attitudes and perceptions of Black Seventh-day Adventists regarding health research and the healthcare system in two regions of the United States. Design Church members were selected from those who participated in the Adventist Health Study-2 (AHS-2) and those who chose not to participate. Participants were selected from two regions of the United States. Setting Participants were interviewed in their churches, in their homes, and in the research study office at Loma Linda University. Interviews were done in the Western and Southern regions of the United States. Participants 384 Black Seventh-day Adventists, aged >30 years. Main Outcome Measures Responses to the structured interviews from those in the Western region were compared to those in the Southern region. Results Those in the Southern region included more elderly subjects; they were more likely to own their home despite earning less; and were more likely to be married. Compared to the Western region participants, we found Southern participants to have greater participation in church activities, greater mistrust of the healthcare system and particular concerns about racial inequalities in care. In contrast, they also reported more positive experiences with their personal healthcare provider than Western participants. Southerners felt that they had greater control over their own health, perhaps in part due to a greater identification with the health teachings of the Adventist church. Conclusions A number of clear differences were found between Black Adventist subjects living in either the Western or Southern regions of the United States. These factors should be considered carefully when planning the promotion for a research study. PMID:20073146

  17. Regional differences in attitudes that may affect health behavior and willingness to participate in research among Black Seventh-day Adventists.

    Science.gov (United States)

    Lampkin, Andy; Yancey, Antronette; Wilson, Colwick; Fraser, Gary E

    2009-01-01

    To identify the attitudes and perceptions of Black Seventh-day Adventists regarding health research and the healthcare system in two regions of the United States. Church members were selected from those who participated in the Adventist Health Study-2 (AHS-2) and those who chose not to participate. Participants were selected from two regions of the United States. Participants were interviewed in their churches, in their homes, and in the research study office at Loma Linda University. Interviews were done in the Western and Southern regions of the United States. 384 Black Seventh-day Adventists, aged >30 years. Responses to the structured interviews from those in the Western region were compared to those in the Southern region. Those in the Southern region included more elderly subjects; they were more likely to own their home despite earning less; and were more likely to be married. Compared to the Western region participants, we found Southern participants to have greater participation in church activities, greater mistrust of the healthcare system and particular concerns about racial inequalities in care. In contrast, they also reported more positive experiences with their personal healthcare provider than Western participants. Southerners felt that they had greater control over their own health, perhaps in part due to a greater identification with the health teachings of the Adventist church. A number of clear differences were found between Black Adventist subjects living in either the Western or Southern regions of the United States. These factors should be considered carefully when planning the promotion for a research study.

  18. Transparency and Quality of Health Apps: The HON Approach.

    Science.gov (United States)

    Ranasinghe, Mayoni; Cabrera, Aude; Postel-Vinay, Nicolas; Boyer, Célia

    2018-01-01

    We are well into the 21st century and the Internet has been around long enough that there are adults who have not known a world without this wonderful tool. And just as time has gone since the beginnings of the Internet, so too has it developed, probably above and beyond the wildest dreams of its founders. These developments, though mostly positive, also have their share of the not so positive. One of these challenges is the difficulty in maintaining accuracy and quality of all the information, data gathered, aggregated or automatically generated being displayed on the Internet on Web websites or via mobile application, and this is a concern in the health domain. In this paper, we attempt to discuss in detail, some of the latest developments along with the challenges each of them entail and proposed Code of Conduct for health apps and connected objects.

  19. Nutrition economics: an innovative approach to informed public health management.

    Science.gov (United States)

