Public Health Agency Accreditation Among Rural Local Health Departments: Influencers and Barriers.

Science.gov (United States)

Beatty, Kate E; Erwin, Paul Campbell; Brownson, Ross C; Meit, Michael; Fey, James

Health department accreditation is a crucial strategy for strengthening public health infrastructure. The purpose of this study was to investigate local health department (LHD) characteristics that are associated with accreditation-seeking behavior. This study sought to ascertain the effects of rurality on the likelihood of seeking accreditation through the Public Health Accreditation Board (PHAB). Cross-sectional study using secondary data from the 2013 National Association of County & City Health Officials (NACCHO) National Profile of Local Health Departments Study (Profile Study). United States. LHDs (n = 490) that responded to the 2013 NACCHO Profile Survey. LHDs decision to seek PHAB accreditation. Significantly more accreditation-seeking LHDs were located in urban areas (87.0%) than in micropolition (8.9%) or rural areas (4.1%) (P < .001). LHDs residing in urban communities were 16.6 times (95% confidence interval [CI], 5.3-52.3) and micropolitan LHDs were 3.4 times (95% CI, 1.1-11.3) more likely to seek PHAB accreditation than rural LHDs (RLHDs). LHDs that had completed an agency-wide strategic plan were 8.5 times (95% CI, 4.0-17.9), LHDs with a local board of health were 3.3 times (95% CI, 1.5-7.0), and LHDs governed by their state health department were 12.9 times (95% CI, 3.3-50.0) more likely to seek accreditation. The most commonly cited barrier was time and effort required for accreditation application exceeded benefits (73.5%). The strongest predictor for seeking PHAB accreditation was serving an urban jurisdiction. Micropolitan LHDs were more likely to seek accreditation than smaller RLHDs, which are typically understaffed and underfunded. Major barriers identified by the RLHDs included fees being too high and the time and effort needed for accreditation exceeded their perceived benefits. RLHDs will need additional financial and technical support to achieve accreditation. Even with additional funds, clear messaging of the benefits of accreditation

State procurement law: facilitating the collaboration between health department and school of public health.

Science.gov (United States)

Huber, George A; Barron, Gerald M; Duchak, Linda S; Raniowski, Martin; Alsahlani, Hazem S; Potter, Margaret A

2014-01-01

The mark of an "academic health department" includes shared activity by academic and practice partners sustained over time. Despite a long history of productive interactivity, the Pennsylvania Department of Health and the University of Pittsburgh's Graduate School of Public Health often faced administrative hurdles in contracting for projects of mutual interest. Seeking to overcome these hurdles, the Commonwealth of Pennsylvania and the University of Pittsburgh's Graduate School of Public Health negotiated a Master Agreement on the basis of statutes designating both as "public procurement units." This provided a template for project specifications, standard financial terms, and a contracting process. Since taking effect, the Master Agreement has supported projects in policy development, capacity building, workforce development, program evaluation, data analysis, and program planning. This experience suggests an approach potentially useful for other states and localities seeking to solidify academic health department partnerships either envisioned for the future or already in place.

Investments for medical equipment in a mother and child health hospital: correlation with level of services/departments.

Science.gov (United States)

Trevisanuto, Daniele; Raggi, Roberto; Bavuusuren, Bayasgalantai; Tudevdorj, Erkhembaatar; Doglioni, Nicoletta; Zanardo, Vincenzo

2011-02-01

To assess whether investments for medical equipments assigned by a team of experts to a mother and child health hospital located in Mongolia were correlated with structural, organizational, and educational level of its services/departments. A score was used for evaluating the level of each service/department. It was based on a 'structural area' and an 'organizational and educational area'. Destination of funds was determined by a team of experts in collaboration with the head of the service/department. Thirty-three of 36 services/departments (91.6%) were evaluated. A total sum of 4,432,140 Euros to invest in medical equipment was estimated. Assigned investments were inversely correlated with the total (structural plus organizational and educational area) score (n = 33; r =  -0.59; p = 0.0002), and the specific scores for structural area (n = 33; r = -0.46; p = 0.005) and organizational and educational area (n = 33; r =  -0.56; p = 0.0006). A large part of the funds for medical equipment was destined to services/departments with low organizational and educational conditions, limiting the potential effect of the aid meanwhile supporting the most in need departments. Educational efforts and monitoring of specific long-term indicators are mandatory.

28 CFR 0.191 - Changes which affect the overall structure of the Department.

Science.gov (United States)

2010-07-01

... structure of the Department. 0.191 Section 0.191 Judicial Administration DEPARTMENT OF JUSTICE ORGANIZATION OF THE DEPARTMENT OF JUSTICE Sections and Subunits § 0.191 Changes which affect the overall structure of the Department. Changes to the overall structure of the Department include: The establishment...

Physician training rotations in a large urban health department.

Science.gov (United States)

Alkon, Ellen; Kim-Farley, Robert; Gunzenhauser, Jeffrey

2014-01-01

Hospitals are the normal setting for physician residency training within the United States. When a hospital cannot provide the specific training needed, a special rotation for that experience is arranged. Linkages between clinical and public health systems are vital to achieving improvements in overall health status in the United States. Nevertheless, most physicians in postgraduate residency programs receive neither training nor practical experience in the practice of public health. For many years, public health rotations have been available within the Los Angeles County Department of Public Health (and its antecedent organizations). Arrangements that existed with local medical schools for residents to rotate with Los Angeles County Department of Health hospitals were extended to include a public health rotation. A general model for the rotation ensured that each resident received education and training relevant to the clinician in practice. Some parts of the model for experience have changed over time while others have not. Also, the challenges and opportunities for both trainees and preceptors have evolved and varied over time. A logic model demonstrates the components and changes with the public health rotation. Changes included alterations in recruitment, expectations, evaluation, formal education, and concepts related to the experience. Changes in the rotation model occurred in the context of other major environmental changes such as new electronic technology, changing expectations for residents, and evolving health services and public health systems. Each impacted the public health rotation. The evaluation method developed included content tests, assessment of competencies by residents and preceptors, and satisfaction measures. Results from the evaluation showed increases in competency and a high level of satisfaction after a public health rotation. The article includes examples of challenges and benefits to a local health department in providing a public

Lessons Learned in Promoting Evidence-Based Public Health: Perspectives from Managers in State Public Health Departments.

Science.gov (United States)

Allen, Peg; Jacob, Rebekah R; Lakshman, Meenakshi; Best, Leslie A; Bass, Kathryn; Brownson, Ross C

2018-03-02

Evidence-based public health (EBPH) practice, also called evidence-informed public health, can improve population health and reduce disease burden in populations. Organizational structures and processes can facilitate capacity-building for EBPH in public health agencies. This study involved 51 structured interviews with leaders and program managers in 12 state health department chronic disease prevention units to identify factors that facilitate the implementation of EBPH. Verbatim transcripts of the de-identified interviews were consensus coded in NVIVO qualitative software. Content analyses of coded texts were used to identify themes and illustrative quotes. Facilitator themes included leadership support within the chronic disease prevention unit and division, unit processes to enhance information sharing across program areas and recruitment and retention of qualified personnel, training and technical assistance to build skills, and the ability to provide support to external partners. Chronic disease prevention leaders' role modeling of EBPH processes and expectations for staff to justify proposed plans and approaches were key aspects of leadership support. Leaders protected staff time in order to identify and digest evidence to address the common barrier of lack of time for EBPH. Funding uncertainties or budget cuts, lack of political will for EBPH, and staff turnover remained challenges. In conclusion, leadership support is a key facilitator of EBPH capacity building and practice. Section and division leaders in public health agencies with authority and skills can institute management practices to help staff learn and apply EBPH processes and spread EBPH with partners.

Informatics and communication in a state public health department: a case study.

Science.gov (United States)

Hills, Rebecca A; Turner, Anne M

2008-11-06

State and local health departments are witnessing growth in the area of informatics. As new informatics projects commence, existing methods of communication within the health department may not be sufficient. We gathered information about roles and communication between a development team and a user group working simultaneously on an informatics project in a state public health department in an effort to better define how communication and role definition is best used within an informatics project.

Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA)

Data.gov (United States)

Department of Veterans Affairs — Civilian Health and Medical Program of the Department of Veterans Affairs (CHAMPVA) is a health care benefit program designed for the dependents of certain Veterans....

How Health Department Contextual Factors Affect Public Health Preparedness (PHP) and Perceptions of the 15 PHP Capabilities.

Science.gov (United States)

Horney, Jennifer A; Carbone, Eric G; Lynch, Molly; Wang, Z Joan; Jones, Terrance; Rose, Dale A

2017-09-01

To assess how health department contextual factors influence perceptions of the 15 Public Health Preparedness Capabilities, developed by the Centers for Disease Control and Prevention (CDC) to provide guidance on organizing preparedness activities. We conducted an online survey and focus group between September 2015 and May 2016 with directors of preparedness programs in state, metropolitan, and territorial jurisdictions funded by CDC's Public Health Emergency Preparedness (PHEP) cooperative agreement. The survey collected demographic information and data on contextual factors including leadership, partnerships, organizational structure, resources and structural capacity, and data and evaluation. Seventy-seven percent (48 of 62) of PHEP directors completed the survey and 8 participated in the focus group. Respondents were experienced directors (mean = 10.6 years), and 58% led 7 or more emergency responses. Leadership, partnerships, and access to fiscal and human resources were associated with perception and use of the capabilities. Despite some deficiencies, PHEP awardees believe the capabilities provide useful guidance and a flexible framework for organizing their work. Contextual factors affect perceptions of the capabilities and possibly the effectiveness of their use. Public Health Implications. The capabilities can be used to address challenges in preparedness, including identifying evidence-based practices, developing performance measures, and improving responses.

Interpersonal influence among public health leaders in the United States department of health and human services.

Science.gov (United States)

Harris, Jenine K; Carothers, Bobbi J; Wald, Lana M; Shelton, Sarah C; Leischow, Scott J

2012-02-17

In public health, interpersonal influence has been identified as an important factor in the spread of health information, and in understanding and changing health behaviors. However, little is known about influence in public health leadership. Influence is important in leadership settings, where public health professionals contribute to national policy and practice agendas. Drawing on social theory and recent advances in statistical network modeling, we examined influence in a network of tobacco control leaders at the United States Department of Health and Human Services (DHHS). Fifty-four tobacco control leaders across all 11 agencies in the DHHS were identified; 49 (91%) responded to a web-based survey. Participants were asked about communication with other tobacco control leaders, who influenced their work, and general job characteristics. Exponential random graph modeling was used to develop a network model of influence accounting for characteristics of individuals, their relationships, and global network structures. Higher job ranks, more experience in tobacco control, and more time devoted to tobacco control each week increased the likelihood of influence nomination, as did more frequent communication between network members. Being in the same agency and working the same number of hours per week were positively associated with mutual influence nominations. Controlling for these characteristics, the network also exhibited patterns associated with influential clusters of network members. Findings from this unique study provide a perspective on influence within a government agency that both helps to understand decision-making and also can serve to inform organizational efforts that allow for more effective structuring of leadership.

Interpersonal influence among public health leaders in the United States Department of Health and Human Services

Directory of Open Access Journals (Sweden)

Jenine K. Harris

2012-02-01

Full Text Available Background. In public health, interpersonal influence has been identified as an important factor in the spread of health information, and in understanding and changing health behaviors. However, little is known about influence in public health leadership. Influence is important in leadership settings, where public health professionals contribute to national policy and practice agendas. Drawing on social theory and recent advances in statistical network modeling, we examined influence in a network of tobacco control leaders at the United States Department of Health and Human Services (DHHS. Design and Methods. Fifty-four tobacco control leaders across all 11 agencies in the DHHS were identified; 49 (91% responded to a web-based survey. Participants were asked about communication with other tobacco control leaders, who influenced their work, and general job characteristics. Exponential random graph modeling was used to develop a network model of influence accounting for characteristics of individuals, their relationships, and global network structures. Results. Higher job ranks, more experience in tobacco control, and more time devoted to tobacco control each week increased the likelihood of influence nomination, as did more frequent communication between network members. Being in the same agency and working the same number of hours per week were positively associated with mutual influence nominations. Controlling for these characteristics, the network also exhibited patterns associated with influential clusters of network members. Conclusions. Findings from this unique study provide a perspective on influence within a government agency that both helps to understand decision-making and also can serve to inform organizational efforts that allow for more effective structuring of leadership.

Integrated Care Programme—Department of Health, UK

OpenAIRE

Dewji, Mo; Passmore, Julie; Wardell, John

2010-01-01

Introduction Integration is seen as a key building block within the strategic plan for improving the health and well-being of the population of England. The Integrated Care Pilot programme is a three-year academically assessed research programme sponsored by the Department of Health, England, which aims to explore and gather evidence to support different approaches to integration. Aims With 16 pilot sites across England the objectives of the programme are based upon a Government commitment to...

Evaluation of a model training program for respiratory-protection preparedness at local health departments.

Science.gov (United States)

Alfano-Sobsey, Edie; Kennedy, Bobby; Beck, Frank; Combs, Brian; Kady, Wendy; Ramsey, Steven; Stockweather, Allison; Service, Will

2006-04-01

Respiratory-protection programs have had limited application in local health departments and have mostly focused on protecting employees against exposure to tuberculosis (TB). The need to provide the public health workforce with effective respiratory protection has, however, been underscored by recent concerns about emerging infectious diseases, bioterrorism attacks, drug-resistant microbes, and environmental exposures to microbial allergens (as in recent hurricane flood waters). Furthermore, OSHA has revoked the TB standard traditionally followed by local health departments, replacing it with a more stringent regulation. The additional OSHA requirements may place increased burdens on health departments with limited resources and time. For these reasons, the North Carolina Office of Public Health Preparedness and Response and industrial hygienists of the Public Health Regional Surveillance Teams have developed a training program to facilitate implementation of respiratory protection programs at local health departments. To date, more than 1,400 North Carolina health department employees have been properly fit-tested for respirator use and have received training in all aspects of respiratory protection. This article gives an overview of the development and evaluation of the program. The training approach presented here can serve as a model that other health departments and organizations can use in implementing similar respiratory-protection programs.

Leadership for Public Health 3.0: A Preliminary Assessment of Competencies for Local Health Department Leaders.

Science.gov (United States)

Jadhav, Emmanuel D; Holsinger, James W; Anderson, Billie W; Homant, Nicholas

2017-01-01

The foundational public health services model V1.0, developed in response to the Institute of Medicine report For the Public's Health: Investing in a Healthier Future identified important capabilities for leading local health departments (LHDs). The recommended capabilities include the organizational competencies of leadership and governance, which are described as consensus building among internal and external stakeholders. Leadership through consensus building is the main characteristic of Democratic Leadership . This style of leadership works best within the context of a competent team. Not much is known about the competency structure of LHD leadership teams. The objectives of this study characterize the competency structure of leadership teams in LHDs and identify the relevance of existing competencies for the practice of leadership in public health. The study used a cross-sectional study design. Utilizing the workforce taxonomy six management and leadership occupation titles were used as job categories. The competencies were selected from the leadership and management domain of public health competencies for the Tier -3, leadership level. Study participants were asked to rank on a Likert scale of 1-10 the relevance of each competency to their current job category, with a rank of 1 being least important and a rank of 10 being most important. The instrument was administered in person. Data were collected in 2016 from 50 public health professionals serving in leadership and management positions in a convenience sample of three LHDS. The competency of most relevance to the highest executive function category was that of "interaction with interrelated systems." For sub-agency level officers the competency of most relevance was "advocating for the role of public health." The competency of most relevance to Program Directors/Managers or Administrators was "ensuring continuous quality improvement." The variation between competencies by job category suggests there are

Building a sustainable Academic Health Department: the South Carolina model.

Science.gov (United States)

Smith, Lillian Upton; Waddell, Lisa; Kyle, Joseph; Hand, Gregory A

2014-01-01

Given the limited resources available to public health, it is critical that university programs complement the development needs of agencies. Unfortunately, academic and practice public health entities have long been challenged in building sustainable collaborations that support practice-based research, teaching, and service. The academic health department concept offers a promising solution. In South Carolina, the partners started their academic health department program with a small grant that expanded into a dynamic infrastructure that supports innovative professional exchange and development programs. This article provides a background and describes the key elements of the South Carolina model: joint leadership, a multicomponent memorandum of agreement, and a shared professional development mission. The combination of these elements allows the partners to leverage resources and deftly respond to challenges and opportunities, ultimately fostering the sustainability of the collaboration.

The Relationship of Policymaking and Networking Characteristics among Leaders of Large Urban Health Departments.

Science.gov (United States)

Leider, Jonathon P; Castrucci, Brian C; Harris, Jenine K; Hearne, Shelley

2015-08-06

The relationship between policy networks and policy development among local health departments (LHDs) is a growing area of interest to public health practitioners and researchers alike. In this study, we examine policy activity and ties between public health leadership across large urban health departments. This study uses data from a national profile of local health departments as well as responses from a survey sent to three staff members (local health official, chief of policy, chief science officer) in each of 16 urban health departments in the United States. Network questions related to frequency of contact with health department personnel in other cities. Using exponential random graph models, network density and centrality were examined, as were patterns of communication among those working on several policy areas using exponential random graph models. All 16 LHDs were active in communicating about chronic disease as well as about use of alcohol, tobacco, and other drugs (ATOD). Connectedness was highest among local health officials (density = .55), and slightly lower for chief science officers (d = .33) and chiefs of policy (d = .29). After accounting for organizational characteristics, policy homophily (i.e., when two network members match on a single characteristic) and tenure were the most significant predictors of formation of network ties. Networking across health departments has the potential for accelerating the adoption of public health policies. This study suggests similar policy interests and formation of connections among senior leadership can potentially drive greater connectedness among other staff.

Assessing STD Partner Services in State and Local Health Departments.

Science.gov (United States)

Cuffe, Kendra M; Leichliter, Jami S; Gift, Thomas L

2018-02-07

State and local health department STD programs provide several partner services to reduce disease transmission. Budget cuts and temporary staff reassignments for public health emergencies may affect the provision of partner services. Determining the impact of staffing reductions on STD rates and public health response should be further assessed.

Role of a state health department in an underground nuclear experiment

Energy Technology Data Exchange (ETDEWEB)

Gerusky, T M [Department of Health, Harrisburg, PA (United States)

1969-07-01

When Project Ketch was first announced to Pennsylvania state officials, the Department of Health, under its legal responsibility to protect the health of the citizens of the state, was quick to realize that a thorough, independent review of the proposal was indeed necessary. Although the project was terminated by the sponsoring company before on-site preliminary evaluation work was begun, it is believed that the Department's approach was sound and practical. This study and the planned joint effort of the state and the Bureau of Radiological health will be discussed in detail. (author)

Role of a state health department in an underground nuclear experiment

International Nuclear Information System (INIS)

Gerusky, T.M.

1969-01-01

When Project Ketch was first announced to Pennsylvania state officials, the Department of Health, under its legal responsibility to protect the health of the citizens of the state, was quick to realize that a thorough, independent review of the proposal was indeed necessary. Although the project was terminated by the sponsoring company before on-site preliminary evaluation work was begun, it is believed that the Department's approach was sound and practical. This study and the planned joint effort of the state and the Bureau of Radiological health will be discussed in detail. (author)

CDC/NACCHO Accreditation Support Initiative: advancing readiness for local and tribal health department accreditation.

Science.gov (United States)

Monteiro, Erinn; Fisher, Jessica Solomon; Daub, Teresa; Zamperetti, Michelle Chuk

2014-01-01

Health departments have various unique needs that must be addressed in preparing for national accreditation. These needs require time and resources, shortages that many health departments face. The Accreditation Support Initiative's goal was to test the assumption that even small amounts of dedicated funding can help health departments make important progress in their readiness to apply for and achieve accreditation. Participating sites' scopes of work were unique to the needs of each site and based on the proposed activities outlined in their applications. Deliverables and various sources of data were collected from sites throughout the project period (December 2011-May 2012). Awardees included 1 tribal and 12 local health departments, as well as 5 organizations supporting the readiness of local and tribal health departments. Sites dedicated their funding toward staff time, accreditation fees, completion of documentation, and other accreditation readiness needs and produced a number of deliverables and example documents. All sites indicated that they made accreditation readiness gains that would not have occurred without this funding. Preliminary evaluation data from the first year of the Accreditation Support Initiative indicate that flexible funding arrangements may be an effective way to increase health departments' accreditation readiness.

The Relationship of Policymaking and Networking Characteristics among Leaders of Large Urban Health Departments

Directory of Open Access Journals (Sweden)

Jonathon P. Leider

2015-08-01

Full Text Available Background: The relationship between policy networks and policy development among local health departments (LHDs is a growing area of interest to public health practitioners and researchers alike. In this study, we examine policy activity and ties between public health leadership across large urban health departments. Methods: This study uses data from a national profile of local health departments as well as responses from a survey sent to three staff members (local health official, chief of policy, chief science officer in each of 16 urban health departments in the United States. Network questions related to frequency of contact with health department personnel in other cities. Using exponential random graph models, network density and centrality were examined, as were patterns of communication among those working on several policy areas using exponential random graph models. Results: All 16 LHDs were active in communicating about chronic disease as well as about use of alcohol, tobacco, and other drugs (ATOD. Connectedness was highest among local health officials (density = .55, and slightly lower for chief science officers (d = .33 and chiefs of policy (d = .29. After accounting for organizational characteristics, policy homophily (i.e., when two network members match on a single characteristic and tenure were the most significant predictors of formation of network ties. Conclusion: Networking across health departments has the potential for accelerating the adoption of public health policies. This study suggests similar policy interests and formation of connections among senior leadership can potentially drive greater connectedness among other staff.

Terrorism preparedness in state health departments--United States, 2001-2003.

Science.gov (United States)

2003-10-31

The anthrax attacks in fall 2001 highlighted the role of infectious disease (ID) epidemiologists in terrorism preparedness and response. Beginning in 2002, state health departments (SHDs) received approximately 1 billion dollars in new federal funding to prepare for and respond to terrorism, infectious disease outbreaks, and other public health threats and emergencies. This funding is being used in part to improve epidemiologic and surveillance capabilities. To determine how states have used a portion of their new funding to increase ID epidemiology capacity, the Iowa Department of Public Health's Center for Acute Disease Epidemiology and the Iowa State University Department of Microbiology conducted two surveys of U.S. state epidemiologists during September 2000-August 2001 and October 2002-June 2003. This report summarizes the results of these surveys, which determined that although the number of SHD epidemiology workers assigned to ID and terrorism preparedness increased by 132%, concerns remained regarding the ability of SHDs to hire qualified personnel. These findings underscore the need to develop additional and more diverse training venues for current and future ID epidemiologists.

Homeland security and public health: role of the Department of Veterans Affairs, the US Department of Homeland Security, and implications for the public health community.

Science.gov (United States)

Koenig, Kristi L

2003-01-01

The terrorist attacks of 11 September 2001 led to the largest US Government transformation since the formation of the Department of Defense following World War II. More than 22 different agencies, in whole or in part, and >170,000 employees were reorganized to form a new Cabinet-level Department of Homeland Security (DHS), with the primary mission to protect the American homeland. Legislation enacted in November 2002 transferred the entire Federal Emergency Management Agency and several Department of Health and Human Services (HHS) assets to DHS, including the Office of Emergency Response, and oversight for the National Disaster Medical System, Strategic National Stockpile, and Metropolitan Medical Response System. This created a potential separation of "health" and "medical" assets between the DHS and HHS. A subsequent presidential directive mandated the development of a National Incident Management System and an all-hazard National Response Plan. While no Department of Veterans Affairs (VA) assets were targeted for transfer, the VA remains the largest integrated healthcare system in the nation with important support roles in homeland security that complement its primary mission to provide care to veterans. The Emergency Management Strategic Healthcare Group (EMSHG) within the VA's medical component, the Veteran Health Administration (VHA), is the executive agent for the VA's Fourth Mission, emergency management. In addition to providing comprehensive emergency management services to the VA, the EMSHG coordinates medical back-up to the Department of Defense, and assists the public via the National Disaster Medical System and the National Response Plan. This article describes the VA's role in homeland security and disasters, and provides an overview of the ongoing organizational and operational changes introduced by the formation of the new DHS. Challenges and opportunities for public health are highlighted.

Obesity Prevention: The Impact of Local Health Departments

Science.gov (United States)

Chen, Zhuo (Adam); Roy, Kakoli; Gotway Crawford, Carol A

2013-01-01

Objective To examine the association between bodyweight status and provision of population-based prevention services. Data Sources The National Association of City and County Health Officials 2005 Profile survey data, linked with two cross-sections of the Behavioral Risk Factor Surveillance System (BRFSS) survey in 2004 and 2005. Study Design Multilevel logistic regressions were used to examine the association between provision of obesity-prevention services and the change in risk of being obese or morbidly obese among BRFSS respondents. The estimation sample was stratified by sex. Low-income samples were also examined. Falsification tests were used to determine whether there is counterevidence. Principal Findings Provision of population-based obesity-prevention services within the jurisdiction of local health departments and specifically those provided by the local health departments are associated with reduced risks of obesity and morbid obesity from 2004 to 2005. The magnitude of the association appears to be stronger among low-income populations and among women. Results of the falsification tests provide additional support of the main findings. Conclusions Population-based obesity-prevention services may be useful in containing the obesity epidemic. PMID:22816510

Analysis of judicial demands in health at the Regional Health Department XII

Directory of Open Access Journals (Sweden)

Leticia Florido Povinske Domingues

2017-08-01

Full Text Available The management of lawsuits in health represents a challenge for most Brazilian municipalities. Many papers described in the literature characterized properly the problem as well as discussed the repercussions on the Unified Health System.In this context, the objective of this study was to analyze the situation of health judicial processes at the twelfth Regional Department in Registro, São Paulo´s state, evaluating the profile of the users who claim in court the couverage of treatment´s costs as well as examination, procedure or medication. For this, we analyzed data on lawsuits in the health field at the twelfth Regional Department in Registro (SP from january 2009 to october 2015.The variables studied were gender, age, municipality of origin of the lawsuit, the mentioned disease, the medical prescription origin, specialty of the prescriber, type of lawsuit triggered, year of the lawsuit, entity judicially triggered and requested items. It was analyzed thirty-eight lawsuits against the twelfth Regional Department, it was observed the prevalence of the female gender, age group above 51 years and originating from the municipality of Registro (SP.The most of the judicial actions are for care given at the Unified Health System, by prescribers of specialty in Clinical Medicine and diagnosed with Diabetes Mellitus. The processes were characterized in the majority by judicial actions called Ordinary Rite, against the State. On the analyzed cases, 92% requested only medications and of these 11% supplements like vitamins and enteral diets.The number of patients who have been served through legal actions in the last three years reached 47% of the total cases registered during the period of the seven years analyzed and the approximate cost was R$ 1,340,000.00.This study contributes to the diagnosis of the processes related to the health judicialization in the region studied. The results showed a predominance of processes which comes from of patients

Perceived Facilitators and Barriers to Local Health Department Workers' Participation in Infectious Disease Emergency Responses.

Science.gov (United States)

Rutkow, Lainie; Paul, Amy; Taylor, Holly A; Barnett, Daniel J

Local health departments play a key role in emergency preparedness and respond to a wide range of threats including infectious diseases such as seasonal influenza, tuberculosis, H1N1, Ebola virus disease, and Zika virus disease. To successfully respond to an infectious disease outbreak, local health departments depend upon the participation of their workforce; yet, studies indicate that sizable numbers of workers would not participate in such a response. The reasons why local health department workers participate, or fail to participate, in infectious disease responses are not well understood. To understand why local health department workers are willing, or not willing, to report to work during an infectious disease response. From April 2015 to January 2016, we conducted 28 semistructured interviews with local health department directors, preparedness staff, and nonpreparedness staff. Interviews were conducted with individuals throughout the United States. We interviewed 28 individuals across 3 groups: local health department directors (n = 8), preparedness staff (n = 10), and nonpreparedness staff (n = 10). Individuals' descriptions of why local health department workers are willing, or not willing, to report to work during an infectious disease response. Factors that facilitate willingness to respond to an infectious disease emergency included availability of vaccines and personal protective equipment; flexible work schedule and childcare arrangements; information sharing via local health department trainings; and perceived commitments to one's job and community. Factors that hinder willingness to respond to an infectious disease emergency included potential disease exposure for oneself and one's family; logistical considerations for care of children, the elderly, and pets; and perceptions about one's role during an infectious disease response. Our findings highlight opportunities for local health departments to revisit their internal policies and engage in

Linking public relations processes and organizational effectiveness at a state health department.

Science.gov (United States)

Wise, Kurt

2003-01-01

This qualitative case study explored a state health department's relationships with strategic constituencies from a public relations perspective. The relationships were explored within the theoretical framework of the Excellence Theory, the dominant paradigm in public research. Findings indicate application of the Excellence Theory has the potential to increase organizational effectiveness at public health entities. With respect to the case investigated, findings indicate that the state health department could increase its organizational effectiveness through the adoption of recommendations based on the Excellence Theory.

W-320 Department of Health documentation

International Nuclear Information System (INIS)

Bailey, J.W.

1998-01-01

The purpose of this document is to gather information required to show that Project W-320 is in compliance with Washington State Department of Health requirements as specified in Radioactive Air Emissions Notice of Construction Project W-320, Tank 241-C-106 Sluicing, DOE/RL-95-45. Specifically, that W-320 is in compliance with ASME N509-1989 (Nuclear Power Plant Air-Cleaning Units and Components) and ASME N5 10-1989 (Testing of Nuclear Air Treatment Systems) for the 296-C-006 exhaust system

W-320 Department of Health documentation

Energy Technology Data Exchange (ETDEWEB)

Bailey, J.W.

1998-08-07

The purpose of this document is to gather information required to show that Project W-320 is in compliance with Washington State Department of Health requirements as specified in Radioactive Air Emissions Notice of Construction Project W-320, Tank 241-C-106 Sluicing, DOE/RL-95-45. Specifically, that W-320 is in compliance with ASME N509-1989 (Nuclear Power Plant Air-Cleaning Units and Components) and ASME N5 10-1989 (Testing of Nuclear Air Treatment Systems) for the 296-C-006 exhaust system.

HIV provider and patient perspectives on the Development of a Health Department "Data to Care" Program: a qualitative study.

Science.gov (United States)

Dombrowski, Julia C; Carey, James W; Pitts, Nicole; Craw, Jason; Freeman, Arin; Golden, Matthew R; Bertolli, Jeanne

2016-06-10

U.S. health departments have not historically used HIV surveillance data for disease control interventions with individuals, but advances in HIV treatment and surveillance are changing public health practice. Many U.S. health departments are in the early stages of implementing "Data to Care" programs to assists persons living with HIV (PLWH) with engaging in care, based on information collected for HIV surveillance. Stakeholder engagement is a critical first step for development of these programs. In Seattle-King County, Washington, the health department conducted interviews with HIV medical care providers and PLWH to inform its Data to Care program. This paper describes the key themes of these interviews and traces the evolution of the resulting program. Disease intervention specialists conducted individual, semi-structured qualitative interviews with 20 PLWH randomly selected from HIV surveillance who had HIV RNA levels >10,000 copies/mL in 2009-2010. A physician investigator conducted key informant interviews with 15 HIV medical care providers. Investigators analyzed de-identified interview transcripts, developed a codebook of themes, independently coded the interviews, and identified codes used most frequently as well as illustrative quotes for these key themes. We also trace the evolution of the program from 2010 to 2015. PLWH generally accepted the idea of the health department helping PLWH engage in care, and described how hearing about the treatment experiences of HIV seropositive peers would assist them with engagement in care. Although many physicians were supportive of the Data to Care concept, others expressed concern about potential health department intrusion on patient privacy and the patient-physician relationship. Providers emphasized the need for the health department to coordinate with existing efforts to improve patient engagement. As a result of the interviews, the Data to Care program in Seattle-King County was designed to incorporate an HIV

Adoption and use of social media among public health departments

OpenAIRE

Thackeray, Rosemary; Neiger, Brad L; Smith, Amanda K; Van Wagenen, Sarah B

2012-01-01

Abstract Background Effective communication is a critical function within any public health system. Social media has enhanced communication between individuals and organizations and has the potential to augment public health communication. However, there is a lack of reported data on social media adoption within public health settings. The purposes of this study were to assess: 1) the extent to which state public health departments (SHDs) are using social media; 2) which social media applicat...

Leadership for Public Health 3.0: A Preliminary Assessment of Competencies for Local Health Department Leaders

Directory of Open Access Journals (Sweden)

Emmanuel D. Jadhav

2017-10-01

Full Text Available BackgroundThe foundational public health services model V1.0, developed in response to the Institute of Medicine report For the Public’s Health: Investing in a Healthier Future identified important capabilities for leading local health departments (LHDs. The recommended capabilities include the organizational competencies of leadership and governance, which are described as consensus building among internal and external stakeholders. Leadership through consensus building is the main characteristic of Democratic Leadership. This style of leadership works best within the context of a competent team. Not much is known about the competency structure of LHD leadership teams. The objectives of this study characterize the competency structure of leadership teams in LHDs and identify the relevance of existing competencies for the practice of leadership in public health.Materials and methodsThe study used a cross-sectional study design. Utilizing the workforce taxonomy six management and leadership occupation titles were used as job categories. The competencies were selected from the leadership and management domain of public health competencies for the Tier -3, leadership level. Study participants were asked to rank on a Likert scale of 1–10 the relevance of each competency to their current job category, with a rank of 1 being least important and a rank of 10 being most important. The instrument was administered in person.DataData were collected in 2016 from 50 public health professionals serving in leadership and management positions in a convenience sample of three LHDS.ResultsThe competency of most relevance to the highest executive function category was that of “interaction with interrelated systems.” For sub-agency level officers the competency of most relevance was “advocating for the role of public health.” The competency of most relevance to Program Directors/Managers or Administrators was “ensuring continuous quality improvement

Local Health Departments’ Use of Twitter

Centers for Disease Control (CDC) Podcasts

2013-05-02

This podcast is an interview with Jenine K. Harris, PhD, from the Brown School at Washington University in St. Louis, MO, about local health departments’ use of Twitter to disseminate diabetes information.  Created: 5/2/2013 by Preventing Chronic Disease (PCD), National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP).   Date Released: 5/2/2013.

Estimating the cost to U.S. health departments to conduct HIV surveillance.

Science.gov (United States)

Shrestha, Ram K; Sansom, Stephanie L; Laffoon, Benjamin T; Farnham, Paul G; Shouse, R Luke; MacMaster, Karen; Hall, H Irene

2014-01-01

HIV case surveillance is a primary source of information for monitoring HIV burden in the United States and guiding the allocation of prevention and treatment funds. While the number of people living with HIV and the need for surveillance data have increased, little is known about the cost of surveillance. We estimated the economic cost to health departments of conducting high-quality HIV case surveillance. We collected primary data on the unit cost and quantity of resources used to operate the HIV case surveillance program in Michigan, where HIV burden (i.e., the number of HIV cases) is moderate to high (n=14,864 cases). Based on Michigan's data, we projected the expected annual HIV surveillance cost for U.S., state, local, and territorial health departments. We based our cost projection on the variation in the number of new and established cases, area-specific wages, and potential economies of scale. We estimated the annual total HIV surveillance cost to the Michigan health department to be $1,286,524 ($87/case), the annual total cost of new cases to be $108,657 ($133/case), and the annual total cost of established cases to be $1,177,867 ($84/case). Our projected median annual HIV surveillance cost per health department ranged from $210,600 in low-HIV burden sites to $1,835,000 in high-HIV burden sites. Our analysis shows that a systematic approach to costing HIV surveillance at the health department level is feasible. For HIV surveillance, a substantial portion of total surveillance costs is attributable to maintaining established cases.

Assessing the Department of Defense’s Approach to Reducing Mental Health Stigma

Science.gov (United States)

2016-01-18

C O R P O R A T I O N RESE ARCH BR IEF Assessing the Department of Defense’s Approach to Reducing Mental Health Stigma When facing mental health ...problems, many service members choose not to seek needed help because of the stigma associated with mental health dis- orders and treatment. Not seeking...mem- bers. The stigma of seeking mental health treatment in the military persists despite the efforts of both the U.S. Depart- ment of Defense (DoD

Adapting to the Changing Climate: An Assessment of Local Health Department Preparations for Climate Change-Related Health Threats, 2008-2012.

Science.gov (United States)

Roser-Renouf, Connie; Maibach, Edward W; Li, Jennifer

2016-01-01

Climate change poses a major public health threat. A survey of U.S. local health department directors in 2008 found widespread recognition of the threat, but limited adaptive capacity, due to perceived lack of expertise and other resources. We assessed changes between 2008 and 2012 in local public health departments' preparedness for the public health threats of climate change, in light of increasing national polarization on the issue, and widespread funding cutbacks for public health. A geographically representative online survey of directors of local public health departments was conducted in 2011-2012 (N = 174; response rate = 50%), and compared to the 2008 telephone survey results (N = 133; response rate = 61%). Significant polarization had occurred: more respondents in 2012 were certain that the threat of local climate change impacts does/does not exist, and fewer were unsure. Roughly 10% said it is not a threat, compared to 1% in 2008. Adaptation capacity decreased in several areas: perceived departmental expertise in climate change risk assessment; departmental prioritization of adaptation; and the number of adaptation-related programs and services departments provided. In 2008, directors' perceptions of local impacts predicted the number of adaptation-related programs and services their departments offered, but in 2012, funding predicted programming and directors' impact perceptions did not. This suggests that budgets were constraining directors' ability to respond to local climate change-related health threats. Results also suggest that departmental expertise may mitigate funding constraints. Strategies for overcoming these obstacles to local public health departments' preparations for climate change are discussed.

Social media adoption in local health departments nationwide.

Science.gov (United States)

Harris, Jenine K; Mueller, Nancy L; Snider, Doneisha

2013-09-01

We examined whether characteristics of local health departments (LHD) and their geographic region were associated with using Facebook and Twitter. We also examined the number of tweets per month for Twitter accounts as an indicator of social media use by LHDs. In 2012, we searched for Facebook and Twitter accounts for 2565 LHDs nationwide, and collected adoption date and number of connections for each account. Number of tweets sent indicated LHD use of social media. LHDs were classified as innovators, early adopters, or nonadopters. Characteristics of LHDs were compared across adoption categories, and we examined geographic characteristics, connections, and use. Twenty-four percent of LHDs had Facebook, 8% had Twitter, and 7% had both. LHDs serving larger populations were more likely to be innovators, tweeted more often, and had more social media connections. Frequency of tweeting was not associated with adoption category. There were differences in adoption across geographic regions, with western states more likely to be innovators. Innovation was also higher in states where the state health department adopted social media. Social media has the potential to aid LHDs in disseminating information across the public health system. More evidence is needed to develop best practices for this emerging tool.

Local Health Departments’ Use of Twitter

Centers for Disease Control (CDC) Podcasts

This podcast is an interview with Jenine K. Harris, PhD, from the Brown School at Washington University in St. Louis, MO, about local health departments’ use of Twitter to disseminate diabetes information.

Effective communication of public health guidance to emergency department clinicians in the setting of emerging incidents: a qualitative study and framework.

Science.gov (United States)

Khan, Yasmin; Sanford, Sarah; Sider, Doug; Moore, Kieran; Garber, Gary; de Villa, Eileen; Schwartz, Brian

2017-04-28

Evidence to inform communication between emergency department clinicians and public health agencies is limited. In the context of diverse, emerging public health incidents, communication is urgent, as emergency department clinicians must implement recommendations to protect themselves and the public. The objectives of this study were to: explore current practices, barriers and facilitators at the local level for communicating public health guidance to emergency department clinicians in emerging public health incidents; and develop a framework that promotes effective communication of public health guidance to clinicians during emerging incidents. A qualitative study was conducted using semi-structured interviews with 26 key informants from emergency departments and public health agencies in Ontario, Canada. Data were analyzed inductively and the analytic approach was guided by concepts of complexity theory. Emergent themes corresponded to challenges and strategies for effective communication of public health guidance. Important challenges related to the coordination of communication across institutions and jurisdictions, and differences in work environments across sectors. Strategies for effective communication were identified as the development of partnerships and collaboration, attention to specific methods of communication used, and the importance of roles and relationship-building prior to an emerging public health incident. Following descriptive analysis, a framework was developed that consists of the following elements: 1) Anticipate; 2) Invest in building relationships and networks; 3) Establish liaison roles and redundancy; 4) Active communication; 5) Consider and respond to the target audience; 6) Leverage networks for coordination; and 7) Acknowledge and address uncertainty. The qualities inherent in local relationships cut across framework elements. This research indicates that relationships are central to effective communication between public health

Estimating the financial resources needed for local public health departments in Minnesota: a multimethod approach.

Science.gov (United States)

Riley, William; Briggs, Jill; McCullough, Mac

2011-01-01

This study presents a model for determining total funding needed for individual local health departments. The aim is to determine the financial resources needed to provide services for statewide local public health departments in Minnesota based on a gaps analysis done to estimate the funding needs. We used a multimethod analysis consisting of 3 approaches to estimate gaps in local public health funding consisting of (1) interviews of selected local public health leaders, (2) a Delphi panel, and (3) a Nominal Group Technique. On the basis of these 3 approaches, a consensus estimate of funding gaps was generated for statewide projections. The study includes an analysis of cost, performance, and outcomes from 2005 to 2007 for all 87 local governmental health departments in Minnesota. For each of the methods, we selected a panel to represent a profile of Minnesota health departments. The 2 main outcome measures were local-level gaps in financial resources and total resources needed to provide public health services at the local level. The total public health expenditure in Minnesota for local governmental public health departments was $302 million in 2007 ($58.92 per person). The consensus estimate of the financial gaps in local public health departments indicates that an additional $32.5 million (a 10.7% increase or $6.32 per person) is needed to adequately serve public health needs in the local communities. It is possible to make informed estimates of funding gaps for public health activities on the basis of a combination of quantitative methods. There is a wide variation in public health expenditure at the local levels, and methods are needed to establish minimum baseline expenditure levels to adequately treat a population. The gaps analysis can be used by stakeholders to inform policy makers of the need for improved funding of the public health system.

Violence toward health care workers in emergency departments in Denizli, Turkey.

Science.gov (United States)

Boz, Bora; Acar, Kemalettin; Ergin, Ahmet; Erdur, Bulent; Kurtulus, Ayse; Turkcuer, Ibrahim; Ergin, Nesrin

2006-01-01

This study sought to determine the frequency and types of violence that occurred during the previous year against health care workers in emergency departments in Denizli, Turkey, and to discern the views of workers on the prevention of such aggressive behavior. This study was conducted from March 1 to April 15, 2003, and included a group of 79 health care workers from the emergency departments of 3 hospitals in Denizli, namely, the Hospital of Pamukkale University Medical Faculty, the City Hospital of Denizli, and the Hospital of the Social Insurance Foundation. Data were collected from a self-administered questionnaire. In all, 88.6% of participants had been subjected to or had witnessed verbal violence, and 49.4% of them had been subjected to or had witnessed physical violence during the previous year. The most frequent reason (31.4%) for violence was abuse of alcohol and drugs by perpetrators. The second most frequent reason (24.7%) was the long waiting times typical of emergency departments. The most common type of violence was loud shouting; swearing, threatening, and hitting were the next most frequent violent behaviors. In all, 36.1% of subjects who had experienced violence reported that they developed psychological problems after the incident. Most participants commented on the insufficiency of currently available security systems within emergency departments and on the need for further training about violence. All health care personnel within emergency departments should be aware of the risk of violence and should be prepared for unpredictable conditions and events; in addition, security systems should be updated so that violence within emergency departments can be prevented.

Department of Structural Research - Overview

International Nuclear Information System (INIS)

Wasiutynski, T.

1999-01-01

Full text: Two main subjects dominated activity of Department of Structural Research this year: dynamics of molecules in condensed matter and magnetic properties of new materials. The former subject is to be understood in a very broad sense. It embraces fast quantum and classical reorientations of small molecules in disordered crystalline phases as well as rather slow motions of large molecules and molecular segments in liquid crystals and polymers. Glassy states occurring in such systems were of particular interest. The magnetic materials studied in our department fall into two categories: canonical substances such as rare earth orthoferrites and the recently discovered molecular magnets. A typical study of a substance in our group consists of a series of experiments involving various complementary methods followed by advanced theoretical and model analysis. The experimental work is performed on great instruments accessible for us owing to the well established network of international cooperations and in great number at our own premises. The main experimental tools of our department are: adiabatic and differential scanning calorimeters, Fourier transformed infrared absorption spectrometer, ac susceptibility/dc magnotemeter and Cahn balance. All of them operate in wide temperature range: 4 - 400 K. Magnetic measurements are carried out in dc field up 56 kOe. An important improvement of out equipment took place last year. New hardware and software were devised to control the calorimetric measurements. Consequently temperature flows as slow as 1 μK/min are now detectable, that makes the calorimeter a perfect tool for the studies of slow relaxational processes in condensed matter. A new option of data acquisition applied to the infrared spectrometer allows one to study the kinetics of phase transformations in real time. The time resolution is of order of few minutes. This is of special importance in the studies of glassy phases which evolve in the time scale of hours

HIV provider and patient perspectives on the Development of a Health Department “Data to Care” Program: a qualitative study

Directory of Open Access Journals (Sweden)

Julia C. Dombrowski

2016-06-01

Full Text Available Abstract Background U.S. health departments have not historically used HIV surveillance data for disease control interventions with individuals, but advances in HIV treatment and surveillance are changing public health practice. Many U.S. health departments are in the early stages of implementing “Data to Care” programs to assists persons living with HIV (PLWH with engaging in care, based on information collected for HIV surveillance. Stakeholder engagement is a critical first step for development of these programs. In Seattle-King County, Washington, the health department conducted interviews with HIV medical care providers and PLWH to inform its Data to Care program. This paper describes the key themes of these interviews and traces the evolution of the resulting program. Methods Disease intervention specialists conducted individual, semi-structured qualitative interviews with 20 PLWH randomly selected from HIV surveillance who had HIV RNA levels >10,000 copies/mL in 2009–2010. A physician investigator conducted key informant interviews with 15 HIV medical care providers. Investigators analyzed de-identified interview transcripts, developed a codebook of themes, independently coded the interviews, and identified codes used most frequently as well as illustrative quotes for these key themes. We also trace the evolution of the program from 2010 to 2015. Results PLWH generally accepted the idea of the health department helping PLWH engage in care, and described how hearing about the treatment experiences of HIV seropositive peers would assist them with engagement in care. Although many physicians were supportive of the Data to Care concept, others expressed concern about potential health department intrusion on patient privacy and the patient-physician relationship. Providers emphasized the need for the health department to coordinate with existing efforts to improve patient engagement. As a result of the interviews, the Data to Care

Radiological safety programme for the health departments in Parana, Brazil

International Nuclear Information System (INIS)

Schmidt, M.F.S.; Tilly, J.G. Jr.