    Nuijten, Mark; Lenoir-Wijnkoop, Irene

    2011-09-01

    The role of nutrition to optimize the use of scarce resources through its linkage with health and welfare should be considered of interest by healthcare decision makers. A favorable impact of food on non-communicable disorders and general health status will improve healthcare expenditure and quality of life.In health economics, an analysis of the costs and effects of a healthcare technology by means of a cost-effectiveness analysis has become an established tool. Projections about the effectiveness and expected costs of an intervention can be modeled using realistic and explicit assumptions based on outcomes from randomized clinical studies. However, the use of health economic techniques to assess costs and effects is not solely restricted to classic healthcare products such as medicines. To illustrate this we used two published cost-effectiveness studies, which consider respectively a preventive treatment against severe respiratory syncytial virus infection in children at high risk of hospitalization and the use of prebiotics for the primary prevention of atopic dermatitis.These examples illustrate that there is a parallel between the methodologies for extrapolation of intermediate outcomes to long-term outcomes between a cost-effectiveness analysis for pharmaceutical or nutrition, as long as the clinical evidence for nutrition fulfils the requirements for pharmaceuticals. Another requirement is that there is clinical widely accepted evidence that matches a comparable level of epidemiological observations about the link between short-term and long-term outcomes.Better understanding of how nutritional status and behavior may interplay with the socioeconomic environment will ultimately contribute to preserving the sustainability of healthcare provisions. Copyright © 2011 Elsevier B.V. All rights reserved.

  20. Developing a Clinical Approach to Air Pollution and Cardiovascular Health.

    Science.gov (United States)

    Hadley, Michael B; Baumgartner, Jill; Vedanthan, Rajesh

    2018-02-13

    Nearly 3 billion people are exposed to household air pollution emitted from inefficient cooking and heating stoves, and almost the entire global population is exposed to detectable levels of outdoor air pollution from traffic, industry, and other sources. Over 3 million people die annually of ischemic heart disease or stroke attributed to air pollution, more than from traditional cardiac risk factors such as obesity, diabetes mellitus, or smoking. Clinicians have a role to play in reducing the burden of pollution-attributable cardiovascular disease. However, there currently exists no clear clinical approach to this problem. Here, we provide a blueprint for an evidence-based clinical approach to assessing and mitigating cardiovascular risk from exposure to air pollution. We begin with a discussion of the global burden of pollution-attributable cardiovascular disease, including a review of the mechanisms by which particulate matter air pollution leads to cardiovascular outcomes. Next, we offer a simple patient-screening tool using known risk factors for pollution exposure. We then discuss approaches to quantifying air pollution exposures and cardiovascular risk, including the development of risk maps for clinical catchment areas. We review a collection of interventions for household and outdoor air pollution, which clinicians can tailor to patients and populations at risk. Finally, we identify future research needed to quantify pollution exposures and validate clinical interventions. Overall, we demonstrate that clinicians can be empowered to mitigate the global burden of cardiovascular disease attributable to air pollution. © 2018 American Heart Association, Inc.

  1. Standardized Approach to Quantitatively Measure Residual Limb Skin Health in Individuals with Lower Limb Amputation.

    Science.gov (United States)

    Rink, Cameron L; Wernke, Matthew M; Powell, Heather M; Tornero, Mark; Gnyawali, Surya C; Schroeder, Ryan M; Kim, Jayne Y; Denune, Jeffrey A; Albury, Alexander W; Gordillo, Gayle M; Colvin, James M; Sen, Chandan K

    2017-07-01

    Objective: (1) Develop a standardized approach to quantitatively measure residual limb skin health. (2) Report reference residual limb skin health values in people with transtibial and transfemoral amputation. Approach: Residual limb health outcomes in individuals with transtibial ( n  = 5) and transfemoral ( n  = 5) amputation were compared to able-limb controls ( n  = 4) using noninvasive imaging (hyperspectral imaging and laser speckle flowmetry) and probe-based approaches (laser doppler flowmetry, transcutaneous oxygen, transepidermal water loss, surface electrical capacitance). Results: A standardized methodology that employs noninvasive imaging and probe-based approaches to measure residual limb skin health are described. Compared to able-limb controls, individuals with transtibial and transfemoral amputation have significantly lower transcutaneous oxygen tension, higher transepidermal water loss, and higher surface electrical capacitance in the residual limb. Innovation: Residual limb health as a critical component of prosthesis rehabilitation for individuals with lower limb amputation is understudied in part due to a lack of clinical measures. Here, we present a standardized approach to measure residual limb health in people with transtibial and transfemoral amputation. Conclusion: Technology advances in noninvasive imaging and probe-based measures are leveraged to develop a standardized approach to quantitatively measure residual limb health in individuals with lower limb loss. Compared to able-limb controls, resting residual limb physiology in people that have had transfemoral or transtibial amputation is characterized by lower transcutaneous oxygen tension and poorer skin barrier function.

  2. An innovative approach to participatory health policy development in Bulgaria: The conception and first achievements of the Partnership for Health.

    Science.gov (United States)

    Dimova, Antoniya; Rohova, Maria; Hasardzhiev, Stanimir; Spranger, Anne

    2018-02-01

    The Bulgarian Partnership for Health was established in 2015 as a new forum for health policy formulation and discussion. The Partnership presents a new approach of structured and sustained stakeholder involvement to overcome the lack of public participation in health policy development and implementation. Constituted as a permanent consultative body to the Council of Ministers, the Partnership engages a wide variety of stakeholders and professionals to shape and improve health policies. The shared governance of the Partnership between the Minister of Health and a patient organisation supports the elaboration of legislative acts based on the stakeholders' collaboration in priority areas. The governance and organisational structure of the Partnership assures capacity building, fast mobilisation of experts, continuity of stakeholder involvement, and increased responsibility in health policy development and implementation. This type of participatory approach may help reconcile initially opposing positions and foster reforms often impeded by political antagonism. Persisting challenges are a rather slow process of policy development and different perceptions of key concepts among the stakeholders. As policy-making in many countries in Eastern Europe suffers from political distrust, the Partnership's approach of involving experts - and not only politicians - could provide inspiration also to other countries, which have struggled with inconsistency of health policies pursued by different governments. Copyright © 2017 The Author(s). Published by Elsevier B.V. All rights reserved.

  3. Mapping an appropriate health promotion approach for crèches in an informal settlement.

    Science.gov (United States)

    Brijlal, P; Gordon, N

    2005-02-01

    People living in informal settlements in South Africa experience the double burden of poverty and ill health. Wallacedene, an informal settlement was highlighted in the media as being a socially and otherwise deprived community, with many accompanying health problems. It was against this background that this study was conducted to gain a better understanding of the health and oral health status of children attending crèches in Wallacedene. It was designed to inform the mapping of an appropriate approach to develop a health promotion programme for crèches. Baseline data were collected through oral and general health examinations, site observations, a structured questionnaire and interviews with key people working with the children at two crèches. The results indicate poor oral and general health. Gingival inflammation (82.8%), caries (81.5%), and moderate to abundant plaque deposits (95.7%), fungal infections (33.9%), runny nose (51.4%), lymphadenopathy (45.7%) and itchy skin (5.7%) were found. Caregivers were not well informed about oral health. However, they were enthusiastic to engage in new interventions. The community was impoverished; public health interventions were limited with minimal resources such as health centres and voluntary service providers. The limited resources were not coordinated and did not adequately address the health and educational needs of the children. A multi-sectoral approach focusing on community development is an appropriate approach to address the needs of crèche children in this community.

  4. Evaluation of conducting a screening assessment of nutritional status of hospitalized patients. Presentation of main goals and objectives of the global health project "NutritionDay".

    Science.gov (United States)

    Jeznach-Steinhagen, Anna; Ostrowska, Joanna; Czerwonogrodzka-Senczyna, Aneta

    2016-01-01

    European Society for Clinical Nutrition and Metabolism (ESPEN) commenced in 2004 a global health project named "NutritionDay" aiming to promote awareness of proper nutritional status of hospitalized patients and to draw attention to the need for early detection of malnutrition among patients. Under the Polish law--pursunat to the regulation of the Minister of Health dated September 15, 2011 (amendment as of 27.12.2013)--a nutritional status of each patient should be assessed at the time of a hospital admission. of this study was to analyze the fulfilment of the mandatory questionnaire assessment of nutritional status at selected wards of one of Warsaw's clinical hospitals. The study included an analysis of medical records of patients hospitalized within 6 months (n = 26375). The correct fulfilment of screening questionnaire assessing nutritional status (NRS 2002 survey) and the information about patients' body weight as well as the results assessment of nutritional status were subject to the analysis. NRS 2002 questionnaire was present in only 67,14% medical records of patients, however 49.24% of them were unfilled. The obtained results confirming low degree of NRS 2002 questionnaires' fulfilment in one of the Warsaw clinical hospitals draws attention to the need for education of hospital personnel in the field of significance of screening of nutritional assessment and its regulations. The "NutritionDay" project is an interesting form to attract attention of the aforementioned problem and its global extent additionally encourage medical units to participate in the project.