1998-01-01

As a result of Brazil's centralized administration in the past, various parts of the public service were somewhat inefficient. Another reason was the size of the country. To improve the situation in the health sector, it was decided to transfer administrative responsibility to the municipal authorities. Accordingly, the public health system is now defined under the appropriate legislation as the 'Unified Health System' (SUS), comprising federal, state and municipal levels. This system promotes decentralization of therapeutic or preventive services (including the Radiation Facility Health Inspectorate) and proposes any additional legislation required. In Parana the Radiation Facility Health Inspectorate has 3600 organizations listed, employing ionizing radiation in medicine, industry and research, which need to be regularly inspected for licensing and control. In 1994, 50% of the annual inspection target in the state was attained. The Radiation Safety Programme for the Health Departments in Parana directs these activities in this State. Its strategies are: (1) to establish implementation phases for activities planned for each area; (2) to take advantage of the SUS structure to introduce or expand operational services at the primary, secondary and tertiary levels with appropriate equipment. The tertiary level involves co-ordination of the Programme and complementary executive functions, as well as maintaining an information system with other related organizations. The other levels include licensing, control and emergency response. As the Programme develops, indicators will be established to help identify progress achieved and correct operating strategy where necessary. Thus, the services provided to the public will be enhanced in quality and the radiation doses reduced. In addition, in emergency situations, the time elapsing between the event and its notification to the authorities will be reduced, minimizing the consequences of any accidents. (author)

48 CFR 1371.113 - Department of Labor occupational safety and health standards for ship repair.

Science.gov (United States)

2010-10-01

... occupational safety and health standards for ship repair. 1371.113 Section 1371.113 Federal Acquisition... CONSTRUCTION AND SHIP REPAIR Provisions and Clauses 1371.113 Department of Labor occupational safety and health standards for ship repair. Insert clause 1352.271-82, Department of Labor Occupational Safety and Health...

Department of Hadron Structure - Overview

International Nuclear Information System (INIS)

Eskreys, A.

2000-01-01

research program and the detector construction has been continued with the goal to be ready by 2005. Department XII is involved in the preparation of the project of the luminosity detector. TESLA is the project of the new generation high energy e + e - linear collider, planned to be built in Hamburg. Our engineers prepared the final version of electronic board which will be used in the control system of cavities for TESLA project. The analysis of the data from the two presently continued experiments (ZEUS, D0) cover the program of research ranging from the exploration of the structure of the matter in photoproduction, deep inelastic e ± p scattering and (anti)pp collisions through the searches of the exotic and rare processes (W, Z, top, leptoquarks production) to the new approach to the traditional subject like properties of the pion emission source or property of the hadronic final states. Above outsketched research has resulted in 1999 in 29 publications in the renown scientific periodicals. (author)

Describing the continuum of collaboration among local health departments with hospitals around the community health assessments.

Science.gov (United States)

Wilson, Kristin D; Mohr, Lisa Buettner; Beatty, Kate E; Ciecior, Amanda

2014-01-01

Hospitals and local health departments (LHDs) are under policy requirements from the Affordable Care Act and accreditation standards through the Public Health Accreditation Board. Tax exempt hospitals must perform a community health needs assessment (CHNA), similar to the community health assessment (CHA) required for LHDs. These efforts have led to a renewed interest in hospitals and LHDs working together to achieve common goals. The purpose of this study is to gain a better understanding of levels of joint action leading toward collaboration between LHDs and hospitals and describe collaboration around CHAs. Local health departments were selected on the basis of reporting collaboration (n = 26) or unsure about collaboration (n = 29) with local hospitals. Local health departments were surveyed regarding their relationship with local hospitals. For LHDs currently collaborating with a hospital, a collaboration continuum scale was calculated. Appropriate nonparametric tests, chi-squares, and Spearman's rank correlations were conducted to determine differences between groups. A total of 44 LHDs responded to the survey (80.0%). Currently collaborating LHDs were more likely to be interested in accreditation and to refer to their CHA 5 or more times a year compared to the unsure LHDs. In the analysis, a collaboration continuum was created and is positively correlated with aspects of the CHA and CHA process. This study is the first attempt to quantify the level of collaboration between LHDs and hospitals around CHAs. Better understanding of the levels of joint action required may assist LHDs in making informed decisions regarding deployment of resources on the path to accreditation.

An Analysis of the Organizational Structures Supporting PPBE within the Military Departments

National Research Council Canada - National Science Library

Hill, Tiffany F

2008-01-01

... differently. Using Mintzberg's theory on organizational structures and Nadler and Tushman's congruence model, an analysis of each department's financial management organizational structure was conducted...

Relationship Between Family Power Structure, Marital Conflicts, and Mental Health in Male Retirees of Alborz Province Department, Iran Ministry of Education

Directory of Open Access Journals (Sweden)

Maryam Soleimani

2016-01-01

Conclusion: The results of the research indicate that power structure of family and marital conflicts can affect mental health of male retirees. And more unequal power structure of family and more marital conflicts can lead to decrease in mental health of male retirees.

New types of organizational structures of accounting departments and their development

OpenAIRE

Шигун, Марія Михайлівна

2015-01-01

Development directions of new types of organizational structures of accounting departments, emergence of which has been caused by present-day conditions of keeping economics relationships, have been researched, as well as peculiarity of complex hierarchical and adaptive structures has been disclosed.

Health Physics Department. Annual progress report 1 January - 31 December 1988

International Nuclear Information System (INIS)

1989-06-01

The report describes the work of the Health Physics Department at Risoe during 1988. The activities cover dosimetry, instrumentation, radioecology, risk by nuclear activities and nuclear emergency preparedness. Lists of staff and publications are included. The emphasis in the report has been placed on basic research and contractual work. However, service functions do constitute a substantial work load for the department. (author)

Health Physics Department annual progress report 1 January - 31 December 1986

International Nuclear Information System (INIS)

1987-05-01

The report describes the work of the Healths Physsics Department at Risoe during 1986. The activities cover dosimetry, instrumentation, radioecology, risk by nuclear activities and nuclear emergency preparedness. Lists of staff and publications are included. The emphasis in the report has been placed on scientific and contractual work. However, service functions do constitute a substantial work load for the department. (author)

Health Physics Department. Annual progress report 1 January - 31 December 1987

International Nuclear Information System (INIS)

1988-08-01

The report describes the work of the Health Physics Department at Risoe during 1987. The activities cover dosimetry, instrumentation, radioecology, risk by nuclear activities and nuclear emergency preparedness. Lists of staff and publications are included. The main emphasis in the report has been placed on scientific and contractual work. However, service functions do constitute a substantial work load for the department. (author)

Assessing the use of computers in industrial occupational health departments.

Science.gov (United States)

Owen, J P

1995-04-01

Computers are widely used in business and industry and the benefits of computerizing occupational health (OH) departments have been advocated by several authors. The requirements for successful computerization of an OH department are reviewed. Having identified the theoretical benefits, the real picture in industry is assessed by surveying 52 firms with over 1000 employees in a large urban area. Only 15 (29%) of the companies reported having any OH service, of which six used computers in the OH department, reflecting the business priorities of most of the companies. The types of software systems used and their main use are examined, along with perceived benefits or disadvantages. With the decreasing costs of computers and increasingly 'user-friendly' software, there is a real cost benefit to be gained from using computers in OH departments, although the concept may have to be 'sold' to management.

Assessing electronic health record systems in emergency departments: Using a decision analytic Bayesian model.

Science.gov (United States)

Ben-Assuli, Ofir; Leshno, Moshe

2016-09-01

In the last decade, health providers have implemented information systems to improve accuracy in medical diagnosis and decision-making. This article evaluates the impact of an electronic health record on emergency department physicians' diagnosis and admission decisions. A decision analytic approach using a decision tree was constructed to model the admission decision process to assess the added value of medical information retrieved from the electronic health record. Using a Bayesian statistical model, this method was evaluated on two coronary artery disease scenarios. The results show that the cases of coronary artery disease were better diagnosed when the electronic health record was consulted and led to more informed admission decisions. Furthermore, the value of medical information required for a specific admission decision in emergency departments could be quantified. The findings support the notion that physicians and patient healthcare can benefit from implementing electronic health record systems in emergency departments. © The Author(s) 2015.

Billing third party payers for vaccines: state and local health department perspectives.

Science.gov (United States)

Quintanilla, Carlos; Duncan, Lorraine; Luther, Lydia

2009-01-01

The cost of adequately immunizing a child has risen steadily with recommendations of new, more expensive vaccines. The Vaccines for Children (VFC) program, a federal entitlement, has continued to fund all recommended vaccines for eligible children. The one other federal vaccine-funding source, Section 317 of the Public Health Service Act, has not kept pace with rising vaccine costs. For local health departments to immunize children not eligible for VFC, but whose families are underinsured or otherwise unable to pay for vaccines, state immunization programs have often relied on Section 317 funds. Recognizing this funding challenge and having learned that children covered by health insurance were being immunized in public clinics with publicly supplied vaccines, the Oregon Immunization Program (OIP) launched a project to expand billing of health plans by local health departments for vaccines administered to covered persons. This has resulted in significant savings of Section 317 funds, allowing the Oregon program to provide more vaccines for high-need persons.

76 FR 44592 - Cooperative Agreement With the World Health Organization Department of Food Safety and Zoonoses...

Science.gov (United States)

2011-07-26

... DEPARTMENT OF HEALTH AND HUMAN SERVICES Food and Drug Administration [Docket No. FDA-2011-N-0010] Cooperative Agreement With the World Health Organization Department of Food Safety and Zoonoses in Support of... agreement with the World Health Organization. The document published stating that the total funding...

[Gender influence on health related quality of life among resident physicians working in an emergency department].

Science.gov (United States)

Fernández-Prada, María; González-Cabrera, Joaquín; Torres G, Francisco; Iribar-Ibabe, Concepción; María Peinado, José

2014-02-01

The high emotional burden of physicians working in emergency departments may affect their quality of life perception. To evaluate health related quality of life among resident physicians performing shifts at an emergency department. Seventy one physicians aged 26,3 ± 1,7 years (47 women), working as residents in an emergency department, answered the short version of the Short-Form Health Survey Questionnaire (SF-36®). This questionnaire analyses eight domains: physical function, body pain, general health, vitality, social function, emotional role and mental health. Women had a significantly worse perception than a reference population in four dimensions of the SF-36, especially mental health and social functioning. Men had scores similar to the reference population. Among women, vitality is the best predictor of mental health and social functioning. Women working as residents in an emergency department have a worse perception of their quality of life than men performing the same job.

Implementation and evaluation of health passport communication tools in emergency departments.

Science.gov (United States)

Heifetz, Marina; Lunsky, Yona

2018-01-01

People with IDD (intellectual or developmental disabilities) and their families consistently report dissatisfaction with their emergency department experience. Clear care plans and communication tools may not only improve the quality of patient care, but also can prevent unnecessary visits and reduce the likelihood of return visits. To evaluate communication tools to be used by people with IDD in psychiatric and general emergency departments in three different regions of Ontario. Health passport communication tools were locally tailored and implemented in each of the three regions. A total of 28 questionnaires and 18 interviews with stakeholders (e.g., hospital staff, community agency representatives, families) were completed across the regions to obtain feedback on the implementation of health passports with people with IDD. Participants felt that the health passport tools provided helpful information, improved communication between patients with IDD and hospital staff, and were user friendly. Continued efforts are needed to work with communities on maintenance of this tool, ensuring all hospital staff are utilizing the information. These findings emphasize the merits of health passport tools being implemented in the health system to support communication between patients with IDD and health care practitioners and the importance of tailoring tools to local settings. Copyright © 2017 Elsevier Ltd. All rights reserved.

Assessing the Knowledge, Skills, and Abilities of Public Health Professionals in Big City Governmental Health Departments.

Science.gov (United States)

McGinty, Meghan D; Castrucci, Brian C; Rios, Debra M

2017-12-13

To identify essential knowledge, skills, and abilities (KSAs) for and characterize gaps in KSAs of professionals working in large, urban health departments. A survey was disseminated to potentially eligible supervisors within 26 of 28 health departments in the largest, most urban jurisdictions in the country. A supervisor was eligible to participate if he or she supervised at least 1 staff member whose highest level of education was a master's degree. A total of 645 eligible supervisors participated in the workforce survey for a response rate of 27.1% and cooperation rate of 55.2%. Supervisors were asked to rate the importance of KSAs to their masters-level staffs' work and indicate their staffs' proficiency. Fifty-eight percent of supervisors reported supervising staff with a master of public health/master of science in public health degree. More than 30% of supervisors indicated that all of the 30 KSAs were essential. Four of the top 10 KSAs rated as essential by supervisors pertained to the ability to communicate. The top skills gaps perceived by supervisors were professional staffs' ability to apply quality improvement concepts to their work (38.0%), understanding of the political system (37.7%), and ability to anticipate changes (33.8%). Public health practitioners receive training in methods, theories, and evidence-based approaches, yet further investment in the workforce is necessary to advance population health. A focus should be placed developing strategic skills rather than advancing narrow specialties. Findings from this research can guide the creation and implementation of training curricula and professional development programs offered within local health departments or targeted to their staff, as well as satisfaction of accreditation requirements. By focusing on building strategic skills, we can ensure a public health workforce that is equipped with the KSAs necessary to practice Public Health 3.0 and leaders who are able to serve as their communities

Health physics department annual progress report 1 January - 31 December 1983

International Nuclear Information System (INIS)

1984-08-01

The report describes the work of the Health Physics Department at Risoe during 1983. The activities cover dosimetry, instrumentation, radioecology, risk by nuclear activities and nuclear emergency preparedness. Lists of staff and publications are included. A great deal of the work in the department is of minor interest to people outside Risoe as it represents service functions. Therefore, the main emphasis in the report has been placed on scientific and contractual work. (author)

Structural issues affecting mixed methods studies in health research: a qualitative study

Science.gov (United States)

2009-01-01

Background Health researchers undertake studies which combine qualitative and quantitative methods. Little attention has been paid to the structural issues affecting this mixed methods approach. We explored the facilitators and barriers to undertaking mixed methods studies in health research. Methods Face-to-face semi-structured interviews with 20 researchers experienced in mixed methods research in health in the United Kingdom. Results Structural facilitators for undertaking mixed methods studies included a perception that funding bodies promoted this approach, and the multidisciplinary constituency of some university departments. Structural barriers to exploiting the potential of these studies included a lack of education and training in mixed methods research, and a lack of templates for reporting mixed methods articles in peer-reviewed journals. The 'hierarchy of evidence' relating to effectiveness studies in health care research, with the randomised controlled trial as the gold standard, appeared to pervade the health research infrastructure. Thus integration of data and findings from qualitative and quantitative components of mixed methods studies, and dissemination of integrated outputs, tended to occur through serendipity and effort, further highlighting the presence of structural constraints. Researchers are agents who may also support current structures - journal reviewers and editors, and directors of postgraduate training courses - and thus have the ability to improve the structural support for exploiting the potential of mixed methods research. Conclusion The environment for health research in the UK appears to be conducive to mixed methods research but not to exploiting the potential of this approach. Structural change, as well as change in researcher behaviour, will be necessary if researchers are to fully exploit the potential of using mixed methods research. PMID:20003210

Structural issues affecting mixed methods studies in health research: a qualitative study.

Science.gov (United States)

O'Cathain, Alicia; Nicholl, Jon; Murphy, Elizabeth

2009-12-09

Health researchers undertake studies which combine qualitative and quantitative methods. Little attention has been paid to the structural issues affecting this mixed methods approach. We explored the facilitators and barriers to undertaking mixed methods studies in health research. Face-to-face semi-structured interviews with 20 researchers experienced in mixed methods research in health in the United Kingdom. Structural facilitators for undertaking mixed methods studies included a perception that funding bodies promoted this approach, and the multidisciplinary constituency of some university departments. Structural barriers to exploiting the potential of these studies included a lack of education and training in mixed methods research, and a lack of templates for reporting mixed methods articles in peer-reviewed journals. The 'hierarchy of evidence' relating to effectiveness studies in health care research, with the randomised controlled trial as the gold standard, appeared to pervade the health research infrastructure. Thus integration of data and findings from qualitative and quantitative components of mixed methods studies, and dissemination of integrated outputs, tended to occur through serendipity and effort, further highlighting the presence of structural constraints. Researchers are agents who may also support current structures - journal reviewers and editors, and directors of postgraduate training courses - and thus have the ability to improve the structural support for exploiting the potential of mixed methods research. The environment for health research in the UK appears to be conducive to mixed methods research but not to exploiting the potential of this approach. Structural change, as well as change in researcher behaviour, will be necessary if researchers are to fully exploit the potential of using mixed methods research.

Institution-to-Institution Mentoring to Build Capacity in 24 Local US Health Departments: Best Practices and Lessons Learned

OpenAIRE

Veatch, Maggie; Goldstein, Gail P.; Sacks, Rachel; Lent, Megan; Van Wye, Gretchen

2014-01-01

Introduction Institutional mentoring may be a useful capacity-building model to support local health departments facing public health challenges. The New York City Department of Health and Mental Hygiene conducted a qualitative evaluation of an institutional mentoring program designed to increase capacity of health departments seeking to address chronic disease prevention. The mentoring program included 2 program models, a one-to-one model and a collaborative model, developed and implemented ...

Profile-IQ: Web-based data query system for local health department infrastructure and activities.

Science.gov (United States)

Shah, Gulzar H; Leep, Carolyn J; Alexander, Dayna

2014-01-01

To demonstrate the use of National Association of County & City Health Officials' Profile-IQ, a Web-based data query system, and how policy makers, researchers, the general public, and public health professionals can use the system to generate descriptive statistics on local health departments. This article is a descriptive account of an important health informatics tool based on information from the project charter for Profile-IQ and the authors' experience and knowledge in design and use of this query system. Profile-IQ is a Web-based data query system that is based on open-source software: MySQL 5.5, Google Web Toolkit 2.2.0, Apache Commons Math library, Google Chart API, and Tomcat 6.0 Web server deployed on an Amazon EC2 server. It supports dynamic queries of National Profile of Local Health Departments data on local health department finances, workforce, and activities. Profile-IQ's customizable queries provide a variety of statistics not available in published reports and support the growing information needs of users who do not wish to work directly with data files for lack of staff skills or time, or to avoid a data use agreement. Profile-IQ also meets the growing demand of public health practitioners and policy makers for data to support quality improvement, community health assessment, and other processes associated with voluntary public health accreditation. It represents a step forward in the recent health informatics movement of data liberation and use of open source information technology solutions to promote public health.

Timing of Clinical Billing Reimbursement for a Local Health Department.

Science.gov (United States)

McCullough, J Mac

2016-01-01

A major responsibility of a local health department (LHD) is to assure public health service availability throughout its jurisdiction. Many LHDs face expanded service needs and declining budgets, making billing for services an increasingly important strategy for sustaining public health service provision. Yet, little practice-based data exist to guide practitioners on what to expect financially, especially regarding timing of reimbursement receipt. This study provides results from one LHD on the lag from service delivery to reimbursement receipt. Reimbursement records for all transactions at Maricopa County Department of Public Health immunization clinics from January 2013 through June 2014 were compiled and analyzed to determine the duration between service and reimbursement. Outcomes included daily and cumulative revenues received. Time to reimbursement for Medicaid and private payers was also compared. Reimbursement for immunization services was received a median of 68 days after service. Payments were sometimes taken back by payers through credit transactions that occurred a median of 333 days from service. No differences in time to reimbursement between Medicaid and private payers were found. Billing represents an important financial opportunity for LHDs to continue to sustainably assure population health. Yet, the lag from service provision to reimbursement may complicate budgeting, especially in initial years of new billing activities. Special consideration may be necessary to establish flexibility in the budget-setting processes for services with clinical billing revenues, because funds for services delivered in one budget period may not be received in the same period. LHDs may also benefit from exploring strategies used by other delivery organizations to streamline billing processes.

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

Science.gov (United States)

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

2017-06-29

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

Targeted health department expenditures benefit birth outcomes at the county level.

Science.gov (United States)

Bekemeier, Betty; Yang, Youngran; Dunbar, Matthew D; Pantazis, Athena; Grembowski, David E

2014-06-01

Public health leaders lack evidence for making decisions about the optimal allocation of resources across local health department (LHD) services, even as limited funding has forced cuts to public health services while local needs grow. A lack of data has also limited examination of the outcomes of targeted LHD investments in specific service areas. This study used unique, detailed LHD expenditure data gathered from state health departments to examine the influence of maternal and child health (MCH) service investments by LHDs on health outcomes. A multivariate panel time-series design was used in 2013 to estimate ecologic relationships between 2000-2010 LHD expenditures on MCH and county-level rates of low birth weight and infant mortality. The unit of analysis was 102 LHD jurisdictions in Washington and Florida. Results indicate that LHD expenditures on MCH services have a beneficial relationship with county-level low birth weight rates, particularly in counties with high concentrations of poverty. This relationship is stronger for more targeted expenditure categories, with expenditures in each of the three specific examined MCH service areas demonstrating the strongest effects. Findings indicate that specific LHD investments in MCH have an important effect on related health outcomes for populations in poverty and likely help reduce the costly burden of poor birth outcomes for families and communities. These findings underscore the importance of monitoring the impact of these evolving investments and ensuring that targeted, beneficial investments are not lost but expanded upon across care delivery systems. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Measuring the authority of local public health directors in the context of organizational structure: an exploratory, multimodal approach.

Science.gov (United States)

Miner Gearin, Kimberly J; Thrash, Allison M Rick; Frauendienst, Renee; Myhre, Julie; Gyllstrom, M Elizabeth; Riley, William J; Schroeder, Janelle

2012-11-01

Studies have reported a relationship between the organization of public health services and variability in public health practice at the local and state levels. A national research agenda has prioritized practice-based research to understand pathways that lead to this variation and examine the impact of these differences on outcomes. To measure the extent to which Minnesota local health directors report having key authorities and examine the relationship between organizational structure and authority of local health directors. : Multimodal. Minnesota local health departments. Directors of Minnesota local health departments. Director authorities. Most Minnesota local health directors reported having 6 key authorities related to budget preparation and modification and interaction with local elected officials (n = 51, 71%). Twelve directors (16%) reported that they have 4 or fewer of the 6 authorities. The authority most commonly reported as lacking was the authority to initiate communication with locally elected officials (n = 15, 21%). The percentage of directors who reported having all 6 authorities was higher among those in stand-alone departments (82%) than those in combined organizations (50%). This descriptive study illustrates that emerging practice-based research networks can successfully collaborate on small-scale research projects with immediate application for systems development. Study findings are being used by local public health officials to help articulate their role, aid in succession planning, and inform elected officials, who need to consider the public health implications of potential changes to local public health governance and organization. More studies are needed to refine measurement of authority and structure.

The U.S. department of energy health and mortality study

International Nuclear Information System (INIS)

Fry, S.A.; Lushbaugh, C.C.; Shy, C.M.; Cragle, D.L.; Checkoway, H.; Blum, S.; Carpenter, A.V.; Dupree, E.A.; Frome, E.L.; Groer, P.G.; Wilson, J.

1985-01-01

Epidemiological studies to evaluate health and mortality among persons employed at some time since 1942 by the U.S. Department of Energy and its predecessors are being carried out by investigators at the Oak Ridge Associated Universities (ORAU) together with others at Hanford and the Los Alamos National Laboratory. The ORAU is responsible for examining relationships between occupational exposure to ionizing radiations from external and/or internal sources and subsequent health and mortality. The health effects of chemical toxicants, especially uranium and other toxic metals are also being investigated. Approximately one third of the estimated total DOE worker population of 600,000 are included in this study. Some results of the study are tabulated. 13 refs

STRUCTURAL AND HIDDEN BARRIERS TO A LOCAL PRIMARY HEALTH CARE INFRASTRUCTURE: AUTONOMY, DECISIONS ABOUT PRIMARY HEALTH CARE, AND THE CENTRALITY AND SIGNIFICANCE OF POWER.

Science.gov (United States)

Freed, Christopher R; Hansberry, Shantisha T; Arrieta, Martha I

2013-09-01

To examine a local primary health care infrastructure and the reality of primary health care from the perspective of residents of a small, urban community in the southern United States. Data derive from 13 semi-structured focus groups, plus three semi-structured interviews, and were analyzed inductively consistent with a grounded theory approach. Structural barriers to the local primary health care infrastructure include transportation, clinic and appointment wait time, and co-payments and health insurance. Hidden barriers consist of knowledge about local health care services, non-physician gatekeepers, and fear of medical care. Community residents have used home remedies and the emergency department at the local academic medical center to manage these structural and hidden barriers. Findings might not generalize to primary health care infrastructures in other communities, respondent perspectives can be biased, and the data are subject to various interpretations and conceptual and thematic frameworks. Nevertheless, the structural and hidden barriers to the local primary health care infrastructure have considerably diminished the autonomy community residents have been able to exercise over their decisions about primary health care, ultimately suggesting that efforts concerned with increasing the access of medically underserved groups to primary health care in local communities should recognize the centrality and significance of power. This study addresses a gap in the sociological literature regarding the impact of specific barriers to primary health care among medically underserved groups.

Public Health Employees' Perception of Workplace Environment and Job Satisfaction: The Role of Local Health Departments' Engagement in Accreditation.

Science.gov (United States)

Ye, Jiali; Verma, Pooja; Leep, Carolyn; Kronstadt, Jessica

To examine the association between local health departments' (LHDs') engagement in accreditation and their staffs' perceptions of workplace environment and the overall satisfaction with their jobs. Data from the 2014 Public Health Workforce Interests and Needs Survey (PH WINS) (local data only) and the 2014 Forces of Change survey were linked using LHDs' unique ID documented by the National Association of County & City Health Officials. The Forces of Change survey assessed LHDs' accreditation status. Local health departments were classified as "formally engaged" in the Public Health Accreditation Board accreditation process if they had achieved accreditation, submitted an application, or submitted a statement of intent. The PH WINS survey measured employees' perception of 3 aspects of workplace environment, including supervisory support, organizational support, and employee engagement. The overall satisfaction was measured using the Job in General Scale (abridged). There are 1884 LHD employees who completed PH WINS and whose agencies responded to the question on the accreditation status of the Forces of Change survey. When compared with employees from LHDs less engaged in accreditation, employees from LHDs that were formally engaged in accreditation gave higher ratings to all 3 aspects of workplace environment and overall job satisfaction. Controlling for employee demographic characteristics and LHD jurisdiction size, the agency's formal engagement in accreditation remained related to a higher score in perceived workplace environment and job satisfaction. After controlling for perceived workplace environment, accreditation status was marginally associated with job satisfaction. The findings provide support for previous reports by LHD leaders on the benefits of accreditation related to employee morale and job satisfaction. The results from this study allow us to further catalog the benefits of accreditation in workforce development and identify factors that may

The influence of management and environment on local health department organizational structure and adaptation: a longitudinal network analysis.

Science.gov (United States)

Keeling, Jonathan W; Pryde, Julie A; Merrill, Jacqueline A

2013-01-01

The nation's 2862 local health departments (LHDs) are the primary means for assuring public health services for all populations. The objective of this study is to assess the effect of organizational network analysis on management decisions in LHDs and to demonstrate the technique's ability to detect organizational adaptation over time. We conducted a longitudinal network analysis in a full-service LHD with 113 employees serving about 187,000 persons. Network survey data were collected from employees at 3 times: months 0, 8, and 34. At time 1 the initial analysis was presented to LHD managers as an intervention with information on evidence-based management strategies to address the findings. At times 2 and 3 interviews documented managers' decision making and events in the task environment. Response rates for the 3 network analyses were 90%, 97%, and 83%. Postintervention (time 2) results showed beneficial changes in network measures of communication and integration. Screening and case identification increased for chlamydia and for gonorrhea. Outbreak mitigation was accelerated by cross-divisional teaming. Network measurements at time 3 showed LHD adaptation to H1N1 and budget constraints with increased centralization. Task redundancy increased dramatically after National Incident Management System training. Organizational network analysis supports LHD management with empirical evidence that can be translated into strategic decisions about communication, allocation of resources, and addressing knowledge gaps. Specific population health outcomes were traced directly to management decisions based on network evidence. The technique can help managers improve how LHDs function as organizations and contribute to our understanding of public health systems.

Overview of experimental research on nuclear structure in department of modern applied physics

International Nuclear Information System (INIS)

Zhu Shengjiang

1999-01-01

The experimental research on nuclear structure in Department of Modern Applied Physics, Tsinghua University has been summarized. The main research results in high spin states of nuclear structure, as well as some low spin states, have been reported

Vibration-based structural health monitoring of harbor caisson structure

Science.gov (United States)

Lee, So-Young; Lee, So-Ra; Kim, Jeong-Tae

2011-04-01

This study presents vibration-based structural health monitoring method in foundation-structure interface of harbor caisson structure. In order to achieve the objective, the following approaches are implemented. Firstly, vibration-based response analysis method is selected and structural health monitoring (SHM) technique is designed for harbor caisson structure. Secondly, the performance of designed SHM technique for harbor structure is examined by FE analysis. Finally, the applicability of designed SHM technique for harbor structure is evaluated by dynamic tests on a lab-scaled caisson structure.

Workforce turnover at local health departments: nature, characteristics, and implications.

Science.gov (United States)

Newman, Sarah J; Ye, Jiali; Leep, Carolyn J

2014-11-01

Employee turnover, defined as total separations from employment, is expensive, can result in lost capacity, and can limit local health departments' (LHDs') ability to respond to public health needs. Despite the importance of workforce capacity in public health, little is known about workforce turnover in LHDs. To examine the extent to which LHDs experience turnover and identify LHD characteristics that are associated with turnover. A cross-sectional data set of employee turnover and LHD characteristics from the 2013 National Profile of LHDs was analyzed. Descriptive statistics and bivariate analyses were conducted in 2014 on turnover rates. The effect of the following LHD characteristics on turnover rates were examined: population size, governance type, degree of urbanization, top executive experience level, expenditures per capita, and LHD budget cuts. In 2013, LHDs experienced a mean turnover rate of 9.88%; approximately one third of turnover was due to retirements. LHDs with shared state and local governance experienced a higher turnover rate than LHDs with exclusive state or local governance. LHDs that are units of state agencies had a significantly higher retirement rate than those governed by local authorities. Top executive experience level, per capita expenditures, and LHD budget cuts were also related to turnover rates. LHDs experienced a lower overall turnover rate than state health departments in 2011 and lower than all local and state government agencies in 2012. Strengthening leadership skills of new top executives and ensuring adequate funding may reduce turnover in LHDs. Copyright © 2014 American Journal of Preventive Medicine. Published by Elsevier Inc. All rights reserved.

Sustaining a quality improvement culture in local health departments applying for accreditation.

Science.gov (United States)

Verma, Pooja; Moran, John W

2014-01-01

This article focuses on local health departments (LHDs) that are advanced in accreditation and quality improvement (QI) efforts and the barriers and facilitators associated with sustaining improvements and building an organizational culture of QI. To understand the barriers and facilitators associated with building and sustaining progress toward a QI culture in LHDs. Quantitative data from a self-reporting survey and qualitative data from telephone interviews. Twenty-two LHDs across the United States responded to the survey. Ten of the 22 LHD respondents participated in telephone interviews. QI lead staff at LHDs that are advanced in accreditation preparation and QI. Self-reported LHD survey ratings against indicators for a QI culture, and the identified barriers and facilitators around sustaining QI initiatives. Of the 6 domains of a QI culture measured in the survey, the percentages of respondents that scored themselves highly to at least 1 indicator in each domain are as follows: leadership commitment (100%); employee empowerment (100%); teamwork and collaboration (100%); continuous process improvement (86%); customer focus (72%); and QI infrastructure (64%). Qualitative data from 10 telephone interviews revealed that key barriers to sustaining progress around QI included staff turnover, budget cuts, and major crises or events that arise as priority. Key facilitators included leadership commitment, accreditation, and dedication of resources and staff time to QI. When engaging in QI, LHDs should consider investing efforts in gaining leadership support and dedicating staff time early in the QI journey to ensure that QI efforts and initiatives are sustained. Local health departments interested in developing a QI culture should also consider pursuing accreditation, as it provides a structured framework for continuous improvement. They should also actively develop QI knowledge and skills among all staff members to minimize the negative impact of staff turnover.

Health sciences libraries' subscriptions to journals: expectations of general practice departments and collection-based analysis.

Science.gov (United States)

Barreau, David; Bouton, Céline; Renard, Vincent; Fournier, Jean-Pascal

2018-04-01

The aims of this study were to (i) assess the expectations of general practice departments regarding health sciences libraries' subscriptions to journals and (ii) describe the current general practice journal collections of health sciences libraries. A cross-sectional survey was distributed electronically to the thirty-five university general practice departments in France. General practice departments were asked to list ten journals to which they expected access via the subscriptions of their health sciences libraries. A ranked reference list of journals was then developed. Access to these journals was assessed through a survey sent to all health sciences libraries in France. Adequacy ratios (access/need) were calculated for each journal. All general practice departments completed the survey. The total reference list included 44 journals. This list was heterogeneous in terms of indexation/impact factor, language of publication, and scope (e.g., patient care, research, or medical education). Among the first 10 journals listed, La Revue Prescrire (96.6%), La Revue du Praticien-Médecine Générale (90.9%), the British Medical Journal (85.0%), Pédagogie Médicale (70.0%), Exercer (69.7%), and the Cochrane Database of Systematic Reviews (62.5%) had the highest adequacy ratios, whereas Family Practice (4.2%), the British Journal of General Practice (16.7%), Médecine (29.4%), and the European Journal of General Practice (33.3%) had the lowest adequacy ratios. General practice departments have heterogeneous expectations in terms of health sciences libraries' subscriptions to journals. It is important for librarians to understand the heterogeneity of these expectations, as well as local priorities, so that journal access meets users' needs.

Designing and evaluating a balanced scorecard for a health information management department in a Canadian urban non-teaching hospital.

Science.gov (United States)

Nippak, Pria Md; Veracion, Julius Isidro; Muia, Maria; Ikeda-Douglas, Candace J; Isaac, Winston W

2016-06-01

This report is a description of a balanced scorecard design and evaluation process conducted for the health information management department at an urban non-teaching hospital in Canada. The creation of the health information management balanced scorecard involved planning, development, implementation, and evaluation of the indicators within the balanced scorecard by the health information management department and required 6 months to complete. Following the evaluation, the majority of members of the health information management department agreed that the balanced scorecard is a useful tool in reporting key performance indicators. These findings support the success of the balanced scorecard development within this setting and will help the department to better align with the hospital's corporate strategy that is linked to the provision of efficient management through the evaluation of key performance indicators. Thus, it appears that the planning and selection process used to determine the key indicators within the study can aid in the development of a balanced scorecard for a health information management department. In addition, it is important to include the health information management department staff in all stages of the balanced scorecard development, implementation, and evaluation phases. © The Author(s) 2014.

Attitudes of Students Studying In Health Related Departments towards the Elderly

Directory of Open Access Journals (Sweden)

Sercan Özbek YAZICI

2016-12-01

Full Text Available Negative attitudes towards the elderly may cause decreases in quality health service provided to the elderly. In the study, the aim was to determine attitudes of students studying in health related departments towards the elderly and relationships between the attitudes and various variables were analyzed. In a descriptive study, the sample included nursing, physiotherapy, and elderly care students. Kogan’s attitude towards old people scale (KAOP was used to measure attitudes towards the elderly and Stanley Coopersmith Self Esteem Inventory (SEI was used to assess the level of students’ self-esteem. The KOAP mean attitude score of the students was 125.6 ± 14.38 and the students had slightly positive attitudes towards the elderly. Students who were at the age of 20 or over and who were living in the city showed more positive attitudes. The students of the Elderly Care Department had the lowest mean score and there was a significant difference between mean KAOP scores of students at Nursing and Elderly Care Department. Also, weak positive correlation was found between the KAOP and SEI mean scores of students. The results implies that the students are required to enhance their positive attitudes towards the elderly. Therefore, students should be provided a training program that improves the positive attitudes

[The department of interdisciplinary emergency medicine: organization, structure and process optimization].

Science.gov (United States)

Bernhard, Michael; Pietsch, Christian; Gries, André

2009-06-01

The essential tasks of a department of interdisciplinary emergency medicine are the initial triage and assessment of vital function as well as the subsequent organization und initiation of emergency treatment. A previously defined set of diagnostic and therapeutic measures is carried out before the patient is allocated to an in-hospital clinical service and is admitted to a ward. Moreover, diagnosis and treatment for outpatients are performed. "Time" is a critical factor to be considered for all organizational and structural aspects of a department of interdisciplinary emergency medicine.

Violence in the emergency department: a survey of health care workers.

Science.gov (United States)

Fernandes, C M; Bouthillette, F; Raboud, J M; Bullock, L; Moore, C F; Christenson, J M; Grafstein, E; Rae, S; Ouellet, L; Gillrie, C; Way, M

1999-11-16

Violence in the workplace is an ill-defined and underreported concern for health care workers. The objectives of this study were to examine perceived levels of violence in the emergency department, to obtain health care workers' definitions of violence, to determine the effect of violence on health care workers and to determine coping mechanisms and potential preventive strategies. A retrospective written survey of all 163 emergency department employees working in 1996 at an urban inner-city tertiary care centre in Vancouver. The survey elicited demographic information, personal definition of violence, severity of violence, degree of stress as a result of violence and estimate of the number of encounters with violence in the workplace in 1996. The authors examined the effects of violence on job performance and job satisfaction, and reviewed coping and potential preventive strategies. Of the 163 staff, 106 (65%) completed the survey. A total of 68% (70/103) reported an increased frequency of violence over time, and 60% (64/106) reported an increased severity. Most of the respondents felt that violence included witnessing verbal abuse (76%) and witnessing physical threats or assaults (86%). Sixty respondents (57%) were physically assaulted in 1996. Overall, 51 respondents (48%) reported impaired job performance for the rest of the shift or the rest of the week after an incident of violence. Seventy-seven respondents (73%) were afraid of patients as a result of violence, almost half (49%) hid their identities from patients, and 78 (74%) had reduced job satisfaction. Over one-fourth of the respondents (27/101) took days off because of violence. Of the 18 respondents no longer working in the emergency department, 12 (67%) reported that they had left the job at least partly owing to violence. Twenty-four-hour security and a workshop on violence prevention strategies were felt to be the most useful potential interventions. Physical exercise, sleep and the company of

[Determining biomedical equipment calibration in health care Institutions in the Risaralda Department of Colombia].

Science.gov (United States)

López-Isaza, Giovanni A; Llamosa-Rincón, Luis E

2008-01-01

Determining quality features related to tracking biomedical equipment calibration patterns and their electrical safety as implemented by Health Care Institutions in the Risaralda department. This was a descriptive study using non-probabilistic sampling and the criterion of a greater equipment inventory and service demand for Clinics, Aesthetic, Radiology and Dentistry Centres and Hospitals. Census; the instrument was applied to 32 health-care institutions distributed throughout the Risaralda departments 14 municipalities between September 2005 and January 2006. Hospitals was the category having a highest number of electro-medical equipment (56%). Pereira (the capital of Risaralda) had 81% of all electro-medical equipment. All the institutions lacked NTC-ISO-IEC-17025 accreditation regarding standards certified by the Superintendence of Industry and Commerce. None of the institutions externally contracted by the institutions being surveyed was accredited. There is a public health risk in the Risaralda department; all health-care institutions lacked NTC-ISO-IEC-17025 accreditation and external institutions (in turn being hired by them for calibrating their equipment) also lacked accreditation. Based on the information obtained from non-calibrated equipment having international patterns, there is a great danger that determining the quality of biomedical equipment calibration patterns may be erroneous. It also places health-care institutions at a competitive disadvantage when compared to other accredited institutions in Colombia or in other countries.

Health Information Technology Adoption in the Emergency Department.

Science.gov (United States)

Selck, Frederic W; Decker, Sandra L

2016-02-01

To describe the trend in health information technology (IT) systems adoption in hospital emergency departments (EDs) and its effect on ED efficiency and resource use. 2007-2010 National Hospital Ambulatory Medical Care Survey - ED Component. We assessed changes in the percent of visits to EDs with health IT capability and the estimated effect on waiting time to see a provider, visit length, and resource use. The percent of ED visits that took place in an ED with at least a basic health IT or an advanced IT system increased from 25.2 and 3.1 percent in 2007 to 69.1 and 30.6 percent in 2010, respectively (p < .05). Controlling for ED fixed effects, waiting times were reduced by 6.0 minutes in advanced IT-equipped EDs (p < .05), and the number of tests ordered increased by 9 percent (p < .01). In models using a 1-year lag, advanced systems also showed an increase in the number of medications and images ordered per visit. Almost a third of visits now occur in EDs with advanced IT capability. While advanced IT adoption may decrease wait times, resource use during ED visits may also increase depending on how long the system has been in place. We were not able to determine if these changes indicated more appropriate care. © Health Research and Educational Trust.

Evaluating the Implementation of a Twitter-Based Foodborne Illness Reporting Tool in the City of St. Louis Department of Health

Directory of Open Access Journals (Sweden)

Jenine K. Harris

2018-04-01

Full Text Available Foodborne illness is a serious and preventable public health problem affecting 1 in 6 Americans with cost estimates over $50 billion annually. Local health departments license and inspect restaurants to ensure food safety and respond to reports of suspected foodborne illness. The City of St. Louis Department of Health adopted the HealthMap Foodborne Dashboard (Dashboard, a tool that monitors Twitter for tweets about food poisoning in a geographic area and allows the health department to respond. We evaluated the implementation by interviewing employees of the City of St. Louis Department of Health involved in food safety. We interviewed epidemiologists, environmental health specialists, health services specialists, food inspectors, and public information officers. Participants viewed engaging innovation participants and executing the innovation as challenges while they felt the Dashboard had relative advantage over existing reporting methods and was not complex once in place. This study is the first to examine practitioner perceptions of the implementation of a new technology in a local health department. Similar implementation projects should focus more on process by developing clear and comprehensive plans to educate and involve stakeholders prior to implementation.

Department of Defense Research, Development, Test, and Evaluation (RDT and E): Appropriations Structure

Science.gov (United States)

2016-12-13

Research Projects Agency website, accessed December 5, 2016, http://www.darpa.mil/about-us/mission. Appropriations Structure of Defense RDT&E...funding streams. Among the many other factors that may affect the effectiveness of the performance of RDT&E are: organizational structures and...Department of Defense Research, Development, Test, and Evaluation (RDT&E): Appropriations Structure John F. Sargent Jr. Specialist in

Program collaboration and service integration activities among HIV programs in 59 U.S. health departments.

Science.gov (United States)

Fitz Harris, Lauren F; Toledo, Lauren; Dunbar, Erica; Aquino, Gustavo A; Nesheim, Steven R

2014-01-01

We identified the level and type of program collaboration and service integration (PCSI) among HIV prevention programs in 59 CDC-funded health department jurisdictions. Annual progress reports (APRs) completed by all 59 health departments funded by CDC for HIV prevention activities were reviewed for collaborative and integrated activities reported by HIV programs for calendar year 2009. We identified associations between PCSI activities and funding, AIDS diagnosis rate, and organizational integration. HIV programs collaborated with other health department programs through data-related activities, provider training, and providing funding for sexually transmitted disease (STD) activities in 24 (41%), 31 (53%), and 16 (27%) jurisdictions, respectively. Of the 59 jurisdictions, 57 (97%) reported integrated HIV and STD testing at the same venue, 39 (66%) reported integrated HIV and tuberculosis testing, and 26 (44%) reported integrated HIV and viral hepatitis testing. Forty-five (76%) jurisdictions reported providing integrated education/outreach activities for HIV and at least one other disease. Twenty-six (44%) jurisdictions reported integrated partner services among HIV and STD programs. Overall, the level of PCSI activities was not associated with HIV funding, AIDS diagnoses, or organizational integration. HIV programs in health departments collaborate primarily with STD programs. Key PCSI activities include integrated testing, integrated education/outreach, and training. Future assessments are needed to evaluate PCSI activities and to identify the level of collaboration and integration among prevention programs.

COGNITIVE LEARNING STRATEGIES OF NON-ENGLISH DEPARTMENT STUDENTS ON NOUN STRUCTURE

Directory of Open Access Journals (Sweden)

Shierly Novalita Yappy

2006-01-01

Full Text Available Learning English for non-English department students is not as easy as it seems. Besides, as much as it is necessary to know how successful learners learn, not less important is to know how less successful learners learn. Using think aloud method, this study aims at finding out the cognitive strategies used by the engineering department students in answering incorrectly problems on TOEFL noun structure-the grammar point in which students made the most errors. Findings uncover the students' strategies and reasoning upon which pedagogical implications can be put forth so that more effective and fruitful instruction can be tailored.

Information resources used in health risk assessment by the New Jersey Department of Environmental Protection

Energy Technology Data Exchange (ETDEWEB)

Post, G.B.; Baratta, M.; Wolfson, S.; McGeorge, L. [New Jersey Department of Environmental Protection, Trenton (United States)

1990-12-31

The New Jersey Department of Environmental Protection`s responsibilities related to health-based risk assessment are described, including its research projects and its development of health based compound specific standards and guidance levels. The resources used by the agency to support health risk assessment work are outlined.

Department of Defense Birth and Infant Health Registry: select reproductive health outcomes, 2003-2014.

Science.gov (United States)

Bukowinski, Anna T; Conlin, Ava Marie S; Gumbs, Gia R; Khodr, Zeina G; Chang, Richard N; Faix, Dennis J

2017-11-01

Established following a 1998 directive, the Department of Defense Birth and Infant Health Registry (Registry) team conducts surveillance of select reproductive health outcomes among military families. Data are compiled from the Military Health System Data Repository and Defense Manpower Data Center to define the Registry cohort and outcomes of interest. Outcomes are defined using ICD-9/ICD-10 and Current Procedural Terminology codes, and include: pregnancy outcomes (e.g., live births, losses), birth defects, preterm births, and male:female infant sex ratio. This report includes data from 2003-2014 on 1,304,406 infants among military families and 258,332 pregnancies among active duty women. Rates of common adverse infant and pregnancy outcomes were comparable to or lower than those in the general US population. These observations, along with prior Registry analyses, provide reassurance that military service is not independently associated with increased risks for select adverse reproductive health outcomes. The Registry's diverse research portfolio demonstrates its unique capabilities to answer a wide range of questions related to reproductive health. These data provide the military community with information to identify successes and areas for improvement in prevention and care.

A taxonomy of state public health preparedness units: an empirical examination of organizational structure.