  5. Temporal Dynamics of Health and Well-Being: A Crowdsourcing Approach to Momentary Assessments and Automated Generation of Personalized Feedback.

    Science.gov (United States)

    van der Krieke, Lian; Blaauw, Frank J; Emerencia, Ando C; Schenk, Hendrika M; Slaets, Joris P J; Bos, Elisabeth H; de Jonge, Peter; Jeronimus, Bertus F

    Recent developments in research and mobile health enable a quantitative idiographic approach in health research. The present study investigates the potential of an electronic diary crowdsourcing study in the Netherlands for (1) large-scale automated self-assessment for individual-based health promotion and (2) enabling research at both the between-persons and within-persons level. To illustrate the latter, we examined between-persons and within-persons associations between somatic symptoms and quality of life. A website provided the general Dutch population access to a 30-day (3 times a day) diary study assessing 43 items related to health and well-being, which gave participants personalized feedback. Associations between somatic symptoms and quality of life were examined with a linear mixed model. A total of 629 participants completed 28,430 assessments, with a mean (SD) of 45 (32) assessments per participant. Most participants (n = 517 [82%]) were women and 531 (84%) had high education. Almost 40% of the participants (n = 247) completed enough assessments (t = 68) to generate personalized feedback including temporal dynamics between well-being, health behavior, and emotions. Substantial between-person variability was found in the within-person association between somatic symptoms and quality of life. We successfully built an application for automated diary assessments and personalized feedback. The application was used by a sample of mainly highly educated women, which suggests that the potential of our intensive diary assessment method for large-scale health promotion is limited. However, a rich data set was collected that allows for group-level and idiographic analyses that can shed light on etiological processes and may contribute to the development of empirical-based health promotion solutions.

  6. Faltas ao trabalho por problemas de saúde na indústria Work days lost due to health problems in industry

    Directory of Open Access Journals (Sweden)

    Sylvia Regina Trindade Yano

    2012-05-01

    Full Text Available Neste estudo transversal, estima-se a prevalência de episódios de faltas ao trabalho por motivo de saúde (FTS, e fatores associados, focalizando o trabalho na indústria. A população do estudo foi uma amostra aleatória por conglomerado de 3.403 trabalhadores de 16 a 65 anos residentes em Salvador, Bahia, Brasil. Dados foram obtidos em entrevistas domiciliares. Entre os trabalhadores da indústria, a prevalência em um ano de FTS em geral, foi 12,5%, 5,5% para FTS relacionados ao trabalho, e 4,1% para FTS agravados pelo trabalho. Não houve diferenças estatisticamente significantes em relação aos demais trabalhadores. Fatores associados à FTS foram percepção de perigo no trabalho, história de acidente de trabalho, e saúde autopercebida como ruim. Os resultados indicam que a ocorrência de faltas ao trabalho é comum, tanto na indústria como nos demais ramos de atividade, podem afetar a produtividade, o que requer programas de prevenção de agentes de risco em locais de trabalho.This cross-sectional study estimated the prevalence of work days lost due to health problems and associated factors among industrial workers. The study population was a simple random cluster sample of 3,403 workers from 16 to 65 years of age in the city of Salvador, Bahia State, Brazil. Data were collected with individual home interviews. Among industrial workers, one-year prevalence of work days lost to health problems was 12.5%, of which 5.5% were directly work-related and 4.1% aggravated by work. There were no statistically significant differences when compared to other worker categories. Self-perceived workplace hazards, history of work-related injury, and poor self-rated health were associated with work days lost due to work-related injuries/diseases. The findings showed that work days lost are common among both industrial and non-industrial workers, thereby affecting productivity and requiring prevention programs.

  7. Impact of a Patient Navigator Program on Hospital-Based and Outpatient Utilization Over 180 Days in a Safety-Net Health System.

    Science.gov (United States)

    Balaban, Richard B; Zhang, Fang; Vialle-Valentin, Catherine E; Galbraith, Alison A; Burns, Marguerite E; Larochelle, Marc R; Ross-Degnan, Dennis

    2017-09-01

    With emerging global payment structures, medical systems need to understand longer-term impacts of care transition strategies. To determine the effect of a care transition program using patient navigators (PNs) on health service utilization among high-risk safety-net patients over a 180-day period. Randomized controlled trial conducted October 2011 through April 2013. Patients admitted to the general medicine service with ≥1 readmission risk factor: (1) age ≥ 60; (2) in-network inpatient admission within prior 6 months; (3) index length of stay ≥ 3 days; or (4) admission diagnosis of heart failure or (5) chronic obstructive pulmonary disease. The analytic sample included 739 intervention patients, 1182 controls. Through hospital visits and 30 days of post-discharge telephone outreach, PNs provided coaching and assistance with medications, appointments, transportation, communication with primary care, and self-care. Primary outcomes: (1) hospital-based utilization, a composite of ED visits and hospital admissions; (2) hospital admissions; (3) ED visits; and (4) outpatient visits. We evaluated outcomes following an index discharge, stratified by patient age (≥ 60 and safety-net patients differentially impacted patients based on age, and among younger patients, outcomes varied over time. Our findings highlight the importance for future research to evaluate care transition programs among different subpopulations and over longer time periods.

  8. ADVANZ - Neglected zoonotc disease control through a One Health approach

    DEFF Research Database (Denmark)

    Saarnak, Christopher; Johansen, Maria Vang; Mukaratirwa, Samson

    2013-01-01

    As quoted in the Lancet in December 2012, endemic and enzootic zoonoses cause about a billion cases of illness and millions of death in people every year. Of these zoonoses, the diseases such as anthrax, bovine tuberculosis, brucellosis, cysticercosis, echinococcosis (hydatid disease) and rabies...... domesticated (livestock or companion) or wild animals to people. ADVANZ is One Health NZD project, funded by the European Commission through its 7th framework program. The session will describe and discuss the initiative, which main aim is to persuade decision makers and empower stakeholders at local, regional...

  9. A computer science approach to managing security in health care.

    Science.gov (United States)

    Asirelli, P; Braccini, G; Caramella, D; Coco, A; Fabbrini, F

    2002-09-01

    The security of electronic medical information is very important for health care organisations, which have to ensure confidentiality, integrity and availability of the information provided. This paper will briefly outline the legal measures adopted by the European Community, Italy and the United States to regulate the use and disclosure of medical records. It will then go on to highlight how information technology can help to address these issues with special reference to the management of organisation policies. To this end, we will present a modelling example for the security policy of a radiological department.

  10. Tailored Educational Approaches for Consumer Health: A Model to Address Health Promotion in an Era of Personalized Medicine.

    Science.gov (United States)

    Cohn, Wendy F; Lyman, Jason; Broshek, Donna K; Guterbock, Thomas M; Hartman, David; Kinzie, Mable; Mick, David; Pannone, Aaron; Sturz, Vanessa; Schubart, Jane; Garson, Arthur T

    2018-01-01

    To develop a model, based on market segmentation, to improve the quality and efficiency of health promotion materials and programs. Market segmentation to create segments (groups) based on a cross-sectional questionnaire measuring individual characteristics and preferences for health information. Educational and delivery recommendations developed for each group. General population of adults in Virginia. Random sample of 1201 Virginia residents. Respondents are representative of the general population with the exception of older age. Multiple factors known to impact health promotion including health status, health system utilization, health literacy, Internet use, learning styles, and preferences. Cluster analysis and discriminate analysis to create and validate segments. Common sized means to compare factors across segments. Developed educational and delivery recommendations matched to the 8 distinct segments. For example, the "health challenged and hard to reach" are older, lower literacy, and not likely to seek out health