Science.gov (United States)

Menachemi, Nir; Yeager, Valerie A; Duncan, W Jack; Katholi, Charles R; Ginter, Peter M

2012-01-01

State public health preparedness units (SPHPUs) were developed in response to federal funding to improve response to disasters: a responsibility that had not traditionally been within the purview of public health. The SPHPUs were created within the existing public health organizational structure, and their placement may have implications for how the unit functions, how communication takes place, and ultimately how well the key responsibilities are performed. This study empirically identifies a taxonomy of similarly structured SPHPUs and examines whether this structure is associated with state geographic, demographic, and threat-vulnerability characteristics. Data representing each SPHPU were extracted from publically available sources, including organizational charts and emergency preparedness plans for 2009. A cross-sectional segmentation analysis was conducted of variables representing structural attributes. Fifty state public health departments. Variables representing "span of control" and "hierarchal levels" were extracted from organizational charts. Structural "complexity" and "centralization" were extracted from state emergency preparedness documents and other secondary sources. On average, 6.6 people report to the same manager as the SPHPU director; 2.1 levels separate the SPHPU director from the state health officer; and a mean of 13.5 agencies collaborate with SPHPU during a disaster. Despite considerable variability in how SPHPUs had been structured, results of the cluster and principal component analysis identified 7 similarly structured groups. Neither the taxonomic groups nor the individual variables representing structure were found to be associated with state characteristics, including threat vulnerabilities. Our finding supports the hypothesis that SPHPUs are seemingly inadvertently (eg, not strategically) organized. This taxonomy provides the basis for which future research can examine how SPHPU structure relates to performance measures and

List of selected publications from Risoe's Health Physics Department 1957-1989

International Nuclear Information System (INIS)

Heikel Vinther, F.

1991-01-01

This list includes scientific and technical papers written by staff members of the former Health Physics Department at Risoe National Laboratory. The first part includes papers in periodicals, proceedings etc. in order of chronology while the second and third part include Riso-R and Riso-M reports respectively arranged according to report numbers. (author)

Health smart cards: differing perceptions of emergency department patients and staff.

Science.gov (United States)

Mohd Rosli, Reizal; Taylor, David McD; Knott, Jonathan C; Das, Atandrila; Dent, Andrew W

2009-02-01

An analytical, cross-sectional survey of 270 emergency department patients and 92 staff undertaken in three tertiary referral hospital emergency departments was completed to compare the perceptions of patients and staff regarding the use of health smart cards containing patient medical records. The study recorded data on a range of health smart card issues including awareness, privacy, confidentiality, security, advantages and disadvantages, and willingness to use. A significantly higher proportion of staff had heard of the card. The perceived disadvantages reported by patients and staff were, overall, significantly different, with the staff reporting more disadvantages. A significantly higher proportion of patients believed that they should choose what information is on the card and who should have access to the information. Patients were more conservative regarding what information should be included, but staff were more conservative regarding who should have access to the information. Significantly fewer staff believed that patients could reliably handle the cards. Overall, however, the cards were considered acceptable and useful, and their introduction would be supported.

A Logic Model for Evaluating the Academic Health Department.

Science.gov (United States)

Erwin, Paul Campbell; McNeely, Clea S; Grubaugh, Julie H; Valentine, Jennifer; Miller, Mark D; Buchanan, Martha

2016-01-01

Academic Health Departments (AHDs) are collaborative partnerships between academic programs and practice settings. While case studies have informed our understanding of the development and activities of AHDs, there has been no formal published evaluation of AHDs, either singularly or collectively. Developing a framework for evaluating AHDs has potential to further aid our understanding of how these relationships may matter. In this article, we present a general theory of change, in the form of a logic model, for how AHDs impact public health at the community level. We then present a specific example of how the logic model has been customized for a specific AHD. Finally, we end with potential research questions on the AHD based on these concepts. We conclude that logic models are valuable tools, which can be used to assess the value and ultimate impact of the AHD.

Evaluation of Syndromic Surveillance Systems in 6 US State and Local Health Departments.

Science.gov (United States)

Thomas, Mathew J; Yoon, Paula W; Collins, James M; Davidson, Arthur J; Mac Kenzie, William R

Evaluating public health surveillance systems is critical to ensuring that conditions of public health importance are appropriately monitored. Our objectives were to qualitatively evaluate 6 state and local health departments that were early adopters of syndromic surveillance in order to (1) understand the characteristics and current uses, (2) identify the most and least useful syndromes to monitor, (3) gauge the utility for early warning and outbreak detection, and (4) assess how syndromic surveillance impacted their daily decision making. We adapted evaluation guidelines from the Centers for Disease Control and Prevention and gathered input from the Centers for Disease Control and Prevention subject matter experts in public health surveillance to develop a questionnaire. We interviewed staff members from a convenience sample of 6 local and state health departments with syndromic surveillance programs that had been in operation for more than 10 years. Three of the 6 interviewees provided an example of using syndromic surveillance to identify an outbreak (ie, cluster of foodborne illness in 1 jurisdiction) or detect a surge in cases for seasonal conditions (eg, influenza in 2 jurisdictions) prior to traditional, disease-specific systems. Although all interviewees noted that syndromic surveillance has not been routinely useful or efficient for early outbreak detection or case finding in their jurisdictions, all agreed that the information can be used to improve their understanding of dynamic disease control environments and conditions (eg, situational awareness) in their communities. In the jurisdictions studied, syndromic surveillance may be useful for monitoring the spread and intensity of large outbreaks of disease, especially influenza; enhancing public health awareness of mass gatherings and natural disasters; and assessing new, otherwise unmonitored conditions when real-time alternatives are unavailable. Future studies should explore opportunities to

32 CFR 644.336 - Notices to Departments of Interior (DI); Health and Human Resources (HHR); Education; and Housing...

Science.gov (United States)

2010-07-01

... 32 National Defense 4 2010-07-01 2010-07-01 true Notices to Departments of Interior (DI); Health and Human Resources (HHR); Education; and Housing and Urban Development (HUD). 644.336 Section 644.336... Departments of Interior (DI); Health and Human Resources (HHR); Education; and Housing and Urban Development...

The Journey toward Voluntary Public Health Accreditation Readiness in Local Health Departments: Leadership and Followership Theories in Action.

Science.gov (United States)

Carman, Angela L

2015-01-01

Local health department directors' intent on getting their organizations ready for accreditation must embrace the blurring of leader/follower lines and create an accreditation readiness team fueled not by traditional leader or follower roles but by teamship.

The Journey toward Voluntary Public Health Accreditation Readiness in Local Health Departments: Leadership and Followership Theories in Action

OpenAIRE

Carman, Angela L.

2015-01-01

Local health department directors’ intent on getting their organizations ready for accreditation must embrace the blurring of leader/follower lines and create an accreditation readiness team fueled not by traditional leader or follower roles but by teamship.

[Satisfaction according to health care insurance systems in an emergency department].

Science.gov (United States)

Dávila, F A; Herrera, J S; Yasnó, D A; Forero, L C; Alvarado, M V

Health satisfaction is a fundamental measure of the quality of health services. This study aims to validate and analyse the results of a quality of care questionnaire to assess the level of satisfaction of patients attended in the emergency department of a high complexity hospital. Observational, cross-sectional study, with a questionnaire designed to assess the quality of service and satisfaction at the end of care in the emergency department. Descriptive statistics of scale were established and presented, as well as determining the construct validity, overall reliability, internal and concurrent validity of an overall against a uni-dimensional scale. A total of 5,961 records were reviewed, most of them (77.3%) reported by patients in the Mandatory Health Plan. High levels of satisfaction overall and by subgroups were found. There were no significant differences between subgroups, with 86.8 for those with Pre-paid Medical Care Plan and 84.4 for mandatory health plan. Cronbach's alpha for the questionnaire was 0.90. The questionnaire proved to be reliable and valid in determining the quality and satisfaction with care. The results showed high levels of satisfaction overall and in the domains. A low consistency between the results of the multidimensional and unidimensional satisfaction scales suggests that there were aspects of satisfaction not investigated on the multidimensional scale. Ecologically-designed before and after studies are required to evaluate the effectiveness of interventions in satisfaction. Copyright © 2016 SECA. Publicado por Elsevier España, S.L.U. All rights reserved.

Use of Local Health Department Websites: A Study of E-Government Adoption and Diffusion

Science.gov (United States)

Aaltonen, Pamela Massie

2013-01-01

Two distinct but converging activities have the potential to alter the way local public health departments conduct business. These activities are the emergence of e-government and the addition of preparedness as a basic function of the public health system. Preparedness implies timely collaboration with government entities, community partners and…

[An experience of collaboration between primary health care and mental health care in La Ribera Department of Health (Valencia, Spain)].

Science.gov (United States)

Morera-Llorca, Miquel; Romeu-Climent, José Enrique; Lera-Calatayud, Guillem; Folch-Marín, Blanca; Palop-Larrea, Vicente; Vidal-Rubio, Sonia

2014-01-01

Despite the high prevalence of mental health problems among patients attending primary care, diagnosis and treatment of these disorders remain inadequate. Sound training of primary care physicians in how to manage mental health problems is needed to reduce the health, economic and social impact associated with these disorders. Among other elements, there is a need for cooperation between primary care physicians and mental health services. Distinct models are available for such collaboration. In 2006, our health department started a collaboration between these two levels of heath care, using a liaison model. Delays until the first specialist visit were reduced and satisfaction among health professionals increased, although these results should be interpreted with caution. Evidence has recently accumulated on the usefulness of the collaborative model, but evaluation of this model and extrapolation of its results are complex. We intend to evaluate our model more thoroughly, similar to other projects in our environment. Copyright © 2014 SESPAS. Published by Elsevier Espana. All rights reserved.

PUBLIC COMMENT ON THE DEPARTMENT OF HEALTH AND HUMAN SERVICES 2018 FEDERAL PHYSICAL ACITIVTY GUIDELINES

Science.gov (United States)

Title: Public Comment on Department of Health and Human Services (DHHS) 2018 Physical Activity Guidelines Author: Wayne E. Cascio, Director, Environmental Public Health Division, US EPA Abstract: In the 2008 Physical Activity Guidelines, the effects of air pollution and advers...

The Journey toward Voluntary Public Health Accreditation Readiness in Local Health Departments: Leadership and Followership Theories in Action

Directory of Open Access Journals (Sweden)

Angela eCarman

2015-03-01

Full Text Available Local health department directors’ intent on getting their organizations ready for accreditation must embrace the blurring of leader/follower lines and create an accreditation readiness team fueled not by traditional leader or follower roles but by teamship.

Health Physics Department annual progress report 1 January - 31 December 1984

International Nuclear Information System (INIS)

1985-05-01

The report describes the work of the Health Physics Department at Risoe during 1984. The activities cover dosimetry, instrumentation, radioecology, risk by nuclear activities and nuclear emergency preparedness. Lists of staff and publications are included. The main emphasis in the report has been placed on scientific and contractual work. Of lesser importance, but still quite significant, are the service functions. (author)

Health Physics Department annual progress report 1 January - 31 December 1985

International Nuclear Information System (INIS)

1986-10-01

The report describes the work of the Health Physics Department at Risoe during 1985. The activities cover dosimetry, instrumentation, radioecology, risk by nuclear activities and nuclear emergency preparedness. Lists of staff and publications are included. The main emphasis in the report has been placed on scientific and contractual work. Of lesser importance, but still quite significant, are the service functions. (author)

Adapting to Health Impacts of Climate Change in the Department of Defense.

Science.gov (United States)

Chrétien, Jean-Paul

2016-01-01

The Department of Defense (DoD) recognizes climate change as a threat to its mission and recently issued policy to implement climate change adaptation measures. However, the DoD has not conducted a comprehensive assessment of health-related climate change effects. To catalyze the needed assessment--a first step toward a comprehensive DoD climate change adaptation plan for health--this article discusses the DoD relevance of 3 selected climate change impacts: heat injuries, vector-borne diseases, and extreme weather that could lead to natural disasters. The author uses these examples to propose a comprehensive approach to planning for health-related climate change impacts in the DoD.

48 CFR 1252.217-80 - Department of Labor Safety and Health Regulations for Ship Repairing.

Science.gov (United States)

2010-10-01

... 48 Federal Acquisition Regulations System 5 2010-10-01 2010-10-01 false Department of Labor Safety and Health Regulations for Ship Repairing. 1252.217-80 Section 1252.217-80 Federal Acquisition Regulations System DEPARTMENT OF TRANSPORTATION CLAUSES AND FORMS SOLICITATION PROVISIONS AND CONTRACT CLAUSES Text of Provisions and Clauses 1252.217-80...

Downsizing of a provincial department of health--causes and implications for fiscal policy.

Science.gov (United States)

Blecher, Mark

2002-06-01

To analyse the financial basis for downsizing of a provincial health department and suggest implications for fiscal policy. Analysis of relevant departmental, provincial and national financing and expenditure trends from 1995/96 to 2002/03. Western Cape (WC) Department of Health (DOH). Downsizing involving 9,282 health workers (27.9%) and closure of 3,601 hospital beds (24.4%) over 5 years. Total aggregate provincial transfers (all provinces) remained fairly constant in real terms. The WC's share decreased from 11.8% in 1996/97 to 9.8% in 2002/03. This was offset by the DOH's share of the WC budget increasing from 25.6% to 29.6%, mainly because of an increase in national health conditional grants. The net effect of financing changes was that the DOH's allocation in real terms was similar in 2002/03 and 1995/96, which suggests that financing changes are not the major cause of downsizing. Expenditure analysis revealed a 39.7% real rise in the average cost of health personnel. Substantial interprovincial inequities remain. The major cause of downsizing was wage growth, particularly following the 1996 wage agreement. Disjointed fiscal and wage policy has affected health services. Simultaneous application of policies of fiscal constraint, redistribution and substantial real wage growth has resulted in substantial downsizing with limited inroads into inequities. Inequities will continue to call for further redistribution, reduction in conditional grants and downsizing, much of which could have been avoided if fiscal and wage policy choices had been optimal.

An integrative review of information systems and terminologies used in local health departments.

Science.gov (United States)

Olsen, Jeanette; Baisch, Mary Jo

2014-02-01

The purpose of this integrative review based on the published literature was to identify information systems currently being used by local health departments and to determine the extent to which standard terminology was used to communicate data, interventions, and outcomes to improve public health informatics at the local health department (LHD) level and better inform research, policy, and programs. Whittemore and Knafl's integrative review methodology was used. Data were obtained through key word searches of three publication databases and reference lists of retrieved articles and consulting with experts to identify landmark works. The final sample included 45 articles analyzed and synthesized using the matrix method. The results indicated a wide array of information systems were used by LHDs and supported diverse functions aligned with five categories: administration; surveillance; health records; registries; and consumer resources. Detail regarding specific programs being used, location or extent of use, or effectiveness was lacking. The synthesis indicated evidence of growing interest in health information exchange groups, yet few studies described use of data standards or standard terminology in LHDs. Research to address these gaps is needed to provide current, meaningful data that inform public health informatics research, policy, and initiatives at and across the LHD level. Coordination at a state or national level is recommended to collect information efficiently about LHD information systems that will inform improvements while minimizing duplication of efforts and financial burden. Until this happens, efforts to strengthen LHD information systems and policies may be significantly challenged.

Learning to Promote Health at an Emergency Care Department: Identifying Expansive and Restrictive Conditions

Science.gov (United States)

Gustavsson, Maria; Ekberg, Kerstin

2015-01-01

This article reports on the findings of a planned workplace health promotion intervention, and the aim is to identify conditions that facilitated or restricted the learning to promote health at an emergency care department in a Swedish hospital. The study had a longitudinal design, with interviews before and after the intervention and follow-up…

Workplace violence against nurses in Indonesian emergency departments.

Science.gov (United States)

Noorana Zahra, Anggri; Feng, Jui-Ying

2018-02-01

The objective of this study was to examine the experiences of violent incidents by nurses in Indonesian emergency departments. The World Health Organization's structured questionnaire on workplace violence in the health sector was modified and translated into Bahasa. The study participants were 169 nurses working in emergency departments in six hospitals in Jakarta and Bekasi, Indonesia. The gathered data were analyzed using descriptive and multivariate logistic regression. Ten percent of emergency nurses reported experiencing physical violence, perpetrated mostly by patients, whereas more than half of emergency nurses (54.6%) reported experiencing non-physical violence, with patients' relative as the main perpetrators. A majority of nurses (55.6%) did not have encouragement to report workplace violence, and very few nurses (10.1%) had received any information or training about workplace violence. The findings of this study highlighted the seriousness of violence in Indonesian emergency departments. Support from management, encouragement to report violence, and access to workplace violence training were expected to mitigate and manage violence against nurses in emergency departments. Copyright © 2018 Elsevier España, S.L.U. All rights reserved.

Evolution in obesity and chronic disease prevention practice in California public health departments, 2010.

Science.gov (United States)

Schwarte, Liz; Ngo, Samantha; Banthia, Rajni; Flores, George; Prentice, Bob; Boyle, Maria; Samuels, Sarah E

2014-11-13

Local health departments (LHDs) are dedicating resources and attention to preventing obesity and associated chronic diseases, thus expanding their work beyond traditional public health activities such as surveillance. This study investigated practices of local health departments in California to prevent obesity and chronic disease. We conducted a web-based survey in 2010 with leaders in California's LHDs to obtain diverse perspectives on LHDs' practices to prevent obesity and chronic disease. The departmental response rate for the 2010 survey was 87% (53 of California's 61 LHDs). Although staff for preventing obesity and chronic disease decreased at 59% of LHDs and stayed the same at 26% of LHDs since 2006, LHDs still contributed the same (12%) or a higher (62%) level of effort in these areas. Factors contributing to internal changes to address obesity and chronic disease prevention included momentum in the field of obesity prevention, opportunities to learn from other health departments, participation in obesity and chronic disease prevention initiatives, and flexible funding streams for chronic disease prevention. LHDs that received foundation funding or had a lead person or organizational unit coordinating or taking the lead on activities related to obesity and chronic disease prevention were more likely than other LHDs to engage in some activities related to obesity prevention. California LHDs are increasing the intensity and breadth of obesity and chronic disease prevention. Findings provide a benchmark from which further changes in the activities and funding sources of LHD chronic disease prevention practice may be measured.

Clinical leadership, structural empowerment and psychological empowerment of registered nurses working in an emergency department.

Science.gov (United States)

Connolly, Megan; Jacobs, Stephen; Scott, Karyn

2018-04-19

To examine clinical leadership of registered nurses in an emergency department, based on evidence that it is important for nurses to feel psychologically and structurally empowered in order to act as clinical leaders. Every registered nurse has the ability to act as a clinical leader. Clinical leadership is the registered nurse's behaviours that provide direction and support to patients and the team in the delivery of patient care. This study explores the connection between the need for structural and psychological empowerment and clinical leadership behaviours. A mixed method, non-experimental survey design was used to examine the psychological empowerment, structural empowerment and clinical leadership of registered nurses working in an emergency department. Emergency department nurses believe they show clinical leadership behaviours most of the time, even though their sense of being psychologically empowered is only moderate. While registered nurses believe they perform clinical leadership behaviours, it is also clear that improvements in structural and psychological empowerment would improve their ability to act as clinical leaders. The results show that for nurses to be able to provide clinical leadership to their patients and colleagues, management must create empowering environments. © 2018 John Wiley & Sons Ltd.

Analysis of National Institutes of Health Funding to Departments of Urology.

Science.gov (United States)

Silvestre, Jason; Agarwal, Divyansh; Lee, David I

2016-05-01

To elucidate the current portfolio of National Institutes of Health (NIH) funding to departments of urology at U.S. medical schools. The NIH Research Portfolio Online Reporting Tools Expenditures and Results was used to generate a comprehensive analysis of NIH research grants awarded to urology departments during 2014. Costs, mechanisms, and institutes were summarized with descriptive statistics. Demographic data were obtained for principal investigators and project abstracts were categorized by research type and area. Fiscal totals were calculated for 2005-2014 and compared with other surgical departments during 2014. One hundred one investigators at 36 urology departments received $55,564,952 in NIH funding during 2014. NIH-funded investigators were predominately male (79%) and PhD scientists (52%). Funding totals did not vary by terminal degree or sex, but increased with higher academic rank (P < .001). The National Cancer Institute (54.7%) and National Institute of Diabetes and Digestive and Kidney Diseases (32.2%) supported the majority of NIH-funded urologic research. The R01 grant accounted for 41.0% of all costs. The top 3 NIH-funded clinical areas were urologic oncology (62.1%), urinary tract infection (8.8%), and neurourology (7.6%). A minority of costs supported clinical research (12.9%). In 2014, urology had the least number of NIH grants relative to general surgery, ophthalmology, obstetrics & gynecology, otolaryngology, and orthopedic surgery. NIH funding to urology departments lags behind awards to departments of other surgical disciplines. Future interventions may be warranted to increase NIH grant procurement in urology. Copyright © 2016 Elsevier Inc. All rights reserved.

48 CFR 1352.271-82 - Department of Labor occupational safety and health standards for ship repair.

Science.gov (United States)

2010-10-01

... occupational safety and health standards for ship repair. 1352.271-82 Section 1352.271-82 Federal Acquisition... of Provisions and Clauses 1352.271-82 Department of Labor occupational safety and health standards... Occupational Safety and Health Standards for Ship Repair (APR 2010) The contractor, in performance of all work...

Local health department food safety and sanitation expenditures and reductions in enteric disease, 2000-2010.

Science.gov (United States)

Bekemeier, Betty; Yip, Michelle Pui-Yan; Dunbar, Matthew D; Whitman, Greg; Kwan-Gett, Tao

2015-04-01

In collaboration with Public Health Practice-Based Research Networks, we investigated relationships between local health department (LHD) food safety and sanitation expenditures and reported enteric disease rates. We combined annual infection rates for the common notifiable enteric diseases with uniquely detailed, LHD-level food safety and sanitation annual expenditure data obtained from Washington and New York state health departments. We used a multivariate panel time-series design to examine ecologic relationships between 2000-2010 local food safety and sanitation expenditures and enteric diseases. Our study population consisted of 72 LHDs (mostly serving county-level jurisdictions) in Washington and New York. While controlling for other factors, we found significant associations between higher LHD food and sanitation spending and a lower incidence of salmonellosis in Washington and a lower incidence of cryptosporidiosis in New York. Local public health expenditures on food and sanitation services are important because of their association with certain health indicators. Our study supports the need for program-specific LHD service-related data to measure the cost, performance, and outcomes of prevention efforts to inform practice and policymaking.

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

Science.gov (United States)

Carlton, Erik L; Singh, Simone Rauscher

2018-05-01

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

Three Hundred Sixty Degree Feedback: program implementation in a local health department.

Science.gov (United States)

Swain, Geoffrey R; Schubot, David B; Thomas, Virginia; Baker, Bevan K; Foldy, Seth L; Greaves, William W; Monteagudo, Maria

2004-01-01

Three Hundred Sixty Degree Feedback systems, while popular in business, have been less commonly implemented in local public health agencies. At the same time, they are effective methods of improving employee morale, work performance, organizational culture, and attainment of desired organizational outcomes. These systems can be purchased "off-the-shelf," or custom applications can be developed for a better fit with unique organizational needs. We describe the City of Milwaukee Health Department's successful experience customizing and implementing a 360-degree feedback system in the context of its ongoing total quality improvement efforts.

Putting Chronic Disease on the Map: Building GIS Capacity in State and Local Health Departments

Science.gov (United States)

Casper, Michele; Tootoo, Joshua; Schieb, Linda

2013-01-01

Techniques based on geographic information systems (GIS) have been widely adopted and applied in the fields of infectious disease and environmental epidemiology; their use in chronic disease programs is relatively new. The Centers for Disease Control and Prevention’s Division for Heart Disease and Stroke Prevention is collaborating with the National Association of Chronic Disease Directors and the University of Michigan to provide health departments with capacity to integrate GIS into daily operations, which support priorities for surveillance and prevention of chronic diseases. So far, 19 state and 7 local health departments participated in this project. On the basis of these participants’ experiences, we describe our training strategy and identify high-impact GIS skills that can be mastered and applied over a short time in support of chronic disease surveillance. We also describe the web-based resources in the Chronic Disease GIS Exchange that were produced on the basis of this training and are available to anyone interested in GIS and chronic disease (www.cdc.gov/DHDSP/maps/GISX). GIS offers diverse sets of tools that promise increased productivity for chronic disease staff of state and local health departments. PMID:23786907

Putting chronic disease on the map: building GIS capacity in state and local health departments.

Science.gov (United States)

Miranda, Marie Lynn; Casper, Michele; Tootoo, Joshua; Schieb, Linda

2013-06-20

Techniques based on geographic information systems (GIS) have been widely adopted and applied in the fields of infectious disease and environmental epidemiology; their use in chronic disease programs is relatively new. The Centers for Disease Control and Prevention's Division for Heart Disease and Stroke Prevention is collaborating with the National Association of Chronic Disease Directors and the University of Michigan to provide health departments with capacity to integrate GIS into daily operations, which support priorities for surveillance and prevention of chronic diseases. So far, 19 state and 7 local health departments participated in this project. On the basis of these participants' experiences, we describe our training strategy and identify high-impact GIS skills that can be mastered and applied over a short time in support of chronic disease surveillance. We also describe the web-based resources in the Chronic Disease GIS Exchange that were produced on the basis of this training and are available to anyone interested in GIS and chronic disease (www.cdc.gov/DHDSP/maps/GISX). GIS offers diverse sets of tools that promise increased productivity for chronic disease staff of state and local health departments.

ACADEMIC STRESS IN STUDENTS FROM HEALTH DEPARTMENTS IN A PUBLIC UNIVERSITY OF CARTAGENA-COLOMBIA

OpenAIRE

Montalvo-Prieto Amparo; Blanco-Blanco Katerin; Cantillo-Martínez Neyi; Castro-González Yuldor; Downs-Bryan Agatha; Romero-Villadiego Eliana

2015-01-01

Introduction: stress is a factor that influences in the quality of life and performance of the individual. It appears when a person identifies dangerous situations that exceeds its own resources and endanger its own being-well. Objective: to describe the stress level in university students from health departments in Cartagena-Colombia. Methods: a descriptive study was carried out in 266 female students chosen by random probabilistic sampling from departments of Nursing, Dent...

Modeling the effects of influenza vaccination of health care workers in hospital departments

NARCIS (Netherlands)

van den Dool, C.; Bonten, M. J. M.; Hak, E.; Wallinga, J.

2009-01-01

Nowadays health care worker (HCW) vaccination is widely recommended. Although the benefits of this strategy have been demonstrated in long-term care settings, no studies have been performed in regular hospital departments. We adapt a previously developed model of influenza transmission in a

Structural Measures - Hospital

Data.gov (United States)

U.S. Department of Health & Human Services — A list of hospitals and the structural measures they report. A structural measure reflects the environment in which hospitals care for patients, for example, whether...

Evaluating the Effectiveness of Community and Hospital Medical Record Integration on Management of Behavioral Health in the Emergency Department.

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Ngo, Stephanie; Shahsahebi, Mohammad; Schreiber, Sean; Johnson, Fred; Silberberg, Mina

2017-11-09

This study evaluated the correlation of an emergency department embedded care coordinator with access to community and medical records in decreasing hospital and emergency department use in patients with behavioral health issues. This retrospective cohort study presents a 6-month pre-post analysis on patients seen by the care coordinator (n=524). Looking at all-cause healthcare utilization, care coordination was associated with a significant median decrease of one emergency department visit per patient (p management of behavioral health patients.

The structure and organization of local and state public health agencies in the U.S.: a systematic review.

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Hyde, Justeen K; Shortell, Stephen M

2012-05-01

This systematic review provides a synthesis of the growing field of public health systems research related to the structure and organization of state and local governmental public health agencies. It includes an overview of research examining the influence of organizational characteristics on public health performance and health status and a summary of the strengths and gaps of the literature to date. Data were retrieved through an iterative process, beginning with key word searches in three publication databases (PubMed, JSTOR, Web of Science). Gray literature was searched through the use of Google Scholar™. Targeted searches on websites and key authors were also performed. Documents underwent an initial and secondary screening; they were retained if they contained information about local or state public health structure, organization, governance, and financing. 77 articles met the study criteria. Public health services are delivered by a mix of local, state, and tribal governmental and nongovernmental agencies and delivered through centralized (28%); decentralized (37%); or combined authority (35%). The majority of studies focused on organizational characteristics that are associated with public health performance based on the 10 Essential Public Health Services framework. Population size of jurisdiction served (>50,000); structure of authority (decentralized and mixed); per capita spending at the local level; some partnerships (academic, health services); and leadership of agency directors have been found to be related to public health performance. Fewer studies examined the relationship between organizational characteristics and health outcomes. Improvements in health outcomes are associated with an increase in local health department expenditures, FTEs per capita, and location of health department within local networks. Public health systems in the U.S. face a number of critical challenges, including limited organizational capacity and financial resources

42 CFR 491.7 - Organizational structure.

Science.gov (United States)

2010-10-01

... 42 Public Health 5 2010-10-01 2010-10-01 false Organizational structure. 491.7 Section 491.7 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES...: Conditions for Certification; and FQHCs Conditions for Coverage § 491.7 Organizational structure. (a) Basic...

Management of information within emergencies departments in developing countries: analysis at the National Emergency Department in Benin.

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Ahanhanzo, Yolaine Glèlè; Kpozehouen, Alphonse; Sopoh, Ghislain; Sossa-Jérôme, Charles; Ouedraogo, Laurent; Wilmet-Dramaix, Michèle

2016-01-01

The management of health information is a key pillar in both emergencies reception and handling facilities, given the strategic position and the potential of these facilities within hospitals, and in the monitoring of public health and epidemiology. With the technological revolution, computerization made the information systems evolve in emergency departments, especially in developed countries, with improved performance in terms of care quality, productivity and patient satisfaction. This study analyses the situation of Benin in this field, through the case of the Academic Clinic of Emergency Department of the National University Teaching Hospital of Cotonou, the national reference hospital. The study is cross-sectional and evaluative. Collection techniques are literature review and structured interviews. The components rated are resources, indicators, data sources, data management and the use-dissemination of the information through a model adapted from Health Metrics Network framework. We used quantitative and qualitative analysis. The absence of a regulatory framework restricts the operation of the system in all components and accounts for the lack and inadequacy of the dedicated resources. Dedication of more resources for this system for crucial needs such as computerization requires sensitization and greater awareness of the administrative authorities about the fact that an effective health information management system is of prime importance in this type of facility.

mHealth Tool for Alcohol Use Disorders Among Latinos in Emergency Department.

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Abujarad, Fuad; Vaca, Federico E

2015-06-01

Latino drinkers experience a disparate number of negative health and social consequences. Emergency Department Alcohol Screening Brief Intervention and Referral to Treatment (ED-SBIRT) is viable and effective at reducing harmful and hazardous drinking. However, barriers (e.g. readily available language translators, provider time burden, resources) to broad implementation remain and account for a major lag in adherence to national guidelines. We describe our approach to the design of a patient-centered bilingual Web-based mobile health ED-SBIRT App that could be integrated into a clinically complex ED environment and used regularly to provide ED-SBIRT for Spanish speaking patients.

Perspectives of Community- and Faith-Based Organizations about Partnering with Local Health Departments for Disasters

Directory of Open Access Journals (Sweden)

Michael Stajura

2012-06-01

Full Text Available Public health emergency planners can better perform their mission if they develop and maintain effective relationships with community- and faith-based organizations in their jurisdictions. This qualitative study presents six themes that emerged from 20 key informant interviews representing a wide range of American community- and faith-based organizations across different types of jurisdictions, organizational types, and missions. This research seeks to provide local health department public health emergency planners with tools to assess and improve their inter-organizational community relationships. The themes identified address the importance of community engagement, leadership, intergroup dynamics and communication, and resources. Community- and faith-based organizations perceive that they are underutilized or untapped resources with respect to public health emergencies and disasters. One key reason for this is that many public health departments limit their engagement with community- and faith-based organizations to a one-way “push” model for information dissemination, rather than engaging them in other ways or improving their capacity. Beyond a reprioritization of staff time, few other resources would be required. From the perspective of community- and faith-based organizations, the quality of relationships seems to matter more than discrete resources provided by such ties.

Perspectives of community- and faith-based organizations about partnering with local health departments for disasters.

Science.gov (United States)

Stajura, Michael; Glik, Deborah; Eisenman, David; Prelip, Michael; Martel, Andrea; Sammartinova, Jitka

2012-07-01

Public health emergency planners can better perform their mission if they develop and maintain effective relationships with community- and faith-based organizations in their jurisdictions. This qualitative study presents six themes that emerged from 20 key informant interviews representing a wide range of American community- and faith-based organizations across different types of jurisdictions, organizational types, and missions. This research seeks to provide local health department public health emergency planners with tools to assess and improve their inter-organizational community relationships. The themes identified address the importance of community engagement, leadership, intergroup dynamics and communication, and resources. Community- and faith-based organizations perceive that they are underutilized or untapped resources with respect to public health emergencies and disasters. One key reason for this is that many public health departments limit their engagement with community- and faith-based organizations to a one-way "push" model for information dissemination, rather than engaging them in other ways or improving their capacity. Beyond a reprioritization of staff time, few other resources would be required. From the perspective of community- and faith-based organizations, the quality of relationships seems to matter more than discrete resources provided by such ties.

Extent and patterns of community collaboration in local health departments: An exploratory survey

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Fisher John W

2011-10-01

Full Text Available Abstract Background Local public health departments (LHDs in the United States have been encouraged to collaborate with various other community organizations and individuals. Current research suggests that many forms of active partnering are ongoing, and there are numerous examples of LHD collaboration with a specific organization for a specific purpose or program. However, no existing research has attempted to characterize collaboration, for the defined purpose of setting community health status priorities, between a defined population of local officials and a defined group of alternative partnering organizations. The specific aims of this study were to 1 determine the range of collaborative involvement exhibited by a study population of local public health officials, and, 2 characterize the patterns of the selection of organizations/individuals involved with LHDs in the process of setting community health status priorities. Methods Local health department officials in North Carolina (n = 53 responded to an exploratory survey about their levels of involvement with eight types of possible collaborator organizations and individuals. Descriptive statistics and the stochastic clustering technique of Self-Organizing Maps (SOM were used to characterize their collaboration. Results Local health officials vary extensively in their level of collaboration with external collaborators. While the range of total involvement varies, the patterns of involvement for this specific function are relatively uniform. That is, regardless of the total level of involvement (low, medium or high, officials maintain similar hierarchical preference rankings with Community Advisory Boards and Local Boards of Health most involved and Experts and Elected Officials least involved. Conclusion The extent and patterns of collaboration among LHDs with other community stakeholders for a specific function can be described and ultimately related to outcome measures of LHD performance.

Characteristics of patients presenting to the vascular emergency department of a tertiary care hospital: a 2-year study

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Kotsikoris Ioannis

2011-11-01

Full Text Available Abstract Background The structure of health care in Greece is receiving increased attention to improve its cost-effectiveness. We sought to examine the epidemiological characteristics of patients presenting to the vascular emergency department of a Greek tertiary care hospital during a 2-year period. We studied all patients presenting to the emergency department of vascular surgery at Red Cross Hospital, Athens, Greece between 1st January 2009 and 31st December 2010. Results Overall, 2452 (49.4% out of 4961 patients suffered from pathologies that should have been treated in primary health care. Only 2509 (50.6% needed vascular surgical intervention. Conclusions The emergency department of vascular surgery in a Greek tertiary care hospital has to treat a remarkably high percentage of patients suitable for the primary health care level. These results suggest that an improvement in the structure of health care is needed in Greece.

Diffusion of innovation in women's health care delivery: the Department of Veterans Affairs' adoption of women's health clinics.

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Yano, Elizabeth M; Goldzweig, Caroline; Canelo, Ismelda; Washington, Donna L

2006-01-01

In response to concerns about the availability and quality of women's health services in Department of Veterans Affairs (VA) medical centers in the early 1990s, Congress approved landmark legislation earmarking funds to enhance women's health services. A portion of the appropriation was used to launch Comprehensive Women's Health Centers as exemplars for the development of VA women's health care throughout the system. We report on the diffusion and characteristics of VA women's health clinics (WHCs) 10 years later. In 2001, we surveyed the senior women's health clinician at each VA medical center serving > or =400 women veterans (83% response rate) regarding their internal organizational characteristics in relation to factors associated with organizational innovation (centralization, complexity, formalization, interconnectedness, organizational slack, size). We evaluated the comparability of WHCs (n = 66) with characteristics of the original comprehensive women's health centers (CWHCs; n = 8). Gender-specific service availability in WHCs was comparable to that of CWHCs with important exceptions in mental health, mammography and osteoporosis management. WHCs were less likely to have same-gender providers (p business case for managers faced with small female patient caseloads.

Report on the baseline measurement of the administrative burden from the Department of Health

OpenAIRE

Department of Health (Ireland)

2013-01-01

The Irish Government in March 2008 set a target to identify measure and reduce the Administrative Burden (AB) of domestic regulation for businesses by 25% by the end of 2012 – on foot of a European Council invitation to all member states in March 2007. As part of a cross-Government process led by the Business Regulation Unit of the Department of Jobs, Enterprise and Innovation (DJEI), the Department of Health carried out a measurement exercise in 2012 on the main Information Obligations...

Evaluation of Functional Preparedness and Non Structural Safety of Different Health Units of Kermanshah University of Medical Sciences in Coping With Natural Disasters

Directory of Open Access Journals (Sweden)

Abdollah Dargahi

2017-07-01

Conclusion: In general, the results showed that the average performance percentage and non-structural vulnerability of health units and various other departments are moderate at the headquarters of health centers. According to the study results, disasters like earthquake, dust, flood, and landslide frequently required preparedness in the whole region.

Department of Structural Research - Overview

International Nuclear Information System (INIS)

Wasiutynski, T.

2001-01-01

Full text: The research activity of our department concerns structural and dynamical properties of molecular solids. The particular subjects of interest in the year 2000 were orientational and conformational disorder on organic materials and the magnetism of new molecular and intermetallic compounds. The experimental work in our department relies on the complementary use of large instruments at international research centres and of the equipment operating in our laboratories. In the neutron scattering studies (ICNS inelastic coherent neutron scattering, IINS inelastic incoherent neutron scattering, QNS quasielastic neutron scattering etc) we mostly avail ourselves of neutron sources of The Institute for Energy Technology (IFE), Kjeller, Norway, and of The Joint Institute for Nuclear Research (JINR) Dubna, Russia. Our proposals are also regularly accepted in the other neutron centres such as Leon Brillouin Laboratory (LLB) Saclay, France, Rutherford Appleton Laboratory (RAL) Oxford, UK. etc. Thermodynamic characteristics of the materials are determined in our calorimetric laboratory equipped with adiabatic and differential scanning calorimeters. It is due to the invention of our researchers that these instruments, partly prototypic, are now capable of providing quantitative results on the kinetic behaviour of materials out of equilibrium. The scanning mode operation of our upgraded Fourier-transform infrared spectrometer allows US to follow the evolution of the dynamics of a material in the real time and in the temperature range 10-310 K. Textures arising in phase transitions are observed with the use of the polarising microscope with temperature-controlled stage. Molecular reorientation motions and relaxation processes are studied in the dielectric measurements. The laboratory of magnetic research possesses a set of modern instruments for measurements of magnetisation and of the AC susceptibility operating down to the helium temperatures. Computation facilities

Influenza | Florida Department of Health

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Health Women's Health WIC Program Community Health Minority Health & Health Equity People with influenza A viruses since early March. * This late-season circulation of influenza B is expected. View the

Selection bias in follow-up interviews with individuals attending the emergency department for occupational injuries

DEFF Research Database (Denmark)

Oesterlund, Anna H; Lander, Flemming; Rytter, Søren

2017-01-01

: Workers aged 18-70 years who contacted the two emergency departments for an acute occupational injury in 2013 were eligible and given a short questionnaire. Following written consent, a semi-structured interview concerning health and transient risk factors was conducted by telephone. The two departments...

Saving Lives and Saving Money: The Role of North Carolina Health Departments in Medicaid Managed Care.

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Bridger, Colleen M; Smith, Steven E; Saunders, Stacie Turpin

2017-01-01

A new Medicaid system is emerging in North Carolina in which accountable care organizations will aim to improve both the quality and value of health care. We explore how local health departments can apply their expertise in population health to help achieve these goals. ©2017 by the North Carolina Institute of Medicine and The Duke Endowment. All rights reserved.

Structural racism in the workplace: Does perception matter for health inequalities?

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McCluney, Courtney L; Schmitz, Lauren L; Hicken, Margaret T; Sonnega, Amanda

2018-02-01

Structural racism has been linked to racial health inequalities and may operate through an unequal labor market that results in inequalities in psychosocial workplace environments (PWE). Experiences of the PWE may be a critical but understudied source of racial health disparities as most adults spend a large portion of their lives in the workplace, and work-related stress affects health outcomes. Further, it is not clear if the objective characteristics of the workplace are important for health inequalities or if these inequalities are driven by the perception of the workplace. Using data from the 2008 to 2012 waves of the Health and Retirement Study (HRS), a probability-based sample of US adults 50 years of age and older and the Department of Labor's Occupational Information Network (O*NET), we examine the role of both standardized, objective (O*NET) and survey-based, subjective (as in HRS) measures of PWEs on health and Black-White health inequalities. We find that Blacks experience more stressful PWEs and have poorer health as measured by self-rated health, episodic memory function, and mean arterial pressure. Mediation analyses suggest that these objective O*NET ratings, but not the subjective perceptions, partially explain the relationship between race and health. We discuss these results within the extant literature on workplace and health and health inequalities. Furthermore, we discuss the use of standardized objective measures of the PWE to capture racial inequalities in workplace environment. Copyright © 2017 Elsevier Ltd. All rights reserved.

An Evaluation of the Cybersecurity Policies for the United States Health & Human Services Department: Criteria, Regulations, and Improvements

OpenAIRE

Derek Mohammed; Ronda Mariani

2014-01-01

This paper examines the criteria necessary for the evaluation of the cybersecurity policies for the United States Health and Human Services Department of the Federal Government. The overall purpose of cybersecurity policies and procedures is supported through compliance with Federal mandated regulation and standards, which serve to protect the organizational services and goals of the United States Health and Human Services Department, and to promote the best possible security practices in the...

[Engagement as motivational driver. Processes of change in an Italian department of mental health].

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Fuschillo, Carmine; Orazzo, Catello; Orazzo, Gabriele Gennaro; Capriola, Elena; Palumbo, Rocco; Grimaldi, Manlio

2017-01-01

The health care reforms of last years have deeply affected the National Health System, resulting in the need for a change in organizational processes and a more efficient and dynamic change management. An effective change management is not possible without a deep involvement (engagement) of professionals, which is itself a key requisite for motivation. This study aims to examine the main instruments of engagement management, as a tool of change according to a modern reorganization approach. We examine the results of this process in the Mental Health Department of the Local Health Company Naples 3 South in recent years, starting with the analysis of its main weaknesses.

Epidemiology of Mental Health Attendances at Emergency Departments: Systematic Review and Meta-Analysis.

Directory of Open Access Journals (Sweden)

Helen Barratt

Full Text Available The characteristics of Emergency Department (ED attendances due to mental or behavioural health disorders need to be described to enable appropriate development of services. We aimed to describe the epidemiology of mental health-related ED attendances within health care systems free at the point of access, including clinical reason for presentation, previous service use, and patient sociodemographic characteristics.Systematic review and meta-analysis of observational studies describing ED attendances by patients with common mental health conditions.18 studies from seven countries met eligibility criteria. Patients attending due to mental or behavioural health disorders accounted for 4% of ED attendances; a third were due to self-harm or suicidal ideation. 58.1% of attendees had a history of psychiatric illness and up to 58% were admitted. The majority of studies were single site and of low quality so results must be interpreted cautiously.Prevalence studies of mental health-related ED attendances are required to enable the development of services to meet specific needs.

Internal evaluation of public health department of Semnan university of medical sciences

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Behrad Pour- Mohammadi

2011-10-01

Full Text Available Introduction: Internal evaluation is a fundamental determinant to quality development in teachingdepartments and faculties. The purpose of this study was an internal departmental evaluation in the publichealth department of Semnan university of medical sciences (SUMS.Materials and Methods: This work was performed (during 2008-2009 in department of public health ofSUMS utilizing an accreditation model. The assessment covered 9 areas, namely: educational missions andobjectives, management and organization, educational programs, scientific board, students, educationalresources, research activities, assessment and evaluation, and graduates. Questionnaires were developed bythe scientific members of the department. After collecting the data, results were categorized according toGourman scoring scale, from unsatisfied class to very strong class, with the range of 1-5 scores.Results: The mean scores in the 9 evaluation areas were obtained and the rankings were as below:Educational programs area was in strong ranking; educational missions and objectives, scientific board,and assessment and evaluation areas were in good ranking; management and organization area was in morethan satisfied ranking; students area was in satisfied ranking; educational resources and research activitiesareas were in borderline ranking; and finally, the department was ranked as unsatisfied in the graduatesarea.Conclusions: Results showed that by achieved mean of 3.19 in whole of the evaluation areas, the publichealth department has placed in "more than satisfied" class. Although the overall status is acceptable, thereis a need to modify the weak points in the suboptimal areas to improve the educational quality in thisdepartment.

Residential Stability Reduces Unmet Health Care Needs and Emergency Department Utilization among a Cohort of Homeless and Vulnerably Housed Persons in Canada.

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Jaworsky, Denise; Gadermann, Anne; Duhoux, Arnaud; Naismith, Trudy E; Norena, Monica; To, Matthew J; Hwang, Stephen W; Palepu, Anita

2016-08-01

This study examined the association of housing status over time with unmet physical health care needs and emergency department utilization among homeless and vulnerably housed persons in Canada. Homeless and vulnerably housed individuals completed interviewer-administered surveys on housing, unmet physical health care needs, health care utilization, sociodemographic characteristics, substance use, and health conditions at baseline and annually for 4 years. Generalized logistic mixed effects regression models examined the association of residential stability with unmet physical health care needs and emergency department utilization, adjusting for potential confounders. Participants were from Vancouver (n = 387), Toronto (n = 390), and Ottawa (n = 396). Residential stability was associated with lower odds of having unmet physical health needs (adjusted odds ratio (AOR), 0.82; 95 % confidence interval (CI), 0.67, 0.98) and emergency department utilization (AOR, 0.74; 95 % CI, 0.62, 0.88) over the 4-year follow-up period, after adjusting for potential confounders. Residential stability is associated with fewer unmet physical health care needs and lower emergency department utilization among homeless and vulnerably housed individuals. These findings highlight the need to address access to stable housing as a significant determinant of health disparities.

The Use of Social Media by State Health Departments in the US: Analyzing Health Communication Through Facebook.

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Jha, Ayan; Lin, Leesa; Savoia, Elena

2016-02-01

The use of social media as a powerful health communication tool is an area of current research interest. Our objective was to describe use of Facebook by State Health Departments (SHDs) in US, and their relationship with CDC's Behavioral Risk Factor Surveillance System (BRFSS) data. Facebook pages of 34 SHDs were studied over a 200 day period, coding 2597 posts into 19 broad health communication categories. Mean number of Facebook posts per SHD was 76.4 (range 34-133); most frequent topic areas included healthy living (12%), communicable diseases (9%), vaccines and immunization (7%), emergency preparedness and response (7%), infant and child health (5%), smoking and tobacco use (5%), and miscellaneous (32%). Through web-based interactive graphics (Google motion charts), we contrasted Facebook posts with CDC's BRFSS data on adult nutrition and physical activity, vaccination, smoking, adolescent health and road traffic accidents. Our research finds an apparent disconnect between content provided on Facebook by SHDs and the health conditions that affect their populations. Acknowledging the severe limitations in funding and human resources faced by the SHDs, our research attempts to present the factual situation in embracing a vastly popular social media platform for health communication. We believe there is a need for research exploring methods to balance the demands and resources.

Perceived Benefits and Challenges of Coordinated Approaches to Chronic Disease Prevention in State Health Departments

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Sequeira, Sonia; Best, Leslie; Jones, Ellen; Baker, Elizabeth A.; Brownson, Ross C.

2014-01-01

Introduction Chronic disease prevention efforts have historically been funded categorically according to disease or risk factor. Federal agencies are now progressively starting to fund combined programs to address common risk. The purpose of this study was to inform transitions to coordinated chronic disease prevention by learning views on perceived benefits and challenges of a coordinated approach to funding. Methods A national survey on evidence-based public health was conducted from March through May 2013 among state health department employees working in chronic disease prevention (N = 865). Participants were asked to rank the top 3 benefits and top 3 challenges in coordinating chronic disease approaches from provided lists and could provide additional responses. Descriptive analyses, χ2 tests, and analysis of variance were conducted. Results The most common perceived benefits of coordinated approaches to chronic disease prevention were improved health outcomes, common risk factors better addressed, and reduced duplication of program efforts. The most common perceived challenges were funding restrictions, such as disease-specific performance measures; competing priorities; lack of communication across programs; funding might be reduced; agency not structured for program coordination; and loss of disease-specific partner support. Rankings of benefits and challenges were similar across states and participant roles; the perceived challenges “lack of communication across programs” (P = .02) and “funding might be reduced” differed by program area (P organizational support for coordinated approaches, and create benefits for organizational partners. PMID:24809362

Local health department translation processes: potential of machine translation technologies to help meet needs.

Science.gov (United States)

Turner, Anne M; Mandel, Hannah; Capurro, Daniel

2013-01-01

Limited English proficiency (LEP), defined as a limited ability to read, speak, write, or understand English, is associated with health disparities. Despite federal and state requirements to translate health information, the vast majority of health materials are solely available in English. This project investigates barriers to translation of health information and explores new technologies to improve access to multilingual public health materials. We surveyed all 77 local health departments (LHDs) in the Northwest about translation needs, practices, barriers and attitudes towards machine translation (MT). We received 67 responses from 45 LHDs. Translation of health materials is the principle strategy used by LHDs to reach LEP populations. Cost and access to qualified translators are principle barriers to producing multilingual materials. Thirteen LHDs have used online MT tools. Many respondents expressed concerns about the accuracy of MT. Overall, respondents were positive about its potential use, if low costs and quality could be assured.

An Evaluation of the Cybersecurity Policies for the United States Health & Human Services Department: Criteria, Regulations, and Improvements

Directory of Open Access Journals (Sweden)

Derek Mohammed

2014-04-01

Full Text Available This paper examines the criteria necessary for the evaluation of the cybersecurity policies for the United States Health and Human Services Department of the Federal Government. The overall purpose of cybersecurity policies and procedures is supported through compliance with Federal mandated regulation and standards, which serve to protect the organizational services and goals of the United States Health and Human Services Department, and to promote the best possible security practices in the protection of information systems from unauthorized actors and cyber-threats. The criteria of the cybersecurity evaluation is identified and analyzed for quality, strengths, weaknesses, and future applicability. Topics within the criteria include organizational operation, regulations and industrial standards compliance, service delivery to national customers, and the prevention and mitigation of IT system and security failure. This analysis determines the strengths and weaknesses, and makes recommendations for revising the cybersecurity policies within the United States Health and Human Services Department.

Local Health Department Food Safety and Sanitation Expenditures and Reductions in Enteric Disease, 2000–2010

Science.gov (United States)

Yip, Michelle Pui-Yan; Dunbar, Matthew D.; Whitman, Greg; Kwan-Gett, Tao

2015-01-01

Objectives. In collaboration with Public Health Practice–Based Research Networks, we investigated relationships between local health department (LHD) food safety and sanitation expenditures and reported enteric disease rates. Methods. We combined annual infection rates for the common notifiable enteric diseases with uniquely detailed, LHD-level food safety and sanitation annual expenditure data obtained from Washington and New York state health departments. We used a multivariate panel time-series design to examine ecologic relationships between 2000–2010 local food safety and sanitation expenditures and enteric diseases. Our study population consisted of 72 LHDs (mostly serving county-level jurisdictions) in Washington and New York. Results. While controlling for other factors, we found significant associations between higher LHD food and sanitation spending and a lower incidence of salmonellosis in Washington and a lower incidence of cryptosporidiosis in New York. Conclusions. Local public health expenditures on food and sanitation services are important because of their association with certain health indicators. Our study supports the need for program-specific LHD service-related data to measure the cost, performance, and outcomes of prevention efforts to inform practice and policymaking. PMID:25689186

[Attitudes and behaviour concerning cigarette smoking among the students of the first year at the Health Department].

Science.gov (United States)

Kowalska, Alina; Rzeźnicki, Adam; Drygas, Wojciech

2006-01-01

Smoking is still very common in Poland. Our country is among the leading countries with the greatest consumption of cigarettes. It is estimated that currently, there are about 40% smokers among men and 20% among women. In the future, most of the graduates from the Health Department will take care of the promotion of healthy life style and health education in the society. It is important that their theoretical knowledge be supported by proper health bases. A health centre worker who is inhaling smoke and at the same time encouraging quitting smoking is by no means credible. The aim of this work was to establish the participation of those students who are inhaling tobacco smoke that is among the students of the three departments of daily students of the Health Department. There were 108 female students who underwent the survey among the first year students of the Heath Department of Medical University of Lodz. The tool used was a survey. In the research carried out between 1st and 15th March 2006, 104 students (96.3%) took part. Among those who handed the surveys back, there were 32 males (30.8%) and 72 women (69.2%). In the group of respondents, which included 104 people, 33 (31.7%) stated that in January and February 2006 smoked cigarettes and 71 people (68.3%) claimed that within that time they did not smoke a single cigarette. Among the smokers, there were 11 males (f = 0.33) and 22 women (f = 0.67), whereas in the non-smokers' group, there were 21 male students (f = 0.30) and 50 female students (f = 0.70). In the past, there were 55 surveyed who inhaled tobacco smoke (52.9%), whereas 49 surveyed (47.1%) stated that they had never smoked in the past. In the smokers' group, there were 18 male students (f = 0.30) and 37 female students (f = 0.70). Among those who claimed they had never smoked before, there were 14 male students (f = 0.30) and 35 female students studies of the Health Department of Medical University of Lodz inhaled tobacco smoke. In comparison with

Assessing Capacity for Sustainability of Effective Programs and Policies in Local Health Departments.

Science.gov (United States)

Tabak, Rachel G; Duggan, Katie; Smith, Carson; Aisaka, Kristelle; Moreland-Russell, Sarah; Brownson, Ross C

2016-01-01

Sustainability has been defined as the existence of structures and processes that allow a program to leverage resources to effectively implement and maintain evidence-based public health and is important in local health departments (LHDs) to retain the benefits of effective programs. Explore the applicability of the Program Sustainability Framework in high- and low-capacity LHDs as defined by national performance standards. Case study interviews from June to July 2013. Standard qualitative methodology was used to code transcripts; codes were developed inductively and deductively. Six geographically diverse LHD's (selected from 3 of high and 3 of low capacity) : 35 LHD practitioners. Thematic reports explored the 8 domains (Organizational Capacity, Program Adaptation, Program Evaluation, Communications, Strategic Planning, Funding Stability, Environmental Support, and Partnerships) of the Program Sustainability Framework. High-capacity LHDs described having environmental support, while low-capacity LHDs reported this was lacking. Both high- and low-capacity LHDs described limited funding; however, high-capacity LHDs reported greater funding flexibility. Partnerships were important to high- and low-capacity LHDs, and both described building partnerships to sustain programming. Regarding organizational capacity, high-capacity LHDs reported better access to and support for adequate staff and staff training when compared with low-capacity LHDs. While high-capacity LHDs described integration of program evaluation into implementation and sustainability, low-capacity LHDs reported limited capacity for measurement specifically and evaluation generally. When high-capacity LHDs described program adoption, they discussed an opportunity to adapt and evaluate. Low-capacity LHDs struggled with programs requiring adaptation. High-capacity LHDs described higher quality communication than low-capacity LHDs. High- and low-capacity LHDs described strategic planning, but high

Assessing capacity for sustainability of effective programs and policies in local health departments

Science.gov (United States)

Tabak, Rachel G.; Duggan, Katie; Smith, Carson; Aisaka, Kristelle; Moreland-Russell, Sarah; Brownson, Ross C.

2015-01-01

Context Sustainability has been defined as the existence of structures and processes that allow a program to leverage resources to effectively implement and maintain evidence-based public health and is important in local health departments (LHDs) to retain the benefits of effective programs. Objective Explore the applicability of the Program Sustainability Framework in high- and low-capacity LHDs as defined by national performance standards. Design Case study interviews from June-July 2013. Standard qualitative methodology was used to code transcripts; codes were developed inductively and deductively. Setting Six geographically diverse LHD’s (selected from three high- and three low-capacity) Participants 35 LHD practitioners Main Outcome Measures Thematic reports explored the eight domains (Organizational Capacity, Program Adaptation, Program Evaluation, Communications, Strategic Planning, Funding Stability, Environmental Support, and Partnerships) of the Program Sustainability Framework. Results High-capacity LHDs described having environmental support, while low-capacity LHDs reported this was lacking. Both high- and low-capacity LHDs described limited funding; however, high-capacity LHDs reported greater funding flexibility. Partnerships were important to high- and low-capacity LHDs, and both described building partnerships to sustain programming. Regarding organizational capacity, high-capacity LHDs reported better access to and support for adequate staff and staff training compared to low-capacity LHDs. While high-capacity LHDs described integration of program evaluation into implementation and sustainability, low-capacity LHDs reported limited capacity for measurement specifically and evaluation generally. When high-capacity LHDs described program adoption, they discussed an opportunity to adapt and evaluate. Low-capacity LHDs struggled with programs requiring adaptation. High-capacity LHDs described higher quality communication than low-capacity LHDs. High

Health insurance, neighborhood income, and emergency department usage by Utah children 1996–1998

Directory of Open Access Journals (Sweden)

Knight Stacey

2005-04-01

Full Text Available Abstract Background It is estimated that approximately half of emergency department (ED usage in the U.S. and other developed countries is for non-urgent conditions and that this usage is related to availability, social, and economic factors. We examined pediatric ED usage in a U.S. state with respect to income, health insurance status, types of medical conditions, and whether introduction of managed care affected utilization by Medicaid children. Methods Emergency department usage rates were calculated from 1996 through 1998 using Utah ED data for children with commercial health insurance, Medicaid, for uninsured children, and by income group estimating neighborhood household income from Zip code of residence. We analyzed usage following the July 1996 transition of Utah Medicaid to managed care. Results Children with Medicaid had approximately 50% greater ED utilization rates than children with commercial health insurance or uninsured children. The majority of usage for Medicaid and uninsured children was for non-traumatic conditions. Only 35% of total ED usage was for non-emergent or non-urgent conditions and this was related to both Medicaid and low household income. Children lacking health insurance were more likely to be discharged against medical advice (OR = 2.36, 95% C.I. 1.88–2.96. There was no reduction in Medicaid ED usage following the transition to managed care. Conclusion Usage of ED services is related to both health insurance status and income. Children lacking health insurance and Medicaid children have excessive usage for conditions which could be treated in a primary care setting. That managed care does not reduce Medicaid ED usage is consistent with findings of other studies.

What predicts recovery orientation in county departments of mental health? A pilot study.

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Brown, Timothy T; Mahoney, Christine B; Adams, Neal; Felton, Mistique; Pareja, Candy

2010-09-01

In this pilot study we examined the determinants of recovery orientation among employees and influential stakeholders in a sample of 12 county departments of mental health in California. A two-level hierarchical linear model with random intercepts was estimated. Analyses show that recovery orientation has a U-shaped relationship with the age of staff/influential stakeholders and is negatively related to the difference between the desired level of adhocracy and the current level of adhocracy. Recovery orientation is positively related to the education level of staff/influential stakeholders, satisfying transformational leadership outcomes, and larger mental health budgets per capita. Policy implications are discussed.

Tweeting for and against public health policy: response to the Chicago Department of Public Health's electronic cigarette Twitter campaign.

Science.gov (United States)

Harris, Jenine K; Moreland-Russell, Sarah; Choucair, Bechara; Mansour, Raed; Staub, Mackenzie; Simmons, Kendall

2014-10-16

In January 2014, the Chicago City Council scheduled a vote on local regulation of electronic cigarettes as tobacco products. One week prior to the vote, the Chicago Department of Public Health (CDPH) released a series of messages about electronic cigarettes (e-cigarettes) through its Twitter account. Shortly after the messages, or tweets, were released, the department's Twitter account became the target of a "Twitter bomb" by Twitter users sending more than 600 tweets in one week against the proposed regulation. The purpose of our study was to examine the messages and tweet patterns in the social media response to the CDPH e-cigarette campaign. We collected all tweets mentioning the CDPH in the week between the e-cigarette campaign and the vote on the new local e-cigarette policy. We conducted a content analysis of the tweets, used descriptive statistics to examine characteristics of involved Twitter users, and used network visualization and descriptive statistics to identify Twitter users prominent in the conversation. Of the 683 tweets mentioning CDPH during the week, 609 (89.2%) were anti-policy. More than half of anti-policy tweets were about use of electronic cigarettes for cessation as a healthier alternative to combustible cigarettes (358/609, 58.8%). Just over one-third of anti-policy tweets asserted that the health department was lying or disseminating propaganda (224/609, 36.8%). Approximately 14% (96/683, 14.1%) of the tweets used an account or included elements consistent with "astroturfing"-a strategy employed to promote a false sense of consensus around an idea. Few Twitter users were from the Chicago area; Twitter users from Chicago were significantly more likely than expected to tweet in support of the policy. Our findings may assist public health organizations to anticipate, recognize, and respond to coordinated social media campaigns.

Florida Department of Health Workers’ Response to 2004 Hurricanes: A Qualitative Analysis

Science.gov (United States)

Herberman Mash, Holly B.; Fullerton, Carol S.; Kowalski-Trakofler, Kathleen; Reissman, Dori B.; Scharf, Ted; Shultz, James M.; Ursano, Robert J.

2015-01-01

Objective Examinations of the demands on public health workers after disaster exposure have been limited. Workers provide emergency care while simultaneously risking injury, damage to personal property, and threats to their own and their family’s safety. We examined the disaster management experiences of 4323 Florida Department of Health workers 9 months after their response to 4 hurricanes and 1 tropical storm during a 7-week period in August and September of 2004. Methods Participants completed a self-report questionnaire focused on work performance, mental and physical health, daily functioning, sleep disturbance, physiological arousal, and injury and work demand at the time of the hurricanes, and answered open-ended questions that described their experiences in more detail. Results A qualitative analysis conducted from the write-in data yielded 4 domains: (1) work/life balance; (2) training for disaster response role; (3) workplace support; and (4) recovery. Conclusions Study findings highlighted a number of concerns that are important to public health workers who provide emergency care after a disaster and, in particular, multiple disasters such as during the 2004 hurricane season. The findings also yielded important recommendations for emergency public health preparedness. PMID:24618166

Florida Department of Health workers' response to 2004 hurricanes: a qualitative analysis.

Science.gov (United States)

Herberman Mash, Holly B; Fullerton, Carol S; Kowalski-Trakofler, Kathleen; Reissman, Dori B; Scharf, Ted; Shultz, James M; Ursano, Robert J

2013-04-01

Examinations of the demands on public health workers after disaster exposure have been limited. Workers provide emergency care while simultaneously risking injury, damage to personal property, and threats to their own and their family's safety. We examined the disaster management experiences of 4323 Florida Department of Health workers 9 months after their response to 4 hurricanes and 1 tropical storm during a 7-week period in August and September of 2004. Participants completed a self-report questionnaire focused on work performance, mental and physical health, daily functioning, sleep disturbance, physiological arousal, and injury and work demand at the time of the hurricanes, and answered open-ended questions that described their experiences in more detail. A qualitative analysis conducted from the write-in data yielded 4 domains: (1) work/life balance; (2) training for disaster response role; (3) workplace support; and (4) recovery. Study findings highlighted a number of concerns that are important to public health workers who provide emergency care after a disaster and, in particular, multiple disasters such as during the 2004 hurricane season. The findings also yielded important recommendations for emergency public health preparedness.

The value from investments in health information technology at the U.S. Department of Veterans Affairs.

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Byrne, Colene M; Mercincavage, Lauren M; Pan, Eric C; Vincent, Adam G; Johnston, Douglas S; Middleton, Blackford

2010-04-01

We compare health information technology (IT) in the Department of Veterans Affairs (VA) to norms in the private sector, and we estimate the costs and benefits of selected VA health IT systems. The VA spent proportionately more on IT than the private health care sector spent, but it achieved higher levels of IT adoption and quality of care. The potential value of the VA's health IT investments is estimated at $3.09 billion in cumulative benefits net of investment costs. This study serves as a framework to inform efforts to measure and calculate the benefits of federal health IT stimulus programs.

CDC's National Environmental Public Health Tracking Program in Action: Case Studies From State and Local Health Departments.

Science.gov (United States)

Eatman, Shana; Strosnider, Heather M

The Centers for Disease Control and Prevention's (CDC's) National Environmental Public Health Tracking Program (Tracking Program) is a multidisciplinary collaboration that involves the ongoing collection, integration, analysis, interpretation, and dissemination of data from environmental hazard monitoring, human exposure surveillance, and health effects surveillance. With a renewed focus on data-driven decision-making, the CDC's Tracking Program emphasizes dissemination of actionable data to public health practitioners, policy makers, and communities. The CDC's National Environmental Public Health Tracking Network (Tracking Network), a Web-based system with components at the national, state, and local levels, houses environmental public health data used to inform public health actions (PHAs) to improve community health. This article serves as a detailed landscape on the Tracking Program and Tracking Network and the Tracking Program's leading performance measure, "public health actions." Tracking PHAs are qualitative statements addressing a local problem or situation, the role of the state or local Tracking Program, how the problem or situation was addressed, and the action taken. More than 400 PHAs have been reported by funded state and local health departments since the Tracking Program began collecting PHAs in 2005. Three case studies are provided to illustrate the use of the Tracking Program resources and data on the Tracking Network, and the diversity of actions taken. Through a collaborative network of experts, data, and tools, the Tracking Program and its Tracking Network are actively informing state and local PHAs. In a time of competing priorities and limited funding, PHAs can serve as a powerful tool to advance environmental public health practice.

[Management policy-making for work and education in health: the case of the Bahia State Health Department, Brazil, 2007-2008].

Science.gov (United States)

Pinto, Isabela Cardoso de Matos; Teixeira, Carmen Fontes

2011-09-01

The construction of Brazil's Unified National Health System (SUS) has raised a set of challenges for the health sector's administrators and personnel, including issues of work management and continuing education for health workers, in view of the financial, political, and organizational constraints in the process of changing the healthcare model. The current study aimed to analyze the process of formulating the Health Work and Education Management Policy by the Bahia State Health Department. Public policy cycle was used as the theoretical framework. The study analyzed data from institutional documents and records of participant observation by one of the authors. The results include mapping the governmental and nongovernmental stakeholders that participated in the process. The analysis highlights a series of problems in the SUS in Bahia related to work management and health workers' profile, taken as the point of departure for priority-setting in the State Strategic Agenda and Health Plan for 2008-2011.

Emergency department crowding in Singapore: Insights from a systems thinking approach.

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Schoenenberger, Lukas K; Bayer, Steffen; Ansah, John P; Matchar, David B; Mohanavalli, Rajagopal L; Lam, Sean Sw; Ong, Marcus Eh

2016-01-01

Emergency Department crowding is a serious and international health care problem that seems to be resistant to most well intended but often reductionist policy approaches. In this study, we examine Emergency Department crowding in Singapore from a systems thinking perspective using causal loop diagramming to visualize the systemic structure underlying this complex phenomenon. Furthermore, we evaluate the relative impact of three different policies in reducing Emergency Department crowding in Singapore: introduction of geriatric emergency medicine, expansion of emergency medicine training, and implementation of enhanced primary care. The construction of the qualitative causal loop diagram is based on consultations with Emergency Department experts, direct observation, and a thorough literature review. For the purpose of policy analysis, a novel approach, the path analysis, is applied. The path analysis revealed that both the introduction of geriatric emergency medicine and the expansion of emergency medicine training may be associated with undesirable consequences contributing to Emergency Department crowding. In contrast, enhancing primary care was found to be germane in reducing Emergency Department crowding; in addition, it has apparently no negative side effects, considering the boundary of the model created. Causal loop diagramming was a powerful tool for eliciting the systemic structure of Emergency Department crowding in Singapore. Additionally, the developed model was valuable in testing different policy options.

The Impact of Emotional Intelligence on Conditions of Trust Among Leaders at the Kentucky Department for Public Health

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Jennifer Redmond Knight

2015-03-01

Full Text Available There has been limited leadership research on emotional intelligence and trust in governmental public health settings. The purpose of this study was to identify and seek to understand the relationship between trust and elements of emotional intelligence, including stress management, at the Kentucky Department for Public Health. The Kentucky Department for Public Health (KDPH serves as Kentucky’s state governmental health department. KDPH is led by a Commissioner and composed of seven primary divisions and 25 branches within those divisions. The study was a non-randomized cross-sectional study utilizing electronic surveys that evaluated conditions of trust among staff members and emotional intelligence among supervisors. Pearson correlation coefficients and corresponding p-values are presented to provide the association between emotional intelligence scales and the conditions of trust. Significant positive correlations were observed between supervisors' stress management and the staff members' trust or perception of supervisors' loyalty(r=0.6, p=0.01, integrity(r=0.5, p=0.03, receptivity(r=0.6, p=0.02, promise fulfillment(r=0.6, p=0.02 and availability (r=0.5, p=0.07. This research lays the foundation for emotional intelligence and trust research and leadership training in other governmental public health settings, such as local, other state, national or international organizations. This original research provides metrics to assess the public health workforce with attention to organizational management and leadership constructs. The survey tools could be used in other governmental public health settings in order to develop tailored training opportunities related to emotional intelligence and trust organizations.

Order of draw practices in venous blood sampling at clinical biochemistry departments in the Danish health care system

DEFF Research Database (Denmark)

Jacobsen, Katja Kemp; Brandt, Ida; Christensen, Anne Vindahl

2018-01-01

the procedures in venous blood sampling among clinical biochemistry departments to assess the uniformity of order of blood draw and adherence to international guidelines in the Danish health care system. METHODS: We collected venous order of draw procedures from 49 clinical biochemistry departments at 22 public...... 15189:2012 accreditation (p = .57). CONCLUSIONS: Venous order of draw procedures is diverse at Danish clinical biochemistry departments and show moderate adherence to international guidelines....

[Position of health at international relations. Part I. Structural dimensions of health].

Science.gov (United States)

Cianciara, Dorota; Wysocki, Mirosław J

2011-01-01

In the article, the health is perceived as complex, multidimensional concept and not as absence of disease. This is consistent with public health perspective, where public health is regarded as public as well as political activity. It aims to solve health and social problems, depends on analysis of phenomena, needs the negotiations and relies on making decision on feasible directions of changes--what, why, how, where, when and by whom should be done. Public health policy developed as a result of international relations, and UN family fora especially, is regarded as significant for creating of health position. The aim of this article was: (1) the analysis of selected concepts and definitions related to structural dimensions of health, used in UN international arrangements; (2) an attempt to explain the evolution of health structure notions at worldwide agenda. The UN main bodies, programmes and funds working on the health field are mentioned and voting rules in UN General Assembly and World Health Assembly are reminded. The following structural dimensions were considered: (a) well-being, (b) human rights, (c) everyday resource, health potential, (4) equity. All were explored in WHO Constitution, Universal Declaration of Human Rights, International Covenant on Economic, Social and Cultural Rights, Ottawa Charter for Health Promotion and numerous WHA and UN GA resolutions, decisions as well as other documents. Some remarkable differences in English and Polish language versions and meanings were pointed out. It was argued that present perception of structural dimension of health is strongly derived from the preamble of the WHO Constitution adopted and signed on 22 July 1946 by the representatives of 61 States. It is an evidence of the strength of this document and wisdom of its authors. The greater progress is associated. with concepts and notion of organizational dimensions of health perceived as action and processes leading to health. Long-term efforts to strengthen

Creating community-based access to primary healthcare for the uninsured through strategic alliances and restructuring local health department programs.

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Scotten, E Shirin L; Absher, Ann C

2006-01-01

In 2003, the Wilkes County Health Department joined with county healthcare providers to develop the HealthCare Connection, a coordinated and continuous system of low-cost quality care for uninsured and low-income working poor. Through this program, local providers of primary and specialty care donate specialty care or ancillary services not provided by the Health Department, which provides case management for the program. Basing their methods on business models learned through the UNC Management Academy for Public Health, planners investigated the best practices for extending healthcare coverage to the underinsured and uninsured, analyzed operational costs, discovered underutilized local resources, and built capacity within the organization. The HealthCare Connection is an example of how a rural community can join together in a common business practice to improve healthcare access for uninsured and/or low-income adults.

Leadership of the Department of Epidemiology of the Johns Hopkins Bloomberg School of Public Health in Its First Century.

Science.gov (United States)

Celentano, David D

2016-03-01

This commentary reviews the contributions of each of the 7 Chairs of the Department of Epidemiology from the Department's inception in 1919 to the advent of the Centennial Celebration of the Johns Hopkins Bloomberg School of Public Health in 2016. The founding Chair, Wade Hampton Frost (1919-1938), was among the handful of foundational thinkers in the discipline of epidemiology. Kenneth Maxcy (1938-1954) and Philip Sartwell (1954-1970) oversaw the Department through the epidemiologic transition from a preponderance of morbidity and mortality due to infectious diseases to a preponderance of noncommunicable diseases. Abraham Lilienfeld (1970-1975) and Leon Gordis (1975-1993) were perhaps best known for their mastery of teaching, influencing generations of both medical and public health students. Jonathan Samet (1994-2008) oversaw a major curriculum revision and expanded the Department significantly, and David Celentano (2008-) is working to rebalance the practice of epidemiology with the etiological foundations of epidemiology. All Chairs were a product of their times, and their research focus and portfolios influenced the direction of the Department. Future generations of Johns Hopkins students will be influenced directly or indirectly by the heritage of these Chairs' actions and those of their faculty. © The Author 2016. Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Structural health monitoring for ship structures

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Farrar, Charles [Los Alamos National Laboratory; Park, Gyuhae [Los Alamos National Laboratory; Angel, Marian [Los Alamos National Laboratory; Bement, Matthew [Los Alamos National Laboratory; Salvino, Liming [NSWC, CADEROCK

2009-01-01

Currently the Office of Naval Research is supporting the development of structural health monitoring (SHM) technology for U.S. Navy ship structures. This application is particularly challenging because of the physical size of these structures, the widely varying and often extreme operational and environmental conditions associated with these ships missions, lack of data from known damage conditions, limited sensing that was not designed specifically for SHM, and the management of the vast amounts of data that can be collected during a mission. This paper will first define a statistical pattern recognition paradigm for SHM by describing the four steps of (1) Operational Evaluation, (2) Data Acquisition, (3) Feature Extraction, and (4) Statistical Classification of Features as they apply to ship structures. Note that inherent in the last three steps of this process are additional tasks of data cleansing, compression, normalization and fusion. The presentation will discuss ship structure SHM challenges in the context of applying various SHM approaches to sea trials data measured on an aluminum multi-hull high-speed ship, the HSV-2 Swift. To conclude, the paper will discuss several outstanding issues that need to be addressed before SHM can make the transition from a research topic to actual field applications on ship structures and suggest approaches for addressing these issues.

Simultaneous Structural Health Monitoring and Vibration Control of Adaptive Structures Using Smart Materials

Directory of Open Access Journals (Sweden)

Myung-Hyun Kim

2002-01-01

Full Text Available The integration of actuators and sensors using smart materials enabled various applications including health monitoring and structural vibration control. In this study, a robust control technique is designed and implemented in order to reduce vibration of an active structure. Special attention is given to eliminating the possibility of interaction between the health monitoring system and the control system. Exploiting the disturbance decoupling characteristic of the sliding mode observer, it is demonstrated that the proposed observer can eliminate the possible high frequency excitation from the health monitoring system. At the same time, a damage identification scheme, which tracks the changes of mechanical impedance due to the presence of damage, has been applied to assess the health condition of structures. The main objective of this paper is to examine the potential of combining the two emerging techniques together. Using the collocated piezoelectric sensors/actuators for vibration suppression as well as for health monitoring, this technique enabled to reduce the number of system components, while enhancing the performance of structures. As an initial study, both simulation and experimental investigations were performed for an active beam structure. The results show that this integrated technique can provide substantial vibration reductions, while detecting damage on the structure at the same time.

Students' attitudes towards impact of the health department website on their health literacy in Semnan University of Medical Sciences.

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Mahdizadeh, Jamileh; Valinejadi, Ali; Pooyesh, Behnoosh; Jafari, Fatemeh; Kahouei, Mehdi

2018-01-01

Health literacy has been of interest to policymakers because of its impact on health decision-making as one of the important issues for promoting community health and improving the quality of health care delivery. Therefore, it seems necessary to examine the status of the website of the health sector of the University of Medical Sciences in promoting health literacy from the viewpoint of the students. This cross-sectional study was performed on 529 medical and allied students in schools affiliated to Semnan University of Medical Sciences, Semnan, Iran between 2016 and 2017. In this study, a valid and reliable adult health literacy questionnaire designed by Montazeri et al. was used. The questionnaire was distributed among students in medical and allied health schools and they were asked to complete the questionnaire. Independent-samples t-test, one-way ANOVA, and Pearson product-moment correlation were used to analyze data by SPSS 19. Mean scores of the participants' attitudes towards reading of health information was 3.14 and towards decision and usage of health information was 2.53. Relationship between the study subjects' demographic characteristics and their attitudes was significant (pwebsite. Hence, the results of this study showed that the website of the health department needs to be redesigned, and this design would allow a better link between the University of Medical Sciences and its audience to promote health literacy.

A Performance Management Initiative for Local Health Department Vector Control Programs.

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Gerding, Justin; Kirshy, Micaela; Moran, John W; Bialek, Ron; Lamers, Vanessa; Sarisky, John

2016-01-01

Local health department (LHD) vector control programs have experienced reductions in funding and capacity. Acknowledging this situation and its potential effect on the ability to respond to vector-borne diseases, the U.S. Centers for Disease Control and Prevention and the Public Health Foundation partnered on a performance management initiative for LHD vector control programs. The initiative involved 14 programs that conducted a performance assessment using the Environmental Public Health Performance Standards. The programs, assisted by quality improvement (QI) experts, used the assessment results to prioritize improvement areas that were addressed with QI projects intended to increase effectiveness and efficiency in the delivery of services such as responding to mosquito complaints and educating the public about vector-borne disease prevention. This article describes the initiative as a process LHD vector control programs may adapt to meet their performance management needs. This study also reviews aggregate performance assessment results and QI projects, which may reveal common aspects of LHD vector control program performance and priority improvement areas. LHD vector control programs interested in performance assessment and improvement may benefit from engaging in an approach similar to this performance management initiative.

State of Hawaii, Department of Health, Clean Water Branch State-wide Water Quality Sampling Dataset 1999-2006 (NODC Accession 0013723)

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National Oceanic and Atmospheric Administration, Department of Commerce — The Monitoring Section of the State of Hawaii, Department of Health, Clean Water Branch collects water quality data at over 300 coastal locations state-wide using...

State of Hawaii, Department of Health, Clean Water Branch State-wide Water Quality Sampling Dataset 1973-1998 (NODC Accession 0013724)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Monitoring Section of the State of Hawaii, Department of Health, Clean Water Branch collects water quality data at over 300 coastal locations state-wide using...

Water sample data set from the State of Hawaii, Department of Health, 1999-2006 in Hawaiian waters (NODC Accession 0013723)

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National Oceanic and Atmospheric Administration, Department of Commerce — Water quality data from were collected by the Monitoring Section of the State of Hawaii, Department of Health. Data were obtained from 373 state-wide coastal...

Department of Health and Children Consolidated Salary Scales effective from June 2007

OpenAIRE

Department of Health (Ireland)

2007-01-01

Department of Health and Children Consolidated Salary Scales effective from June 2007 For the 1st worksheet, the pay-scales for grades read across. The current rate (1/06/07), 2% (2.5% if earning less than â,¬20,859 per annum) Towards 2016 and one historical rate are shown for the 1st worksheet. The grades within each section are displayed in the same order as in previous Pay Scales. Click here to download PDF 173kb

[The role of the public health personnel in the Prevention Department (in the Hygiene Services and Public Health Care and Hygiene of Food and Nutrition): proposal for the future of public health care].

Science.gov (United States)

Brusaferro, Silvio; Marcolongo, Adriano; Schiava, Flavio; Bggio, Luca; Betta, Alberto; Buzzo, Armando; Cinquetti, Sandro; Coin, Paulo; Dal Fior, Tina; De Battisti, Fabio; De Marchi, Chiara; De Noni, Lucia; Donatoni, Luigi; Ferraresso, Anna; Gallo, Giovanni; Gallo, Lorenza; Gallo, Tolinda; Gottardello, Lorena; Menegon, Tiziana; Minuzzo, Michele; Paussi, Gianna; Pinna, Clara; Poli, Albino; Rossato, Luigi; Sbrogliò, Luca; Simeoni, Josef; Speccini, Manuela; Stoppato, Ugo; Superbi, Piero; Tardivo, Stefano; Urdich, Alessandro; Valsecchi, Massimo; Zamparo, Manuela

2008-01-01

A global and local discussion on Public Health relevance is taking place, including the future role and organization of its services. Noteworthy becomes the role played by Public Health Specialists. This work presents the results of a workshop, carried out following the Guilbert methodology, whose aim was to define Public Health Doctors functions and their related activities. The programme involved 30 professionals from Triveneto area (North Eastern Italy), working in Prevention Departments at National Health Service and Universities. The key-functions identified were: 1) Health status assessment and identification of community risk factors, 2) Health Promotion, 3) Prevention, 4) Protection, 5) Planning, 6) Communication, 7) Professional Training, 8) Alliances and resources for complex Public Health programs, 9) Crisis management in Public Health, 10) Research. For each function activities were identified, meaning concerning areas and contents that must be warranted by professionals. This experience allowed to share existing attitudes and experiences present in Triveneto area, and it can stand as a feasible instrument for different settings. Nevertheless, it appears mandatory explaining at each level in the society role and functions of Prevention Departments.

A Cluster Randomized Evaluation of a Health Department Data to Care Intervention Designed to Increase Engagement in HIV Care and Antiretroviral Use.

Science.gov (United States)

Dombrowski, Julia C; Hughes, James P; Buskin, Susan E; Bennett, Amy; Katz, David; Fleming, Mark; Nunez, Angela; Golden, Matthew R

2018-06-01

Many US health departments have implemented Data to Care interventions, which use HIV surveillance data to identify persons who are inadequately engaged in HIV medical care and assist them with care reengagement, but the effectiveness of this strategy is uncertain. We conducted a stepped-wedge, cluster-randomized evaluation of a Data to Care intervention in King County, Washington, 2011 to 2014. Persons diagnosed as having HIV for at least 6 months were eligible based on 1 of 2 criteria: (1) viral load (VL) greater than 500 copies/mL and CD4 less than 350 cells/μL at the last report in the past 12 months or (2) no CD4 or VL reported to the health department for at least 12 months. The intervention included medical provider contact, patient contact, and a structured individual interview. Health department staff assisted patients with reengagement using health systems navigation, brief counseling, and referral to support services. We clustered all eligible cases in the county by the last known medical provider and randomized the order of clusters for intervention, creating contemporaneous intervention and control periods (cases in later clusters contributed person-time to the control period at the same time that cases in earlier clusters contributed person-time to the intervention period). We compared the time to viral suppression (VL <200 copies/mL) for individuals during intervention and control periods using a Cox proportional hazards model. We identified 997 persons (intention to treat [ITT]), 18% of whom had moved or died. Of the remaining 822 (modified ITT), 161 (20%) had an undetectable VL reported before contact and 164 (20%) completed the individual interview. The hazard ratio (HR) for time to viral suppression did not differ between the intervention and control periods in ITT (HR, 1.21 [95% confidence interval, 0.85-1.71]) or modified ITT (HR, 1.18 [95% confidence interval, 0.83-1.68]) analysis. The Data to Care intervention did not impact time to viral

Lower Colorado River GRP Dams and Water Retention Structures, Arizona, 2012, Arizona Department of Environmental Quality

Data.gov (United States)

U.S. Environmental Protection Agency — Location of dams and water retention structures as compiled from multiple sources by the Arizona Department of Environmental Quality (ADEQ). The data are "sensitive"...

The Use of Telemental Health to Meet the Mental Health Needs of Women Using Department of Veterans Affairs Services.

Science.gov (United States)

Moreau, Jessica L; Cordasco, Kristina M; Young, Alexander S; Oishi, Sabine M; Rose, Danielle E; Canelo, Ismelda; Yano, Elizabeth M; Haskell, Sally G; Hamilton, Alison B

Women veterans are a growing segment of Department of Veterans Affairs (VA) users with distinct mental health needs and well-documented barriers to care. Telemental health holds much promise for reducing barriers to mental health care. We assessed VA stakeholders' perceptions of telemental health's appropriateness and potential to address the mental health needs of women veteran VA users. We conducted semistructured qualitative interviews with 40 key leadership and clinical stakeholders at VA medical centers and associated outpatient clinics. Transcripts were summarized in a template of key domains developed based on the interview guide, and coded for topics relevant to women's mental health needs and telehealth services. Telemental health was perceived to increase access to mental health care, including same-gender care and access to providers with specialized training, especially for rural women and those with other limiting circumstances. Respondents saw women veterans as being particularly poised to benefit from telemental health, owing to responsibilities associated with childcare, spousal care, and elder caregiving. Interviewees expressed enthusiasm for telemental health's potential and were eager to expand services, including women-only mental health groups. Implementation challenges were also noted. Overall, our stakeholders saw telemental health as a good fit for helping to address the perceived needs of women veterans, especially in addressing the geographical barriers experienced by rural women and those with a limited ability to travel. These findings can help to inform gender-tailored expansion of telemental health within and outside of the VA. Published by Elsevier Inc.

Family structure and health, how companionship acts as a buffer against ill health

Directory of Open Access Journals (Sweden)

Kizuki Masashi

2007-11-01

Full Text Available Abstract Background Health and well-being are the result of synergistic interactions among a variety of determinants. Family structure and composition are social determinants that may also affect health behaviours and outcomes. This study was performed to examine the associations between family structure and health and to determine the protective effects of support mechanisms to improve quality of health outcome. Methods Six hundred people, selected by multistage sampling to obtain a representative population of men and women aged 20–60 living in communities in Japan, were included in this study. Data regarding subjective views of one's own health, family structure, lifestyle and social support were collected through structured face-to-face interviews on home visits. Systolic and diastolic blood pressures, height and weight were measured by trained examiners. The associations between family structure and health after controlling for demographics, lifestyle and social support were examined using logistic and linear regression analyses. Results Subjects living alone were significantly more likely to be in ill health, as determined using the General Health Questionnaire, in comparison to those in extended families (OR = 3.14. Subjects living alone or as couples were significantly more likely to suffer from severe hypertension in comparison to those living in extended families (OR = 8.25, OR = 4.90. These associations remained after controlling for the influence of lifestyle. Subjects living only with spouse or in nuclear family had higher probabilities of mental ill health in the absence than in the presence of people showing concern for their well-being. Conclusion The results of this study infers that a support mechanism consisting of companionship and the presence of family or other people concerned for one's well being acts as a buffer against deleterious influence of living in small family that will lead to improved quality of health outcome.

Structural health monitoring system/method using electroactive polymer fibers

Science.gov (United States)

Scott-Carnell, Lisa A. (Inventor); Siochi, Emilie J. (Inventor)

2013-01-01

A method for monitoring the structural health of a structure of interest by coupling one or more electroactive polymer fibers to the structure and monitoring the electroactive responses of the polymer fiber(s). Load changes that are experienced by the structure cause changes in the baseline responses of the polymer fiber(s). A system for monitoring the structural health of the structure is also provided.

Students’ attitudes towards impact of the health department website on their health literacy in Semnan University of Medical Sciences

Science.gov (United States)

Mahdizadeh, Jamileh; Valinejadi, Ali; Pooyesh, Behnoosh; Jafari, Fatemeh

2018-01-01

Background and aim Health literacy has been of interest to policymakers because of its impact on health decision-making as one of the important issues for promoting community health and improving the quality of health care delivery. Therefore, it seems necessary to examine the status of the website of the health sector of the University of Medical Sciences in promoting health literacy from the viewpoint of the students. Methods This cross-sectional study was performed on 529 medical and allied students in schools affiliated to Semnan University of Medical Sciences, Semnan, Iran between 2016 and 2017. In this study, a valid and reliable adult health literacy questionnaire designed by Montazeri et al. was used. The questionnaire was distributed among students in medical and allied health schools and they were asked to complete the questionnaire. Independent-samples t-test, one-way ANOVA, and Pearson product-moment correlation were used to analyze data by SPSS 19. Results Mean scores of the participants’ attitudes towards reading of health information was 3.14 and towards decision and usage of health information was 2.53. Relationship between the study subjects’ demographic characteristics and their attitudes was significant (pwebsite. Hence, the results of this study showed that the website of the health department needs to be redesigned, and this design would allow a better link between the University of Medical Sciences and its audience to promote health literacy. PMID:29588815

Implications of network structure on public health collaboratives.

Science.gov (United States)

Retrum, Jessica H; Chapman, Carrie L; Varda, Danielle M

2013-10-01

Interorganizational collaboration is an essential function of public health agencies. These partnerships form social networks that involve diverse types of partners and varying levels of interaction. Such collaborations are widely accepted and encouraged, yet very little comparative research exists on how public health partnerships develop and evolve, specifically in terms of how subsequent network structures are linked to outcomes. A systems science approach, that is, one that considers the interdependencies and nested features of networks, provides the appropriate methods to examine the complex nature of these networks. Applying Mays and Scutchfields's categorization of "structural signatures" (breadth, density, and centralization), this research examines how network structure influences the outcomes of public health collaboratives. Secondary data from the Program to Analyze, Record, and Track Networks to Enhance Relationships (www.partnertool.net) data set are analyzed. This data set consists of dyadic (N = 12,355), organizational (N = 2,486), and whole network (N = 99) data from public health collaborations around the United States. Network data are used to calculate structural signatures and weighted least squares regression is used to examine how network structures can predict selected intermediary outcomes (resource contributions, overall value and trust rankings, and outcomes) in public health collaboratives. Our findings suggest that network structure may have an influence on collaborative-related outcomes. The structural signature that had the most significant relationship to outcomes was density, with higher density indicating more positive outcomes. Also significant was the finding that more breadth creates new challenges such as difficulty in reaching consensus and creating ties with other members. However, assumptions that these structural components lead to improved outcomes for public health collaboratives may be slightly premature. Implications of

Adoption and use of social media among public health departments.

Science.gov (United States)

Thackeray, Rosemary; Neiger, Brad L; Smith, Amanda K; Van Wagenen, Sarah B

2012-03-26

Effective communication is a critical function within any public health system. Social media has enhanced communication between individuals and organizations and has the potential to augment public health communication. However, there is a lack of reported data on social media adoption within public health settings. The purposes of this study were to assess: 1) the extent to which state public health departments (SHDs) are using social media; 2) which social media applications are used most often; and 3) how often social media is used interactively to engage audiences. This was a non-experimental, cross sectional study of SHD social media sites. Screen capture software Snag-It® was used to obtain screenshots of SHD social media sites across five applications. These sites were coded for social media presence, interactivity, reach, and topic. Sixty percent of SHDs reported using at least one social media application. Of these, 86.7% had a Twitter account, 56% a Facebook account, and 43% a YouTube channel. There was a statistically significant difference between average population density and use of social media (p = .01). On average, SHDs made one post per day on social media sites, and this was primarily to distribute information; there was very little interaction with audiences. SHDs have few followers or friends on their social media sites. The most common topics for posts and tweets related to staying healthy and diseases and conditions. Limitations include the absence of a standard by which social media metrics measure presence, reach, or interactivity; SHDs were only included if they had an institutionally maintained account; and the study was cross sectional. Social media use by public health agencies is in the early adoption stage. However, the reach of social media is limited. SHDs are using social media as a channel to distribute information rather than capitalizing on the interactivity available to create conversations and engage with the audience. If

Development of structural health monitoring techniques using dynamics testing

Energy Technology Data Exchange (ETDEWEB)

James, G.H. III [Sandia National Labs., Albuquerque, NM (United States). Experimental Structural Dynamics Dept.

1996-03-01

Today`s society depends upon many structures (such as aircraft, bridges, wind turbines, offshore platforms, buildings, and nuclear weapons) which are nearing the end of their design lifetime. Since these structures cannot be economically replaced, techniques for structural health monitoring must be developed and implemented. Modal and structural dynamics measurements hold promise for the global non-destructive inspection of a variety of structures since surface measurements of a vibrating structure can provide information about the health of the internal members without costly (or impossible) dismantling of the structure. In order to develop structural health monitoring for application to operational structures, developments in four areas have been undertaken within this project: operational evaluation, diagnostic measurements, information condensation, and damage identification. The developments in each of these four aspects of structural health monitoring have been exercised on a broad range of experimental data. This experimental data has been extracted from structures from several application areas which include aging aircraft, wind energy, aging bridges, offshore structures, structural supports, and mechanical parts. As a result of these advances, Sandia National Laboratories is in a position to perform further advanced development, operational implementation, and technical consulting for a broad class of the nation`s aging infrastructure problems.

Collaborating across the Departments of Veterans Affairs and Defense to integrate mental health and chaplaincy services.

Science.gov (United States)

Nieuwsma, Jason A; Jackson, George L; DeKraai, Mark B; Bulling, Denise J; Cantrell, William C; Rhodes, Jeffrey E; Bates, Mark J; Ethridge, Keith; Lane, Marian E; Tenhula, Wendy N; Batten, Sonja V; Meador, Keith G

2014-12-01

Recognizing that clergy and spiritual care providers are a key part of mental health care systems, the Department of Veterans Affairs (VA) and Department of Defense (DoD) jointly examined chaplains' current and potential roles in caring for veterans and service members with mental health needs. Our aim was to evaluate the intersection of chaplain and mental health care practices in VA and DoD in order to determine if improvement is needed, and if so, to develop actionable recommendations as indicated by evaluation findings. A 38-member multidisciplinary task group partnered with researchers in designing, implementing, and interpreting a mixed methods study that included: 1) a quantitative survey of VA and DoD chaplains; and 2) qualitative interviews with mental health providers and chaplains. Quantitative: the survey included all full-time VA chaplains and all active duty military chaplains (n = 2,163 completed of 3,464 invited; 62 % response rate). Qualitative: a total of 291 interviews were conducted with mental health providers and chaplains during site visits to 33 VA and DoD facilities. Quantitative: the online survey assessed intersections between chaplaincy and mental health care and took an average of 37 min to complete. Qualitative: the interviews assessed current integration of mental health and chaplain services and took an average of 1 h to complete. When included on interdisciplinary mental health care teams, chaplains feel understood and valued (82.8-100 % of chaplains indicated this, depending on the team). However, findings from the survey and site visits suggest that integration of services is often lacking and can be improved. Closely coordinating with a multidisciplinary task group in conducting a mixed method evaluation of chaplain-mental health integration in VA and DoD helped to ensure that researchers assessed relevant domains and that findings could be rapidly translated into actionable recommendations.

Tuberculosis in hospital department health care workers

Directory of Open Access Journals (Sweden)

Sandra Saleiro

2007-11-01

Full Text Available Introduction: Tuberculosis (TB is considered an occupational disease in health care workers (HCW and its transmission in health care facilities is an important concern. Some hospital departments are at higher risk of infection. Objective: To describe TB cases detected after TB screening in HCW from a hospital department (Ear, Nose and Throat – ENT who had had contact with active TB cases. Material and methods: All HCW (73 from Hospital São João's ENT Unit who had been in contact with two in-patients with active TB underwent TB screening. Those who had symptoms underwent chest X-ray and mycobacteriological sputum exam. Results: Of 73 HCW who underwent TB screening, TB diagnosis was established in 9 (8 female; median age: 30 years; 1 doctor, 6 nurses, 2 nursing auxiliaries. Pulmonary TB was found in 8 and extra- -pulmonary TB in 1. Microbiology diagnosis was obtained in 7 cases by sputum smear, n = 2; culture exam in bronchial lavage, n = 4 and histological exam of pleural tissue, n = 1. In 4 cases, Mycobacterium tuberculosis genomic DNA was extracted from cultures and molecular typing was done. All cases had identical MIRU types, which allowed identification of the epidemiological link. Conclusion: Nosocomial TB is prominent and efforts should be made to implement successful infection control measures in health care facilities and an effective TB screening program in HCW. Molecular typing of Mycobacterium tuberculosis facilitates cluster identification. Resumo: Introdução: A tuberculose é considerada uma doença ocupacional nos profissionais de saúde e a sua transmissão, nas instituições de saúde, constitui um problema importante. Alguns serviços hospitalares estão particularmente expostos a risco de infecção. Objectivo: Caracterizar os casos de tuberculose detectados na sequência de um rastreio efectuado aos profissionais de saúde de um serviço hospitalar

Local health departments and specific maternal and child health expenditures: relationships between spending and need.

Science.gov (United States)

Bekemeier, Betty; Dunbar, Matthew; Bryan, Matthew; Morris, Michael E

2012-11-01

As a part of the Public Health Activities and Service Tracking study and in collaboration with partners in 2 Public Health Practice-Based Research Network states, we examined relationships between local health department (LHD) maternal and child health (MCH) expenditures and local needs. We used a multivariate pooled time-series design to estimate ecologic associations between expenditures in 3 MCH-specific service areas and related measures of need from 2005 to 2010 while controlling for other factors. Retrospective expenditure data from LHDs and for 3 MCH services represented annual investments in (1) Special Supplemental Nutrition for Women, Infants, and Children (WIC), (2) family planning, and (3) a composite of Maternal, Infant, Child, and Adolescent (MICA) service. Expenditure data from all LHDs in Florida and Washington were then combined with "need" and control variables. Our sample consisted of the 102 LHDs in Florida and Washington and the county (or multicounty) jurisdictions they serve. Expenditures for WIC and for our composite of MICA services were strongly associated with need among LHDs in the sample states. For WIC, this association was positive, and for MICA services, this association was negative. Family planning expenditures were weakly associated, in a positive direction. Findings demonstrate wide variations across programs and LHDs in relation to need and may underscore differences in how programs are funded. Programs with financial disbursements based on guidelines that factor in local needs may be better able to provide service as local needs grow than programs with less needs-based funding allocations.

HCUP Nationwide Emergency Department Database (NEDS) Restricted Access File

Data.gov (United States)

U.S. Department of Health & Human Services — The Nationwide Emergency Department Sample (NEDS) was created to enable analyses of emergency department (ED) utilization patterns and support public health...

Health Literacy Among Parents of Pediatric Patients Seen in the Emergency Department

Directory of Open Access Journals (Sweden)

Tran, T. Paul

2008-08-01

Full Text Available BACKGROUND: Health literacy is an important predictor of healthcare outcomes, but research on this topic has largely been absent from the emergency medicine literature.OBJECTIVE: We measured the prevalence of health literacy in parents or guardians of pediatric patients seen in the emergency department (ED.METHODS: This was an observational study conducted in a Midwestern urban, university-based, tertiary, Level 1 trauma center ED with 33,000 visits/year. Using convenience sampling during a three-month period, English-speaking parents or guardians of pediatric patients (< 19 yrs. were asked to complete the short version of the Test of Functional Health Literacy for Adults (s-TOFHLA. Parents/guardians were excluded if they had uncorrected visual impairment, required an interpreter, had altered mental status, or if the patients they accompanied were the subjects of a medical or trauma activation.RESULTS: Of the 188 parents or guardians approached, six did not consent or withdrew, one was excluded, leaving 181 (96.3% in the study. Of these, 19 (10.5% had either "marginal" or "inadequate" health literacy, while 162 (89.5%, 95% CI: 84.1%, 93.6% had "adequate" health literacy.CONCLUSION: A large majority (89.5% of English-speaking parents or guardians of pediatric patients evaluated in the ED have adequate health literacy. This data may prompt ED professionals to adjust their communication styles in the evaluation of children. Future multi-center studies are needed to confirm the findings in this pilot study.

Connecting the Dots: State Health Department Approaches to Addressing Shared Risk and Protective Factors Across Multiple Forms of Violence.

Science.gov (United States)

Wilkins, Natalie; Myers, Lindsey; Kuehl, Tomei; Bauman, Alice; Hertz, Marci

Violence takes many forms, including intimate partner violence, sexual violence, child abuse and neglect, bullying, suicidal behavior, and elder abuse and neglect. These forms of violence are interconnected and often share the same root causes. They can also co-occur together in families and communities and can happen at the same time or at different stages of life. Often, due to a variety of factors, separate, "siloed" approaches are used to address each form of violence. However, understanding and implementing approaches that prevent and address the overlapping root causes of violence (risk factors) and promote factors that increase the resilience of people and communities (protective factors) can help practitioners more effectively and efficiently use limited resources to prevent multiple forms of violence and save lives. This article presents approaches used by 2 state health departments, the Maryland Department of Health and Mental Hygiene and the Colorado Department of Public Health and Environment, to integrate a shared risk and protective factor approach into their violence prevention work and identifies key lessons learned that may serve to inform crosscutting violence prevention efforts in other states.

Change, Challenge and Opportunity: Departments of Medicine and Their Leaders.

Science.gov (United States)

Feussner, John R; Landefeld, C Seth; Weinberger, Steven E

2016-01-01

Academic Health Centers are evolving to larger and more complex Academic Health Systems (AHS), reflecting financial stresses requiring them to become nimble, efficient, and patient (consumer) and faculty (employee) focused. The evolving AHS organization includes many positive attributes: unity of purpose, structural integration, collaboration and teamwork, alignment of goals with resource allocation, and increased financial success. The organization, leadership, and business acumen of the AHS influence directly opportunities for Departments of Medicine. Just as leadership capabilities of the AHS affect its future success, the same is true for departmental leadership. The Department of Medicine is no longer a quasi- autonomous entity, and the chairperson is no longer an independent decision-maker. Departments of Medicine will be most successful if they maintain internal unity and cohesion by not fragmenting along specialty lines. Departments with larger endowments or those with public financial support have more flexibility when investing in the academic missions. The chairpersons of the future should serve as change agents while simultaneously adopting a "servant leadership" model. Chairpersons with executive and team building skills, and business acumen and experience, are more likely to succeed in managing productive and lean departments. Quality of patient care and service delivery enhance the department's effectiveness and credibility and assure access to additional financial resources to subsidize the academic missions. Moreover, the drive for excellence, high performance and growth will fuel financial solvency. Copyright © 2016 Southern Society for Clinical Investigation. Published by Elsevier Inc. All rights reserved.

Flu Surveillance: Department of Health

Science.gov (United States)

Health & Wellness Food, Water & Environment Birth, Death & Marriage Records Laboratory Healthcare facility managers Schools & child care providers Rhode Island Data Flu Surviellance Healthcare Management Agency Centers for Disease Control &amo; Prevention Flu.gov World Health Organization We can

Quality of coding diagnoses in emergency departments: effects on mapping the public's health.

Science.gov (United States)

Aharonson-Daniel, Limor; Schwartz, Dagan; Hornik-Lurie, Tzipi; Halpern, Pinchas

2014-01-01

Emergency department (ED) attendees reflect the health of the population served by that hospital and the availability of health care services in the community. To examine the quality and accuracy of diagnoses recorded in the ED to appraise its potential utility as a guage of the population's medical needs. Using the Delphi process, a preliminary list of health indicators generated by an expert focus group was converted to a query to the Ministry of Health's database. In parallel, medical charts were reviewed in four hospitals to compare the handwritten diagnosis in the medical record with that recorded on the standard diagnosis "pick list" coding sheet. Quantity and quality of coding were assessed using explicit criteria. During 2010 a total of 17,761 charts were reviewed; diagnoses were not coded in 42%. The accuracy of existing coding was excellent (mismatch 1%-5%). Database query (2,670,300 visits to 28 hospitals in 2009) demonstrated potential benefits of these data as indicators of regional health needs. The findings suggest that an increase in the provision of community care may reduce ED attendance. Information on ED visits can be used to support health care planning. A "pick list" form with common diagnoses can facilitate quality recording of diagnoses in a busy ED, profiling the population's health needs in order to optimize care. Better compliance with the directive to code diagnosis is desired.

Marketing health care to employees: the structure of employee health care plan satisfaction.

Science.gov (United States)

Mascarenhas, O A

1993-01-01

Providing cost-contained comprehensive quality health care to maintain healthy and productive employees is a challenging problem for all employers. Using a representative panel of metropolitan employees, the author investigates the internal and external structure of employee satisfaction with company-sponsored health care plans. Employee satisfaction is differentiated into four meaningful groups of health care benefits, whereas its external structure is supported by the traditional satisfaction paradigms of expectation-disconfirmation, attribution, and equity. Despite negative disconfirmation, employees register sufficiently high health care satisfaction levels, which suggests some useful strategies that employers may consider implementing.

CDC’s National Environmental Public Health Tracking Program in Action: Case Studies From State and Local Health Departments

Science.gov (United States)

Eatman, Shana; Strosnider, Heather M.

2017-01-01

The Centers for Disease Control and Prevention’s (CDC’s) National Environmental Public Health Tracking Program (Tracking Program) is a multidisciplinary collaboration that involves the ongoing collection, integration, analysis, interpretation, and dissemination of data from environmental hazard monitoring, human exposure surveillance, and health effects surveillance. With a renewed focus on data-driven decision-making, the CDC’s Tracking Program emphasizes dissemination of actionable data to public health practitioners, policy makers, and communities. The CDC’s National Environmental Public Health Tracking Network (Tracking Network), a Web-based system with components at the national, state, and local levels, houses environmental public health data used to inform public health actions (PHAs) to improve community health. This article serves as a detailed landscape on the Tracking Program and Tracking Network and the Tracking Program’s leading performance measure, “public health actions.” Tracking PHAs are qualitative statements addressing a local problem or situation, the role of the state or local Tracking Program, how the problem or situation was addressed, and the action taken. More than 400 PHAs have been reported by funded state and local health departments since the Tracking Program began collecting PHAs in 2005. Three case studies are provided to illustrate the use of the Tracking Program resources and data on the Tracking Network, and the diversity of actions taken. Through a collaborative network of experts, data, and tools, the Tracking Program and its Tracking Network are actively informing state and local PHAs. In a time of competing priorities and limited funding, PHAs can serve as a powerful tool to advance environmental public health practice. PMID:28763381

Health lifestyle theory and the convergence of agency and structure.

Science.gov (United States)

Cockerham, William C

2005-03-01

This article utilizes the agency-structure debate as a framework for constructing a health lifestyle theory. No such theory currently exists, yet the need for one is underscored by the fact that many daily lifestyle practices involve considerations of health outcomes. An individualist paradigm has influenced concepts of health lifestyles in several disciplines, but this approach neglects the structural dimensions of such lifestyles and has limited applicability to the empirical world. The direction of this article is to present a theory of health lifestyles that includes considerations of both agency and structure, with an emphasis upon restoring structure to its appropriate position. The article begins by defining agency and structure, followed by presentation of a health lifestyle model and the theoretical and empirical studies that support it.

Use of evidence-based interventions in state health departments: a qualitative assessment of barriers and solutions.

Science.gov (United States)

Dodson, Elizabeth A; Baker, Elizabeth A; Brownson, Ross C

2010-01-01

Existing knowledge on chronic disease prevention is not systematically disseminated and applied. State-level public health practitioners are in positions to implement programs and services related to chronic disease control. To advance dissemination science, this study sought to evaluate how and why evidence-based decision making (EBDM) is occurring. Specifically, it identified barriers to using EBDM commonly faced by state-level chronic disease practitioners and solutions for increasing the use of EBDM. Descriptive research using online survey methods. State health departments. Members of the National Association of Chronic Disease Directors. Barriers to using EBDM and solutions to increase the use of EBDM. In total, 469 people completed the survey (64% response rate). More than 60% of respondents described their position as project managers or coordinators. Nearly 80% of respondents were women, and 39% reported at least a master's degree as their highest degree. The survey elicited responses from every US state and the District of Columbia. Commonly-cited barriers to using EBDM included lack of time, resources, funding, and data. Participants noted that promising solutions to increase the use of EBDM include improved leadership, training, and collaboration. These results identify several modifiable barriers to EBDM among state-level public health practitioners. This information may improve state health departments' abilities to facilitate and encourage EBDM. In turn, this may assist chronic disease practitioners in implementing chronic disease interventions that have been proven effective. The use of such interventions will improve public health through the prevention of chronic diseases.

National Differences in Regional Emergency Department Boarding Times: Are US Emergency Departments Prepared for a Public Health Emergency?

Science.gov (United States)

Love, Jennifer S; Karp, David; Delgado, M Kit; Margolis, Gregg; Wiebe, Douglas J; Carr, Brendan G

2016-08-01

Boarding admitted patients decreases emergency department (ED) capacity to accommodate daily patient surge. Boarding in regional hospitals may decrease the ability to meet community needs during a public health emergency. This study examined differences in regional patient boarding times across the United States and in regions at risk for public health emergencies. A retrospective cross-sectional analysis was performed by using 2012 ED visit data from the American Hospital Association (AHA) database and 2012 hospital ED boarding data from the Centers for Medicare and Medicaid Services Hospital Compare database. Hospitals were grouped into hospital referral regions (HRRs). The primary outcome was mean ED boarding time per HRR. Spatial hot spot analysis examined boarding time spatial clustering. A total of 3317 of 4671 (71%) hospitals were included in the study cohort. A total of 45 high-boarding-time HRRs clustered along the East/West coasts and 67 low-boarding-time HRRs clustered in the Midwest/Northern Plains regions. A total of 86% of HRRs at risk for a terrorist event had high boarding times and 36% of HRRs with frequent natural disasters had high boarding times. Urban, coastal areas have the longest boarding times and are clustered with other high-boarding-time HRRs. Longer boarding times suggest a heightened level of vulnerability and a need to enhance surge capacity because these regions have difficulty meeting daily emergency care demands and are at increased risk for disasters. (Disaster Med Public Health Preparedness. 2016;10:576-582).

State of Hawaii, Department of Health, Clean Water Branch Special Surveys for Bellow Beach, Oahu, Hawaii 1992-1999 (NODC Accession 0014264)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Monitoring Section of the State of Hawaii, Department of Health, Clean Water Branch collected water quality samples at six sites near the mouth of streams and...

Embedded Active Fiber Optic Sensing Network for Structural Health Monitoring in Harsh Environments

Energy Technology Data Exchange (ETDEWEB)

Wang, Anbo [Virginia Polytechnic Inst. and State Univ. (Virginia Tech), Blacksburg, VA (United States)

2016-09-30

This report summarizes technical progress on the program “Embedded Active Fiber Optic Sensing Network for Structural Health Monitoring in Harsh Environments” funded by the National Energy Technology Laboratory of the U.S. Department of Energy, and performed by the Center for Photonics Technology at Virginia Tech. The objective of this project is to develop a first-of-a-kind technology for remote fiber optic generation and detection of acoustic waves for structural health monitoring in harsh environments. During the project period, which is from April 1, 2013 to Septemeber 30, 2016, three different acoustic generation mechanisms were studied in detail for their applications in building a fiber optic acoustic generation unit (AGU), including laser induced plasma breakdown (LIP), Erbium-doped fiber laser absorption, and metal laser absorption. By comparing the performance of the AGUs designed based on these three mechanisms and analyzing the experimental results with simulations, the metal laser absorption method was selected to build a complete fiber optic structure health monitoring (FO-SHM) system for the proposed high temperature multi-parameter structure health monitoring application. Based on the simulation of elastic wave propagation and fiber Bragg grating acoustic pulse detection, an FO-SHM element together with a completed interrogation system were designed and built. This system was first tested on an aluminum piece in the low-temperature range and successfully demonstrated its capability of multi-parameter monitoring and multi-point sensing. In the later stages of the project, the research was focused on improving the surface attachment design and preparing the FO-SHM element for high temperature environment tests. After several upgrades to the surface attachment methods, the FO-SHM element was able to work reliably up to 600oC when attached to P91 pipes, which are the target material of this project. In the final stage of this project, this FO

42 CFR 485.627 - Condition of participation: Organizational structure.

Science.gov (United States)

2010-10-01

... participation: Organizational structure. (a) Standard: Governing body or responsible individual. The CAH has a... 42 Public Health 5 2010-10-01 2010-10-01 false Condition of participation: Organizational structure. 485.627 Section 485.627 Public Health CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF...

Ohio Appalachia public health department personnel: human papillomavirus (HPV) vaccine availability, and acceptance and concerns among parents of male and female adolescents.

Science.gov (United States)

Oldach, Benjamin R; Katz, Mira L

2012-12-01

Public health departments (n = 48) serving the 32 counties of Ohio Appalachia were contacted to determine human papillomavirus (HPV) vaccine availability and to assess patient and parental attitudes, perceived barriers, and decisional differences about vaccination for male and female adolescents. Nurses or nursing supervisors in 46 of 48 health departments agreed to participate with 45 (97.8 %) reporting that HPV vaccines were available for males and females. HPV vaccination barriers reported most frequently were lack of knowledge about the vaccines, concerns about potential side effects, the newness of the HPV vaccines, and parents believing their children were not sexually active or were too young to receive an HPV vaccine. Provider reports of the primary differences in the acceptability of an HPV vaccine among parents of males compared to the parents of females were lack of awareness that an HPV vaccine was available for males, not understanding why the vaccine should be given to males, and fear of vaccination increasing sexual promiscuity among female adolescents. Half of the health departments (n = 24) reported that parents of females were more receptive toward HPV vaccination, 16 health departments reported no difference in acceptability based on gender of the child, and 5 health departments reported that parents of males were more receptive. This study suggests that there are different informational needs of males and females and parents of male and female children when making an informed decision about HPV vaccination. Findings highlight content to include in strategies to increase HPV vaccination rates among Appalachia Ohio residents.

Accessibility and acceptability of the Department of Veteran Affairs health care: diverse veterans' perspectives.

Science.gov (United States)

Damron-Rodriguez, JoAnn; White-Kazemipour, Whitney; Washington, Donna; Villa, Valentine M; Dhanani, Shawkat; Harada, Nancy D

2004-03-01

Diverse veteran's perspectives on the accessibility and acceptability of the Department of Veteran Affairs (VA) health services are presented. The qualitative methodology uses 16 focus groups (N = 178) stratified by war cohort (World War II and Korean Conflict versus Vietnam War and Persian Gulf War) and four ethnic/racial categories (African American, Asian American, European American, Hispanic American). Five themes emerged regarding veterans' health care expectations: (1) better information regarding available services, (2) sense of deserved benefits, (3) concern about welfare stigma, (4) importance of physician attentiveness, and (5) staff respect for patients as veterans. Although veterans' ethnic/racial backgrounds differentiated their military experiences, it was the informants' veteran identity that framed what they expected of VA health services. Accessibility and acceptability of VA health care is related to veterans' perspectives of the nature of their entitlement to service. Provider education and customer service strategies should consider the identified factors to increase access to VA as well as improve veterans' acceptance of the care.

Terrorism and emergency preparedness in state and territorial public health departments--United States, 2004.

Science.gov (United States)

2005-05-13

After the events of September 11, 2001, federal funding for state public health preparedness programs increased from $67 million in fiscal year (FY) 2001 to approximately $1 billion in FY 2002. These funds were intended to support preparedness for and response to terrorism, infectious disease outbreaks, and other public health threats and emergencies. The Council of State and Territorial Epidemiologists (CSTE) assessed the impact of funding on epidemiologic capacity, including terrorism preparedness and response, in state health departments in November 2001 and again in May 2004, after distribution of an additional $1 billion in FY 2003. This report describes the results of those assessments, which indicated that increased funding for terrorism preparedness and emergency response has rapidly increased the number of epidemiologists and increased capacity for preparedness at the state level. However, despite the increase in epidemiologists, state public health officials estimate that 192 additional epidemiologists, an increase of 45.3%, are needed nationwide to fully staff terrorism preparedness programs.

A Complex Interplay: Cognitive Behavioural Therapy for Severe Health Anxiety in Addison's Disease to Reduce Emergency Department Admissions.

Science.gov (United States)

Daniels, Jo; Sheils, Elizabeth

2017-07-01

Addison's disease (AD) is a rare chronic illness caused by adrenocortical insufficiency. Due to the pivotal role of the regulating hormone cortisol in AD, there is a common symptom overlap between the presentation of anxiety and adrenal crisis. Previous literature has identified the prevalence of anxiety in endocrinological disorders, however there is a paucity of research examining the complex interplay between AD and anxiety. This paper describes a single case study of a patient with severe health anxiety and co-morbid AD. The aims of the study were to establish if standard cognitive behavioural therapy for health anxiety in AD can lead to a reduction in psychological distress, and whether this approach is an effective intervention for the reduction of Emergency Department admissions. A single case design was used, with pre- and post-measures of health anxiety, general anxiety and depression. Data on Emergency Department admissions prior to and following treatment were used to assess change in this domain. Reliable and clinically significant reductions were seen across all measures, from severe to sub-clinical levels. There was a complete amelioration of Emergency Department admissions in the 12 months following completion of treatment. This preliminary study provides a sound rationale for further research into AD complicated by anxiety. Findings support the clinical utility of the cognitive behavioural therapy model for complex presentations of AD, offering a potential treatment option where anxiety is elevated and interfering with self-management and leading to high levels of health service use.

Structural health monitoring 2012. Proceedings. Vol. 2

International Nuclear Information System (INIS)

Boller, Christian

2012-01-01

Structural Health Monitoring (SHM) is an emerging technology, dealing with the development and implementation of techniques and systems where monitoring, inspection and damage detection become an integral part of structures and thus a matter of automation. It further merges with a variety of techniques related to diagnostics and prognostics. SHM emerged from the field of smart structures and laterally encompasses disciplines such as structural dynamics, materials and structures, fatigue and fracture, non-destructive testing and evaluation, sensors and actuators, microelectronics, signal processing and much more. To be effective in the development of SHM systems, a multidisciplinary approach is therefore required. Without this global view it will be difficult for engineers to holistically manage the operation of an engineering structure through its life cycle in the future and to generate new breakthroughs in structural engineering. The second volume of the proceedings contains topics dealing with applications in the field of aeronautics, astronautic, civil engineering (bridges), energy (wind power), structural health monitoring (transportation), and poster presentations. Ten of the contributions are separately analyzed for the ENERGY database.

Have Maryland local health departments effectively put in place the information technology relevant to emergency preparedness?

Science.gov (United States)

Nguh, Jonas

2013-01-01

Ever since the terrorist attacks of 9/11, the federal government has increased funding for emergency preparedness. However, the literature continues to document several areas of weaknesses in public health emergency management by local health departments (LHD). This lack of preparedness affects the entire public. The purpose of this study was to determine whether or not Maryland LHDs have effectively put in place the information technology (IT) that is relevant for emergency preparedness. Base Firm-wide IT Infrastructure Services and the Feeny/Willcocks Framework for Core IS Capabilities are the two conceptual frameworks used in this study. This qualitative study used the survey method and the data were analyzed through content analysis. The results revealed that utilization, practice, and performance of IT by Maryland LHDs are not efficient or effective. Recommendations included the development of "best practices," increased funding for IT infrastructure and the establishment of strategic management framework for IT initiatives. Implications for positive social change include the development of recommendations to enhance emergency preparedness practice, and advancement of knowledge so as to facilitate the functions, and duties of health departments in emergency preparedness operations.

Development of a Survey to Assess Local Health Department Organizational Processes and Infrastructure for Supporting Obesity Prevention.

Science.gov (United States)

Xiao, Ting; Stamatakis, Katherine A; McVay, Allese B

Local health departments (LHDs) have an important function in controlling the growing epidemic of obesity in the United States. Data are needed to gain insight into the existence of routine functions and structures of LHDs that support and sustain obesity prevention efforts. The purpose of this study was to develop and examine the reliability of measures to assess foundational LHD organizational processes and functions specific to obesity prevention. Survey measures were developed using a stratified, random sample of US LHDs to assess supportive organizational processes and infrastructure for obesity prevention representing different domains. Data were analyzed using weighted κ and intraclass correlation coefficient for assessing test-retest reliability. Most items and summary indices in the majority of survey domains had moderate/substantial or almost perfect reliability. The overall findings support this survey instrument to be a reliable measurement tool for a large number of processes and functions that comprise obesity prevention-related capacity in LHDs.

Smart Materials in Structural Health Monitoring, Control and Biomechanics

CERN Document Server

Soh, Chee-Kiong; Bhalla, Suresh

2012-01-01

"Smart Materials in Structural Health Monitoring, Control and Biomechanics" presents the latest developments in structural health monitoring, vibration control and biomechanics using smart materials. The book mainly focuses on piezoelectric, fibre optic and ionic polymer metal composite materials. It introduces concepts from the very basics and leads to advanced modelling (analytical/ numerical), practical aspects (including software/ hardware issues) and case studies spanning civil, mechanical and aerospace structures, including bridges, rocks and underground structures. This book is intended for practicing engineers, researchers from academic and R&D institutions and postgraduate students in the fields of smart materials and structures, structural health monitoring, vibration control and biomedical engineering. Professor Chee-Kiong Soh and Associate Professor Yaowen Yang both work at the School of Civil and Environmental Engineering, Nanyang Technological University, Singapore. Dr. Suresh Bhalla is an A...

Department of Defense Base Structure Report (A Summary of DOD's Real Property Inventory), Fiscal year 2005 Baseline

National Research Council Canada - National Science Library

2005-01-01

The Base Structure Report represents a consolidated summary of the Services native real property inventories to provide an overall look at the physical infrastructure that makes up the Department of Defense...

Connecting the Dots: State Health Department Approaches to Addressing Shared Risk and Protective Factors Across Multiple Forms of Violence

Science.gov (United States)

Wilkins, Natalie; Myers, Lindsey; Kuehl, Tomei; Bauman, Alice; Hertz, Marci

2018-01-01

Violence takes many forms, including intimate partner violence, sexual violence, child abuse and neglect, bullying, suicidal behavior, and elder abuse and neglect. These forms of violence are interconnected and often share the same root causes. They can also co-occur together in families and communities and can happen at the same time or at different stages of life. Often, due to a variety of factors, separate, “siloed” approaches are used to address each form of violence. However, understanding and implementing approaches that prevent and address the overlapping root causes of violence (risk factors) and promote factors that increase the resilience of people and communities (protective factors) can help practitioners more effectively and efficiently use limited resources to prevent multiple forms of violence and save lives. This article presents approaches used by 2 state health departments, the Maryland Department of Health and Mental Hygiene and the Colorado Department of Public Health and Environment, to integrate a shared risk and protective factor approach into their violence prevention work and identifies key lessons learned that may serve to inform crosscutting violence prevention efforts in other states. PMID:29189502

Structural health and the politics of African American masculinity.

Science.gov (United States)

Metzl, Jonathan M

2013-07-01

This commentary describes ways in which notions of African American men's "health" attained by individual choice-embedded in the notion that African American men should visit doctors or engage in fewer risky behaviors-are at times in tension with larger cultural, economic, and political notions of "health." It argues that efforts to improve the health of Black men must take structural factors into account, and failure to do so circumvents even well-intentioned efforts to improve health outcomes. Using historical examples, the article shows how attempts to identify and intervene into what are now called social determinants of health are strengthened by addressing on-the-ground diagnostic disparities and also the structural violence and racism embedded within definitions of illness and health. And, that, as such, we need to monitor structural barriers to health that exist in institutions ostensibly set up to incarcerate or contain Black men and in institutions ostensibly set up to help them.

Openness to Change: Experiential and Demographic Components of Change in Local Health Department Leaders

OpenAIRE

Jadhav, Emmanuel D.; Holsinger, James W.; Fardo, David W.

2015-01-01

Background During the 2008–2010 economic recession, Kentucky local health department (LHD) leaders utilized innovative strategies to maintain their programs. A characteristic of innovative strategy is leader openness to change. Leader demographical research in for-profit organizations has yielded valuable insight into leader openness to change. For LHD leaders, the nature of the association between leader demographic and organizational characteristics on leader openness to change is unknow...

Forecasting the Revenues of Local Public Health Departments in the Shadows of the "Great Recession".

Science.gov (United States)

Reschovsky, Andrew; Zahner, Susan J

2016-01-01

The ability of local health departments (LHD) to provide core public health services depends on a reliable stream of revenue from federal, state, and local governments. This study investigates the impact of the "Great Recession" on major sources of LHD revenues and develops a fiscal forecasting model to predict revenues to LHDs in one state over the period 2012 to 2014. Economic forecasting offers a new financial planning tool for LHD administrators and local government policy makers. This study represents a novel research application for these econometric methods. Detailed data on revenues by source for each LHD in Wisconsin were taken from annual surveys conducted by the Wisconsin Department of Health Services over an 8-year period (2002-2009). A forecasting strategy appropriate for each revenue source was developed resulting in "base case" estimates. An analysis of the sensitivity of these revenue forecasts to a set of alternative fiscal policies by the federal, state, and local governments was carried out. The model forecasts total LHD revenues in 2012 of $170.5 million (in 2010 dollars). By 2014, inflation-adjusted revenues will decline by $8 million, a reduction of 4.7%. Because of population growth, per capita real revenues of LHDs are forecast to decline by 6.6% between 2012 and 2014. There is a great deal of uncertainty about the future of federal funding in support of local public health. A doubling of the reductions in federal grants scheduled under current law would result in an additional $4.4 million decline in LHD revenues in 2014. The impact of the Great Recession continues to haunt LHDs. Multiyear revenue forecasting offers a new financial tool to help LHDs better plan for an environment of declining resources. New revenue sources are needed if sharp drops in public health service delivery are to be avoided.

Illinois department of public health H1N1/A pandemic communications evaluation survey.

Energy Technology Data Exchange (ETDEWEB)

Walsh, D.; Decision and Information Sciences

2010-09-16

Because of heightened media coverage, a 24-hour news cycle and the potential miscommunication of health messages across all levels of government during the onset of the H1N1 influenza outbreak in spring 2009, the Illinois Department of Public Health (IDPH) decided to evaluate its H1N1 influenza A communications system. IDPH wanted to confirm its disease information and instructions were helping stakeholders prepare for and respond to a novel influenza outbreak. In addition, the time commitment involved in preparing, issuing, monitoring, updating, and responding to H1N1 federal guidelines/updates and media stories became a heavy burden for IDPH staff. The process and results of the H1N1 messaging survey represent a best practice that other health departments and emergency management agencies can replicate to improve coordination efforts with stakeholder groups during both emergency preparedness and response phases. Importantly, the H1N1 survey confirmed IDPH's messages were influencing stakeholders decisions to activate their pandemic plans and initiate response operations. While there was some dissatisfaction with IDPH's delivery of information and communication tools, such as the fax system, this report should demonstrate to IDPH that its core partners believe it has the ability and expertise to issue timely and accurate instructions that can help them respond to a large-scale disease outbreak in Illinois. The conclusion will focus on three main areas: (1) the survey development process, (2) survey results: best practices and areas for improvement and (3) recommendations: next steps.

Structural health monitoring with a wireless vibration sensor network

NARCIS (Netherlands)

Basten, T.G.H.; Sas, P; Schiphorst, F.B.A.; Jonckheere, S.; Moens, D.

2012-01-01

Advanced maintenance strategies for infrastructure assets such as bridges or off shore wind turbines require actual and reliable information of the maintenance status. Structural health monitoring based on vibration sensing can help in supplying the input needed for structural health monitoring

Mental-Health Conditions, Barriers to Care, and Productivity Loss Among Officers in An Urban Police Department

Science.gov (United States)

Fox, Justin; Desai, Mayur M.; Britten, Karissa; Lucas, Georgina; Luneau, Renee; Rosenthal, Marjorie S.

2014-01-01

Background Police officers are frequently exposed to situations that can negatively impact their mental health. Methods We conducted this study of an urban police department to determine 1) the prevalence of post-traumatic stress disorder (PTSD), depression, and alcohol abuse; 2) patterns of and barriers to mental-health services utilization; and 3) the impact these conditions have on productivity loss. Results Among 150 officers, PTSD (24%), depression (9%), and alcohol abuse (19%) were common. Only 46.7% had ever sought mental-health services; the most commonly cited barriers to accessing services were concerns regarding confidentiality and the potential “negative career impact.” Officers with mental-health conditions had higher productivity loss (5.9% vs 3.4%, P police officers are common, and costly, yet most officers had never accessed mental-health services; many due to modifiable risk factors. PMID:23155671

Can market structure explain cross-country differences in health?

Directory of Open Access Journals (Sweden)

Kate Rybczynski

2013-03-01

Full Text Available There is a well documented health disparity between several European countries and the United States. This health gap remains even after controlling for socioeconomic status and risk factors. At the same time, we note that the U.S. market structure is characterized by significantly more large corporations and "super-sized" retail outlets than Europe. Because big business is hierarchical in nature and has been reported to engender urban sprawl, inferior work environments, and loss of social capital, all identified as correlates of poor health, we suggest that differences in market structure may help account for some of the unexplained differences in health across Europe and North America. Using national level data, this study explores the relationship between market structure and health. We investigate whether individuals who live in countries with proportionately more small business are healthier than those who do not. We use two measures of national health: life expectancy at birth, and age-standardized estimates of diabetes rates. Results from ordinary least squares regressions suggest that, there is a large and statistically significant association between market structure (the ratio of small to total businesses and health, even after controlling income, public percent of health expenditure, and obesity rates. This association is robust to additional controls such as insufficient physical activity, smoking, alcohol disease, and air pollution.

Ohio Appalachia public health department personnel: Human papillomavirus (HPV) vaccine availability, and acceptance and concerns among parents of male and female adolescents

OpenAIRE

Oldach, Benjamin R.; Katz, Mira L.

2012-01-01

Public health departments (n=48) serving the 32 counties of Ohio Appalachia were contacted to determine human papillomavirus (HPV) vaccine availability and to assess patient and parental attitudes, perceived barriers, and decisional differences about vaccination for male and female adolescents. Nurses or nursing supervisors in 46 of 48 health departments agreed to participate with 45 (97.8%) reporting that HPV vaccines were available for males and females. HPV vaccination barriers reported mo...

A sequential model for the structure of health care utilization.

NARCIS (Netherlands)

Herrmann, W.J.; Haarmann, A.; Baerheim, A.

2017-01-01

Traditional measurement models of health care utilization are not able to represent the complex structure of health care utilization. In this qualitative study, we, therefore, developed a new model to represent the health care utilization structure. In Norway and Germany, we conducted episodic

Structural health monitoring using wireless sensor networks

Science.gov (United States)

Sreevallabhan, K.; Nikhil Chand, B.; Ramasamy, Sudha

2017-11-01

Monitoring and analysing health of large structures like bridges, dams, buildings and heavy machinery is important for safety, economical, operational, making prior protective measures, and repair and maintenance point of view. In recent years there is growing demand for such larger structures which in turn make people focus more on safety. By using Microelectromechanical Systems (MEMS) Accelerometer we can perform Structural Health Monitoring by studying the dynamic response through measure of ambient vibrations and strong motion of such structures. By using Wireless Sensor Networks (WSN) we can embed these sensors in wireless networks which helps us to transmit data wirelessly thus we can measure the data wirelessly at any remote location. This in turn reduces heavy wiring which is a cost effective as well as time consuming process to lay those wires. In this paper we developed WSN based MEMS-accelerometer for Structural to test the results in the railway bridge near VIT University, Vellore campus.

Asthma Medication Ratio Predicts Emergency Depart...

Data.gov (United States)

U.S. Department of Health & Human Services — According to findings reported in Asthma Medication Ratio Predicts Emergency Department Visits and Hospitalizations in Children with Asthma, published in Volume 3,...

The Impact of Structural Competence towards Speaking Competence of the Fourth Semester Students of English Department

Directory of Open Access Journals (Sweden)

Muhammad Nafi Annury

2013-11-01

Full Text Available This paper tries to define any impact of structural competence towards speaking competence. In this research, the writer used descriptive co-relational method. It was used to describe whether there was an impact between two variables, i.e. structural competence (X as independent variable and speaking competence (Y as dependent variable. The subject of study was the fourth semester students of English department of Tarbiyah Faculty IAIN Walisongo Semarang. After the data had been analyzed, it was found that there was significant impact of structural competence especially in appropriateness. It helped students to arrange words into sentences that they utter.

An overview of public health service health-related activities as they relate to the Department of Energy's environmental restoration program

International Nuclear Information System (INIS)

Kocher, P.L.; Bashor, M.M.

1991-01-01

The Agency for Toxic Substances and Disease Registry (ATSDR) was created by the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA) as an agency of the Public Health Service. Under the Superfund Amendments and Reauthorization Act of 1986 (SARA; CERCLA as amended), the public health responsibilities of ATSDR were greatly expanded. Among the responsibilities are (1) preparing health assessments for each site proposed for or listed on the National Priorities List (NPL) established by the US Environmental Protection Agency; (2) conducting epidemiologic and other health studies around NPL sites; (3) establishing registries of exposed individuals; (4) establishing health surveillance programs; (5) developing toxicological profiles for hazardous substances; (6) performing health and emergency response consultations; and (7) performing other health-related activities (e.g., health education). In October 1990, ATSDR signed a memorandum of understanding (MOU) with the Department of Energy (DOE) headquarters requiring that DOE operations offices sign interagency agreements (IAGs) with ATSDR for its conduct of 104(i) health activities at DOE sites. These activities include health assessments, related health studies such as surveillance programs, epidemiologic studies, and registries of exposed persons, and toxicological profiles of hazardous substances unique to DOE sites. ATSDR's studies will focus more on an assessment of the health risk to human populations residing in and around DOE sites than on an evaluation of the health risk to workers on site. Nevertheless, CERCLA, the MOU, and site-specific IAGs authorize ATSDR's access to health and environmental data concerning each site. The IAGs contemplate that ATSDR work closely with DOE operations offices in their implementation of their respective environmental restoration programs

Towards "Zero" False Positive in Structural Health Monitoring

National Research Council Canada - National Science Library

Chiu, Wing K; Chang, F. K; Tian, Daniel T

2007-01-01

Structural Health Monitoring (SHM) is one aspect of a revolution based on the use of Smart Materials and Structures technologies that have the potential to provide major gains in structural performance and cost-efficient life management...

State of Hawaii, Department of Health, Clean Water Branch Hanalei, Kauai Water Quality Sampling Dataset October 2005 - November 2006 (NODC Accession 0020391)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Monitoring Section of the State of Hawaii, Department of Health, Clean Water Branch collected water quality data at 8 sites centered on Hanalei Bay on the north...

The Impact of a Health IT Changeover on Medical Imaging Department Work Processes and Turnaround Times: A mixed method study.

Science.gov (United States)

Georgiou, A; Prgomet, M; Lymer, S; Hordern, A; Ridley, L; Westbrook, J

2015-01-01

To assess the impact of introducing a new Picture Archiving and Communication System (PACS) and Radiology Information System (RIS) on: (i) Medical Imaging work processes; and (ii) turnaround times (TATs) for x-ray and CT scan orders initiated in the Emergency Department (ED). We employed a mixed method study design comprising: (i) semi-structured interviews with Medical Imaging Department staff; and (ii) retrospectively extracted ED data before (March/April 2010) and after (March/April 2011 and 2012) the introduction of a new PACS/RIS. TATs were calculated as: processing TAT (median time from image ordering to examination) and reporting TAT (median time from examination to final report). Reporting TAT for x-rays decreased significantly after introduction of the new PACS/RIS; from a median of 76 hours to 38 hours per order (pMedical Imaging staff reported that the changeover to the new PACS/RIS led to gains in efficiency, particularly regarding the accessibility of images and patient-related information. Nevertheless, assimilation of the new PACS/RIS with existing Departmental work processes was considered inadequate and in some instances unsafe. Issues highlighted related to the synchronization of work tasks (e.g., porter arrangements) and the material set up of the work place (e.g., the number and location of computers). The introduction of new health IT can be a "double-edged sword" providing improved efficiency but at the same time introducing potential hazards affecting the effectiveness of the Medical Imaging Department.

Smart Sensing Technologies for Structural Health Monitoring of Civil Engineering Structures

OpenAIRE

M. Sun; W. J. Staszewski; R. N. Swamy

2010-01-01

Structural Health Monitoring (SHM) aims to develop automated systems for the continuous monitoring, inspection, and damage detection of structures with minimum labour involvement. The first step to set up a SHM system is to incorporate a level of structural sensing capability that is reliable and possesses long term stability. Smart sensing technologies including the applications of fibre optic sensors, piezoelectric sensors, magnetostrictive sensors and self-diagnosing fibre reinforced compo...

Preparedness of emergency departments in northwest England for managing chemical incidents: a structured interview survey

Directory of Open Access Journals (Sweden)

Walter Darren

2007-12-01

Full Text Available Abstract Background A number of significant chemical incidents occur in the UK each year and may require Emergency Departments (EDs to receive and manage contaminated casualties. Previously UK EDs have been found to be under-prepared for this, but since October 2005 acute hospital Trusts have had a statutory responsibility to maintain decontamination capacity. We aimed to evaluate the level of preparedness of Emergency Departments in North West England for managing chemical incidents. Methods A face-to-face semi-structured interview was carried out with the Nurse Manager or a nominated deputy in all 18 Emergency Departments in the Region. Results 16/18 departments had a written chemical incident plan but only 7 had the plan available at interview. All had a designated decontamination area but only 11 felt that they were adequately equipped. 12/18 had a current training programme for chemical incident management and 3 had no staff trained in decontamination. 13/18 could contain contaminated water from casualty decontamination and 6 could provide shelter for casualties before decontamination. Conclusion We have identified major inconsistencies in the preparedness of North West Emergency Departments for managing chemical incidents. Nationally recognized standards on incident planning, facilities, equipment and procedures need to be agreed and implemented with adequate resources. Issues of environmental safety and patient dignity and comfort should also be addressed.

42 CFR 59.7 - What criteria will the Department of Health and Human Services use to decide which family...

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false What criteria will the Department of Health and Human Services use to decide which family planning services projects to fund and in what amount? 59.7... FOR FAMILY PLANNING SERVICES Project Grants for Family Planning Services § 59.7 What criteria will the...

Structural Health Monitoring Based on Combined Structural Global and Local Frequencies

Directory of Open Access Journals (Sweden)

Jilin Hou

2014-01-01

Full Text Available This paper presents a parameter estimation method for Structural Health Monitoring based on the combined measured structural global frequencies and structural local frequencies. First, the global test is experimented to obtain the low order modes which can reflect the global information of the structure. Secondly, the mass is added on the member of structure to increase the local dynamic characteristic and to make the member have local primary frequency, which belongs to structural local frequency and is sensitive to local parameters. Then the parameters of the structure can be optimized accurately using the combined structural global frequencies and structural local frequencies. The effectiveness and accuracy of the proposed method are verified by the experiment of a space truss.

Improving maternal and neonatal departments in high and low resource settings: the opinion of local health providers.

Science.gov (United States)

Trevisanuto, Daniele; Bavuusuren, Bayasgalantai; Wickramasinghe, Chandani S; Dharmaratne, Saminda M; Doglioni, Nicoletta; Giordan, Alessia; Zanardo, Vincenzo; Carlo, Waldemar A

2011-10-01

We compared local health caregivers' opinions regarding the priority areas for improving the maternal and neonatal departments in low and high resource countries. Personnel involved in maternal and neonatal care operating in level III, teaching hospitals in four countries (Sri Lanka, Mongolia, USA, and Italy) were asked to fill out an anonymous, written questionnaire. The questionnaire was completed by 1112 out of 1265 (87.9%) participants. "Personnel's education" was classified as the first most important intervention by health providers working in high (49.0%) as well as in low (29.9%) resource countries, respectively. Improvement in salary, equipment, internet access, and organizational protocols were considered as the most important interventions by a significantly larger percentage of personnel from low resource countries in comparison with those from high resource countries. Health providers from high resource countries considered organizational aspects (to define specific roles and responsibilities) as a priority more frequently than their colleagues from low resource countries. Although education of personnel was valued as the highest priority for improving maternal and neonatal departments there are substantial differences in priorities associated with the working setting. Local caregivers' opinion may contribute to better design interventions in settings with high or limited resources.

A cross-sectional study of pre-travel health-seeking practices among travelers departing Sydney and Bangkok airports.

Science.gov (United States)

Heywood, Anita E; Watkins, Rochelle E; Iamsirithaworn, Sopon; Nilvarangkul, Kessarawan; MacIntyre, C Raina

2012-05-02

Pre-travel health assessments aim to promote risk reduction through preventive measures and safe behavior, including ensuring travelers are up-to-date with their immunizations. However, studies assessing pre-travel health-seeking practices from a variety of medical and non-medical sources and vaccine uptake prior to travel to both developing and developed countries within the Asia-Pacific region are scarce. Cross-sectional surveys were conducted between July and December 2007 to assess pre-travel health seeking practices, including advice from health professionals, health information from other sources and vaccine uptake, in a sample of travelers departing Sydney and Bangkok airports. A two-stage cluster sampling technique was used to ensure representativeness of travelers and travel destinations. Pre-travel health seeking practices were assessed using a self-administered questionnaire distributed at the check-in queues of departing flights. Logistic regression models were used to identify significant factors associated with seeking pre-travel health advice from a health professional, reported separately for Australian residents, residents of other Western countries and residents of countries in Asia. A total of 843 surveys were included in the final sample (Sydney 729, response rate 56%; Bangkok 114, response rate 60%). Overall, pre-travel health information from any source was sought by 415 (49%) respondents with 298 (35%) seeking pre-travel advice from a health professional, the majority through general practice. Receipt of a pre-travel vaccine was reported by 100 (12%) respondents. Significant factors associated with seeking pre-travel health advice from a health professional differed by region of residence. Asian travelers were less likely to report seeking pre-travel health advice and uptake of pre-travel vaccines than Australian or other Western travelers. Migrant Australians were less likely to report seeking pre-travel health advice than Australian

A cross-sectional study of pre-travel health-seeking practices among travelers departing Sydney and Bangkok airports

Science.gov (United States)

2012-01-01

Background Pre-travel health assessments aim to promote risk reduction through preventive measures and safe behavior, including ensuring travelers are up-to-date with their immunizations. However, studies assessing pre-travel health-seeking practices from a variety of medical and non-medical sources and vaccine uptake prior to travel to both developing and developed countries within the Asia-Pacific region are scarce. Methods Cross-sectional surveys were conducted between July and December 2007 to assess pre-travel health seeking practices, including advice from health professionals, health information from other sources and vaccine uptake, in a sample of travelers departing Sydney and Bangkok airports. A two-stage cluster sampling technique was used to ensure representativeness of travelers and travel destinations. Pre-travel health seeking practices were assessed using a self-administered questionnaire distributed at the check-in queues of departing flights. Logistic regression models were used to identify significant factors associated with seeking pre-travel health advice from a health professional, reported separately for Australian residents, residents of other Western countries and residents of countries in Asia. Results A total of 843 surveys were included in the final sample (Sydney 729, response rate 56%; Bangkok 114, response rate 60%). Overall, pre-travel health information from any source was sought by 415 (49%) respondents with 298 (35%) seeking pre-travel advice from a health professional, the majority through general practice. Receipt of a pre-travel vaccine was reported by 100 (12%) respondents. Significant factors associated with seeking pre-travel health advice from a health professional differed by region of residence. Asian travelers were less likely to report seeking pre-travel health advice and uptake of pre-travel vaccines than Australian or other Western travelers. Migrant Australians were less likely to report seeking pre-travel health

Predicting the impact of chronic health conditions on workplace productivity and accidents: results from two US Department of Energy national laboratories.

Science.gov (United States)

Frey, Jodi Jacobson; Osteen, Philip J; Berglund, Patricia A; Jinnett, Kimberly; Ko, Jungyai

2015-04-01

Examine associations of chronic health conditions on workplace productivity and accidents among US Department of Energy employees. The Health and Work Performance Questionnaire-Select was administered to a random sample of two Department of Energy national laboratory employees (46% response rate; N = 1854). The majority (87.4%) reported having one or more chronic health conditions, with 43.4% reporting four or more conditions. A population-attributable risk proportions analysis suggests improvements of 4.5% in absenteeism, 5.1% in presenteeism, 8.9% in productivity, and 77% of accidents by reducing the number of conditions by one level. Depression was the only health condition associated with all four outcomes. Results suggest that chronic conditions in this workforce are prevalent and costly. Efforts to prevent or reduce condition comorbidity among employees with multiple conditions can significantly reduce costs and workplace accident rates.

Organizational Structure and Management in Romanian Health System

OpenAIRE

Boldureanu Daniel; Boldureanu Gabriela

2010-01-01

The health system in Romania in a continuous transformation from a centralized system (type Semashko) exists before 1989 year to one based on social health insurance (type Bismark). This paper examines the management and the organizational structure of the health system in Romania, and the relations between them in the context of the Health Reform Law.

Where Is Obesity Prevention on the Map? Distribution and Predictors of Local Health Department Prevention Activities in Relation to County-Level Obesity Prevalence in the US

Science.gov (United States)

Stamatakis, Katherine A.; Leatherdale, Scott T.; Marx, Christine; Yan, Yan; Colditz, Graham A.; Brownson, Ross C.

2013-01-01

Context The system of local health departments (LHD) in the US has potential to advance a locally-oriented public health response in obesity control and reduce geographic disparities. However, the extent to which obesity prevention programs correspond to local obesity levels is unknown. Objective This study examines the extent to which LHDs across the US have responded to local levels of obesity by examining the association between jurisdiction level obesity prevalence and the existence of obesity prevention programs. Design Data on LHD organizational characteristics from the Profile Study of Local Health Departments and county-level estimates of obesity from the Behavioral Risk Factor Surveillance System were analyzed (n=2,300). Since local public health systems are nested within state infrastructure, multilevel models were used to examine the relationship between county-level obesity prevalence and LHD obesity prevention programming and to assess the impact of state-level clustering. Setting 2,300 local health department jurisdictions defined with respect to county boundaries Participants Practitioners in local health departments who responded to the 2005 Profile Study of Local Health Departments. Main Outcome Measures Likelihood of having obesity prevention activities and association with area-level obesity prevalence Results The existence of obesity prevention activities was not associated with prevalence of obesity in the jurisdiction. A substantial portion of the variance in LHD activities was explained by state-level clustering. Conclusions This paper identified a gap in the local public health response to the obesity epidemic and underscores the importance of multilevel modeling in examining predictors of LHD performance. PMID:22836530

National Institutes of Health Funding to Departments of Orthopaedic Surgery at U.S. Medical Schools.

Science.gov (United States)

Silvestre, Jason; Ahn, Jaimo; Levin, L Scott

2017-01-18

The National Institutes of Health (NIH) is the largest supporter of biomedical research in the U.S., yet its contribution to orthopaedic research is poorly understood. In this study, we analyzed the portfolio of NIH funding to departments of orthopaedic surgery at U.S. medical schools. The NIH RePORT (Research Portfolio Online Reporting Tools) database was queried for NIH grants awarded to departments of orthopaedic surgery in 2014. Funding totals were determined for award mechanisms and NIH institutes. Trends in NIH funding were determined for 2005 to 2014 and compared with total NIH extramural research funding. Funding awarded to orthopaedic surgery departments was compared with that awarded to departments of other surgical specialties in 2014. Characteristics of NIH-funded principal investigators were obtained from department web sites. In 2014, 183 grants were awarded to 132 investigators at 44 departments of orthopaedic surgery. From 2005 to 2014, NIH funding increased 24.3%, to $54,608,264 (p = 0.030), but the rates of increase seen did not differ significantly from those of NIH extramural research funding as a whole (p = 0.141). Most (72.6%) of the NIH funding was awarded through the R01 mechanism, with a median annual award of $343,980 (interquartile range [IQR], $38,372). The majority (51.1%) of the total funds supported basic science research, followed by translational (33.0%), clinical (10.0%), and educational (5.9%) research. NIH-funded orthopaedic principal investigators were predominately scientists whose degree was a PhD (71.1%) and who were male (79.5%). Eleven NIH institutes were represented, with the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) providing the preponderance (74.2%) of the funding. In 2014, orthopaedic surgery ranked below the surgical departments of general surgery, ophthalmology, obstetrics and gynecology, otolaryngology, and urology in terms of NIH funding received. The percentage increase of NIH

Frequency Selective Surface for Structural Health Monitoring

Science.gov (United States)

Norlyana Azemi, Saidatul; Mustaffa, Farzana Hazira Wan; Faizal Jamlos, Mohd; Abdullah Al-Hadi, Azremi; Soh, Ping Jack

2018-03-01

Structural health monitoring (SHM) technologies have attained attention to monitor civil structures. SHM sensor systems have been used in various civil structures such as bridges, buildings, tunnels and so on. However the previous sensor for SHM is wired and encounter with problem to cover large areas. Therefore, wireless sensor was introduced for SHM to reduce network connecting problem. Wireless sensors for Structural Health monitoring are new technology and have many advantages to overcome the drawback of conventional and wired sensor. This project proposed passive wireless SHM sensor using frequency selective surface (FSS) as an alternative to conventional sensors. The electromagnetic wave characteristic of FSS will change by geometrical changes of FSS due to mechanical strain or structural failure. The changes feature is used as a sensing function without any connecting wires. Two type of design which are circular ring and square loop along with the transmission and reflection characteristics of SHM using FSS were discussed in this project. A simulation process has shown that incident angle characteristics can be use as a data for SHM application.

Time-frequency Methods for Structural Health Monitoring

NARCIS (Netherlands)

Pyayt, A.L.; Kozionov, A.P.; Mokhov, I.I.; Lang, B.; Meijer, R.J.; Krzhizhanovskaya, V.V.; Sloot, P.M.A.

2014-01-01

Detection of early warning signals for the imminent failure of large and complex engineered structures is a daunting challenge with many open research questions. In this paper we report on novel ways to perform Structural Health Monitoring (SHM) of flood protection systems (levees, earthen dikes and

Time-frequency methods for structural health monitoring

NARCIS (Netherlands)

Pyayt, A.L.; Kozionov, A.P.; Mokhov, I.I.; Lang, B.; Meijer, R.J.; Krzhizhanovskaya, V.V.; Sloot, P.M.A.

2014-01-01

Detection of early warning signals for the imminent failure of large and complex engineered structures is a daunting challenge with many open research questions. In this paper we report on novel ways to perform Structural Health Monitoring (SHM) of flood protection systems (levees, earthen dikes and

Department of Energy's safety and health program for enrichment plant workers is not adequately implemented

International Nuclear Information System (INIS)

Staats, E.B.

1980-01-01

The Department of Energy's (DOE's) program to protect the safety and health of employees at its contractor-operated uranium enrichment plants has not been fully implemented by DOE's Oak Ridge Operations Office. Appraisals and inspections of plant conditions are not as frequent and/or as thorough as required. Instead of independently investigating employee complaints, DOE has delegated this responsibility to the contractor. It is recommended that the Secretary of Energy make sure that Oak Ridge properly conducts inspections and appraisals and investigates and follows up on all employee complaints. He should also take steps to provide increased independence and objectivity in the Oak Ridge Operations Office's safety and health program. Furthermore, the Congress should authorize the Secretary of Energy to institute a program of non-reimbursable penalties and fines for violations of safety and health standards and procedures

Opportunities and challenges for structural health monitoring of radioactive waste systems and structures

Energy Technology Data Exchange (ETDEWEB)

Giurgiutiu, Victor [University of South Carolina, Columbia, SC 29208 (United States); Mendez Torres, Adrian E. [Savannah River National Laboratory, Aiken, SC 29808 (United States)

2013-07-01

Radioactive waste systems and structures (RWSS) are safety-critical facilities in need of monitoring over prolonged periods of time. Structural health monitoring (SHM) is an emerging technology that aims at monitoring the state of a structure through the use of networks of permanently mounted sensors. SHM technologies have been developed primarily within the aerospace and civil engineering communities. This paper addresses the issue of transitioning the SHM concept to the monitoring of RWSS and evaluates the opportunities and challenges associated with this process. Guided wave SHM technologies utilizing structurally-mounted piezoelectric wafer active sensors (PWAS) have a wide range of applications based on both propagating-wave and standing-wave methodologies. Hence, opportunities exist for transitioning these SHM technologies into RWSS monitoring. However, there exist certain special operational conditions specific to RWSS such as: radiation field, caustic environments, marine environments, and chemical, mechanical and thermal stressors. In order to address the high discharge of used nuclear fuel (UNF) and the limited space in the storage pools the U.S. the Department of Energy (DOE) has adopted a 'Strategy for the Management and Disposal of Used Nuclear Fuel and High-Level Radioactive Waste' (January 2013). This strategy endorses the key principles that underpin the Blue Ribbon Commission's on America's Nuclear Future recommendations to develop a sustainable program for deploying an integrated system capable of transporting, storing, and disposing of UNF and high-level radioactive waste from civilian nuclear power generation, defense, national security, and other activities. This will require research to develop monitoring, diagnosis, and prognosis tools that can aid to establish a strong technical basis for extended storage and transportation of UNF. Monitoring of such structures is critical for assuring the safety and security of the

Survey determinant factors of telemedicine strategic planning from the managers and experts perspective in the health department, isfahan university of medical sciences.

Science.gov (United States)

Keshvari, Hamid; Haddadpoor, Asefeh; Taheri, Behjat; Nasri, Mehran; Aghdak, Pezhman

2014-10-01

Awareness of Outlook, objectives, benefits and impact of telemedicine technology that can promote services quality, reduce costs, increase access to Specialized and subspecialty services, and immediately guide the health system subconsciously to the introduction greater use of technology. Therefore, the aim of this study was to determine the strengths, weaknesses, opportunities and threats in the telemedicine strategic planning from the managers and experts perspective in the health department, Isfahan University of Medical Sciences, in order to take a step towards facilitating strategic planning and approaching the equity aim in health in the province. This is a descriptive-analytical study, that data collection was done cross-sectional. The study population was composed of all managers and certified experts at the health department in Isfahan university of Medical Sciences. The sample size was 60 patients according to inclusion criteria. Information was collected by interview method. Researcher attempted to use the structured and specific questionnaire Then were investigated the viewpoints of experts and managers about determinative factors (strengths, weaknesses, opportunities and threats) in the strategic planning telemedicine. Data were analyzed using descriptive statistics (frequency, mean) and software SPSS 19. Data analysis showed that change management (100%) and continuity of supply of credit (79/3%) were weakness point within the organization and strengths of the program were, identity and health telemedicine programs (100%), goals and aspirations of the current directors of the organization and its compliance with the goals of telemedicine (100%), human resources interested using computers in daily activities in peripheral levels (93/1%). Also organization in the field of IT professionals, had opportunities, and repayment specialist's rights by insurance organizations is a threat for it. According to the strengths, weaknesses, opportunities and threats

Openness to change: experiential and demographic components of change in in Local Health Department leaders

OpenAIRE

Emmanuel D Jadhav; James W. Holsinger; David W Fardo

2015-01-01

Background: During the 2008-10 economic recession, Kentucky local health department (LHD) leaders utilized innovative strategies to maintain their programs. A characteristic of innovative strategy is leader openness to change. Leader demographical research in for-profit organizations has yielded valuable insight into leader openness to change. For LHD leaders the nature of the association between leader demographic and organizational characteristics on leader openness to change is unknown. Th...

Should they stay or should they go? Leader duration and financial performance in local health departments.

Science.gov (United States)

Jadhav, Emmanuel D; Holsinger, James W; Mays, Glen; Fardo, David

2015-01-01

The delivery of programs by local health departments (LHDs) has shifted from "if we do not have the money we don't do it" to LHD directors should "identify and fund public health priorities." This shift has subsequently increased performance expectations of LHD leaders. In the for-profit sector the leaders' failure to perform has resulted in a shortening tenure trend. Tenure is a proxy for human capital accumulation. In LHDs, the nature of association, if any, between leader tenure and agency performance is unknown. Examine association between financial performance of LHDs with short-, average-, and long-tenured LHD leaders. Variation in leader characteristics and percent change in expenditure were examined using a longitudinal cohort design and positive deviance methodology. Bivariate analysis of LHD financial performance and leader characteristics was conducted, and a logistic regression model was developed to test association between leader tenure and LHDs that experienced a positive percentage expenditure change. From a total of 2523 LHDs, 1453 were examined. The cross-sectional surveys of US public health agencies conducted by the National Association of County and City Health Officials in 2008 and 2010 contain the leader and LHD variables. Approximately 44% of LHDs experienced a positive percentage expenditure change. Leader tenure, age, gender, and education status were significantly associated with a positive percentage expenditure change using a chi-square test of independence. From the logistic regression analysis tenure, educational status, employment status, area population, governance, classification, and jurisdiction were statistically significant. Local health departments with leaders whose tenure was less than 2 years were less likely than those with average tenure to experience a positive percentage expenditure change. The odds ratios for tenure suggest that tenure is positively associated up to a threshold level and then declines. Implying that

Structural Determinants and Children's Oral Health: A Cross-National Study.

Science.gov (United States)

Baker, S R; Foster Page, L; Thomson, W M; Broomhead, T; Bekes, K; Benson, P E; Aguilar-Diaz, F; Do, L; Hirsch, C; Marshman, Z; McGrath, C; Mohamed, A; Robinson, P G; Traebert, J; Turton, B; Gibson, B J

2018-03-01

Much research on children's oral health has focused on proximal determinants at the expense of distal (upstream) factors. Yet, such upstream factors-the so-called structural determinants of health-play a crucial role. Children's lives, and in turn their health, are shaped by politics, economic forces, and social and public policies. The aim of this study was to examine the relationship between children's clinical (number of decayed, missing, and filled teeth) and self-reported oral health (oral health-related quality of life) and 4 key structural determinants (governance, macroeconomic policy, public policy, and social policy) as outlined in the World Health Organization's Commission for Social Determinants of Health framework. Secondary data analyses were carried out using subnational epidemiological samples of 8- to 15-y-olds in 11 countries ( N = 6,648): Australia (372), New Zealand (three samples; 352, 202, 429), Brunei (423), Cambodia (423), Hong Kong (542), Malaysia (439), Thailand (261, 506), United Kingdom (88, 374), Germany (1498), Mexico (335), and Brazil (404). The results indicated that the type of political regime, amount of governance (e.g., rule of law, accountability), gross domestic product per capita, employment ratio, income inequality, type of welfare regime, human development index, government expenditure on health, and out-of-pocket (private) health expenditure by citizens were all associated with children's oral health. The structural determinants accounted for between 5% and 21% of the variance in children's oral health quality-of-life scores. These findings bring attention to the upstream or structural determinants as an understudied area but one that could reap huge rewards for public health dentistry research and the oral health inequalities policy agenda.

Acoustic Techniques for Structural Health Monitoring

Science.gov (United States)

Frankenstein, B.; Augustin, J.; Hentschel, D.; Schubert, F.; Köhler, B.; Meyendorf, N.

2008-02-01

Future safety and maintenance strategies for industrial components and vehicles are based on combinations of monitoring systems that are permanently attached to or embedded in the structure, and periodic inspections. The latter belongs to conventional nondestructive evaluation (NDE) and can be enhanced or partially replaced by structural health monitoring systems. However, the main benefit of this technology for the future will consist of systems that can be differently designed based on improved safety philosophies, including continuous monitoring. This approach will increase the efficiency of inspection procedures at reduced inspection times. The Fraunhofer IZFP Dresden Branch has developed network nodes, miniaturized transmitter and receiver systems for active and passive acoustical techniques and sensor systems that can be attached to or embedded into components or structures. These systems have been used to demonstrate intelligent sensor networks for the monitoring of aerospace structures, railway systems, wind energy generators, piping system and other components. Material discontinuities and flaws have been detected and monitored during full scale fatigue testing. This paper will discuss opportunities and future trends in nondestructive evaluation and health monitoring based on new sensor principles and advanced microelectronics. It will outline various application examples of monitoring systems based on acoustic techniques and will indicate further needs for research and development.

Wireless Smart Sensor Network System Using SmartBridge Sensor Nodes for Structural Health Monitoring of Existing Concrete Bridges

Science.gov (United States)

Gaviña, J. R.; Uy, F. A.; Carreon, J. D.

2017-06-01

There are over 8000 bridges in the Philippines today according to the Department of Public Works and Highways (DPWH). Currently, visual inspection is the most common practice in monitoring the structural integrity of bridges. However, visual inspections have proven to be insufficient in determining the actual health or condition of a bridge. Structural Health Monitoring (SHM) aims to give, in real-time, a diagnosis of the actual condition of the bridge. In this study, SmartBridge Sensor Nodes were installed on an existing concrete bridge with American Association of State Highway and Transportation Officials (AASHTO) Type IV Girders to gather vibration of the elements of the bridge. Also, standards on the effective installation of SmartBridge Sensor Nodes, such as location and orientation was determined. Acceleration readings from the sensor were then uploaded to a server, wherein they are monitored against certain thresholds, from which, the health of the bridge will be derived. Final output will be a portal or webpage wherein the information, health, and acceleration readings of the bridge will be available for viewing. With levels of access set for different types of users, the main users will have access to download data and reports. Data transmission and webpage access are available online, making the SHM system wireless.

Job satisfaction of Department of Veterans Affairs peer mental health providers.

Science.gov (United States)

Chang, Bei-Hung; Mueller, Lisa; Resnick, Sandra G; Osatuke, Katerine; Eisen, Susan V

2016-03-01

Department of Veterans Affairs (VA) peer specialists and vocational rehabilitation specialists are Veterans employed in mental health services to help other Veterans with similar histories and experiences. Study objectives were to (a) examine job satisfaction among these employees, (b) compare them to other VA mental health workers, and (c) identify factors associated with job satisfaction across the 3 cohorts. The study sample included 152 VA-employed peer specialists and 222 vocational rehabilitation specialists. A comparison group included 460 VA employees from the same job categories. All participants completed the Job Satisfaction Index (11 aspects and overall satisfaction ratings). Linear regression was used to compare job satisfaction and identify its predictors among the 3 cohorts. Job satisfaction was fairly high, averaging "somewhat satisfied" to "very satisfied" in 6 (peer specialists) and 9 (vocational rehabilitation specialists) of the 11 aspects and overall job ratings. Adjusting for length of employment, age and gender resulted in no significant group differences with 2 exceptions: White peer specialists were less satisfied with pay and promotion opportunities than vocational rehabilitation specialists and comparison-group employees. Across all cohorts, shorter length of time employed in the job was associated with higher job satisfaction. The high job satisfaction levels among the 2 peer cohorts suggest support for the policy of hiring peer specialists in the VA. Furthermore, the results are consistent with those of the nonveteran samples, indicating that integrating peer providers into mental health care is possible in VA and non-VA settings. (c) 2016 APA, all rights reserved).

Structural adjustment and health: A conceptual framework and evidence on pathways.

Science.gov (United States)

Kentikelenis, Alexander E

2017-08-01

Economic reform programs designed by the International Monetary Fund and the World Bank-so-called 'structural adjustment programs'-have formed one of the most influential policy agendas of the past four decades. To gain access to financial support from these organizations, countries-often in economic crisis-have reduced public spending, limited the role of the state, and deregulated economic activity. This article identifies the multiple components of structural adjustment, and presents a conceptual framework linking them to health systems and outcomes. Based on a comprehensive review of the academic literature, the article identifies three main pathways through which structural adjustment affects health: policies directly targeting health systems; policies indirectly impacting health systems; and policies affecting the social determinants of health. The cogency of the framework is illustrated by revisiting Greece's recent experience with structural adjustment, drawing on original IMF reports and secondary literature. Overall, the framework offers a lens through which to analyze the health consequences of structural adjustment across time, space and levels of socioeconomic development, and can be utilized in ex ante health impact assessments of these policies. Copyright © 2017 Elsevier Ltd. All rights reserved.

Survey of social health insurance structure in selected countries; providing framework for basic health insurance in Iran.

Science.gov (United States)

Mohammadi, Effat; Raissi, Ahmad Reza; Barooni, Mohsen; Ferdoosi, Massoud; Nuhi, Mojtaba

2014-01-01

Health system reforms are the most strategic issue that has been seriously considered in healthcare systems in order to reduce costs and increase efficiency and effectiveness. The costs of health system finance in our country, lack of universal coverage in health insurance, and related issues necessitate reforms in our health system financing. The aim of this research was to prepare a structure of framework for social health insurance in Iran and conducting a comparative study in selected countries with social health insurance. This comparative descriptive study was conducted in three phases. The first phase of the study examined the structure of health social insurance in four countries - Germany, South Korea, Egypt, and Australia. The second phase was to develop an initial model, which was designed to determine the shared and distinguishing points of the investigated structures, for health insurance in Iran. The third phase was to validate the final research model. The developed model by the Delphi method was given to 20 professionals in financing of the health system, health economics and management of healthcare services. Their comments were collected in two stages and its validity was confirmed. The study of the structure of health insurance in the selected countries shows that health social insurance in different countries have different structures. Based on the findings of the present study, the current situation of the health system, and the conducted surveys, the following framework is suitable for the health social insurance system in Iran. The Health Social Insurance Organization has a unique service by having five funds of governmental employees, companies and NGOs, self-insured, villagers, and others, which serves as a nongovernmental organization under the supervision of public law and by decision- and policy-making of the Health Insurance Supreme Council. Membership in this organization is based on the nationality or residence, which the insured by

Factors Associated With the Likelihood of Hospitalization Following Emergency Department Visits for Behavioral Health Conditions.

Science.gov (United States)

Hamilton, Jane E; Desai, Pratikkumar V; Hoot, Nathan R; Gearing, Robin E; Jeong, Shin; Meyer, Thomas D; Soares, Jair C; Begley, Charles E

2016-11-01

Behavioral health-related emergency department (ED) visits have been linked with ED overcrowding, an increased demand on limited resources, and a longer length of stay (LOS) due in part to patients being admitted to the hospital but waiting for an inpatient bed. This study examines factors associated with the likelihood of hospital admission for ED patients with behavioral health conditions at 16 hospital-based EDs in a large urban area in the southern United States. Using Andersen's Behavioral Model of Health Service Use for guidance, the study examined the relationship between predisposing (characteristics of the individual, i.e., age, sex, race/ethnicity), enabling (system or structural factors affecting healthcare access), and need (clinical) factors and the likelihood of hospitalization following ED visits for behavioral health conditions (n = 28,716 ED visits). In the adjusted analysis, a logistic fixed-effects model with blockwise entry was used to estimate the relative importance of predisposing, enabling, and need variables added separately as blocks while controlling for variation in unobserved hospital-specific practices across hospitals and time in years. Significant predisposing factors associated with an increased likelihood of hospitalization following an ED visit included increasing age, while African American race was associated with a lower likelihood of hospitalization. Among enabling factors, arrival by emergency transport and a longer ED LOS were associated with a greater likelihood of hospitalization while being uninsured and the availability of community-based behavioral health services within 5 miles of the ED were associated with lower odds. Among need factors, having a discharge diagnosis of schizophrenia/psychotic spectrum disorder, an affective disorder, a personality disorder, dementia, or an impulse control disorder as well as secondary diagnoses of suicidal ideation and/or suicidal behavior increased the likelihood of hospitalization

United States Department of Health and Human Services Biodosimetry and radiological/nuclear medical countermeasure programs

International Nuclear Information System (INIS)

Homer, Mary J.; Raulli, Robert; Esker, John; Moyer, Brian; Wathen, Lynne; DiCarlo-Cohen, Andrea L.; Maidment, Bert W.; Rios, Carmen; Macchiarini, Francesca; Hrdina, Chad; Prasanna, Pataje G.

2016-01-01

The United States Department of Health and Human Services (HHS) is fully committed to the development of medical countermeasures to address national security threats from chemical, biological, radiological, and nuclear agents. Through the Public Health Emergency Medical Countermeasures Enterprise, HHS has launched and managed a multi-agency, comprehensive effort to develop and operationalize medical countermeasures. Within HHS, development of medical countermeasures includes the National Institutes of Health (NIH), (led by the National Institute of Allergy and Infectious Diseases), the Office of the Assistant Secretary of Preparedness and Response/Biomedical Advanced Research and Development Authority (BARDA); with the Division of Medical Countermeasure Strategy and Requirements, the Centers for Disease Control and Prevention, and the Food and Drug Administration as primary partners in this endeavor. This paper describes various programs and coordinating efforts of BARDA and NIH for the development of medical countermeasures for radiological and nuclear threats. (authors)

Restructuring a State Nutrition Education and Obesity Prevention Program: Implications of a Local Health Department Model for SNAP-Ed.

Science.gov (United States)

Wu, Helen W; Backman, Desiree; Kizer, Kenneth W

The US Department of Agriculture Supplemental Nutrition Assistance Program-Education (SNAP-Ed) funds state programs to improve nutrition and physical activity in low-income populations through its Nutrition Education and Obesity Prevention grants. States vary in how they manage and structure these programs. California substantially restructured its program in 2012 to universally position local health departments (LHDs) as the programmatic lead in all jurisdictions. This study sought to determine whether California's reorganization aligned with desirable attributes of decentralized public management. This study conducted 40 in person, semistructured interviews with 57 local, state, and federal SNAP-Ed stakeholders between October 2014 and March 2015. Local respondents represented 15 counties in all 7 of California's SNAP-Ed regions. We identified 3 common themes that outlined advantages or disadvantages of local public management, and we further defined subthemes within: (1) coordination and communication (within local jurisdictions, across regions, between local and state), (2) efficiency (administrative, fiscal, program), and (3) quality (innovation, skills). We conducted qualitative content analysis to evaluate how respondents characterized the California experience for each theme, identifying positive and negative experiences. California's LHD model offers some distinct advantages, but the model does not exhibit all the advantages of decentralized public management. Strategic planning, partnerships, subcontracting, and fiscal oversight are closer to communities than previously. However, administrative burden remains high and LHDs are limited in their ability to customize programs on the basis of community needs because of state and federal constraints. California's use of a universal LHD model for SNAP-Ed is novel. Recent federal SNAP-Ed changes present an opportunity for other states to consider this structure. Employing small-scale approaches initially (eg

Sustaining a Focus on Health Equity at the Centers for Disease Control and Prevention Through Organizational Structures and Functions.

Science.gov (United States)

Dean, Hazel D; Roberts, George W; Bouye, Karen E; Green, Yvonne; McDonald, Marian

2016-01-01

The public health infrastructure required for achieving health equity is multidimensional and complex. The infrastructure should be responsive to current and emerging priorities and capable of providing the foundation for developing, planning, implementing, and evaluating health initiatives. This article discusses these infrastructure requirements by examining how they are operationalized in the organizational infrastructure for promoting health equity at the Centers for Disease Control and Prevention, utilizing the nation's premier public health agency as a lens. Examples from the history of the Centers for Disease Control and Prevention's work in health equity from its centers, institute, and offices are provided to identify those structures and functions that are critical to achieving health equity. Challenges and facilitators to sustaining a health equity organizational infrastructure, as gleaned from the Centers for Disease Control and Prevention's experience, are noted. Finally, we provide additional considerations for expanding and sustaining a health equity infrastructure, which the authors hope will serve as "food for thought" for practitioners in state, tribal, or local health departments, community-based organizations, or nongovernmental organizations striving to create or maintain an impactful infrastructure to achieve health equity.

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.

The Department of Energy`s Rocky Flats Plant: A guide to record series useful for health-related research. Volume VII. Employee occupational exposure and health

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-08-01

This is the seventh in a series of seven volumes which constitute a guide to records of the Rocky Flats Plant useful for conducting health-related research. The primary purpose of Volume VII is to describe record series pertaining to employee occupational exposure and health at the Department of Energy`s (DOE) Rocky Flats Plant, now named the Rocky Flats Environmental Technology Site, near Denver, Colorado. History Associates Incorporated (HAI) prepared this guide as part of its work as the support services contractor for DOE`s Epidemiologic Records Inventory Project. This introduction briefly describes the Epidemiologic Records Inventory Project and HAI`s role in the project, provides a history of occupational exposure monitoring and health practices at Rocky Flats, and identifies organizations contributing to occupational exposure monitoring and health policies and activities. Other topics include the scope and arrangement of the guide and the organization to contact for access to these records. Comprehensive introductory and background information is available in Volume 1. Other volumes in the guide pertain to administrative and general subjects, facilities and equipment, production and materials handling, environmental and workplace monitoring, and waste management. In addition, HAI has produced a subject-specific guide, titled The September 1957 Rocky Flats Fire: A Guide to Record Series of the Department of Energy and Its Contractors, which researchers should consult for further information about records related to this incident.

Global Health Engagement and The Department of Defense as a Vehicle for Security and Sustainable Global Health.

Science.gov (United States)

Moten, Asad; Schafer, Daniel; Burkett, Edwin K

2018-01-01

The Unites States Department of Defense (DoD) is viewed by many in the general public as a monolithic government entity whose primary purpose is to coordinate this country's ability to make war and maintain a military presence around the world. However, the DoD is in fact a multidimensional organization whose global impact is as expansive as it is varying and is responsible for far-reaching global health interventions. The United States has worked toward providing long-term care among host nation populations by providing training in several areas related to medicine, with positive results. These efforts can be built upon with substantial positive effects. Building health infrastructure and capacity around the world is essential. The DoD is the most generously funded agency in the world, and the resources at its disposal provide the opportunity to make great gains in the long term in terms of both health and security worldwide. With efficient and careful use of DoD resources, and partnerships with key non-governmental organizations with specialized knowledge and great passion, partnerships can be forged with communities around the world to ensure that public health is achieved in even the most underserved communities. A move toward creating sustainable health systems with long-term goals and measurable outcomes is an essential complement to the already successful disaster and emergency relief that the United States military already provides. By ensuring that communities around the world are both provided with access to the sustainable health care they need and that emergency situations can be responded to in an efficient way, the United States can serve its duty as a leader in sharing expertise and resources for the betterment and security of all humankind. Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

U.S. Department of Energy Illness, and Injury Surveillance Program, Worker Health At A Glance, 1995-2004

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-10-01

The Department of Energy’s (DOE) Illness and Injury Surveillance Program (IISP) has monitored the health of contractor workers at selected DOE sites since 1990. For the first time, the IISP has sufficient data to describe, in a collective manner, the health trends occurring among workers at a number of DOE sites during a 10-year period. This brief report and the more detailed Worker Health Summary assess illness and injury trends of DOE workers according to gender, age, occupational group, and program office over the 10-year period, 1995 through 2004. During this time, over 137,000 individual contractor workers were employed at the 15 DOE sites participating in the IISP.

Wait Time for Treatment in Hospital Emergency Departments: 2009

Science.gov (United States)

... Medical Care Survey: 2003 emergency department summary. Advance data from vital and health statistics; no 358. Hyattsville, MD: National Center for Health Statistics. 2005. Burt CW, McCaig LF, Valverde RH. Analysis of ambulance diversions in U.S. emergency departments. Ann ...

New trends in structural health monitoring

CERN Document Server

Güemes, J

2013-01-01

Experts actively working in structural health monitoring and control techniques present the current research, areas of application and tendencies for the future of this technology, including various design issues involved. Examples using some of the latest hardware and software tools, experimental data from small scale laboratory demonstrators and measurements made on real structures illustrate the book. It will be a reference for professionals and students in the areas of engineering, applied natural sciences and engineering management.

The proportion of work-related emergency department visits not expected to be paid by workers' compensation: implications for occupational health surveillance, research, policy, and health equity.

Science.gov (United States)

Groenewold, Matthew R; Baron, Sherry L

2013-12-01

To examine trends in the proportion of work-related emergency department visits not expected to be paid by workers' compensation during 2003-2006, and to identify demographic and clinical correlates of such visits. A total of 3,881 work-related emergency department visit records drawn from the 2003-2006 National Hospital Ambulatory Medical Care Surveys. Secondary, cross-sectional analyses of work-related emergency department visit data were performed. Odds ratios and 95 percent confidence intervals were modeled using logistic regression. A substantial and increasing proportion of work-related emergency department visits in the United States were not expected to be paid by workers' compensation. Private insurance, Medicaid, Medicare, and workers themselves were expected to pay for 40 percent of the work-related emergency department visits with this percentage increasing annually. Work-related visits by blacks, in the South, to for-profit hospitals and for work-related illnesses were all more likely not to be paid by workers' compensation. Emergency department-based surveillance and research that determine work-relatedness on the basis of expected payment by workers' compensation systematically underestimate the occurrence of occupational illness and injury. This has important methodological and policy implications. © Health Research and Educational Trust.

Case study: Massachusetts Department of Public Health's Southeastern Massachusetts health study on leukemia around Pilgrim Nuclear Power Station: Who won?

Energy Technology Data Exchange (ETDEWEB)

Flanagan, Anita [Boston Edison Company (United States)

1993-07-01

In October 1990, the Massachusetts Department of Public Health released their Southeastern Massachusetts health study. This is a study of leukemia incidence in 22 towns around Pilgrim NPP, for the period 1978 through 1986. Pilgrim Station had been returned to operation following a 3 year outage, from 1986-1989. During this period, some $300 million in capital outlay was invested by Boston Edison in upgrading safety systems and installing the so-Called Three Mile Island upgrades. A copy of the peer review panel report is attached to this paper. Because of the interest in the Southeastern Massachusetts Health Study in Europe. There are three major points the Panel made which can summarized: 1. No excess of leukemia was found around Pilgrim Station. 2. The Southeastern Massachusetts Health Study over-predicted by a factor of 90 the number of leukemia cases attributable to plant operation. 3. The Southeastern Massachusetts Health Study failed to account for exposure to natural background radiation, which represents far larger biological exposure than plant Operation. Given All Of This, One Might Ask Why Didn't Common Sense Prevail In The Beginning? One Answer Might Be The Energy Of The Media In Pursuing The Story And Playing It Up No Matter What. Another Answer Might Be That The Original Study Purported To Show 'What Everyone Knows'. No One Really Stopped To Question Whether The Study Was Politically Motivated, Given That The Division of Environmental Health's Budget Had Been Cut.

Case study: Massachusetts Department of Public Health's Southeastern Massachusetts health study on leukemia around Pilgrim Nuclear Power Station: Who won?

International Nuclear Information System (INIS)

Flanagan, Anita

1993-01-01

In October 1990, the Massachusetts Department of Public Health released their Southeastern Massachusetts health study. This is a study of leukemia incidence in 22 towns around Pilgrim NPP, for the period 1978 through 1986. Pilgrim Station had been returned to operation following a 3 year outage, from 1986-1989. During this period, some $300 million in capital outlay was invested by Boston Edison in upgrading safety systems and installing the so-Called Three Mile Island upgrades. A copy of the peer review panel report is attached to this paper. Because of the interest in the Southeastern Massachusetts Health Study in Europe. There are three major points the Panel made which can summarized: 1. No excess of leukemia was found around Pilgrim Station. 2. The Southeastern Massachusetts Health Study over-predicted by a factor of 90 the number of leukemia cases attributable to plant operation. 3. The Southeastern Massachusetts Health Study failed to account for exposure to natural background radiation, which represents far larger biological exposure than plant Operation. Given All Of This, One Might Ask Why Didn't Common Sense Prevail In The Beginning? One Answer Might Be The Energy Of The Media In Pursuing The Story And Playing It Up No Matter What. Another Answer Might Be That The Original Study Purported To Show 'What Everyone Knows'. No One Really Stopped To Question Whether The Study Was Politically Motivated, Given That The Division of Environmental Health's Budget Had Been Cut

U.S. Department of Energy, Illness and Injury Surveillance Program, Worker Health Summary, 1995-2004

Energy Technology Data Exchange (ETDEWEB)

U.S. Department of Energy, Office of Health, Safety and Security, Office of Illness and Injury Prevention Programs

2007-10-01

The Department of Energy’s (DOE) Illness and Injury Surveillance Program has created an opportunity to assess illness and injury rates and patterns among workers at participating sites for well over a decade. The Worker Health Summary introduces an additional perspective on worker health with the introduction of analyses comparing the experience of sites in different program offices and a focus on time trends covering a decade of worker illness and injury experience. These analyses by program office suggest that illness and injury patterns among National Nuclear Security Administration (NNSA) workers diverge in many ways from those seen among Environmental Management (EM) and Science workers for reasons not yet understood. These differences will receive further investigation in future special focus studies, as will other findings of interest. With the time depth now available in our data, the Worker Health Summary reveals an additional nuance in worker health trends: changing health patterns in a specialized and skilled but aging work force. Older workers are becoming an increasing percentage of the work force, and their absence rates for diseases such as diabetes and hypertension are increasing as well. The impact of these emerging health issues, if properly addressed, can be managed to maintain or even enhance worker health and productivity. Prevention strategies designed to reduce the toll of these health conditions appear warranted, and this report gives us an indication of where to focus them. The analyses that follow reflect the Illness and Injury Surveillance Program’s continued commitment to apply a public health perspective in protecting the health of DOE’s work force.

US Department of Energy Environment, Safety and Health Progress Assessment of the Nevada Test Site

Energy Technology Data Exchange (ETDEWEB)

1992-08-01

This report documents the result of the US Department of Energy (DOE) Environment, Safety, and Health (ES&H) Progress Assessment of the Nevada Test Site (NTS), Nye County, Nevada. The assessment, which was conducted from July 20 through August 4, 1992, included a selective review of the ES&H management systems and progress of the responsible DOE Headquarters Program Offices; the DOE Nevada Field Office (NV); and the site contractors. The ES&H Progress Assessments are part of the Secretary of Energy`s continuing effort to institutionalize line management accountability and the self-assessment process throughout DOE and its contractor organizations. This report presents a summary of issues and progress in the areas of environment, safety and health, and management.

US Department of Energy Environment, Safety and Health Progress Assessment of the Nevada Test Site

International Nuclear Information System (INIS)

1992-08-01

This report documents the result of the US Department of Energy (DOE) Environment, Safety, and Health (ES ampersand H) Progress Assessment of the Nevada Test Site (NTS), Nye County, Nevada. The assessment, which was conducted from July 20 through August 4, 1992, included a selective review of the ES ampersand H management systems and progress of the responsible DOE Headquarters Program Offices; the DOE Nevada Field Office (NV); and the site contractors. The ES ampersand H Progress Assessments are part of the Secretary of Energy's continuing effort to institutionalize line management accountability and the self-assessment process throughout DOE and its contractor organizations. This report presents a summary of issues and progress in the areas of environment, safety and health, and management

42 CFR 50.405 - What is the structure of review committees?

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false What is the structure of review committees? 50.405 Section 50.405 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GRANTS POLICIES OF GENERAL APPLICABILITY Public Health Service Grant Appeals Procedure § 50.405 What is the...

Department of Defense, Deployment Health Clinical Center

Science.gov (United States)

... general public of trends in mental health and mental health care within the Military Health System Get The Numbers Real Warriors Campaign Real Warriors Campaign A multimedia public awareness campaign designed to combat the stigma associated with ...

Structural health monitoring an advanced signal processing perspective

CERN Document Server

Chen, Xuefeng; Mukhopadhyay, Subhas

2017-01-01

This book highlights the latest advances and trends in advanced signal processing (such as wavelet theory, time-frequency analysis, empirical mode decomposition, compressive sensing and sparse representation, and stochastic resonance) for structural health monitoring (SHM). Its primary focus is on the utilization of advanced signal processing techniques to help monitor the health status of critical structures and machines encountered in our daily lives: wind turbines, gas turbines, machine tools, etc. As such, it offers a key reference guide for researchers, graduate students, and industry professionals who work in the field of SHM.

HCUP State Emergency Department Databases (SEDD) - Restricted Access File

Data.gov (United States)

U.S. Department of Health & Human Services — The State Emergency Department Databases (SEDD) contain the universe of emergency department visits in participating States. Restricted access data files are...

Governance structures impact on eHealth

DEFF Research Database (Denmark)

Kierkegaard, Patrick

2015-01-01

Background National eHealth implementation efforts need to move beyond the scope of making technology the primary focus and instead consider the broader spectrum of influences that can either hinder or facilitate eHealth adoption such as governance structures and policies. In this study, Denmark...... serves as an ideal candidate for further examination due to the country׳s rich history of intertwining events that have played an important role in the dynamic relationship between governance and eHealth success and failures. Methods A case study approach was used to gather a combination of primary...... and secondary data sources. All data collection was carried out through desk-research. Data collection relied on performing an extensive search of literature for relevant studies using combinations of keywords that reflected eHealth and governance-related topics. Inclusion and exclusion criteria׳s were applied...

Addressing health inequalities by using Structural Funds. A question of opportunities.

Science.gov (United States)

Neagu, Oana Maria; Michelsen, Kai; Watson, Jonathan; Dowdeswell, Barrie; Brand, Helmut

2017-03-01

Making up a third of the EU budget, Structural and Investment Funds can provide important opportunities for investing in policies that tackle inequalities in health. This article looks back and forward at the 2007-2013 and 2014-2020 financial periods in an attempt to inform the development of health equity as a strand of policy intervention under regional development. It combines evidence from health projects funded through Structural Funds and a document analyses that locates interventions for health equity under the new regulations. The map of opportunities has changed considerably since the last programming period, creating more visibility for vulnerable groups, social determinants of health and health systems sustainability. As the current programming period is progressing, this paper contributes to maximizing this potential but also identifying challenges and implementation gaps for prospective health system engagement in pursuing health equity as part of Structural Funds projects. The austerity measures and their impact on public spending, building political support for investments as well as the difficulties around pursuing health gains as an objective of other policy areas are some of the challenges to overcome. European Structural and Investment Funds could be a window of opportunity that triggers engagement for health equity if sectors adopt a transformative approach and overcome barriers, cooperate for common goals and make better use of the availability of these resources. Copyright © 2017 Elsevier B.V. All rights reserved.

Health monitoring of civil structures using fiber optic sensors

International Nuclear Information System (INIS)

Varma, Veto; Kumar, Praveen; Charan, J.J.; Reddy, G.R.; Vaze, K.K.; Kushwaha, H.S.

2003-08-01

During the lifetime of the reactor, the civil structure is subjected to many operational and environmental loads. Hence it is increasingly important to monitor the conditions of the structure and insure its safety and integrity. The conventional gauges have proved to be not sufficiently catering the problem of long term health monitoring of the structure because of its many limitations. Hence it is mandatory to develop a technique for the above purpose. Present study deals with the application of Fiber optic sensors (EFPI strain Gauges) in the civil structure for its health monitoring. Various experiments were undertaken and suitability of sensors was checked. A technique to embed the optical sensor inside the concrete is successfully developed and tested. (author)

42 CFR 57.216 - What additional Department regulations apply to schools?

Science.gov (United States)

2010-10-01

... 42 Public Health 1 2010-10-01 2010-10-01 false What additional Department regulations apply to schools? 57.216 Section 57.216 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN... schools? (a) Participating schools are advised that in addition to complying with the terms and conditions...

A national survey on health department capacity for community engagement in emergency preparedness.

Science.gov (United States)

Schoch-Spana, Monica; Selck, Frederic W; Goldberg, Lisa A

2015-01-01

Limited systematic knowledge exists about how public health practitioners and policy makers can best strengthen community engagement in public health emergency preparedness ("CE-PHEP"), a top priority for US national health security. To investigate local health department (LHD) adoption of federally recommended participatory approaches to PHEP and to identify LHD organizational characteristics associated with more intense CE-PHEP. National survey in 2012 of LHDs using a self-administered Web-based questionnaire regarding LHD practices and resources for CE-PHEP ("The Community Engagement for Public Health Emergency Preparedness Survey"). Differences in survey responses were examined, and a multivariate analysis was used to test whether LHD organizational characteristics were associated with differences in CE-PHEP intensity. A randomized sample of 754 LHDs drawn from the 2565 LHDs that had been invited to participate in the 2010 National Profile of LHDs. Sample selection was stratified by the size of population served and geographic location. Emergency preparedness coordinators reporting on their respective LHDs. CE-PHEP intensity as measured with a scoring system that rated specific CE-PHEP practices by LHD according to the relative degrees of public participation and community capacity they represented. Survey response rate was 61%. The most common reported CE-PHEP activity was disseminating personal preparedness materials (90%); the least common was convening public forums on PHEP planning (22%). LHD characteristics most strongly associated with more intense CE-PHEP were having a formal CE-PHEP policy, allocating funds for CE-PHEP, having strong support from community-based organizations, and employing a coordinator with prior CE experience. Promising ways to engage community partners more fully in the PHEP enterprise are institutionalizing CE-PHEP objectives, employing sufficient and skilled staff, leveraging current community-based organization support, and

Stress, mental health, and job performance among active duty military personnel: findings from the 2002 Department of Defense Health-Related Behaviors Survey.

Science.gov (United States)

Hourani, Laurel L; Williams, Thomas V; Kress, Amii M

2006-09-01

This study examined the extent to which high levels of occupational and family stress were associated with mental health problems and productivity loss among active duty military personnel. We analyzed data from the 2002 Department of Defense Survey of Health-Related Behaviors among Military Personnel, which provided extensive population-based information on 12,756 active duty personnel in all branches of the military worldwide. Military personnel reported higher levels of stress at work than in their family life. The personnel reporting the highest levels of occupational stress were those 25 or younger, those who were married with spouses not present, and women. Personnel with high levels of stress had significantly higher rates of mental health problems and productivity loss than those with less stress. We recommend that prevention and intervention efforts geared toward personnel reporting the highest levels of stress be given priority for resources in this population.

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

OpenAIRE

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

2016-01-01

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

Everyday discrimination and physical health: Exploring mental health processes.

Science.gov (United States)

Earnshaw, Valerie A; Rosenthal, Lisa; Carroll-Scott, Amy; Santilli, Alycia; Gilstad-Hayden, Kathryn; Ickovics, Jeannette R

2016-10-01

Goals of this study were to examine the mental health processes whereby everyday discrimination is associated with physical health outcomes. Data are drawn from a community health survey conducted with 1299 US adults in a low-resource urban area. Frequency of everyday discrimination was associated with overall self-rated health, use of the emergency department, and one or more chronic diseases via stress and depressive symptoms operating in serial mediation. Associations were consistent across members of different racial/ethnic groups and were observed even after controlling for indicators of stressors associated with structural discrimination, including perceived neighborhood unsafety, food insecurity, and financial stress. © The Author(s) 2015.

Perceptions of Health Communication, Water Treatment and Sanitation in Artibonite Department, Haiti, March-April 2012.

Directory of Open Access Journals (Sweden)

Holly Ann Williams

Full Text Available The international response to Haiti's ongoing cholera outbreak has been multifaceted, including health education efforts by community health workers and the distribution of free water treatment products. Artibonite Department was the first region affected by the outbreak. Numerous organizations have been involved in cholera response efforts in Haiti with many focusing on efforts to improve water, sanitation, and hygiene (WASH. Multiple types of water treatment products have been distributed, creating the potential for confusion over correct dosage and water treatment methods. We utilized qualitative methods in Artibonite to determine the population's response to WASH messages, use and acceptability of water treatment products, and water treatment and sanitation knowledge, attitudes and practices at the household level. We conducted eighteen focus group discussions (FGDs: 17 FGDs were held with community members (nine among females, eight among males; one FGD was held with community health workers. Health messages related to WASH were well-retained, with reported improvements in hand-washing. Community health workers were identified as valued sources of health information. Most participants noted a paucity of water-treatment products. Sanitation, specifically the construction of latrines, was the most commonly identified need. Lack of funds was the primary reason given for not constructing a latrine. The construction and maintenance of potable water and sanitation services is needed to ensure a sustainable change.

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

Fibre Optic Sensors for Structural Health Monitoring of Aircraft Composite Structures: Recent Advances and Applications

Directory of Open Access Journals (Sweden)

Raffaella Di Sante

2015-07-01

Full Text Available In-service structural health monitoring of composite aircraft structures plays a key role in the assessment of their performance and integrity. In recent years, Fibre Optic Sensors (FOS have proved to be a potentially excellent technique for real-time in-situ monitoring of these structures due to their numerous advantages, such as immunity to electromagnetic interference, small size, light weight, durability, and high bandwidth, which allows a great number of sensors to operate in the same system, and the possibility to be integrated within the material. However, more effort is still needed to bring the technology to a fully mature readiness level. In this paper, recent research and applications in structural health monitoring of composite aircraft structures using FOS have been critically reviewed, considering both the multi-point and distributed sensing techniques.

Fibre Optic Sensors for Structural Health Monitoring of Aircraft Composite Structures: Recent Advances and Applications

Science.gov (United States)

Di Sante, Raffaella

2015-01-01

In-service structural health monitoring of composite aircraft structures plays a key role in the assessment of their performance and integrity. In recent years, Fibre Optic Sensors (FOS) have proved to be a potentially excellent technique for real-time in-situ monitoring of these structures due to their numerous advantages, such as immunity to electromagnetic interference, small size, light weight, durability, and high bandwidth, which allows a great number of sensors to operate in the same system, and the possibility to be integrated within the material. However, more effort is still needed to bring the technology to a fully mature readiness level. In this paper, recent research and applications in structural health monitoring of composite aircraft structures using FOS have been critically reviewed, considering both the multi-point and distributed sensing techniques. PMID:26263987

Department of Structural Research - Overview

International Nuclear Information System (INIS)

Wasiutynski, T.

2002-01-01

competing ferro- and antiferromagnetic interactions give rise to phase transitions which have been studied by means of static and dynamic magnetometry. For two series Gd T Mg (T= Ag, Au, Pd and Pt) and R Pd In (R = Gd, Tb, Dy, Ho, and Er) the temperatures and the types of phase transitions have been determined. Solid solutions of orthoferrites and orthogallates have been investigated wthin a joint project with the Academy of Mining and Metallurgy. Substitution of the Fe +3 ions in the distorted perovskite structure by the nonmagnetic ions of Al +3 and Ga +3 results in substantial shift of the compensation point and of the spontaneous spin reorientation region. A new subject in our studies is a search for molecular and polymeric systems (organic and organometallic) showing cooperative magnetic phenomena. Among the different compounds (synthesized in the Institute of Chemistry of the Jagiellonian University) the most interesting one is Cu 4 (H 2 O) 4 [W(CN) 8 ] 4 . The compound has been found to be a soft ferromagnet with T c = 34 K. Our Department maintains a program of weekly internal seminars. The latter provide a unique discussion forum for our current results as well as those presented by invited speakers. Much of our activity would not be possible without the financial support from the Polish Committee for Scientific Research. (author)

Technical assistance from state health departments for communities engaged in policy, systems, and environmental change: the ACHIEVE Program.

Science.gov (United States)

Hefelfinger, Jenny; Patty, Alice; Ussery, Ann; Young, Walter

2013-10-24

This study assessed the value of technical assistance provided by state health department expert advisors and by the staff of the National Association of Chronic Disease Directors (NACDD) to community groups that participated in the Action Communities for Health, Innovation, and Environmental Change (ACHIEVE) Program, a CDC-funded health promotion program. We analyzed quantitative and qualitative data reported by community project coordinators to assess the nature and value of technical assistance provided by expert advisors and NACDD staff and the usefulness of ACHIEVE resources in the development and implementation of community action plans. A grounded theory approach was used to analyze and categorize phrases in text data provided by community coordinators. Open coding placed conceptual labels on text phrases. Frequency distributions of the quantitative data are described and discussed. The most valuable technical assistance and program support resources were those determined to be in the interpersonal domain (ie, interactions with state expert advisors, NACDD staff, and peer-to-peer support). The most valuable technical assistance events were action institutes, coaches' meetings, webinars, and technical assistance conference calls. This analysis suggests that ACHIEVE communities valued the management and training assistance provided by expert advisors and NACDD staff. State health department expert advisors provided technical guidance and support, including such skills or knowledge-based services as best-practice strategies, review and discussion of community assessment data, sustainability planning, and identification of possible funding opportunities. NACDD staff led development and implementation of technical assistance events.

Self-learning health monitoring algorithm in composite structures

Science.gov (United States)

Grassia, Luigi; Iannone, Michele; Califano, America; D'Amore, Alberto

2018-02-01

The paper describes a system that it is able of monitoring the health state of a composite structure in real time. The hardware of the system consists of a wire of strain sensors connected to a control unit. The software of the system elaborates the strain data and in real time is able to detect the presence of an eventual damage of the structures monitored with the strain sensors. The algorithm requires as input only the strains of the monitored structured measured on real time, i.e. those strains coming from the deformations of the composite structure due to the working loads. The health monitoring system does not require any additional device to interrogate the structure as often used in the literature, instead it is based on a self-learning procedure. The strain data acquired when the structure is healthy are used to set up the correlations between the strain in different positions of structure by means of neural network. Once the correlations between the strains in different position have been set up, these correlations act as a fingerprint of the healthy structure. In case of damage the correlation between the strains in the position of the structure near the damage will change due to the change of the stiffness of the structure caused by the damage. The developed software is able to recognize the change of the transfer function between the strains and consequently is able to detect the damage.

Department of High Energy Physics: Overview

International Nuclear Information System (INIS)

Nassalski, J.

1999-01-01

Full text: The main activity of our Department is experimental high energy physics with accelerators. Experiments are carried using large facilities: - at CERN, the European Laboratory for Particle Physics in Geneva, - at Celsius Storage Ring in Uppsala and - in DESY laboratory in Hamburg, where several groups of physicists from our Department are members of international collaborations. They are listed below together with the main physics interests: At CERN - Delphi at LEP - tests of the Standard Model, b-quark physics, SUSY search, - NA48 - CP-violation in K 0 decays, rare decays, - SMC - spin dependent nucleon structure function, the Bjorken sum, - NA49 and WA98 - heavy ion physics. At CELSIUS - WASA - threshold production of light mesons, rare meson decays. At DESY - ZEUS - proton and photon structure functions, diffractive production. In most of these experiments our Department also contributed to the instrumentation of detectors and is presently involved in data collection, detector supervision and in data analysis. At the same time the Department is also involved in preparation of new experiments: - CMS (Compact Muon Solenoid) and ALICE at the LHC (Large Hadron Collider) at CERN, - COMPASS (Compact Muon and Proton Apparatus for Structure and Spectroscopy) at the SPS at CERN, - WASA-Promice - an upgrade of the present detector at Celsius, - hyperfragment experiment at JINR, Dubna. The department has small workshop which was recently involved in an upgrade of the WASA detector. In our Department there are also two physicists working on the phenomenology of a quark-gluon plasma and on the low energy hadron-hadron interactions. Physicist from our Department collaborate with the Department of the Experimental Physics of Warsaw University. They are also involved in teaching and in supervision of diploma students. There is a group of 9 PhD students. (author)

Adoption of Smart Structures for Prevention of Health Hazards in Buildings

Science.gov (United States)

Oke, Ayodeji; Aigbavboa, Clinton; Ngema, Wiseman

2017-11-01

The importance of building quality to the health and well-being of occupants and surrounding neighbors cannot be overemphasized. Smart structures were construed to proffer solution to various issues of sustainable development including social factors that is concerned with health and safety of people. Based on existing literature materials on building quality, smart structures and general aspect of sustainable developments, this study examined the benefits of smart structures in the prevention of various health issues in infrastructural buildings, which has been a concern for stakeholders in the architecture, engineering and construction industry. The criterion for indoor environmental quality was adopted and various health and bodily issues related to building quality were explained. The adoption of smart structure concept will help to manage physical, chemical, biological and psychological factors of building with a view to enhancing better quality of life of occupants.

The business case for payer support of a community-based health information exchange: a humana pilot evaluating its effectiveness in cost control for plan members seeking emergency department care.

Science.gov (United States)

Tzeel, Albert; Lawnicki, Victor; Pemble, Kim R

2011-07-01

As emergency department utilization continues to increase, health plans must limit their cost exposure, which may be driven by duplicate testing and a lack of medical history at the point of care. Based on previous studies, health information exchanges (HIEs) can potentially provide health plans with the ability to address this need. To assess the effectiveness of a community-based HIE in controlling plan costs arising from emergency department care for a health plan's members. Albert Tzeel. The study design was observational, with an eligible population (N = 1482) of fully insured plan members who sought emergency department care on at least 2 occasions during the study period, from December 2008 through March 2010. Cost and utilization data, obtained from member claims, were matched to a list of persons utilizing the emergency department where HIE querying could have occurred. Eligible members underwent propensity score matching to create a test group (N = 326) in which the HIE database was queried in all emergency department visits, and a control group (N = 325) in which the HIE database was not queried in any emergency department visit. Post-propensity matching analysis showed that the test group achieved an average savings of $29 per emergency department visit compared with the control group. Decreased utilization of imaging procedures and diagnostic tests drove this cost-savings. When clinicians utilize HIE in the care of patients who present to the emergency department, the costs borne by a health plan providing coverage for these patients decrease. Although many factors can play a role in this finding, it is likely that HIEs obviate unnecessary service utilization through provision of historical medical information regarding specific patients at the point of care.

Structural racism and health inequities in the USA: evidence and interventions.

Science.gov (United States)

Bailey, Zinzi D; Krieger, Nancy; Agénor, Madina; Graves, Jasmine; Linos, Natalia; Bassett, Mary T

2017-04-08

Despite growing interest in understanding how social factors drive poor health outcomes, many academics, policy makers, scientists, elected officials, journalists, and others responsible for defining and responding to the public discourse remain reluctant to identify racism as a root cause of racial health inequities. In this conceptual report, the third in a Series on equity and equality in health in the USA, we use a contemporary and historical perspective to discuss research and interventions that grapple with the implications of what is known as structural racism on population health and health inequities. Structural racism refers to the totality of ways in which societies foster racial discrimination through mutually reinforcing systems of housing, education, employment, earnings, benefits, credit, media, health care, and criminal justice. These patterns and practices in turn reinforce discriminatory beliefs, values, and distribution of resources. We argue that a focus on structural racism offers a concrete, feasible, and promising approach towards advancing health equity and improving population health. Copyright © 2017 Elsevier Ltd. All rights reserved.

Engaging youth in food activism in New York City: lessons learned from a youth organization, health department, and university partnership.

Science.gov (United States)

Tsui, Emma; Bylander, Kim; Cho, Milyoung; Maybank, Aletha; Freudenberg, Nicholas

2012-10-01

Research indicates that insufficient emphasis on community collaboration and partnership can thwart innovative community-driven work on the social determinants of health by local health departments. Appreciating the importance of enhancing community participation, the New York City Department of Health and Mental Hygiene (DOHMH) helped lead the development of the Health Equity Project (HEP), an intervention aimed at increasing the capacity of urban youth to identify and take action to reduce food-related health disparities. DOHMH partnered with the City University of New York School of Public Health and several local youth organizations to design and implement the intervention. HEP was conducted with 373 young people in 17 cohorts at 14 unique sites: six in Brooklyn, six in the Bronx, and two in Harlem. Partnered youth organizations hosted three stages of work: interactive workshops on neighborhood health disparities, food environments, and health outcomes; food-focused research projects conducted by youth; and small-scale action projects designed to change local food environments. Through these activities, HEP appears to have been successful in introducing youth to the social, economic, and political factors that shape food environments and to the influence of food on health outcomes. The intervention was also somewhat successful in providing youth with community-based participatory research skills and engaging them in documenting and then acting to change their neighborhood food environments. In the short term, we are unable to assess how successful HEP has been in building young leaders who will continue to engage in this kind of activism, but we suspect that more extended interactions would be needed to achieve this more ambitious goal. Experiences at these sites suggest that youth organizations with a demonstrated capacity to engage youth in community service or activism and a commitment to improving food or other health-promoting community resources make the

Young smokers' narratives: public health, disadvantage and structural violence.

Science.gov (United States)

Lewis, Sue; Russell, Andrew

2013-06-01

This research article on youth smoking in disadvantaged communities is the product of a qualitative study to understand the issues faced by young smokers--and those trying not to be smokers--in such communities. Environmental factors and peer influence are widely recognised influences on adolescents' take-up and continuation of smoking but less is known about whether, what, how and why circumstances in disadvantaged communities affect young people's pathways towards and away from smoking. Focusing on a youth club in a disadvantaged neighbourhood in the North East of England, narratives about young people's relationships with tobacco provide an ethnographically rich, thick description of the experiences of a group that is too often easily ignored. We argue that young people are caught between competing domains that together exert a form of structural violence. These are, first, the economic and political structures that have overseen de-industrialisation; second, the media structures that create desire for what they cannot afford; third the structures of international organised crime that conspire to provide them with the means to consume from which 'legitimate' structures effectively exclude them. Rather than expecting young people to comply with the health imperative, interventions need to bridge issues of agency and critical consciousness, which structural violence otherwise insidiously erodes. © 2013 The Authors. Sociology of Health & Illness © 2013 Foundation for the Sociology of Health & Illness/John Wiley & Sons Ltd.

42 CFR 57.316 - What additional Department regulations apply to schools?

Science.gov (United States)

2010-10-01

... schools? 57.316 Section 57.316 Public Health PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN... STUDENT LOANS Nursing Student Loans § 57.316 What additional Department regulations apply to schools? Participating schools are advised that in addition to complying with the terms and conditions of these...

COGME 1995 Physician Workforce Funding Recommendations for Department of Health and Human Services' Programs. Council on Graduate Medical Education, 7th Report.

Science.gov (United States)

Council on Graduate Medical Education.

This report presents specific recommendations to the Department of Health and Human Services and Congress from the Council on Graduate Medical Education that address Medicare's direct and indirect graduate medical education (GME) payments and the monies allocated by the Public Health Service that is targeted toward physician education and primary…

Designing a clinical dashboard to fill information gaps in the emergency department.

Science.gov (United States)

Swartz, Jordan L; Cimino, James J; Fred, Matthew R; Green, Robert A; Vawdrey, David K

2014-01-01

Data fragmentation within electronic health records causes gaps in the information readily available to clinicians. We investigated the information needs of emergency medicine clinicians in order to design an electronic dashboard to fill information gaps in the emergency department. An online survey was distributed to all emergency medicine physicians at a large, urban academic medical center. The survey response rate was 48% (52/109). The clinical information items reported to be most helpful while caring for patients in the emergency department were vital signs, electrocardiogram (ECG) reports, previous discharge summaries, and previous lab results. Brief structured interviews were also conducted with 18 clinicians during their shifts in the emergency department. From the interviews, three themes emerged: 1) difficulty accessing vital signs, 2) difficulty accessing point-of-care tests, and 3) difficulty comparing the current ECG with the previous ECG. An emergency medicine clinical dashboard was developed to address these difficulties.

Financing reform and structural change in the health services industry.

Science.gov (United States)

Higgins, C W; Phillips, B U

1986-08-01

This paper reviews the major trends in financing reform, emphasizing their impact on those characteristics of the market for health services that economists have viewed as monopolistic, and discusses the implications of structural change for the allied health professions. Hopefully, by understanding the fundamental forces of change and responding to uncertainty with flexibility and imagination, the allied health professions can capitalize on the opportunities afforded by structural change. Overall, these trends should result in the long-term outlook for use of allied health services to increase at an average annual rate of 9% to 10%. Allied health professionals may also witness an increase in independent practice opportunities. Finally, redistribution of jobs will likely occur in favor of outpatient facilities, home health agencies, and nontraditional settings. This in turn will have an impact on allied health education, which will need to adapt to these types of reforms.

U.S. Department of energy worker health risk evaluation methodology for assessing risks associated with environmental restoration and waste management

International Nuclear Information System (INIS)

Blaylock, B.P.; Legg, J.; Travis, C.C.; Scofield, P.A.

1995-06-01

This document describes a worker health risk evaluation methodology for assessing risks associated with Environmental Restoration (ER) and Waste Management (WM). The methodology is appropriate for estimating worker risks across the Department of Energy (DOE) Complex at both programmatic and site-specific levels. This document supports the worker health risk methodology used to perform the human health risk assessment portion of the DOE Programmatic Environmental Impact Statement (PEIS) although it has applications beyond the PEIS, such as installation-wide worker risk assessments, screening-level assessments, and site-specific assessments

U.S. Department of Energy worker health risk evaluation methodology for assessing risks associated with environmental restoration and waste management

Energy Technology Data Exchange (ETDEWEB)

Blaylock, B.P.; Legg, J.; Travis, C.C. [Oak Ridge National Lab., TN (United States). Center for Risk Management; Simek, M.A.; Sutherland, J. [Univ. of Tennessee, Knoxville, TN (United States); Scofield, P.A. [Office of Environmental Compliance and Documentation (United States)

1995-06-01

This document describes a worker health risk evaluation methodology for assessing risks associated with Environmental Restoration (ER) and Waste Management (WM). The methodology is appropriate for estimating worker risks across the Department of Energy (DOE) Complex at both programmatic and site-specific levels. This document supports the worker health risk methodology used to perform the human health risk assessment portion of the DOE Programmatic Environmental Impact Statement (PEIS) although it has applications beyond the PEIS, such as installation-wide worker risk assessments, screening-level assessments, and site-specific assessments.

75 FR 9012 - Privacy Act of 1974, as Amended; Computer Matching Program (SSA/U.S. Department of Health and...

Science.gov (United States)

2010-02-26

... INFORMATION: A. General The Computer Matching and Privacy Protection Act of 1988 (Pub. L. 100-503), amended... SOCIAL SECURITY ADMINISTRATION [Docket No. SSA-2009-0052] Privacy Act of 1974, as Amended; Computer Matching Program (SSA/ U.S. Department of Health and Human Services (HHS), Administration for...

Mapping the Zambian prison health system: An analysis of key structural determinants.

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Topp, Stephanie M; Moonga, Clement N; Luo, Nkandu; Kaingu, Michael; Chileshe, Chisela; Magwende, George; Henostroza, German

2017-07-01

Health and health service access in Zambian prisons are in a state of 'chronic emergency'. This study aimed to identify major structural barriers to strengthening the prison health systems. A case-based analysis drew on key informant interviews (n = 7), memos generated during workshops (n = 4) document review and investigator experience. Structural determinants were defined as national or macro-level contextual and material factors directly or indirectly influencing prison health services. The analysis revealed that despite an favourable legal framework, four major and intersecting structural factors undermined the Zambian prison health system. Lack of health financing was a central and underlying challenge. Weak health governance due to an undermanned prisons health directorate impeded planning, inter-sectoral coordination, and recruitment and retention of human resources for health. Outdated prison infrastructure simultaneously contributed to high rates of preventable disease related to overcrowding and lack of basic hygiene. These findings flag the need for policy and administrative reform to establish strong mechanisms for domestic prison health financing and enable proactive prison health governance, planning and coordination.

Information seeking for making evidence-informed decisions: a social network analysis on the staff of a public health department in Canada

Directory of Open Access Journals (Sweden)

Yousefi-Nooraie Reza

2012-05-01

Full Text Available Abstract Background Social network analysis is an approach to study the interactions and exchange of resources among people. It can help understanding the underlying structural and behavioral complexities that influence the process of capacity building towards evidence-informed decision making. A social network analysis was conducted to understand if and how the staff of a public health department in Ontario turn to peers to get help incorporating research evidence into practice. Methods The staff were invited to respond to an online questionnaire inquiring about information seeking behavior, identification of colleague expertise, and friendship status. Three networks were developed based on the 170 participants. Overall shape, key indices, the most central people and brokers, and their characteristics were identified. Results The network analysis showed a low density and localized information-seeking network. Inter-personal connections were mainly clustered by organizational divisions; and people tended to limit information-seeking connections to a handful of peers in their division. However, recognition of expertise and friendship networks showed more cross-divisional connections. Members of the office of the Medical Officer of Health were located at the heart of the department, bridging across divisions. A small group of professional consultants and middle managers were the most-central staff in the network, also connecting their divisions to the center of the information-seeking network. In each division, there were some locally central staff, mainly practitioners, who connected their neighboring peers; but they were not necessarily connected to other experts or managers. Conclusions The methods of social network analysis were useful in providing a systems approach to understand how knowledge might flow in an organization. The findings of this study can be used to identify early adopters of knowledge translation interventions, forming

Information seeking for making evidence-informed decisions: a social network analysis on the staff of a public health department in Canada

Science.gov (United States)

2012-01-01

Background Social network analysis is an approach to study the interactions and exchange of resources among people. It can help understanding the underlying structural and behavioral complexities that influence the process of capacity building towards evidence-informed decision making. A social network analysis was conducted to understand if and how the staff of a public health department in Ontario turn to peers to get help incorporating research evidence into practice. Methods The staff were invited to respond to an online questionnaire inquiring about information seeking behavior, identification of colleague expertise, and friendship status. Three networks were developed based on the 170 participants. Overall shape, key indices, the most central people and brokers, and their characteristics were identified. Results The network analysis showed a low density and localized information-seeking network. Inter-personal connections were mainly clustered by organizational divisions; and people tended to limit information-seeking connections to a handful of peers in their division. However, recognition of expertise and friendship networks showed more cross-divisional connections. Members of the office of the Medical Officer of Health were located at the heart of the department, bridging across divisions. A small group of professional consultants and middle managers were the most-central staff in the network, also connecting their divisions to the center of the information-seeking network. In each division, there were some locally central staff, mainly practitioners, who connected their neighboring peers; but they were not necessarily connected to other experts or managers. Conclusions The methods of social network analysis were useful in providing a systems approach to understand how knowledge might flow in an organization. The findings of this study can be used to identify early adopters of knowledge translation interventions, forming Communities of Practice, and

Prevalence and risk factors of workplace violence against health care workers in emergency department in Ismailia, Egypt.

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Abdellah, Rasha Farouk; Salama, Khaled Morsy

2017-01-01

Emergency department is one of the high-risk areas, where violence against health care workers (HCWs) is a prevalent and serious problem. Violence has negative effects on HCWs, and therefore on the quality of care provided in emergency department. This study aimed to determine the prevalence, types, sources and risk factors of violence reported by HCWs in emergency department. A cross-sectional study was conducted using a standardized questionnaire developed by the WHO. One hundred thirty four questionnaires were included in this study (94.4% response rate). WPV was reported by 59.7% of HCWs. Verbal violence was the most reported (58.2%), compared to physical violence (15.7%). The most reported reasons for violence were waiting time and that patient and family expectations not being met. Only 29.5% of HCWs who experienced verbal violence and 23.8% of who experienced physical violence reported it to hospital authority. About 75% of HCW thought that work place violence could be prevented, and about 60% said that no action was taken against the attacker by hospital authority. Violence against HCWs in emergency department is a significant issue that cannot be ignored. There are multiple reasons. The key point in dealing with the problem is to treat its specific causes.

Telemental health evaluations enhance access and efficiency in a critical access hospital emergency department.

Science.gov (United States)

Southard, Erik P; Neufeld, Jonathan D; Laws, Stephanie

2014-07-01

Mentally ill patients in crisis presenting to critical access hospital emergency rooms often face exorbitant wait times to be evaluated by a trained mental health provider. Patients may be discharged from the hospital before receiving an evaluation or boarded in a hospital bed for observation, reducing quality and increasing costs. This study examined the effectiveness of an emergency telemental health evaluation service implemented in a rural hospital emergency room. Retrospective data collection was implemented to consider patients presenting to the emergency room for 212 days prior to telemedicine interventions and for 184 days after. The study compared measures of time to treatment, length of stay (regardless of inpatient or outpatient status), and door-to-consult time. There were 24 patients seen before telemedicine was implemented and 38 seen using telemedicine. All patients had a mental health evaluation ordered by a physician and completed by a mental health specialist. Significant reductions in all three time measures were observed. Mean and median times to consult were reduced from 16.2 h (standard deviation=13.2 h) and 14.2 h, respectively, to 5.4 h (standard deviation =6.4 h) and 2.6 h. Similar reductions in length of stay and door-to-consult times were observed. By t tests, use of telemedicine was associated with a statistically significant reduction in all three outcome measures. Telemedicine appears to be an effective intervention for mentally ill patients by providing more timely access to mental health evaluations in rural hospital emergency departments.

HEALTH DEPARTMENT REPORTS AND NOTES: TO STATE AND MUNICIPAL HEALTH OFFICERS.

Science.gov (United States)

1913-11-01

This new division of the Journal is specially designed to be of use to active Health Officers of the countries represented in the American Public Health Association. It will be unable to serve its true function unless the Health Officers are willing to coöperate by sending to the Journal copies of their reports, bulletins, new ordinances and personal information which will be of general interest. Furthermore it would be distinctly desirable if communications on subjects of general interest are submitted for publication in this division of the Journal. The management will further welcome any suggestions from Health Officers for the improvement of this division. All communications should be addressed to Selskar M. Gunn, Managing Editor, American Journal of Public Health, 755 Boylston St., Boston, Mass.

A Simple Demonstration of Concrete Structural Health Monitoring Framework

Energy Technology Data Exchange (ETDEWEB)

Mahadevan, Sankaran [Idaho National Lab. (INL), Idaho Falls, ID (United States); Agarwal, Vivek [Idaho National Lab. (INL), Idaho Falls, ID (United States); Cai, Guowei [Idaho National Lab. (INL), Idaho Falls, ID (United States); Nath, Paromita [Idaho National Lab. (INL), Idaho Falls, ID (United States); Bao, Yanqing [Idaho National Lab. (INL), Idaho Falls, ID (United States); Bru Brea, Jose Maria [Idaho National Lab. (INL), Idaho Falls, ID (United States); Koester, David [Idaho National Lab. (INL), Idaho Falls, ID (United States); Adams, Douglas [Idaho National Lab. (INL), Idaho Falls, ID (United States); Kosson, David [Idaho National Lab. (INL), Idaho Falls, ID (United States)

2015-03-01

Assessment and management of aging concrete structures in nuclear power plants require a more systematic approach than simple reliance on existing code margins of safety. Structural health monitoring of concrete structures aims to understand the current health condition of a structure based on heterogeneous measurements to produce high confidence actionable information regarding structural integrity that supports operational and maintenance decisions. This ongoing research project is seeking to develop a probabilistic framework for health diagnosis and prognosis of aging concrete structures in a nuclear power plant subjected to physical, chemical, environment, and mechanical degradation. The proposed framework consists of four elements—damage modeling, monitoring, data analytics, and uncertainty quantification. This report describes a proof-of-concept example on a small concrete slab subjected to a freeze-thaw experiment that explores techniques in each of the four elements of the framework and their integration. An experimental set-up at Vanderbilt University’s Laboratory for Systems Integrity and Reliability is used to research effective combination of full-field techniques that include infrared thermography, digital image correlation, and ultrasonic measurement. The measured data are linked to the probabilistic framework: the thermography, digital image correlation data, and ultrasonic measurement data are used for Bayesian calibration of model parameters, for diagnosis of damage, and for prognosis of future damage. The proof-of-concept demonstration presented in this report highlights the significance of each element of the framework and their integration.

'Oral health is not my department'. Perceptions of elderly patients' oral health by general medical practitioners in primary health care centres: a qualitative interview study.

Science.gov (United States)

Andersson, Kerstin; Furhoff, Anna-Karin; Nordenram, Gunilla; Wårdh, Inger

2007-03-01

The purpose of this study was to explore general medical practitioners' (GPs) perceptions of the oral health of their elderly patients. The design was a qualitative study based on individual in-depth interviews with GPs. The criterion for inclusion in the study was that the GP was a specialist in family medicine working in a primary health care centre (PHCC:s) in the county of Stockholm. The participants took part in the study after informed consent. Eleven GPs were interviewed. The interview started with semi-structured questions about the respondents' clinical presentation of their elderly patients', e.g. medication, medical treatment and socioeconomic status. The interview concluded with questions about the respondents' experiences of and perceptions of the oral health of their patients. This process started with the first interview and proceeded with successive interviews until no new relevant information was forthcoming. The initial semi-structured part of the interview guide was analysed for content with special reference to descriptive answers. The final open questions were analysed by a method inspired by grounded theory (GT) and comprised three stages: open coding, axial coding and selective coding. In the GT influenced analysis process, three categories, health perspective, working conditions and cultural differences, each in turn containing subcategories, were identified and labelled. The most significant category, cultural differences, was identified as the core category, explaining the central meaning of the respondents' perceptions of the oral health of their elderly patients. The GPs in this study showed little or no awareness of the oral health of their elderly patients. The interviews disclosed several contributing factors. Barriers to closer integration of oral and general health in the elderly were identified. There existed a cultural gap between the disciplines of dentistry and medicine, which does not enhance and may be detrimental to the

The health terminology project glossaries` structure

Directory of Open Access Journals (Sweden)

Sátia Marini

2014-04-01

Full Text Available Current paper was motivated by a Master´s degree in Translation Studies on one of the glossaries of the Health Terminology Project (PTS of the Ministry of Health (MS inBrazil, by which the products developed by the project were analyzed. The authors would like to forward their experience earned from the development of these instruments and from the evolution of the glossary´s layout and structure. Although within the same institution, each instrument is made suitable to the specific purpose of each area and the terminology project accumulates experience by the constant improvement of previously developed glossaries (adding new terms; providing the equivalent word in other languages for terms already defined and by the establishment of new ones. The evolution of the structure of the glossaries was qualitatively analyzed; remarks on the types of cross references were made; a quantitative survey of their main features was undertaken. Finally, the importance of this type of work should be underscored either within the government, or in the academy or in private companies, for the sharing of intellectual knowledge.

Structural health monitoring 2012. Proceedings. Vol. 1

International Nuclear Information System (INIS)

Boller, Christian

2012-01-01

Structural Health Monitoring (SHM) is an emerging technology, dealing with the development and implementation of techniques and systems where monitoring, inspection and damage detection become an integral part of structures and thus a matter of automation. It further merges with a variety of techniques related to diagnostics and prognostics. SHM emerged from the field of smart structures and laterally encompasses disciplines such as structural dynamics, materials and structures, fatigue and fracture, non-destructive testing and evaluation, sensors and actuators, microelectronics, signal processing and much more. To be effective in the development of SHM systems, a multidisciplinary approach is therefore required. Without this global view it will be difficult for engineers to holistically manage the operation of an engineering structure through its life cycle in the future and to generate new breakthroughs in structural engineering. The first volume of the proceedings contains topics dealing with physics, materials and sensors. Five of the contributions are separately analyzed for the ENERGY database.

[ISO 9001 certification of innovation and clinical research departments: Extending the scope of health assessment].

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Sambou, C; Guillemaut, S; Morelle, M; Achache, A; Le Corroller, A-G; Perol, D; Perrier, L

2017-04-01

The International organization for standardization (ISO) is the world leader in providing industrial and commercial standards and certifications. Beyond medical devices, four French clinical research and innovation departments have received an ISO 9001 certification (the standard for quality management). Simultaneously, medico-economic studies have become increasingly important in the public decision process. Using the clinical research and innovation department from the Léon-Bérard Cancer Center as an example, the purpose of this article is to show how the scope of the ISO 9001 certification has been extended to cover medico-economic studies. All of the processes, procedures, operating modes, documents, and indicators used by the clinical research and innovation department of the Léon-Bérard center were investigated. Literature searches were conducted using Medline keywords. The recommendations from the French national authority for health and other organizations, such as the International society for pharmacoeconomics and outcomes research (ISPOR), were also considered, as well as the recommendations of the General inspectorate of social affairs. In accordance with the national and international recommendations, two procedures were created and four procedures were revised at this center. Five indicators of quality and an evaluation chart were developed. By adopting the ISO 9001 certification into its medico-economic studies, the clinical research and innovation department of the Léon-Bérard center has used an innovative approach in the context of the growing importance of economic studies in decision-making. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Perception of Workforce Skills Needed Among Public Health Professionals in Local Health Departments: Staff Versus Top Executives.

Science.gov (United States)

Ye, Jiali; Leep, Carolyn; Robin, Nathalie; Newman, Sarah

2015-01-01

To examine how top executives and staff from local health departments (LHDs) perceive the importance of various types of workforce skills, and to assess the differences in the perception of the importance of these workforce skills between these 2 groups and among LHDs serving different-sized jurisdictions. Data for this study were drawn from the 2014 Public Health Workforce Interests and Needs Survey (PH WINS) and the 2015 Forces of Change survey. While PH WINS collected data from LHD staff, the Forces of Change survey was administered to LHD top executives. Ratings of perceived importance of workforce skills from LHD staff and top executives were compared. Overall, LHD workers at all levels believe that core competencies are important for their jobs. The perceived importance of these skills differed somewhat across supervisory level (nonsupervisory staff vs supervisory staff vs top executives). Communication was rated as one of the most important skills by all groups. For top executives, ensuring that programs are managed within budget constraints was the most important skill for their employees. However, this skill was rated much lower among staff. Policy development skills were rated to be of lowest importance by LHD leaders and staff. LHD leaders and staff agree on the relative importance of some competencies, although they also show some clear differences in the relative importance that they place on other competencies. It is essential to strengthen the communication between public health leaders and staff regarding the importance of workforce skills. More investigation is needed to assess whether and how gaps in staff competencies are addressed in the workforce development strategies.

Study of radiation protection at the Department of Radiology and Toxicology, Faculty of Health and Social Studies of University of South Bohemia

International Nuclear Information System (INIS)

Singer, J.; Kuna, P.

2005-01-01

In this paper authors deals with study of radiation protection at the Department of Radiology and Toxicology, Faculty of Health and Social Studies of University of South Bohemia. This department providing awareness of the concept of radiation protection in persons of different professions, who will come into contact with ionizing radiation sources. These are e.g. specialists in health services, employees in defectoscopy and industry, members of police and fire fighting services, etc. For these persons, the Department of Radiology and Toxicology was established at the Faculty of Health and Social Studies of University of South Bohemia that offer their relevant education in theory and practice of radiation problems that are accredited in following direction: bachelor study in Applied radiobiology and toxicology; bachelor study in Biophysics and medical techniques; and master study in Crisis radiobiology and toxicology. These specified subjects are arranged in such a way that the student can be introduced into the teaching text based on the concept and history of relevant problems, for example: radiation physics, ionizing radiation dosimetry, clinical dosimetry. In accordance with a survey implemented in the field of health services it was found that there is a lack of people with technical education in the field of radiation at the level of Bachelors. These requirements are most properly adhered to by the specialty 'Radiological Technician' that is currently being planned at the Faculty of Health and Social Studies and that will be subjected to the accreditation process. The specialty 'Radiological Assistant' was formerly accredited at the faculty, whose activity is different from that of the 'Radiological Technician', as defined by Law of the Czech Republic No. 96/2004 Sb

Emergency Department Telepsychiatry Service Model for a Rural Regional Health System: The First Steps.

Science.gov (United States)

Meyer, James D; McKean, Alastair J S; Blegen, Rebecca N; Demaerschalk, Bart M

2018-05-09

Emergency departments (EDs) have recognized an increasing number of patients presenting with mental health (MH) concerns. This trend imposes greater demands upon EDs already operating at capacity. Many ED providers do not feel they are optimally prepared to provide the necessary MH care. One consideration in response to this dilemma is to use advanced telemedicine technology for psychiatric consultation. We examined a rural- and community-based health system operating 21 EDs, none of which has direct access to psychiatric consultation. Dedicated beds to MH range from zero (in EDs with only 3 beds) to 6 (in an ED with 38 beds). We conducted a needs assessment of this health system. This included a survey of emergency room providers with a 67% response rate and site visits to directly observe patient flow and communication with ED staff. A visioning workshop provided input from ED staff. Data were also obtained, which reflected ED admissions for the year 2015. The data provide a summary of provider concerns, a summary of MH presentations and diagnosis, and age groupings. The data also provide a time when most MH concerns present to the ED. Based upon these results, a proposed model for delivering comprehensive regional emergency telepsychiatry and behavioral health services is proposed. Emergency telepsychiatry services may be a tenable solution for addressing the shortage of psychiatric consultation to EDs in light of increasing demand for MH treatment in the ED.

The Implementation Analysis of Intellectual Capital to Department Performance in Padang State University

Directory of Open Access Journals (Sweden)

Sulastri sulastri

2015-09-01

Full Text Available The purpose of this research was to observe the effect of the age of the organization department in Padang State University on performance through human capital, structural capital and relational capital. The sample is all of department in Padang State University, which is 33 departments. The data were collected through questionnaires and analyzed using partial least squares (PLS. The results showed that the age of the department is not direct and significant impact on the department performance. While the age departments significantly affect the department's human capital, structural capital and relational capital. Furthermore, the human capital, structural capital and relational capital significantly positive affect the department performance. This research failed to prove the existence of variable human capital, structural capital and relational capital as a mediating variable but serves as an intervening variable. Its means that age of department performance cannot determine performance without increasing the human capital, structural capital and relational capital.

Public Swimming Pools | Florida Department of Health

Science.gov (United States)

Illness Disease Reporting and Surveillance Bureau of Public Health Laboratories Environmental Health Air Air Monitoring Carbon Monoxide Indoor Air Quality Mold Radon Water Aquatic Toxins Beach Water Quality purification, testing, treatment, and disinfection procedures. To ensure that the pool technicians are

Structural and contextual dimensions of Iranian primary health care system at local level.

Science.gov (United States)

Zanganeh Baygi, Mehdi; Seyedin, Hesam; Salehi, Masoud; Jafari Sirizi, Mehdi

2015-01-01

In recent years, family physician plan was established as the main strategy of health system in Iran, while organizational structure of the primary health care system has remained the same as thirty years ago. This study was performed to illustrate structural and contextual dimensions of organizational structure and relationship between them in Iranian primary health care system at local level. A cross-sectional quantitative study was conducted from January to June 2013, during which 121 questionnaires were distributed among senior and junior managers of city health centers at Medical Sciences universities in Iran. Validity of the questionnaire was confirmed by experts (CVI = 0.089 and CVR more than 0.85) and Cronbach α was utilized for reliability (α = 0.904). We used multistage sampling method in this study and analysis of the data was performed by SPSS software using different tests. Local level of primary health care system in Iran had mechanical structure, but in contextual dimensions the results showed different types. There was a significant relationship between structural and contextual dimensions (r = 0.642, P value structural dimensions. Because of the changes in goals and strategies of Iranian health system in recent years, it is urgently recommended to reform the current structure to increase efficiency and effectiveness of the system.

Nuclear Safety Research Department annual report 2000

International Nuclear Information System (INIS)

Majborn, B.; Damkjaer, A.; Nielsen, S.P.; Nonboel, E.

2001-08-01

The report presents a summary of the work of the Nuclear Safety Research Department in 2000. The department's research and development activities were organized in two research programmes: 'Radiation Protection and Reactor Safety' and 'Radioecology and Tracer Studies'. In addition the department was responsible for the tasks 'Applied Health Physics and Emergency Preparedness', 'Dosimetry', 'Environmental Monitoring', and Irradiation and Isotope Services'. Lists of publications, committee memberships and staff members are included. (au)

Dr Mario Raviglione, director of the Stop TB Department World Health Organization. Interview by Christo Hall.

Science.gov (United States)

Raviglione, Mario

2012-03-01

Tuberculosis (TB) is a very global disease; there are over 9 million new incidences of TB every year with the vast majority of cases emerging in the developing world. As one of three major diseases associated with poverty it affects the areas where poverty is most prevalent, notably Asia and Africa. While the incidence rate has been slowly declining in the developed world it continues to pose a major health threat to even the most developed nations. To demonstrate the global, and persistent, nature of TB we asked Dr Mario Raviglione, Director of the World Health Organization's Stop TB Department to provide an analysis on the current TB situation in the United Kingdom and comment on what measures should be taken to alleviate the issue of TB in one of the world's richest countries.

Implementing optical fibres for the structural health monitoring of composite patch repaired structures

DEFF Research Database (Denmark)

Karatzas, Vasileios; Kotsidis, Elias A.; Tsouvalis, Nicholas G.

2017-01-01

Structural health monitoring is increasingly being implemented to improve the level of safety of structures and to reduce inspection and repair costs by allowing for correct planning of these actions, if needed. Composite patch repairing presents an appealing alternative to traditional repair...... methods as it enables the reduction of closedown time and the mitigation of complications associated with traditional repair methods. As reinforcement with the use of composite patches is predominantly performed at defected structures, the urge to monitor the performance of the repair becomes even greater...

Health sociology from post-structuralism to the new materialisms.

Science.gov (United States)

Fox, Nick J

2016-01-01

The article reviews the impact of post-structuralism and postmodern social theory upon health sociology during the past 20 years. It then addresses the emergence of new materialist perspectives, which to an extent build upon insights of post-structuralist concerning power, but mark a turn away from a textual or linguistic focus to address the range of materialities that affect health, illness and health care. I conclude by assessing the impact of these movements for health sociology. © The Author(s) 2015.

Family Structure Changes and Children's Health, Behavior, and Educational Outcomes

DEFF Research Database (Denmark)

Rasmussen, Astrid Würtz

More and more children do not grow up in traditional nuclear families. Instead, they grow up in single-parent households or in families with a step-parent. Hence, it is important to improve our understanding of the impact of "shocks" in family structure due to parental relationship dissolution...... on children. In this study I empirically test whether children are traumatized both in the short and the long run by shocks in the family structure during childhood. I focus on educational, behavioral, and health outcomes. A population sample of Danish children born in January to May 1985 is used...... for the analysis. The empirical cross-sectional analysis indicates a negative relation between the number of family structure changes and children.s health, behavior, and educational outcomes. These results are con.rmed by a differences-in-differences analysis of health outcomes. This suggests...

Neighborhood Disadvantage, Residential Segregation, and Beyond-Lessons for Studying Structural Racism and Health.

Science.gov (United States)

Riley, Alicia R

2018-04-01

A recent surge of interest in identifying the health effects of structural racism has coincided with the ongoing attention to neighborhood effects in both epidemiology and sociology. Mindful of these currents in the literature, it makes sense that we are seeing an emergent tendency in health disparities research to operationalize structural racism as either neighborhood disadvantage or racial residential segregation. This review essay synthesizes findings on the relevance of neighborhood disadvantage and residential segregation to the study of structural racism and health. It then draws on recent literature to propose four lessons for moving beyond traditional neighborhood effects approaches in the study of structural racism and health. These lessons are (1) to shift the focus of research from census tracts to theoretically meaningful units of analysis, (2) to leverage historic and geographic variation in race relations, (3) to combine data from multiple sources, and (4) to challenge normative framing that aims to explain away racial health disparities without discussing racism or racial hierarchy. The author concludes that research on the health effects of structural racism should go beyond traditional neighborhood effects approaches if it is to guide intervention to reduce racial and ethnic health disparities.

Assessing the value of structural health monitoring

DEFF Research Database (Denmark)

Thöns, S.; Faber, Michael Havbro

2013-01-01

Structural Health Monitoring (SHM) systems are designed for assisting owners and operators with information and forecasts concerning the fitness for purpose of structures and building systems. The benefit associated with the implementation of SHM may in some cases be intuitively anticipated...... as their responses and performances over their life-cycle. In addition, the quality of monitoring and the performance of possible remedial actions triggered by monitoring results are modeled probabilistically.The consequences accounted for, in principle include all consequences associated with the performance...

Alaska Department of Health and Social Services

Science.gov (United States)

marijuana means for Alaska and you. Careline: 1-877-266-HELP (4357) Alaska's Tobacco Quitline Learn the Twitter Find us on Facebook Quicklinks Alaska Opioid Policy Task Force "Spice" Synthetic Marijuana Health Information Alaska State Plan for Senior Services, FY 2016-FY 2019 Get health insurance at

Health Monitoring of Composite Material Structures using a Vibrometry Technique

Science.gov (United States)

Schulz, Mark J.

1997-01-01

Large composite material structures such as aircraft and Reusable Launch Vehicles (RLVS) operate in severe environments comprised of vehicle dynamic loads, aerodynamic loads, engine vibration, foreign object impact, lightning strikes, corrosion, and moisture absorption. These structures are susceptible to damage such as delamination, fiber breaking/pullout, matrix cracking, and hygrothermal strain. To ensure human safety and load-bearing integrity, these structures must be inspected to detect and locate often invisible damage and faults before becoming catastrophic. Moreover, nearly all future structures will need some type of in-service inspection technique to increase their useful life and reduce maintenance and overall costs. Possible techniques for monitoring the health and indicating damage on composite structures include: c-scan, thermography, acoustic emissions using piezoceramic actuators or fiber-optic wires with gratings, laser ultrasound, shearography, holography, x-ray, and others. These techniques have limitations in detecting damage that is beneath the surface of the structure, far away from a sensor location, or during operation of the vehicle. The objective of this project is to develop a more global method for damage detection that is based on structural dynamics principles, and can inspect for damage when the structure is subjected to vibratory loads to expose faults that may not be evident by static inspection. A Transmittance Function Monitoring (TFM) method is being developed in this project for ground-based inspection and operational health monitoring of large composite structures as a RLV. A comparison of the features of existing health monitoring approaches and the proposed TFM method is given.

Goals and organisational structure of the movement for global mental health.

Science.gov (United States)

Minas, Harry; Wright, Alexandra; Kakuma, Ritsuko

2014-01-01

The Movement for Global Mental Health (MGMH), established in 2008, is in a period of transition, as is the field of global mental health. The transfer of Secretariat functions from the Centre for International Mental Health to the Public Health Foundation of India was a suitable time to reflect on the goals of MGMH and on the form of organisational structure that would best serve the organisation in its efforts to achieve its goals. An online survey was sent to the 4,000 registered members of MGMH seeking the views of the membership on both the goals of MGMH and on the preferred form of organisational structure. There was near unanimous (95%) agreement with the MGMH goals as stated at the time of the survey. The current form of organisation of MGMH, a loose network of individuals and organisations registered through the MGMH website, was the least preferred (29.9%) form of organisation for the future of MGMH. More than two thirds (70.1%) of respondents would prefer a formal legal structure, with 60% of this group favouring a Charitable Organisation structure and 40% preferring an international Association structure. The response rate (7%) was too small and too skewed (predominantly academics and health professionals from high income countries) to allow any clear conclusions to be drawn from the survey. However, both the fact that responses were too few and skewed and the preferences expressed by respondents raise issues for careful consideration by the current MGMH Secretariat. The global mental health field and MGMH are in a time of transition. The move to the new secretariat is an opportunity for systematic consideration of the organisational structure and governance arrangements that will best serve the goals of MGMH.

Automatic Sensor-Fault Detection System for Comprehensive Structural Health Monitoring System

National Research Council Canada - National Science Library

Chan, Hian-Leng; Zhang, Chang; Qing, Peter X; Ooi, Teng K; Marotta, Steve A

2005-01-01

Structural health monitoring systems are viewed as viable means to reduce life-cycle costs, increase structural reliability, and extend the operational hours for a wide variety of composite structures...

Prognostics Design Solutions in Structural Health Monitoring Systems

Data.gov (United States)

National Aeronautics and Space Administration — The chapter describes the application of prognostic techniques to the domain of structural health and demonstrates the efficacy of the methods using fatigue data...

The department of energy's Russian health studies program

International Nuclear Information System (INIS)

2017-01-01

Recognized for conducting cutting edge science in the field of radiation health effects research, the Department of Energy's (DOE) Russian Health Studies Program has continued to generate excitement and enthusiasm throughout its 22-year quest to assess worker and public health risks from radiation exposure resulting from nuclear weapons production activities in the former Soviet Union. The three goals of the program are to: (1) Clarify the relationship between health effects and chronic low-to-medium dose radiation exposure, (2) Estimate the cancer risks from exposure to gamma, neutron and alpha radiation, (3) Provide information to the national and international organizations that determine radiation protection standards and practices. Pursuant to the Joint Coordinating Committee for Radiation Effects Research (JCCRER) Agreement, it is possible to study the effects of radiation at multiple nuclear weapons production facilities throughout Russia. To date, however, the research has focused on: (1) current and former workers from the Mayak Production Association (Mayak), the first Russian nuclear weapons production facility in Ozersk, Russia and (2) current and past residents along the Techa River who were impacted from airborne and waterborne radioactive releases from Mayak. Mayak is comparable to DOE's Hanford facility in Richland, Washington. Mayak workers and Techa River residents received protracted exposures at low-to-moderate dose rates to both internal and external ionizing radiation. Because for over 50 years the Russian Government collected and stored data on Mayak workers and residents in surrounding communities along the Techa River exposed to external and internal radiation, there was a large amount of exposure, workplace and clinical data suitable for conducting epidemiological studies. The Russian Health Studies Program has evolved through four phases since its inception in 1994: (1) coordinating, planning and building infrastructure and

Cigarette smoke chemistry market maps under Massachusetts Department of Public Health smoking conditions.

Science.gov (United States)

Morton, Michael J; Laffoon, Susan W

2008-06-01

This study extends the market mapping concept introduced by Counts et al. (Counts, M.E., Hsu, F.S., Tewes, F.J., 2006. Development of a commercial cigarette "market map" comparison methodology for evaluating new or non-conventional cigarettes. Regul. Toxicol. Pharmacol. 46, 225-242) to include both temporal cigarette and testing variation and also machine smoking with more intense puffing parameters, as defined by the Massachusetts Department of Public Health (MDPH). The study was conducted over a two year period and involved a total of 23 different commercial cigarette brands from the U.S. marketplace. Market mapping prediction intervals were developed for 40 mainstream cigarette smoke constituents and the potential utility of the market map as a comparison tool for new brands was demonstrated. The over-time character of the data allowed for the variance structure of the smoke constituents to be more completely characterized than is possible with one-time sample data. The variance was partitioned among brand-to-brand differences, temporal differences, and the remaining residual variation using a mixed random and fixed effects model. It was shown that a conventional weighted least squares model typically gave similar prediction intervals to those of the more complicated mixed model. For most constituents there was less difference in the prediction intervals calculated from over-time samples and those calculated from one-time samples than had been anticipated. One-time sample maps may be adequate for many purposes if the user is aware of their limitations. Cigarette tobacco fillers were analyzed for nitrate, nicotine, tobacco-specific nitrosamines, ammonia, chlorogenic acid, and reducing sugars. The filler information was used to improve predicting relationships for several of the smoke constituents, and it was concluded that the effects of filler chemistry on smoke chemistry were partial explanations of the observed brand-to-brand variation.

Radiopharmaceutical prescription in nuclear medicine departments

International Nuclear Information System (INIS)

Biechlin-Chassel, M.L.; Lao, S.; Bolot, C.; Francois-Joubert, A.

2010-01-01

In France, radiopharmaceutical prescription is often discussed depending to which juridical structure the nuclear medicine department is belonging. According to current regulation, this prescription is an obligation in a department linked to hospital with a pharmacy department inside. But situation remains unclear for independent nuclear medicine departments where physicians are not constrained to prescribe radiopharmaceuticals. However, as radiographers and nurses are only authorized to realize theirs acts in front of a medical prescription, one prescription must be realized. Nowadays, computerized prescription tools have been developed but only for radiopharmaceutical drugs and not for medical acts. In the aim to achieve a safer patient care, the prescription regulation may be applied whatever differences between nuclear medicines departments. (authors)

Multi-metric model-based structural health monitoring

Science.gov (United States)

Jo, Hongki; Spencer, B. F.

2014-04-01

ABSTRACT The inspection and maintenance of bridges of all types is critical to the public safety and often critical to the economy of a region. Recent advanced sensor technologies provide accurate and easy-to-deploy means for structural health monitoring and, if the critical locations are known a priori, can be monitored by direct measurements. However, for today's complex civil infrastructure, the critical locations are numerous and often difficult to identify. This paper presents an innovative framework for structural monitoring at arbitrary locations on the structure combining computational models and limited physical sensor information. The use of multi-metric measurements is advocated to improve the accuracy of the approach. A numerical example is provided to illustrate the proposed hybrid monitoring framework, particularly focusing on fatigue life assessment of steel structures.

Long-term real-time structural health monitoring using wireless smart sensor

Science.gov (United States)

Jang, Shinae; Mensah-Bonsu, Priscilla O.; Li, Jingcheng; Dahal, Sushil

2013-04-01

Improving the safety and security of civil infrastructure has become a critical issue for decades since it plays a central role in the economics and politics of a modern society. Structural health monitoring of civil infrastructure using wireless smart sensor network has emerged as a promising solution recently to increase structural reliability, enhance inspection quality, and reduce maintenance costs. Though hardware and software framework are well prepared for wireless smart sensors, the long-term real-time health monitoring strategy are still not available due to the lack of systematic interface. In this paper, the Imote2 smart sensor platform is employed, and a graphical user interface for the long-term real-time structural health monitoring has been developed based on Matlab for the Imote2 platform. This computer-aided engineering platform enables the control, visualization of measured data as well as safety alarm feature based on modal property fluctuation. A new decision making strategy to check the safety is also developed and integrated in this software. Laboratory validation of the computer aided engineering platform for the Imote2 on a truss bridge and a building structure has shown the potential of the interface for long-term real-time structural health monitoring.

The characteristics of hospital emergency department visits made by people with mental health conditions who had dental problems.

Science.gov (United States)

Nalliah, Romesh P; Da Silva, John D; Allareddy, Veerasathpurush

2013-06-01

There is a paucity of knowledge regarding nationally representative estimates of hospital-based emergency department (ED) visits for dental problems made by people with mental health conditions. The authors conducted a study to provide nationwide estimates of hospital-based ED visits attributed to dental caries, pulpal and periapical lesions, gingival and periodontal lesions and mouth cellulitis/abscess made by people with mental health conditions. The authors used the Nationwide Emergency Department Sample, which is a component of the Healthcare Cost and Utilization Project sponsored by the Agency for Healthcare Research and Quality. ED visits attributable to dental caries, pulpal and periapical lesions, gingival and periodontal lesions and mouth cellulitis/abscess were identified by the emergency care provider by using diagnostic codes in International Classification of Diseases, Ninth Revision, Clinical Modification. The authors examined outcomes, including hospital charges. They used simple descriptive statistics to summarize the data. In 2008, people with mental health conditions made 15,635,253 visits to hospital-based ED in the United States. A diagnosis of dental caries, pulpal and periapical lesions, gingival and periodontal lesions and mouth cellulitis/abscess represented 63,164 of these ED visits. The breakdown of the ED visits was 34,574 with dental caries, 25,352 with pulpal and periapical lesions, 9,657 with gingival and periodontal lesions, and 2,776 with mouth cellulitis/abscess. The total charge for ED visits in the United States was $55.46 million in 2008. In 2008, people with mental health conditions made 63,164 visits to hospital-based EDs and received a diagnosis of dental caries, pulpal and periapical lesions, gingival and periodontal lesions or mouth cellulitis/abscess. These ED visits incurred substantial hospital charges. Programs designed to reduce the number of ED visits made by this population for common dental problems could have a

Quality control of mammography departments in Slovakia

International Nuclear Information System (INIS)

Horvathova, M.; Nikodemova, D.

2007-01-01

Complete test of publication follows. Considering the fact that mammary gland is the most sensitive organ to ionizing radiation, the Commission of the Ministry of Health of SR for QA in radiology organized a pilot two-run country wide audit conducted in 42 mammography departments that have met the beforehand criteria. During the audit the methods for establishing the individual parameters in technical and clinical part of quality assurance in mammography were elaborated and implemented. Technical and clinical parameters of the imaging process that mostly affect the quality of diagnostic information were followed up. These parameters included: the object thickness compensation, optical density deviation, evaluation of the film quality by means of special phantom, etc. Important measurement of ESDs at participating departments enabled to compare the radiation load of mammography patients in Slovakia with reference values in European guidelines. The uniform standard method for QA at mammography departments was elaborated and published as the regulation of the Ministry of Health for performance of preventive mammography examinations in SR. The presented results show the improved quality of mammography examinations due to regular check-ups of technical and clinical parameters and fulfilment of the required values in all parameters. The audit results are the basis for continuous quality assessment of mammography departments as a main prerequisite for conducting preventive examinations and for health insurance purposes.

Dynamic Analysis with Fibre Optic Sensors for Structural Health Monitoring

National Research Council Canada - National Science Library

Paolozzi, Antonio; Gasbarri, Paolo

2006-01-01

Structural Health Monitoring (SHM) is a new frontier of non destructing testing. Often SHM is associated with fibre optic sensors whose signals can be used to identify the structure and consequently its damage...

Police suicide in small departments: a comparative analysis.

Science.gov (United States)

Violanti, John M; Mnatsakanova, Anna; Burchfiel, Cecil M; Hartley, Tara A; Andrew, Michael E

2012-01-01

The majority of police suicide research has focused on larger police departments. Very little research has been done within small departments. The present study compared suicide rates between small and larger police departments. Two Hundred ninty-eight departments were drawn from the U.S. Public Safety Officer Benefits database totaling 119,624 officers. Annual suicide rates were calculated per 100,000 for each of four category (by size of department) and p-values from Chi-square tests were employed to assess differences in rates across categories. The annual suicide rate varied significantly across departments. Smaller police departments had a significantly higher suicide rate than large departments. Possible reasons include lack of availability for mental health assistance, increased workload and danger and community visibility.

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

Science.gov (United States)

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

2013-01-01

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

Planning and Implementing Immunization Billing Programs at State and Local Health Departments: Barriers and Possible Solutions.

Science.gov (United States)

Corriero, Rosemary; Redmon, Ginger

Before participating in a project funded by the Centers for Disease Control and Prevention, most state and local health departments (LHDs) were not seeking reimbursement or being fully reimbursed by insurance plans for the cost of immunization services (including vaccine costs and administration fees) they provided to insured patients. Centers for Disease Control and Prevention's Billables Project was designed to enable state and LHDs to bill public and private insurance plans for immunization services provided to insured patients. Identify and describe key barriers state and LHDs may encounter while planning and implementing a billing program, as well as possible solutions for overcoming those barriers. This study used reports from Billables Project participants to explore barriers they encountered when planning and implementing a billing program and steps taken to address those barriers. Thirty-eight state immunization programs. Based on project participants' reports, barriers were noted in 7 categories: (1) funding and costs, (2) staff, (3) health department characteristics, (4) third-party payers and insurance plans, (5) software, (6) patient insurance status, and (7) other barriers. Possible solutions for overcoming those barriers included hiring or seeking external help, creating billing guides and training modules, streamlining workflows, and modifying existing software systems. Overcoming barriers during planning and implementation of a billing program can be challenging for state and LHDs, but the experiences and suggestions of past Billables Project participants can help guide future billing program efforts.

30 CFR 77.403-1 - Mobile equipment; rollover protective structures (ROPS).

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Mobile equipment; rollover protective structures (ROPS). 77.403-1 Section 77.403-1 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY SAFETY STANDARDS, SURFACE COAL MINES AND SURFACE...

30 CFR 77.403 - Mobile equipment; falling object protective structures (FOPS).

Science.gov (United States)

2010-07-01

... 30 Mineral Resources 1 2010-07-01 2010-07-01 false Mobile equipment; falling object protective structures (FOPS). 77.403 Section 77.403 Mineral Resources MINE SAFETY AND HEALTH ADMINISTRATION, DEPARTMENT OF LABOR COAL MINE SAFETY AND HEALTH MANDATORY SAFETY STANDARDS, SURFACE COAL MINES AND SURFACE WORK...

Portrait of rural emergency departments in Quebec and utilisation of the Quebec Emergency Department Management Guide: a study protocol.

Science.gov (United States)

Fleet, Richard; Archambault, Patrick; Légaré, France; Chauny, Jean-Marc; Lévesque, Jean-Frédéric; Ouimet, Mathieu; Dupuis, Gilles; Haggerty, Jeannie; Poitras, Julien; Tanguay, Alain; Simard-Racine, Geneviève; Gauthier, Josée

2013-01-01

Emergency departments are important safety nets for people who live in rural areas. Moreover, a serious problem in access to healthcare services has emerged in these regions. The challenges of providing access to quality rural emergency care include recruitment and retention issues, lack of advanced imagery technology, lack of specialist support and the heavy reliance on ambulance transport over great distances. The Quebec Ministry of Health and Social Services published a new version of the Emergency Department Management Guide, a document designed to improve the emergency department management and to humanise emergency department care and services. In particular, the Guide recommends solutions to problems that plague rural emergency departments. Unfortunately, no studies have evaluated the implementation of the proposed recommendations. To develop a comprehensive portrait of all rural emergency departments in Quebec, data will be gathered from databases at the Quebec Ministry of Health and Social Services, the Quebec Trauma Registry and from emergency departments and ambulance services managers. Statistics Canada data will be used to describe populations and rural regions. To evaluate the use of the 2006 Emergency Department Management Guide and the implementation of its various recommendations, an online survey and a phone interview will be administered to emergency department managers. Two online surveys will evaluate quality of work life among physicians and nurses working at rural emergency departments. Quality-of-care indicators will be collected from databases and patient medical files. Data will be analysed using statistical (descriptive and inferential) procedures. This protocol has been approved by the CSSS Alphonse-Desjardins research ethics committee (Project MP-HDL-1213-011). The results will be published in peer-reviewed scientific journals and presented at one or more scientific conferences.

System Identification of Wind Turbines for Structural Health Monitoring

DEFF Research Database (Denmark)

Perisic, Nevena

Structural health monitoring is a multi-disciplinary engineering field that should allow the actual wind turbine maintenance programmes to evolve to the next level, hence increasing safety and reliability and decreasing turbines downtime. The main idea is to have a sensing system on the structure...... cases are considered, two practical problems from the wind industry are studied, i.e. monitoring of the gearbox shaft torque and the tower root bending moments. The second part of the thesis is focused on the influence of friction on the health of the wind turbine and on the nonlinear identification...... that monitors the system responses and notifies the operator when damages or degradations have been detected. However, some of the response signals that contain important information about the health of the wind turbine components cannot be directly measured, or measuring them is highly complex and costly...

Designing food structures for nutrition and health benefits.

Science.gov (United States)

Norton, Jennifer E; Wallis, Gareth A; Spyropoulos, Fotis; Lillford, Peter J; Norton, Ian T

2014-01-01

In addition to providing specific sensory properties (e.g., flavor or textures), there is a need to produce foods that also provide functionality within the gastrointestinal (GI) tract, over and above simple nutrition. As such, there is a need to understand the physical and chemical processes occurring in the mouth, stomach, small intestine, and large intestine, in addition to the food structure-physiology interactions. In vivo techniques and in vitro models have allowed us to study and simulate these processes, which aids us in the design of food microstructures that can provide functionality within the human body. Furthermore, it is important to be aware of the health or nutritional needs of different groups of consumers when designing food structures, to provide targeted functionality. Examples of three groups of consumers (elderly, obese, and athletes) are given to demonstrate their differing nutritional requirements and the formulation engineering approaches that can be utilized to improve the health of these individuals. Eating is a pleasurable process, but foods of the future will be required to provide much more in terms of functionality for health and nutrition.

Structural health monitoring of wind turbine blades

Science.gov (United States)

Rumsey, Mark A.; Paquette, Joshua A.

2008-03-01

As electric utility wind turbines increase in size, and correspondingly, increase in initial capital investment cost, there is an increasing need to monitor the health of the structure. Acquiring an early indication of structural or mechanical problems allows operators to better plan for maintenance, possibly operate the machine in a de-rated condition rather than taking the unit off-line, or in the case of an emergency, shut the machine down to avoid further damage. This paper describes several promising structural health monitoring (SHM) techniques that were recently exercised during a fatigue test of a 9 meter glass-epoxy and carbon-epoxy wind turbine blade. The SHM systems were implemented by teams from NASA Kennedy Space Center, Purdue University and Virginia Tech. A commercial off-the-shelf acoustic emission (AE) NDT system gathered blade AE data throughout the test. At a fatigue load cycle rate around 1.2 Hertz, and after more than 4,000,000 fatigue cycles, the blade was diagnostically and visibly failing at the out-board blade spar-cap termination point at 4.5 meters. For safety reasons, the test was stopped just before the blade completely failed. This paper provides an overview of the SHM and NDT system setups and some current test results.

Effects of Economic Conditions and Organizational Structure on Local Health Jurisdiction Revenue Streams and Personnel Levels in Connecticut, 2005-2012.

Science.gov (United States)

Pallas, Sarah Wood; Kertanis, Jennifer; O'Keefe, Elaine; Humphries, Debbie L

2015-01-01

We investigated whether or not changes in economic conditions during the 2008-2010 U.S. recession were associated with changes in Connecticut local health jurisdictions' (LHJs') revenue or personnel levels. We analyzed Connecticut Department of Public Health 2005-2012 annual report data from 91 Connecticut LHJs, as well as publicly available data on economic conditions. We used fixed- and random-effect regression models to test whether or not LHJ per capita revenues and full-time equivalent (FTE) personnel differed during and post-recession compared with pre-recession, or varied with recession intensity, as measured by unemployment rates and housing permits. On average, total revenue per capita was significantly lower during and post-recession compared with pre-recession, with two-thirds of LHJs experiencing per capita revenue reductions. FTE personnel per capita were significantly lower post-recession. Changes in LHJ-level unemployment rates and housing permits did not explain the variation in revenue or FTE personnel per capita. Revenue and personnel differed significantly by LHJ organizational structure across all time periods. Economic downturns can substantially reduce resources available for local public health. LHJ organizational structure influences revenue levels and sources, with implications for the scope, quality, and efficiency of services delivered.

Structural health monitoring for fatigue life prediction of orthotropic brdige decks

NARCIS (Netherlands)

Pijpers, R.J.M.; Pahlavan, P.L.; Paulissen, J.H.; Hakkesteegt, H.C.; Jansen, T.H.

2013-01-01

Infrastructure asset owners are more and more confronted with structures reaching the end of their structural life. Structural Health Monitoring (SHM) systems should provide up-to-date information about the actual condition, as well predict the structural life and required maintenance of the assets

Effect of a Targeted Women's Health Intervention in an Inner-City Emergency Department

Directory of Open Access Journals (Sweden)

Debra Houry

2011-01-01

Full Text Available Objective. To evaluate the effect of an Emergency Department (ED based, educational intervention for at-risk health behaviors. Methods. A randomized trial over a one-year period. African American women, aged 21–55, presenting to the ED waiting room were eligible. Each participant took a computer-based survey on health risk behaviors. Participants who screened positive on any of four validated scales (for IPV, nicotine, alcohol, or drug dependence were randomized to standard information about community resources (control or to targeted educational handouts based upon their screening results (intervention. Participants were surveyed at 3 months regarding contacts with community resources and harm-reduction actions. Results. 610 women were initially surveyed; 326 screened positive (13.7% for IPV, 40.1% for nicotine addiction, 26.6% for alcohol abuse, and 14.4% for drug abuse. 157 women were randomized to intervention and 169 to control. Among women who completed follow-up (=71, women in the Intervention Group were significantly more likely to have contacted local resources (37% versus 9%, =0.04 and were more likely to have taken risk-reducing action (97% versus 79%, =0.04. Conclusion. Targeted, brief educational interventions may be an effective method for targeting risk behaviors among vulnerable ED populations.

Structure, health benefits, antioxidant property and processing and ...

African Journals Online (AJOL)

Structure, health benefits, antioxidant property and processing and storage of carotenoids. ... It is sensitive to heat, light and oxygen. Enzymatic ... Thermal treatment and freezing increases the extractability of b-carotene from the food matrices.

Meanings of health: interrogating structure and culture.

Science.gov (United States)

Dutta, Mohan Jyoti; Basu, Ambar

2008-11-01

Based on the argument that context ought to be centralized in discourses of health communication, this article applies the culture-centered approach to engage in dialogue about issues of health with 18 men in rural West Bengal. The culture-centered approach is based on dialogue between the researcher and the community members, with the goals of listening to the voices of cultural members in suggesting culture-based health solutions. In this project, our discursive engagement with the participants suggests that health is primarily constructed as an absence, framed in the realm of minimal access to healthcare resources. In a situation where the resources are limited, the participants discussed the importance of trust in their relationship with the local provider. Health was also seen as a collective resource that was both an asset of the collective and a responsibility of the collective. Finally, the participants also pointed out the ways in which corruption in the structure introduced a paradox in policy discourse and the material conditions of the participants.

The Role of the IT Department in Organizational Redesign.

Science.gov (United States)

Petersen, Lone Stub

2015-01-01

Focus within eHealth research is often on development and implementation. However, the role of information systems maintenance and management is often neglected. In order for the IT department to accommodate the needs of the hospitals and continuous change of organization and practice there is a need for developing an understanding of the complex relationship between the IT department and clinical practice. In this paper the concept of redesign is used to deepen our understanding of IT related organizational change in healthcare organizations. In the paper I argue that the IT department is a central partner, steward and power in organizational change and learning in hospitals as the IT department serve both as a barrier and a catalyst of change and flexibility in the organization through management of information systems maintenance and redesign. Therefore it is important to consider and secure appropriate forms for stewarding redesign and learning in cooperation between the health care organizations and the IT department.

Department of Energy ALARA implementation guide. Response to the Health Physics Society

Energy Technology Data Exchange (ETDEWEB)

Connelly, J.M. [Dept. of Energy, Washington, DC (United States)

1995-03-01

In the August 1993 Health Physics Society (HPS) newsletter, the HPS Scientific and Public Issues Committee published a Position Statement entitled {open_quotes}Radiation Protection of the Public and the Environment.{close_quotes}. In this article, this HPS committee made the statement that they were deeply concerned by the trend for agencies to incorporate the ALARA concept as a regulatory requirements, without providing specific guidance as to what it means and how to implement it consistently. The HPS position paper was in response to the DOE notice on proposed rulemaking for Title 10 Code of Federal Regulations Part 834, {open_quotes}Radiation Protection of the Public and the Environment{close_quotes} (10 CFR 834). In the notice of proposed rulemaking for 10 CFR 834, the Department of Energy (DOE) defined ALARA as follows: {open_quotes}As used in this part, ALARA is not a dose limit, but rather a process which has the objective of attaining doses as far below the applicable limit of this part as is reasonably achievable{close_quotes} (10 CFR 834.2, p. 16283 of the Federal Register). The HPS position paper continues, {open_quotes}The section goes on to elaborate on what is meant by a process without providing sufficient guidance to assure uniform applicability of the process.{close_quotes}. Although this concern is directed towards the ALARA process as it relates to the environment, the Office of Health, which is responsible for occupational workers, shares the same definition for ALARA.

Orthotics, prosthesis and mobility aids (OPM dispensation in the Regional Health Department of the 3RD Region of Sao Paulo State

Directory of Open Access Journals (Sweden)

Camila Caminha Caro

2014-12-01

Full Text Available Objective: To identify the process of dispensation of orthotics, prostheses and mobility aids (OPM by the Unified Health System (SUS in the Regional Health Department of the 3rd Region (DRSIII of Sao Paulo state; perform a mapping of the existing physical rehabilitation services in that region; and subsequently correlate the data with applicable laws. Methodology: This is an exploratory cross-sectional qualitative study whose subjects were the main professionals involved in the process of OPM dispensation, or responsible for their acquisition flow in the cities of that region. Data collection was carried out through a semi-structured questionnaire, developed by the researchers themselves, composed of questions aiming to identify the physical rehabilitation centers in the towns, the staff members involved, the provision of assistive technology through SUS, delivery time and existence of waiting lists. Results and discussion: The data were statistically measured, categorized, described and correlated with the current legislation aimed to guarantee access to assistive technology. We observed that the practice around this resource in the 3rd region concentrates in a single care center, causing long waits and poor efficiency of the services provided, in addition to maintaining a paternalistic aspect. Conclusion: This study provides evidence that, although the right to access to assistive technology is legally guaranteed, there are still many difficulties and challenges around this practice.

Nuclear Safety Research Department annual report 2000

Energy Technology Data Exchange (ETDEWEB)

Majborn, B.; Damkjaer, A.; Nielsen, S.P.; Nonboel, E

2001-08-01

The report presents a summary of the work of the Nuclear Safety Research Department in 2000. The department's research and development activities were organized in two research programmes: 'Radiation Protection and Reactor Safety' and 'Radioecology and Tracer Studies'. In addition the department was responsible for the tasks 'Applied Health Physics and Emergency Preparedness', 'Dosimetry', 'Environmental Monitoring', and Irradiation and Isotope Services'. Lists of publications, committee memberships and staff members are included. (au)

Quantification of the Value of Structural Health Monitoring Information for Fatigue Deteriorating Structural Systems

DEFF Research Database (Denmark)

Thöns, Sebastian; Schneider, Ronald; Faber, Michael Havbro

2015-01-01

This paper addresses the quantification of the value of structural health monitoring (SHM) before its implementation for structural systems on the basis of its Value of Information (VoI). The value of SHM is calculated utilizing the Bayesian pre-posterior decision analysis modelling the structural...... life cycle performance, the integrity management and the structural risks. The relevance and precision of SHM information for the reduction of the structural system risks and the expected cost of the structural integrity management throughout the life cycle constitutes the value of SHM...... and is quantified with this framework. The approach is focused on fatigue deteriorating structural steel systems for which a continuous resistance deterioration formulation is introduced. In a case study, the value of SHM for load monitoring is calculated for a Daniels system subjected to fatigue deterioration...

Family Structure Changes and Children's Health, Behavior, and Educational Outcomes

DEFF Research Database (Denmark)

Rasmussen, Astrid Würtz

More and more children do not grow up in traditional nuclear families. Instead they grow up in single parent households or in families with a step-parent. Hence it is important to improve our understanding of the impact of "shocks" in family structure due to parental relationship dissolution...... on children. In this study I empirically test whether children are traumatized both in the short and the long run by shocks in the family structure during childhood. I focus on educational, behavioral, and health outcomes. A population sample of Danish children born in January to May 1983, 1984, and 1985...... is used for the analysis. The empirical cross-sectional analysis indicates a negative relation between the number of family structure changes and children.s educational outcomes. Children experiencing many family structure changes also seem to have worse health outcomes....

Examination of the Perception and Experiences of the Patients in the Emergency Departments of Imam Khomeini and Shariati Hospitals Regarding the Quality of Care Provided by the Health Care System

Directory of Open Access Journals (Sweden)

Somaye Fakharian

2017-01-01

Full Text Available Background: The emergency department (ED is considered to act as a gate keeper of treatment for patients. Thereby, EDs must achieve customer satisfaction by providing quality services. Patient satisfaction and experiences are important parts of health care quality, but patient expectations are seldom included in quality assessments. Materials and Methods: The objective of this study was to identify patient’s perception of quality of care are given by care system at ED in Imam Khomeini and Shariaty Hospital. A qualitative approach using content analysis was adopted. Data was collected via semi-structured interviews from 45 patients hospitalized at different ward from emergency department. The method proposed by Colizzi was used for data analysis. Results: The finding of this study revealed that patient experience were five main category: patient satisfaction, dissatisfaction, interpretation, attendant role and advices. Each of these group included five subcategories included: environment, medical staff, hospital management, information and education factor, patient rights. Therefore, all factors in subgroups are effective in satisfaction or dissatisfaction and others. Response to these patient need and expectation are almost easy and practicable and our finding of this study can help health and emergency care provider for doing that and improvement of quality of care. Conclusion: Identifying areas for quality improvement are important, to know where to take action. These finding may facilitate this work and improve patients perception of quality of care at emergency department. The use of a these data can also provide a research-based instrument for future studies.

Research and Development in a Department of Education.

Science.gov (United States)

Hawley, Willis D.; Sheekey, Arthur

1979-01-01

This outline of the organizational structure for the new department of education lists propositions to guide the reorganization of educational research and innovation activities and discusses the potential functions of several new department offices. (RLV)

Multivariate determinants of self-management in Health Care: assessing Health Empowerment Model by comparison between structural equation and graphical models approaches

Directory of Open Access Journals (Sweden)

Filippo Trentini

2015-03-01

Full Text Available Backgroung. In public health one debated issue is related to consequences of improper self-management in health care.  Some theoretical models have been proposed in Health Communication theory which highlight how components such general literacy and specific knowledge of the disease might be very important for effective actions in healthcare system.  Methods. This  paper aims at investigating the consistency of Health Empowerment Model by means of both graphical models approach, which is a “data driven” method and a Structural Equation Modeling (SEM approach, which is instead “theory driven”, showing the different information pattern that can be revealed in a health care research context.The analyzed dataset provides data on the relationship between the Health Empowerment Model constructs and the behavioral and health status in 263 chronic low back pain (cLBP patients. We used the graphical models approach to evaluate the dependence structure in a “blind” way, thus learning the structure from the data.Results. From the estimation results dependence structure confirms links design assumed in SEM approach directly from researchers, thus validating the hypotheses which generated the Health Empowerment Model constructs.Conclusions. This models comparison helps in avoiding confirmation bias. In Structural Equation Modeling, we used SPSS AMOS 21 software. Graphical modeling algorithms were implemented in a R software environment.

New technologies and surgical innovation: five years of a local health technology assessment program in a surgical department.

Science.gov (United States)

Poulin, Paule; Austen, Lea; Kortbeek, John B; Lafrenière, René

2012-06-01

There is pressure for surgical departments to introduce new and innovative health technologies in an evidence-based manner while ensuring that they are safe and effective and can be managed with available resources. A local health technology assessment (HTA) program was developed to systematically integrate research evidence with local operational management information and to make recommendations for subsequent decision by the departmental executive committee about whether and under what conditions the technology will be used. The authors present a retrospective analysis of the outcomes of this program as used by the Department of Surgery & Surgical Services in the Calgary Health Region over a 5-year period from December 2005 to December 2010. Of the 68 technologies requested, 15 applications were incomplete and dropped, 12 were approved, 3 were approved for a single case on an urgent/emergent basis, 21 were approved for "clinical audit" for a restricted number of cases with outcomes review, 14 were approved for research use only, and 3 were referred to additional review bodies. Subsequent outcome reports resulted in at least 5 technologies being dropped for failure to perform. Decisions based on local HTA program recommendations were rarely "yes" or "no." Rather, many technologies were given restricted approval with full approval contingent on satisfying certain conditions such as clinical outcomes review, training protocol development, or funding. Thus, innovation could be supported while ensuring safety and effectiveness. This local HTA program can be adapted to a variety of settings and can help bridge the gap between evidence and practice.

Electronic health records, adoption, quality of care, legal and privacy issues and their implementation in emergency departments.

Science.gov (United States)

Ben-Assuli, Ofir

2015-03-01

Recently, the healthcare sector has shown a growing interest in information technologies. Two popular health IT (HIT) products are the electronic health record (EHR) and health information exchange (HIE) networks. The introduction of these tools is believed to improve care, but has also raised some important questions and legal and privacy issues. The implementation of these systems has not gone smoothly, and still faces some considerable barriers. This article reviews EHR and HIE to address these obstacles, and analyzes the current state of development and adoption in various countries around the world. Moreover, legal and ethical concerns that may be encountered by EHR users and purchasers are reviewed. Finally, links and interrelations between EHR and HIE and several quality of care issues in today's healthcare domain are examined with a focus on EHR and HIE in the emergency department (ED), whose unique characteristics makes it an environment in which the implementation of such technology may be a major contributor to health, but also faces substantial challenges. The paper ends with a discussion of specific policy implications and recommendations based on an examination of the current limitations of these systems. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

A mobile sensing system for structural health monitoring: design and validation

International Nuclear Information System (INIS)

Zhu, Dapeng; Yi, Xiaohua; Wang, Yang; Lee, Kok-Meng; Guo, Jiajie

2010-01-01

This paper describes a new approach using mobile sensor networks for structural health monitoring. Compared with static sensors, mobile sensor networks offer flexible system architectures with adaptive spatial resolutions. The paper first describes the design of a mobile sensing node that is capable of maneuvering on structures built with ferromagnetic materials. The mobile sensing node can also attach/detach an accelerometer onto/from the structural surface. The performance of the prototype mobile sensor network has been validated through laboratory experiments. Two mobile sensing nodes are adopted for navigating on a steel portal frame and providing dense acceleration measurements. Transmissibility function analysis is conducted to identify structural damage using data collected by the mobile sensing nodes. This preliminary work is expected to spawn transformative changes in the use of mobile sensors for future structural health monitoring

A mobile sensing system for structural health monitoring: design and validation

Science.gov (United States)

Zhu, Dapeng; Yi, Xiaohua; Wang, Yang; Lee, Kok-Meng; Guo, Jiajie

2010-05-01

This paper describes a new approach using mobile sensor networks for structural health monitoring. Compared with static sensors, mobile sensor networks offer flexible system architectures with adaptive spatial resolutions. The paper first describes the design of a mobile sensing node that is capable of maneuvering on structures built with ferromagnetic materials. The mobile sensing node can also attach/detach an accelerometer onto/from the structural surface. The performance of the prototype mobile sensor network has been validated through laboratory experiments. Two mobile sensing nodes are adopted for navigating on a steel portal frame and providing dense acceleration measurements. Transmissibility function analysis is conducted to identify structural damage using data collected by the mobile sensing nodes. This preliminary work is expected to spawn transformative changes in the use of mobile sensors for future structural health monitoring.

Leadership and effective succession planning in health-system pharmacy departments.

Science.gov (United States)

Ellinger, Lara Kathryn; Trapskin, Philip J; Black, Raymond; Kotis, Despina; Alexander, Earnest

2014-04-01

Leadership succession planning is crucial to the continuity of the comprehensive vision of the hospital pharmacy department. Leadership development is arguably the main component of training and preparing pharmacists to assume managerial positions. Succession planning begins with a review of the organizational chart in the context of the institution's strategic plan. Then career ladders are developed and key positions that require succession plans are identified. Employee profiles and talent inventory should be performed for all employees to identify education, talent, and experience, as well as areas that need improvement. Employees should set objective goals that align with the department's strategic plan, and management should work collaboratively with employees on how to achieve their goals within a certain timeframe. The succession planning process is dynamic and evolving, and periodic assessments should be conducted to determine how improvements can be made. Succession planning can serve as a marker for the success of hospital pharmacy departments.

Deciphering the imperative: translating public health quality improvement into organizational performance management gains.

Science.gov (United States)

Beitsch, Leslie M; Yeager, Valerie A; Moran, John

2015-03-18

With the launching of the national public health accreditation program under the auspices of the Public Health Accreditation Board (PHAB), health department momentum around quality improvement adoption has accelerated. Domain 9 of the PHAB standards (one of 12 domains) focuses on evaluation and improvement of performance and is acting as a strong driver for quality improvement and performance management implementation within health departments. Widespread adoption of quality improvement activities in public health trails that in other US sectors. Several performance management models have received broad acceptance, including models among government and nonprofits. A model specifically for public health has been developed and is presented herein. All models in current use reinforce customer focus; streamlined, value-added processes; and strategic alignment. All are structured to steer quality improvement efforts toward organizational priorities, ensuring that quality improvement complements performance management. High-performing health departments harness the synergy of quality improvement and performance management, providing powerful tools to achieve public health strategic imperatives.

Water quality data from the State of Hawaii, Department of Health, from the Coastal Waters of Hawaii from 05 November 2005 to 15 November 2006 (NODC Accession 0020391)

Data.gov (United States)

National Oceanic and Atmospheric Administration, Department of Commerce — The Monitoring Section of the State of Hawaii, Department of Health, Clean Water Branch collected water quality data at 8 sites centered on Hanalei Bay on the north...

Role of innovative institutional structures in integrated governance. A case study of integrating health and nutrition programs in Chhattisgarh, India.

Science.gov (United States)

Kalita, Anuska; Mondal, Shinjini

2012-01-01

The aim of this paper is to highlight the significance of integrated governance in bringing about community participation, improved service delivery, accountability of public systems and human resource rationalisation. It discusses the strategies of innovative institutional structures in translating such integration in the areas of public health and nutrition for poor communities. The paper draws on experience of initiating integrated governance through innovations in health and nutrition programming in the resource-poor state of Chhattisgarh, India, at different levels of governance structures--hamlets, villages, clusters, blocks, districts and at the state. The study uses mixed methods--i.e. document analysis, interviews, discussions and quantitative data from facilities surveys--to present a case study analyzing the process and outcome of integration. The data indicate that integrated governance initiatives improved convergence between health and nutrition departments of the state at all levels. Also, innovative structures are important to implement the idea of integration, especially in contexts that do not have historical experience of such partnerships. Integration also contributed towards improved participation of communities in self-governance, community monitoring of government programs, and therefore, better services. As governments across the world, especially in developing countries, struggle towards achieving better governance, integration can serve as a desirable process to address this. Integration can affect the decentralisation of power, inclusion, efficiency, accountability and improved service quality in government programs. The institutional structures detailed in this paper can provide models for replication in other similar contexts for translating and sustaining the idea of integrated governance. This paper is one of the few to investigate innovative public institutions of a and community mobilisation to explore this important, and under

Public health capacity in the provision of health care services.

Science.gov (United States)

Valdmanis, Vivian; DeNicola, Arianna; Bernet, Patrick

2015-12-01

In this paper, we assess the capacity of Florida's public health departments. We achieve this by using bootstrapped data envelopment analysis (DEA) applied to Johansen's definition of capacity utilization. Our purpose in this paper is to measure if there is, theoretically, enough excess capacity available to handle a possible surge in the demand for primary care services especially after the implementation of the Affordable Care Act that includes provisions for expanded public health services. We measure subunit service availability using a comprehensive data source available for all 67 county health departments in the provision of diagnostic care and primary health care. In this research we aim to address two related research questions. First, we structure our analysis so as to fix budgets. This is based on the assumption that State spending on social and health services could be limited, but patient needs are not. Our second research question is that, given the dearth of primary care providers in Florida if budgets are allowed to vary is there enough medical labor to provide care to clients. Using a non-parametric approach, we also apply bootstrapping to the concept of plant capacity which adds to the productivity research. To preview our findings, we report that there exists excess plant capacity for patient treatment and care, but question whether resources may be better suited for more traditional types of public health services.

Financial incentives and accountability for integrated medical care in Department of Veterans Affairs mental health programs.

Science.gov (United States)

Kilbourne, Amy M; Greenwald, Devra E; Hermann, Richard C; Charns, Martin P; McCarthy, John F; Yano, Elizabeth M

2010-01-01

This study assessed the extent to which mental health leaders perceive their programs as being primarily accountable for monitoring general medical conditions among patients with serious mental illness, and it assessed associations with modifiable health system factors. As part of the Department of Veterans Affairs (VA) 2007 national Mental Health Program Survey, 108 mental health program directors were queried regarding program characteristics. Perceived accountability was defined as whether their providers, as opposed to external general medical providers, were primarily responsible for specific clinical tasks related to serious mental illness treatment or high-risk behaviors. Multivariable logistic regression was used to determine whether financial incentives or other system factors were associated with accountability. Thirty-six percent of programs reported primary accountability for monitoring diabetes and cardiovascular risk after prescription of second-generation antipsychotics, 10% for hepatitis C screening, and 17% for obesity screening and weight management. In addition, 18% and 27% of program leaders, respectively, received financial bonuses for high performance for screening for risk of diabetes and cardiovascular disease and for alcohol misuse. Financial bonuses for diabetes and cardiovascular screening were associated with primary accountability for such screening (odds ratio=5.01, pFinancial incentives to improve quality performance may promote accountability in monitoring diabetes and cardiovascular risk assessment within mental health programs. Integrated care strategies (co-location) might be needed to promote management of high-risk behaviors among patients with serious mental illness.

A rationale for a museum of health

Directory of Open Access Journals (Sweden)

Farzaneh Yousefi

2015-11-01

Full Text Available The museum of health is a place that presents health science and human body and any other subjects that can affect human health. In this museum visitors can learn the mechanisms and functions of human body and learn how to protect and take care of their bodies. They can also learn several diseases and their consequences on human body and how to fight against them. This museum is a big step for improvement of general society health level by increasing society’s health knowledge. In this article structure, departments and also benefits of the health museum are evaluated.

Plutonium working group report on environmental, safety and health vulnerabilities associated with the Department's plutonium storage. Volume I: Summary

International Nuclear Information System (INIS)

1994-11-01

At the conclusion of the Cold War, the Department of Energy (DOE) stopped plutonium processing for nuclear weapons production. Facilities used for that purpose now hold significant quantities of plutonium in various forms. Unless properly stored and handled, plutonium can present environment, safety and health (ES ampersand H) hazards. Improperly stored plutonium poses a variety of hazards. When containers or packaging fail to fully protect plutonium metal from exposure to air, oxidation can occur and cause packaging failures and personnel contamination. Contamination can also result when plutonium solutions leak from bottles, tanks or piping. Plutonium in the form of scrap or residues generated by weapons production are often very corrosive, chemically reactive and difficult to contain. Buildings and equipment that are aging, poorly maintained or of obsolete design contribute to the overall problem. Inadvertent accumulations of plutonium of any form in sufficient quantities within facilities can result in nuclear criticality events that could emit large amounts of radiation locally. Contamination events and precursors of criticality events are causing safety and health concerns for workers at the Department's plutonium facilities. Contamination events also potentially threaten the public and the surrounding environment

Structural health monitoring (vibration) as a tool for identifying structural alterations of the lumbar spine

DEFF Research Database (Denmark)